When it comes to prevention of substance use in our “tween” population, turning kids on to ‘thought control’ may just be the answer to getting them to say no, Medical News Today reports.

New research published in the Journal of Studies on Alcohol and Drugs, co-led by professors Roisin O’Connor of Concordia University and Craig Colder of State University of New York at Buffalo, has found that around the” tween-age” years, youth are decidedly ambivalent toward cigarettes and alcohol. It seems that the youngsters have both positive and negative associations with these harmful substances and have yet to decide one way or the other. Because they are especially susceptible to social influences, media portrayals of drug use and peer pressure become strong allies of substance use around these formative years.

“Initiation and escalation of alcohol and cigarette use occurring during late childhood and adolescence makes this an important developmental period to examine precursors of substance use,” O’Connor said. “We conducted this study to have a better understanding of what puts this group at risk for initiating substance use so we can be more proactive with prevention.”

The study showed that at the impulsive, automatic level, these kids thought these substances were bad but they were easily able to overcome these biases and think of them as good when asked to place them with positive words. O’Connor explains that “this suggests that this age group may be somewhat ambivalent about drinking and smoking. We need to be concerned when kids are ambivalent because this is when they may be more easily swayed by social influences.”

According to O’Connor, drinking and smoking among this age group is influenced by both impulsive (acting without thinking), and controlled (weighing the pros against the cons) decisional processes. With this study, both processes were therefore examined to best understand the risk for initiating substance use.

To do this, close to 400 children between the ages of 10 and 12 participated in a computer-based test that involved targeted tasks. The tweens were asked to place pictures of cigarettes and alcohol with negative or positive words. The correct categorization of some trials, for example, involved placing pictures of alcohol with a positive word in one category and placing pictures of alcohol with negative words in another category.

The next step in the study is to look at kids over a longer period of time. The hypothesis from the research is that as tweens begin to use these substances there will be an apparent weakening in their negative biases toward drinking and smoking. The desire will eventually outweigh the costs. It is also expected that they will continue to easily outweigh the pros relative to the cons related to substance use.

O’Connor said researchers would like to continue to track the youth, who, he said, know that drugs are inherently bad.

“The problem is the likelihood of external pressures that are pushing them past their ambivalence so that they use. In a school curriculum format I see helping kids deal with their ambivalence in the moment when faced with the choice to use or not use substances,” O’Connor concluded.

Source:www.cadca.org 15th March 2012

Adolescents’ use of marijuana may increase the risk of heroin addiction later in life, a new study suggests. Researchers say the work adds to “overwhelming” evidence that people under 21 should not use marijuana because of the risk of damaging the developing brain.

The idea that smoking cannabis increases the user’s chance of going on to take harder drugs such as heroin is highly contentious. Some dub cannabis a “gateway” drug, arguing that peer pressure and exposure to drug dealers will tempt users to escalate their drug use. Others insist that smoking cannabis is unrelated to further drug use.

Now research in rats suggests that using marijuana reduces future sensitivity to opioids, which makes people more vulnerable to heroin addiction later in life. It does so by altering the brain chemistry of marijuana users, say the researchers.

“Adolescents in particular should never take cannabis – it’s far too risky because the brain areas essential for behaviour and cognitive functioning are still developing and are very sensitive to drug exposure,” says Jasmin Hurd, who led the study at the Karolinska Institute in Sweden.
But Hurd acknowledges that most people who use cannabis begin in their teens. A recent survey reported that as many as 20% of 16-year-olds in the US and Europe had illegally used cannabis in the previous month.

“Teenage” rats

In order to explore how the adolescent use of cannabis affects later drug use, Hurd and colleagues set up an experiment in rats aimed to mirror human use as closely as possible.

In the first part of the trial, six “teenage” rats were given a small dose of THC – the active chemical in cannabis – every three days between the ages of 28 and 49 days, which is the equivalent of human ages 12 to 18. The amount of THC given was roughly equivalent to a human smoking one joint every three days, Hurd explains. A control group of six rats did not receive THC.

One week after the first part was completed, catheters were inserted in all 12 of the adult rats and they were able to self-administer heroin by pushing a lever.
“At first, all the rats behaved the same and began to self-administer heroin frequently,” says Hurd. “But after a while, they stabilised their daily intake at a certain level. We saw that the ones that had been on THC as teenagers stabilised their intake at a much higher level than the others – they appeared to be less sensitive to the effects of heroin. And this continued throughout their lives.”

Hurd says reduced sensitivity to the heroin means the rats take larger doses, which has been shown to increase the risk of addiction.

Drug memory

The researchers then examined specific brain cells in the rats, including the opioid and cannabinoid receptors. They found that the rats that had been given THC during adolescence had a significantly altered opioid system in the area associated with reward and positive emotions. This is also the area linked to addiction.

“These are very specific changes and they are long-lasting, so the brain may ‘remember’ past cannabis experimentation and be vulnerable to harder drugs later in life,” Hurd says.
Neurologist Jim van Os, a cannabis expert at the University of Maastricht in the Netherlands told New Scientist the research was a welcome addition to our understanding of how cannabis affects the adolescent brain.

“The issue of cross-sensitisation of cannabis/opioid receptors has been a controversial one, but these findings show the drug’s damaging effects on the reward structures of the brain,” van Oshe says. “There is now overwhelming evidence that nobody in the brain’s developmental stage – under the age of 21 – should use cannabis.”

Source: On line edition of Neuropsychopharmacology. Reported in NewScientist.com July 2006

• Young people in the UK have by far the most positive expectations of alcohol in Europe and are least likely to feel that it might cause them harm.
• Exposure to alcohol marketing increases the likelihood that young people will start to use alcohol and the amount they consume.
• The alcohol industry spends £800 million on marketing in the UK annually
• A spends £153 encouraging drinking per £1 contributed to Drinkaware – the industry led alcohol information organisation charged with promoting sensible drinking.
• Underage drinkers consume approximately the equivalent of 6.9 million pints of beer or 1.7 million bottles each week
• 630,000 11- to 17-year-olds drink twice or more each week.
• Between 2002 and 2009 – 92,220 under-18s were admitted to hospital in England for alcohol-related conditions- over 36 children or young people each day.
• Under-18s alcohol-related hospital admissions increased by 32% between 2002 and 2007.
• The latest European School Survey Project on Alcohol and Other Drugs reported that in the UK 26% of 11-15 year-olds reported suffering an accident or injury because of their drinking, the highest percentage in Europe.
• Although cases of dependence amongst underage drinkers are rare, in 2008/9 – 8,799 younger people accessed treatment for alcohol up from 4,886 in 2005/6.

