December 2, 2020 - Podcast

Episode 65—Substance use, and breast cancer

From a deadly pandemic to divisive politics, there were already plenty of reasons why someone could turn to substance abuse in 2020. Now, here come the holidays. Melissa Cyders, associate professor of psychology at IUPUI whose work focuses on long-term opioid use disorder recovery, says this year has a lot of stuff piling on to the holiday season — grief, stress, and conflict are all triggers for alcohol and drug use. However, Cyders says while the next couple of months could be a recipe for disaster, there are things people can do to address concerning behaviors. In fact, there are some changes stemming from the COVID-19 pandemic that might actually help prevent those in recovery from relapsing. For instance, social distancing due to the pandemic can lead to feelings of isolation, but not gathering for holidays might also eliminate a source of stress for some people, Cyders says. It is still too early to tell if the holidays, combined with the pandemic, will cause an increase in alcohol use, she says. But for those concerned about someone else’s increased substance use or possibility of a setback in their recovery, Cyders recommended talking with other people who care about that person and asking what they notice in order to get a full picture. When addressing a specific person with your concerns, Cyders recommends using compassion and understanding of the hardships that person might be facing. Avoid directly telling the person to just stop. For those concerned for themselves, Cyders recommends telling someone and telling them early. Keep a journal of your thoughts, moods and how much you are drinking or using to look for patterns of using substances to address negative moods or stress. Cyders added that substance use and recovery are individual for each person and should be addressed as such. Like anyone navigating our ever-changing environment, Cyders says the isolation and other factors involved with the pandemic may result in positive or negative feelings depending on the person. Having the support of others, even virtually or by phone, can be a huge help during these times.

In others news, while strides have been made in diagnosing and treating breast cancer, one in eight women in the U.S. still will develop the disease in their lifetime. While Black women develop cancer at the same rate as women of other racial and ethnic backgrounds, the cancer often occurs at a younger age and is more aggressive. Harikrishna Nakshatri, Marion J. Morrison Professor Breast Cancer Research and professor of Surgery, Biochemistry and Molecular Biology, is working to identify the unique biology that may make Black women more susceptible to aggressive breast cancer. His research has shown that normal breast tissue in Black women contains a cell type called PZP at a much higher number than the normal breast tissue of Caucasian women. PZP cells increase in number when Caucasian women develop breast cancer, while they are naturally higher in Black women. Nakshatri's lab is exploring the nature of these cells, if breast cancer can originate from the cells and their role in helping cancer grow. Another explanation may come from a genetic mutation called duffy, which is present in Black women with sub-Saharan Africa ancestry. Nakshatri says the mutation is embedded in this population because it protects them against malarial infection. Current research has shown that when women who carry this mutation develop breast cancer, the cancer tends to be much more aggressive. Nakshatri says the vast majority of people think of health disparities from the point of view of socio-economic factors, but his team is looking at the biologic factors or the biologic basis of health disparities. This doesn't account for all cases of health disparity, he says, but there is a certain section where it may inform treatment. Nakshatri’s research could lead to improved treatments for Black women, who face a higher mortality rate for breast cancer.