Source:www.alcoholconcern.org.uk Nov.2011

  W De La Haye (1), K Powell-Booth (2). (1) The University of the West Indies, Mona Campus, Jamaica, (2) The University of the West Indies, Mona Campus & University of Technology, Jamaica.

 Background: Cannabis is a popular drug mainly among adolescent males in Jamaica. The aim of this study was to assess whether there is a difference in performance of male cannabis users and non-users on tests of learning, memory, attention and intelligence.

 Methods: Psychological tests of intelligence, learning and memory were administered for all participants. Tests included Wechsler Intelligence Scales for Children, fourth edition (WISC-IV) Wide Range Assessment of Memory and Learning, third edition (WRAML. 3). The sample size (N = 62), with an age range of 13 and 17 years, comprised 2 groups: adolescent users of cannabis (n = 30), the experimental group, and non-users of canabis (n = 32), the control group. Both groups’ performance was compared on each test. Independent t-tests were used to analyze the data, with alpha = .05.

 Results: There is a significant difference in performance between the groups, as non-users had higher scores on all tests of memory than users of cannabis. The largest mean difference was for Verbal Intelligence Quotient (VIQ), 6.65, followed by Digit Span Forward 6.47, and 6.60 for Digit Span Backward, while the smallest mean difference was for the Picture Memory sub – test. The mean age was 14.97 years, (SD = 1.36).

 Conclusion: Users of cannabis displayed cognitive deficits on all tests of memory.

Findings lend support to research that suggests that cannabis use may impair learning and memory.

Source:  Winston De La Haye, M.D., M.P.H., D.M.

Lecturer and Consultant Psychiatrist .  Dep. of Community Health & Psychiatry

The University of the West Indies, Mona Campus,JAMAICA  

TORONTO, Nov. 2 — Methamphetamine can be detected in the hair of newborns whose mothers used the drug during pregnancy, researchers here have found.

Action Points

Note that this study shows that methamphetamine used during pregnancy can be found in the hair of neonates, suggesting it crosses the placental barrier with effects that are not completely understood.

Advise patients who ask that drug abuse during pregnancy can be detrimental to the fetus, with a range of physical and intellectual sequelae, as well as hazardous to the mother.

It represents the first direct evidence in humans that crystal meth, which is a growing drug-abuse problem in North America, can cross the placenta and affect the growing fetus, according to Facundo Garcia-Bournissen, M.D., of the Motherisk program at the Hospital for Sick Children.
Researchers at the program have been testing hair samples from parents and adults across Canada for several years, usually when there is clinical suspicion of drug abuse on the part of parents, Dr. Garcia-Bournissen and colleagues reported in the online issue of Archives of Disease in Childhood.
From June 1997 through December 2005, the database accumulated results of 34,278 tests for drugs in hair, representing 8,270 people. Nearly 60% (or 4,926) of these people were positive for at least one drug of abuse, the researchers said.
In a retrospective analysis, Dr. Garcia-Bournissen and colleagues examined the incidence of methamphetamine in hair samples:
• The first methamphetamine was found in hair in 2003, when six samples tested positive, with a slight increase in 2004, with eight cases.
• There were 372 cases in 2005 and the researchers said preliminary data for 2006 indicates that the surge has not stopped.
• The study identified 11 mother-neonate pairs in which each was positive for methamphetamine.
• Also, one newborn was negative, although the mother was positive.
The median methamphetamine values in the mother-baby pairs were 1.75 ng/mg for the mothers and 1.63 ng/mg for the newborns. Dr. Garcia-Bournissen and colleagues said.
The median concentrations were not significantly different, “suggesting that the transplacental transfer of methamphetamine is extensive,” the researchers said. On an individual level, maternal and neonatal drug levels correlated significantly (at P=0.003, using Spearman’s rho test, with r=0.8).
Interestingly, among the 171 subjects who were positive for methamphetamine and whose hair was tested for other drugs, 83.5% were positive for at least one other drug, usually cocaine, Dr. Garcia-Bournissen and colleagues found.
In contrast, among the 1,053 subjects negative for methamphetamine but positive for some other drug, only 38% were positive for more than one drug, they said.
“Positive exposure to methamphetamine strongly suggests that the person is a polydrug user, which may have important implications for fetal safety,” the researchers said.
The effects of the drug on the exposed child remain unclear, Dr. Garcia-Bournissen and colleagues noted, although there is some evidence that “children exposed in utero to methamphetamine are at risk of developmental problems, because of either the effect of direct exposure to the drug during pregnancy or growing in the environment associated with parental methamphetamine misuse, or probably both.”
Because the study was retrospective and anonymous, clinical information on the exposed infants is not available, the researchers said.

Source: www.medpage.today.com 2nd Nov. 2006

As marijuana use among teenagers increases and its perceived danger among this age group decreases, clinicians need to know the latest science about the harmful effects of the drug on the adolescent brain, according to a researcher at theUniversityofColorado,Denver.

Paula Riggs, PhD, Professor of Psychiatry, notes the most recent Monitoring the Future Survey shows a significant increase in marijuana use, including daily marijuana use among U. S. high school students and a decrease in perceived risk of use. “There are a number of indicators, including the increasing number of states that have passed ‘medical marijuana’ legislation, and that society as a whole tends to view marijuana as a relatively benign, recreational drug. However, scientific research does not support this.”

A growing body of research shows that adolescent marijuana use can be detrimental to the brain development and may produce long-lasting neurocognitive deficits and increased risk of mental health problems including psychosis, said Dr. Riggs, who spoke about this topic at the recent California Society of Addiction Medicine meeting.

Marijuana is the most commonly used illicit drug in the United States. Although some have questioned whether marijuana is an addictive drug, scientific research shows that one in 10 people overall, and one in six adolescents, who use marijuana develop dependence or addiction, Dr. Riggs says. Research shows that marijuana can cause structural damage, neuronal loss and impair brain function on a number of levels, from basic motor coordination to more complex tasks, such as the ability to plan, organize, solve problems, remember, make decisions and control behavior and emotions.

Dr. Riggs also cited recent studies indicating that adolescents may be more vulnerable to addiction, in part due to rapid brain development. “Emerging research suggests that individuals who start using marijuana during their teenage years may have longer-lasting cognitive impairments in executive functioning than those who start later,” she says. “Animal studies also suggest that exposure to marijuana during adolescence compared to adulthood may increase the vulnerability or risk of developing addiction to other substances of abuse such as cocaine and methamphetamine.”

She adds, “It is important for pediatricians, psychiatrists and other mental health clinicians to be aware of current research because they are on the front line to identify teens when they first start to experiment. They need to be able to effectively screen adolescents for marijuana use, and be armed with the scientific facts to educate teens and families about associated risks.”

Source   www.partnershipatdrugfree.org  Nov. 2011

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Mar 24, 2011

Marijuana use during adolescence and young adulthood increases the risk of psychotic symptoms, while continued cannabis use may increase the risk for psychotic disorder in later life, concludes a new study published in the British Medical Journal.

Cannabis is the most commonly used illicit drug in the world, particularly among adolescents, and is consistently linked with an increased risk for mental illness. However, it is hasn’t been clear whether the link between cannabis and psychosis is causal, or whether it is because people with psychosis use cannabis to “self- medicate” their symptoms.

So a team of researchers, led by Professor Jim van Os from Maastricht University in the Netherlands, investigated the association between cannabis use and the incidence and persistence of psychotic symptoms over 10 years.

The study occurred in Germany and involved a random sample of 1,923 teens and young adults from the ages of 14 to 24.

Incident cannabis use almost doubled the risk of later incident psychotic symptoms, even after accounting for factors such as age, sex, socioeconomic status, use of other drugs, and other psychiatric diagnoses. Furthermore, in those with cannabis use at the start of the study, continued use of cannabis over the study period increased the risk of persistent psychotic symptoms. There was no evidence for self medication effects as psychotic symptoms did not predict later cannabis use.

These results “help to clarify the temporal association between cannabis use and psychotic experiences,” the authors said in their study summary. “In addition, cannabis use was confirmed as an environmental risk factor impacting on the risk of persistence of psychotic experiences.”

Source: British Medical Journal March 2011

The story that broke one afternoon in mid-March was startling, even to editors who have been around for a while.
A 19-year-old man had died and 10 others were sickened in a mass overdose after experimenting with a synthetic drug during a party in Blaine.
We have written before about the problems of designer synthetic drugs, which are molecularly different from illegal drugs and sometimes can be acquired legally in shops or over the Internet. But this was the first time we had seen such deadly ramifications. After covering the case in Blaine, which resulted in one man being charged with third-degree murder, we set out to discover just how big a problem these drugs are posing in society. Our preliminary research revealed that this was a growing problem nationally, with devastating consequences across the country.
In the months since, we have researched or acquired dozens of these synthetic drugs, to discover how easy they are to buy and whether consumers are given any warnings at all when they buy the drugs.
We have talked to users, victims and witnesses across the country about some of the unintended consequences of ingesting synthetic drugs. And we have enlisted a number of experts, researchers and businesses in the greater Twin Cities community to help us identify what exactly is in the most common compounds so we can pinpoint the true risk to consumers. For example, Internet Exposure, a web development and marketing firm, is conducting research for us on how people are using the Internet to research and buy drugs, while MedTox Laboratories in St. Paul is testing chemicals for us.
The results of our investigation will unfold in stories that we will publish over the next few months, with the first appearing online today. It is a tragic story of a party that went wrong in a small town in Oklahoma, with eerie similarities to the party in Blaine earlier this year. We went to Oklahoma to illustrate that if synthetic drugs are a problem in such a small, tight-knit community like Konawa, they can create trouble anywhere in Middle America.
Police officer Kat Green, who arrives at the party in Oklahoma to find her own son nearly incapacitated, repeatedly wonders why her son would put something in his body without knowing exactly what it was.
Why indeed, would anyone?
The answer to that question seems to be that these partygoers are taking synthetic drugs because they think it will be fun, the drugs are often touted as legal, and the drugs are easily acquired, making them seem less dangerous than illegal drugs like marijuana, cocaine or hallucinogens. (Some people also take synthetic drugs because they may not show up on drug tests. )
Pamela Louwagie, who has been one of the primary reporters on this investigation, said that some of the partygoers in both Blaine and Oklahoma had researched the drugs they thought they were acquiring, while others “simply seemed to trust that their friends had done enough research to be safe.
“It was striking that, in each case, they didn’t get what was ordered,” Louwagie said. “That showcases the true danger in these things. Many of these substances, while they have been around … for a while, are truly untested. And if you buy them, you don’t know what they have been mixed with and, in some cases, whether you’re even getting the right thing.”
What’s also striking is the trust buyers put in the notion that it is safe to acquire a synthetic drug over the Internet, from an unproven source.
We hope that when we have finished our investigation, we will have helped parents, teenagers and other adults truly understand the risk that synthetic drugs pose — as well as the dangers of buying substances from some unknown source somewhere around the globe who just happens to advertise on the Internet.
I’ll be sharing this story with my own daughters; I urge others to share it with friends and family as well.

Source: Nancy Barnes, Editor, www. StarTribune.com 24th July 2011

Women who smoke while pregnant should be aware that they are increasing the chance their baby will be born malformed, say experts.
The risk for having a baby with missing or deformed limbs or a cleft lip is over 25% higher for smokers, data show. Along with higher risks of miscarriage and low birth weight, it is another good reason to encourage women to quit, say University College London doctors.
In England and Wales 17% of women smoke during pregnancy. And among under 20s the figure is 45%. Although most will go on to have a healthy baby, smoking can cause considerable damage to the unborn child.
Missing limbs
Researchers now estimate that each year in England and Wales several hundred babies are born with a physical defect directly caused by their mother’s smoking. Every year in England and Wales around 3,700 babies in total are born with such a condition. The experts base their calculations on 172 research papers published over the last 50 years, which looked at maternal smoking and birth defects.
The findings, from 174,000 cases of malformation and 11.7 million healthy births, revealed that smoking increased the risk of many abnormalities. The chance of a baby being born with missing or deformed limbs is 26% higher, and cleft lip or palate is 28% more likely.
Similarly, the risk of clubfoot 28% greater, and gastrointestinal defects 27% more. Skull defects are 33% more likely, and eye defects 25% more common. The greatest increase in risk – of 50% – was for a condition called gastroschisis, where parts of the stomach or intestines protrude through the skin. Professor Allan Hackshaw, who led the research, suspects many women who smoke while pregnant do not know about these risks.
“There’s still this idea among some women that if you smoke the baby will be small and that will make it easier when it comes to the delivery. “But what is not appreciated is that smoking during pregnancy increases the risk of defects in the child that are life-long.”
Women should quit smoking before becoming pregnant, or very early on, to reduce the risks
He said very few public health educational policies mention birth defects when referring to smoking and those that do are not very specific – this is largely because of past uncertainty over which ones are directly linked. “Now we have this evidence, advice should be more explicit about the kinds of serious defects such as deformed limbs, and facial and gastrointestinal malformations that babies of mothers who smoke during pregnancy could suffer from,” he said.
Of the 700,000 babies born each year in England and Wales, around 120,000 babies are born to mums who smoke. Amanda Sandford of Action on Smoking and Health said: “This study shows some of the worst outcomes of smoking during pregnancy. Pregnant smokers will be shocked to learn that their nicotine habit could cause eye or limb deformities in their baby.
“There is clearly a need to raise awareness of these risks among girls and to ensure pregnant women are given all the support they need to help them quit smoking and to stay stopped after the birth.” Basky Thilaganathan of the Royal College of Obstetricians and Gynaecologists said women who struggled to quit should at least cut down on how much they smoke.
Professor Hackshaw said the risk was likely dose-related – meaning the more a woman smokes, the bigger the risk to her unborn child.

Source: www.bbc.co.uk 12th July 2011

Abstract

OBJECTIVE:

Moderate to heavy levels of prenatal alcohol exposure have been associated with alterations in child behavior, but limited data are available on adverse effects after low levels of exposure. The objective of this study was to evaluate the dose-response effect of prenatal alcohol exposure for adverse child behavior outcomes at 6 to 7 years of age.

METHODS:

Beginning in 1986, women attending the urban university-based maternity clinic were routinely screened at their first prenatal visit for alcohol and drug use by trained research assistants from the Fetal Alcohol Research Center. All women reporting alcohol consumption at conception of at least 0.5 oz absolute alcohol/day and a 5% random sample of lower level drinkers and abstainers were invited to participate to be able to identify the associations between alcohol intake and child development. Maternal alcohol, cigarette, and illicit drug use were prospectively assessed during pregnancy and postnatally. The independent variable in this study, prenatal alcohol exposure, was computed as the average absolute alcohol intake (oz) per day across pregnancy. At each prenatal visit, mothers were interviewed about alcohol use during the previous 2 weeks. Quantities and types of alcohol consumed were converted to fluid ounces of absolute alcohol and averaged across visits to generate a summary measure of alcohol exposure throughout pregnancy. Alcohol was initially used as a dichotomous variable comparing children with no prenatal alcohol exposure to children with any exposure. To evaluate the effects of different levels of exposure, the average absolute alcohol intake was relatively arbitrarily categorized into no, low (>0 but <0.3 fl oz of absolute alcohol/day), and moderate/heavy (>/=0.3 fl oz of absolute alcohol/day) for the purpose of this study. Six years later, 665 families were contacted. Ninety-four percent agreed to testing. Exclusions included children who missed multiple test appointments, had major congenital malformations (other than fetal alcohol syndrome), possessed an IQ >2 standard deviations from the sample mean, or had incomplete data. The Achenbach Child Behavior Checklist (CBCL) was used to assess child behavior. The CBCL is a parent questionnaire applicable to children ages 4 to 16 years. It is widely used in the clinical assessment of children’s behavior problems and has been extensively used in research. Eight syndrome scales are further grouped into Externalizing or undercontrolled (Aggressive and Delinquent) behavior and Internalizing or overcontrolled (Anxious/Depressed, Somatic Complaints, and Withdrawn) behaviors. Three syndromes (Social, Thought, and Attention Problems) fit neither group. Higher scores are associated with more problem behaviors. Research assistants who were trained and blinded to exposure status independently interviewed the child and caretaker. Data were collected on a broad range of control variables known to influence childhood behavior and/or to be associated with prenatal alcohol exposure. These included perinatal factors of maternal age, education, cigarette, cocaine, and other substances of abuse and the gestational age of the baby. Postnatal factors studied included maternal psychopathology, continuing alcohol and drug use, family structure, socioeconomic status, children’s whole blood lead level, and exposure to violence. Data were collected only from black women as there was inadequate representation of other racial groups.

STATISTICAL ANALYSES:

Statistical analyses were performed using the SPSS statistical package. Frequency distribution, cross-tabulation, odds ratio, and chi(2) tests were used for analyzing categorical data. Continuous data were analyzed using t tests, analyses of variance (ANOVAs) with posthoc tests, and regression analysis.

RESULTS:

Testing was available for 501 parent-children dyads. Almost one fourth of the women denied alcohol use during pregnancy. Low levels of alcohol use were reported in 63.8% and moderate/heavy use in 13% of pregnancies. Increasing prenatal alcohol exposure was associated with lower birth weight and gestational age, higher lead levels, higher maternal age, and lower education level, prenatal exposure to cocaine and smoking, custody changes, lower socioeconomic status, and paternal drinking and drug use at the time of pregnancy. Children with any prenatal alcohol exposure were more likely to have higher CBCL scores on Externalizing (Aggressive and Delinquent) and Internalizing (Anxious/Depressed and Withdrawn) syndrome scales and the Total Problem Score. The odds ratio of scoring in the clinical range for Delinquent behavior was 3.2 (1.3-7.6) in children with any prenatal exposure to alcohol compared with nonexposed controls. The threshold dose was evaluated with the 3 prenatal alcohol exposure groups. One-way ANOVA revealed a significant between group difference for Externalizing (Aggressive and Delinquent) and the Total Problem Score

Source: Pediatrics. 2001 Aug;108(2):E34.PMID: 11483844 [PubMed - indexed for MEDLINE]

Abstract

BACKGROUND:

The development of the fetal endocannabinoid receptor system may be vulnerable to maternal cannabis use during pregnancy and may produce long-term consequences in children. In this study, we aimed to determine the relationship between gestational cannabis use and childhood attention problems and aggressive behavior.

METHODS:

Using a large general population birth cohort, we examined the associations between parental prenatal cannabis and tobacco use and childhood behavior problems at 18 months measured using the Child Behavior Checklist in N=4077 children. Substance use was measured in early pregnancy.

RESULTS:

Linear regression analyses demonstrated that gestational exposure to cannabis is associated with behavioral problems in early childhood but only in girls and only in the area of increased aggressive behavior (B=2.02; 95% CI: 0.30-3.73; p=0.02) and attention problems (B=1.04; 95% CI: 0.46-1.62; p<0.001). Furthermore, this study showed that long-term (but not short term) tobacco exposure was associated with behavioral problems in girls (B=1.16; 95% CI: 0.20-2.12; p=0.02). There was no association between cannabis use of the father and child behavior problems.

CONCLUSIONS:

Our results suggest that intrauterine exposure to cannabis is associated with an increased risk for aggressive behavior and attention problems as early as 18 months of age in girls, but not boys. Further research is needed to explore the association between prenatal cannabis exposure and child behavior at later ages. Our data support educating future mothers about the risk to their babies should they smoke cannabis during pregnancy.

Source: http://www.ncbi.nlm.nih.gov/pubmed/21470799 4th April 2011

Prolonged prenatal exposure to nicotine decreases the number of newborn cells in the hippocampus, a brain area important in learning and memory, according to preliminary research presented at Neuroscience 2010, the annual meeting of the Society for Neuroscience, held in San Diego. The study offers a neurobiological explanation for why the children of women who smoke during pregnancy are at an increased risk of developing learning disabilities.

“Previous research has shown that nicotine, cocaine, and other addictive drugs decrease the number of newborn cells in adults. Our research suggests that these effects may be even more dramatic in newborn animals,” said Robin Lester, PhD, of the University of Alabama at Birmingham, who directed the study. “These findings provide further warnings to expectant mothers that they should seek help in refraining from smoking during pregnancy,” Lester said.
To mimic the conditions of moderate to heavy smoking in a pregnant mother, Lester and his colleagues treated pregnant rats with nicotine through an implanted mini-pump, which acts similarly to a nicotine patch. The researchers then counted the number of newborn cells in the offsprings’ dentate gyrus, a section of the hippocampus known to contain neuronal stem cells. They also monitored synaptic plasticity — the reorganization of neural pathways considered essential to learning.
“We found a reduced number of dividing stem cells and altered plasticity in the newborn animals exposed to nicotine,” Lester said. These findings may lead to new approaches to treating learning disabilities and other behavior deficits associated with prenatal nicotine exposure.

Source: Society for Neuroscience (2010, November 15). Prenatal exposure to nicotine affects stem cells in hippocampus. ScienceDaily. Retrieved May 8, 2011, from http://www.sciencedaily.com¬ /releases/2010/11/101115155215.htm

Exposure to second hand smoke has a direct, measurable impact on the brain—and the effect is similar to what happens in the brain of the person doing the smoking. In fact, exposure to this secondhand smoke evokes cravings among smokers, according to a study funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

The study, published in Archives of General Psychiatry, used positron emission tomography to demonstrate that one hour of secondhand smoke in an enclosed space results in enough nicotine reaching the brain to bind receptors that are normally targeted by direct exposure to tobacco smoke. This happens in the brain of both smokers and non-smokers.

Previous research has shown that exposure to secondhand smoke increases the likelihood that children will become teenage smokers and makes it more difficult for adult smokers to quit. Such associations suggest that secondhand smoke acts on the brain to promote smoking behavior.

“This study gives concrete evidence to support policies that ban smoking in public places, particularly enclosed spaces and around children,” said Arthur Brody, M.D., of the University of California at Los Angeles Department of Psychiatry and Biobehavioral Sciences and corresponding author for the article

Source: www.cadca.org 5th May 2011

Many mothers and fathers think that allowing their children to have a supervised drink is a good way of exposing them to alcohol safely and taking away its illicit thrill. But new research suggests it sends mixed signals that result in them being more likely to abuse alcohol as they enter their core teenage years.
A joint American-Australian study of more than 1,900 12 and 13-year-olds found that those whose parents took such a “harm minimisation” approach were more likely to have experienced “alcohol-related consequences” – such as not being able to stop drinking, getting into fights, or having blackouts – two years later than those whose parents had a “zero-tolerance” strategy.
A year into the study, almost twice as many Australian teenagers (67 per cent) had drunk alcohol in the presence of an adult than their American counterparts (35 per cent), reflecting general attitudes in Australia and the US when it comes to supervised underage drinking.
The following year, just over a third (36 per cent) of the Australians had experienced alcohol-related consequences compared to only a fifth (21 per cent) of the Americans.
While cultural differences alone could feasibly account for the disparity, the results also found that teens who had been allowed to drink while supervised were more likely to have had such experiences regardless of which country they were from.
The results of the study, conducted by the Centre for Adolescent Health in Melbourne, Australia, and the Social Development Research Group in Seattle, USA, are published today in the Journal of Studies on Alcohol and Drugs.
British attitudes to teenage drinking are more similar to those in Australia than America, a matter reflected in law. While in the UK and Australia one can buy an alcoholic drink in a pub or off-licence from the age of 18, in the US the minimum age is 21. However, two years ago Sir Liam Donaldson, then England’s chief medical officer, said children under 15 should never be given alcohol, even though it is legal for parents to give a child over five alcohol in the home.
A separate Dutch study of 500 12-to-15-year-olds, also published in the JSAD today, found that it was the amount of alcohol available at home, and not how much parents drank, that determined teenage drinking habits – suggesting parents should keep their drinks cabinets locked.
Dr Barbara McMorris, of Minnesota University, who led the first study, said: “Both studies show that parents matter. “Despite the fact that peers and friends become important influences as adolescents get older, parents still have a big impact.” She added: “Kids need parents to be parents and not drinking buddies. Adults need to be clear about what messages they are sending. Kids need black and white messages early on. “Such messages will help reinforce limits as teens get older and opportunities to drink increase.”

Source: www.telegraph.co.uk/health 28th April 2011

A public-smoking ban in Australia has led more parents to smoke at home, raising health risks for kids, researchers say.
The research from the Australian National University’s Research School of Social Sciences concluded that “bans in recreational public places can perversely increase tobacco exposure of nonsmokers … Children seem to be particularly affected. The level of cotinine (a nicotine by product measurable in saliva) in children considerably increases as a result of bans in public places.”
Public smoking bans tend to “displace smokers to private places where they contaminate nonsmokers,” said authors Jerome Adda, Ph.D., and Francesca Cornaglia, Ph.D., visiting scholars from University College London.

Source: Medical Post April 4 2006

Background

Many studies have suggested that adolescence is a period of particular vulnerability to neurocognitive effects associated with substance misuse. However, few large studies have measured differences in cognitive performance between chronic cannabis users who started in early adolescence(before age 15) with those who started later.

 Aims

To examine the executive functioning of individuals who started chronic cannabis use before age 15 compared with those who started chronic cannabis use after 15 and controls.

Method

We evaluated the performance of 104 chronic cannabis users (49 early-onset users and 55 late-onset users) and 44 controls who undertook neuropsychological tasks, with a focus on executive functioning. Comparisons involving neuropsychological measures were performed using generalised linear model analysis of variance (ANOVA).

 Results

The early-onset group showed significantly poorer performance compared with the controls and the late-onset group on tasks assessing sustained attention, impulse control and executive functioning.

Conclusions

Early-onset chronic cannabis users exhibited poorer cognitive performance than controls and late-onset users in executive

functioning. Chronic cannabis use, when started before age 15, may have more deleterious effects on neurocognitive functioning.

Source:  The British Journal of Psychiatry (2011) 198, 442–447. doi: 10.1192/bjp.bp.110.077479

Abstract

OBJECTIVE:

Prenatal cocaine exposure has been associated with alterations in neonatal behavior and more recently a dose-response relationship has been identified. However, few data are available to address the long-term behavioral effects of prenatal exposures in humans. The specific aim of this report is to evaluate the school-age behavior of children prenatally exposed to cocaine.

METHODS:

All black non-human immunodeficiency virus-positive participants in a larger pregnancy outcomes study who delivered singleton live born infants between September 1, 1989 and August 31, 1991 were eligible for study participation. Staff members of the larger study extensively screened study participants during pregnancy for cocaine, alcohol, cigarettes, and other illicit drugs. Prenatal drug exposure was defined by maternal history elicited by structured interviews with maternal and infant drug testing as clinically indicated. Cocaine exposure was considered positive if either history or laboratory results were positive. Six years later, 665 families were contacted; 94% agreed to participate. The child, primary caretaker (parent), and, when available, the biologic mothers were tested in our research facilities. Permission was elicited to obtain blinded teacher assessments of child behavior with the Achenbach Teacher’s Report Form (TRF). Drug use since the child’s birth was assessed by trained researchers using a structured interview.

RESULTS:

Complete laboratory and teacher data were available for 499 parent-child dyads, with a final sample size for all analyses of 471 (201 cocaine-exposed) after the elimination of mentally retarded subjects. A comparison of relative Externalizing (Aggressive, Delinquent) to Internalizing (Anxious/Depressed, Withdrawn, Somatic Complaints) behaviors of the offspring was computed for the TRF by taking the difference between the 2 subscales to create an Externalizing-Internalizing Difference (T. M. Achenbach, personal communication, 1998). Univariate comparisons revealed that boys were significantly more likely to score in the clinically significant range on total TRF, Externalizing-Internalizing, and Aggressive Behaviors than were girls. Children prenatally exposed to cocaine had higher Externalizing-Internalizing Differences compared with controls but did not have significantly higher scores on any of the other TRF variables. Additionally, boys prenatally exposed to cocaine were twice as likely as controls to have clinically significant scores for externalizing (25% vs 13%) and delinquent behavior (22% vs 11%). Gender, prenatal exposures (cocaine and alcohol), and postnatal risk factors (custody changes, current drug use in the home, child’s report of violence exposure) were all related to problem behaviors. Even after controlling for gender, other prenatal substance exposures, and home environment variables, cocaine-exposed children had higher Externalizing-Internalizing Difference scores. Prenatal exposure to alcohol was associated with higher total score, increased attention problems, and more delinquent behaviors. Prenatal exposure to cigarettes was not significantly related to the total TRF score or any of the TRF subscales. Postnatal factors associated with problem behaviors included both changes in custody status and current drug use in the home. Change in custody status of the cocaine-exposed children, but not of the controls, was related to higher total scores on the TRF and more externalizing and aggressive behaviors. Current drug use in the home was associated with higher scores on the externalizing and aggressive subscales.

CONCLUSIONS:

Results of this study suggest gender-specific behavioral effects related to prenatal cocaine exposure. Prenatal alcohol exposure also had a significant impact on the TRF. Postnatal exposures, including current drug use in the home and the child’s report of violence exposure, had an independent effect on teacher-assessed child behavioral problems.

Source:  Pediatrics. 2000 Oct;106(4):782-91.

A new assessment tool may allow doctors to evaluate the impact of methamphetamine on babies exposed in the womb. The tool may help identify which babies will go on to develop problems due to exposure to the drug, according to a new study.

Medical News Today reports that doctors at the Warren Alpert Medical School of Brown University andWomen & InfantsHospital inProvidence,RI, looked at the effects of prenatal exposure to methamphetamine in 185 newborns and compared them with 195 newborns who were not exposed to meth, but were exposed to alcohol, tobacco or marijuana before birth.

They reported at the Pediatric Academic Societies meeting inDenver that an assessment tool called the NICU Network Neurobehavioral Scale (NNNS) was used to evaluate the babies during the first four days of life and again when they were one month old.  The tool evaluates the babies’ muscle tone, reflexes, behavior, motor development and stress.

The researchers said that the tests could help identify which babies are doing well and which are the ones who could benefit from intervention and prevention services.

Source: www.drugfree.org/join-together  3^rd May 2011

Background

Alcohol is responsible for a significant portion of the global burden of disease. There is widespread concern reported in the media and other sources about drinking trends among young people, particularly heavy episodic or “binge” drinking. Prominent among policy responses, in theUKand elsewhere, have been attempts to manage antisocial behaviour related to intoxication in public spaces. Much less attention has been given to the longer term effects of excessive drinking in adolescence on later adult health and well-being. Some studies suggest that individuals “mature out” of late adolescent drinking behaviour, whilst others identify enduring effects on drinking and broader health and social outcomes in adulthood.

If adolescent drinking does not cause later difficulties in adulthood then intervention approaches aimed at addressing the acute consequences of alcohol, such as unintentional injuries and anti-social behaviour, may be the most appropriate solution. If causal relationships do exist, however, this approach will not address the cumulative harms produced by alcohol, unless such intervention successfully modifies the long-term relationship with alcohol, which seems unlikely. To address this issue a systematic review of cohort studies was conducted, as this approach provides the strongest observational study design to evaluate evidence for causal inference.

Methods

A systematic review was undertaken of the available literature using relevant online databases and standard systematic review literature search techniques. The search parameters included database articles from 1964 to 2008. This approach was supplemented through the use of hand searching of key journals, citation searching and contact with the primary authors of relevant studies. A data collection protocol was developed and the entire process was undertaken independently on two occasions by different researchers. All subsequent study tasks were also duplicated. Only peer-reviewed published data were used and further unpublished information was not sought from authors.

Studies of drinking behaviour were included if they collected data on at least two points in time, were at least 3 years apart, and from the same cohort. Cohorts formed from general population sources, including college students and military conscripts, were included. Studies based on selected or special populations such as children of alcoholics, mental health patients, and offenders were excluded.

We evaluated the strength of causal inference possible in these studies by assessing whether all possible contributing factors (confounders) had been taken into account. We also gave greater weight to studies that had follow-up rates of 80% or greater, and which had sample sizes of 1,000 participants or more.

Results

Fifty-four studies were eligible for inclusion in this review. Approximately half of all reports (n = 26) were from US studies, ten were fromSweden, eight fromBritain, four fromNew Zealand, three fromAustralia, two fromFinland, and one from theNetherlands. More than half (n = 30) originated from school-based cohorts. Birth cohorts were more likely to be the subject of multiple studies (n = 11/14). Nineteen (35%) studies, based on eight different cohorts, were assessed as having stronger capacity for causal inference), and we focussed primarily on these studies.

The main results were as follows –

• The majority of the studies provided evidence for a link between adolescent drinking and drinking behaviour in later adulthood.
• All studies assessing alcohol problems or dependence in adulthood found statistically significant associations with late adolescent drinking.
• Mortality was examined in only one cohort; the Swedish Conscript Study. It found that late adolescent heavy drinkers were twice as likely to have died compared to moderate drinkers by the mid-thirties. The majority of these deaths were due to car crashes and suicides. The risk of death due to alcohol specific causes (e.g. alcohol intoxication, liver cirrhosis) was also higher for this group.
• One study found no effect of adolescent drinking on court convictions or property offences by age 21, however one other study found that adolescent alcohol problems were predictive of official recorded criminal convictions by the mid-thirties.
• There was no effect of adolescent drinking on any of the mental health outcomes included in the studies, apart from the study noted above which did find that heavier adolescent drinkers had a higher risk of suicide in adulthood.
• One of the studies identified a small but significant effect of adolescent alcohol use on later tobacco use, however a similar relationship was not observed in other studies once confounding factors present in late adolescence were controlled.
• The majority of studies found that there was no association between adolescent drinking and drug use or dependence, after controlling for confounding.
• One study found a link between adolescent drinking at age 16 and educational attainment at age 42, however this effect was only evident in men.

Discussion

This systematic review investigated whether late adolescent alcohol consumption is a time-limited activity without significant longer term consequences or whether it impacts upon adult health and well being. It is clear that the evidence base on long-term consequences is not as extensive nor as compelling as it could be. There is a large evidence base attesting to the ongoing impacts of late adolescent drinking on adult drinking behaviours, though most studies cannot strongly support causal inferences because of their designs. There is robust evidence from one US National school cohort that apparent effects on later alcohol consumption persist beyond the age of 30, which is longer than had previously been understood. Possible effects on subsequent alcohol problems including dependence are somewhat more complex than effects upon subsequent alcohol consumption per se. Evidence from multiple well-designed cohort studies indicates that other factors indicative of heightened psychosocial risk more broadly are also implicated. It is nonetheless striking that effects on alcohol problems assessed at ages in the mid 30s appear to have been produced by elevated consumption in late adolescence. Findings from a rigorousNew Zealandbirth cohort study on nonalcohol outcomes, however, demonstrate that many apparent effects of late adolescent drinking are actually due to other factors. Certainty about the long-term consequences of late adolescent drinking is thus not easily achieved.

Notwithstanding the limitations of the evidence base and of this review, and attenuations over time in the strength of the direct effects, late adolescent alcohol consumption appears a probable cause of increased drinking well into adulthood, through to ages at which adult social roles have been achieved. Heavier drinking seems most likely, however, to be only one component in a complex causal process. The contribution of adolescent drinking has probably been overestimated in previous studies through not taking accouint of other possible explanations. There are also uncertainties induced by self-reported data. The importance of these findings is highlighted in the context of work showing strong stability of drinking patterns through the fourth and fifth decades of life. A wide range of health and other harms, such as liver cirrhosis, are caused by alcohol at middle and older ages. Late adolescent drinking, by virtue of its probable effect on long-term adult alcohol consumption is likely to contribute to the burden of alcohol-related disease. Continuities from adolescence to adulthood in drinking patterns have been observed across a range of measures including frequency of consumption and heavy drinking.

In this study it seems that alcohol consumption confers additional risk of alcohol problems both on those who are already more vulnerable in various ways to poorer health and psychosocial outcomes, and strikingly also among those who are not otherwise vulnerable. Possible effects on adult alcohol problems and dependence including hospitalisation identified here result from heavier drinking in adolescence without necessarily involving problems at younger ages. If these effects are confirmed, there are two important implications: (1) Reducing late adolescent alcohol consumption in the general population may be expected to make a long-term contribution to reducing the incidence of adult alcohol problems; (2) In more vulnerable populations, late adolescent drinking may be one cause among many of later difficulties, and its effects may be more severe and long-lasting than for other groups. Having relatively secure psychosocial resources may somewhat buffer these risks, and their consequent potential for adverse effects, but it does not remove them. These statements should be read with some caution given studies of mediators and moderators of these effects are lacking, limiting our understanding of their nature. Nevertheless, this systematic review affords more secure inference of the likely existence of these effects than has been possible previously. It is possible that relationships with alcohol forged during late adolescence may have cumulative lifetime drinking related consequences that are also simply not well captured by the existing literature.

In addition to making both alcohol and heavy drinking less available, less acceptable, and more expensive, these findings indicate a need for policy makers to encourage young people to be more cognisant of the long-term risks to adult health and well-being, and to act on this awareness in their decision making about whether and how much to drink. This encouragement requires much more than the provision of accurate information about risks if it is to have any real prospect of influencing actual behaviour. Alcohol harm reduction has largely been concerned with reducing various risks inherent in drinking situations and their immediate aftermaths. This study demonstrates the need to develop a longer term perspective on harm reduction.

Source:Alcohol Insights No.80

Abstract

A review of the existing literature on the occurrence of challenging behavior among children with prenatal drug exposure was conducted. While a large number of studies were identified that evaluated various outcomes of prenatal drug exposure, only 37 were found that directly evaluated challenging behaviors. Of the 37 studies, 23 focused on prenatal cocaine exposure, and 14 focused on prenatal alcohol exposure; most studies relied on broadband measures such as the CBCL for the assessment of challenging behavior. Among the 37 studies, a clear role for the postnatal environment on developing challenging behaviors was evident; however, prenatal alcohol exposure showed a much clearer independent effect upon challenging behaviors than was noted in the prenatal cocaine studies. Additionally, only 3 of the 37 studies addressed interventions for challenging behaviors, each of which showed an improvement in child behavior or parent-child interactions. As researchers have continued to show the importance of the postnatal environment, it is likely that interventions addressing specific environmental risk factors will be helpful to reduce or prevent challenging behaviors among this population.

Source:  http://www.ncbi.nlm.nih.gov/pubmed/18037268  Dec. 2008

Abstract

Delta (9)-tetrahydrocannabinol (THC), the most important psychoactive substance in cannabis, is frequently detected in blood from apprehended drivers suspected for drugged driving. Both experimental and epidemiological studies have demonstrated the negative effects of THC upon cognitive functions and psychomotor skills. These effects could last longer than a measurable concentration of THC in blood. Culpability studies have recently demonstrated an increased risk of becoming responsible in fatal or injurious traffic accidents, even with low blood concentrations of THC. It has also been demonstrated that there is a correlation between the degree of impairment, the drug dose and the THC blood concentration. It is very important to focus on the negative effect of cannabis on fitness to drive in order to prevent injuries and loss of human life and to avoid large economic consequences to the society.

Source:  Tidsskr Nor Laegeforen. 2007 Mar 1;127(5):583-4.

Opioid use just before conception or in early pregnancy has been associated with an increased risk for birth defects, including hypoplastic left heart syndrome, one of the most critical heart defects.
According to an ongoing, population-based study conducted by the Centers for Disease Control and Prevention (CDC), women receiving opioid analgesic treatment in early pregnancy had a 2- to 3-fold increased risk of delivering infants with conoventricular septal defects, atrioventricular septal defects, hypoplastic left heart syndrome, spina bifida, or gastroschisis.
“It’s important to acknowledge that although there is an increased risk for some types of major birth defects from an exposure to opioid analgesics, that absolute risk for any individual woman is relatively modest,” principal investigator Cheryl S. Broussard, PhD, from the CDC’s National Center on Birth Defects and Developmental Disabilities, said in a news release.
“However, with very serious and life-threatening birth defects like hypoplastic left heart syndrome, the prevention of even a small number of cases is very important,” she said.

Source: The study was published online February 24 in the American Journal of Obstetrics and Gynecology.

• Those who started smoking the drug at college were 90 per cent more likely to have psychotic symptoms in their mid-20s
• Some users suffered psychotic symptoms including hallucinations, delusions and disordered thoughts
Young people who use cannabis are doubling their risk of developing psychotic symptoms, experts warn. And mental health problems persist among those who continue using it compared with those who stop, according to research by an international team of scientists.
Their study adds to mounting evidence that smoking cannabis can trigger psychotic illnesses such as schizophrenia in vulnerable youngsters. It appears to demolish counter-arguments that cannabis does not cause symptoms of mental illness, or that some turn to the drug as a form of self-medication to deal with them.
The research also shows a link with psychosis at a very early stage of use among young people who previously never experienced such symptoms. They include paranoid ideas, hallucinations, hearing voices or bizarre behaviour.
The study, by a team from Germany, the Netherlands and the Institute of Psychiatry in London, focused on more than 1,900 volunteers aged 14 to 24 living in Germany. It followed up with the group after three years and eight years.
Those who had not previously used cannabis but began to during the study had double the risk of developing psychotic symptoms, it found. If they carried on using it, they were at an increased risk of psychotic experiences compared with those who did not. There was also no evidence that suffering psychotic symptoms was likely to result in people turning to cannabis for relief.
Reporting on their findings in the British Medical Journal, the team concluded: ‘Cannabis use precedes the onset of psychotic symptoms in individuals with no history of them.’
Cannabis may also increase the risk of lasting harm to mental health by making such symptoms persist with continued use. Last month, Australian researchers found that cannabis use accelerates the onset of full-blown mental illness almost three years earlier in people at risk.
Sir Robin Murray, professor of psychiatric research at the Institute of Psychiatry, said of the latest study: ‘It is one of ten prospective studies all pointing in this same direction. In short, it adds a further brick to the wall of evidence showing that use of traditional cannabis is a contributory cause of psychoses like schizophrenia.
‘It adds new information by showing that it is those who show psychotic symptoms within a few years of initiating cannabis use who are especially likely to develop persistent psychotic symptoms if they persist in their use of cannabis.’
Previous research has shown that a quarter of the population has a genetic predisposition which makes them ten times more likely to develop psychosis and other schizophrenia-like symptoms after smoking cannabis. Experts warn that anyone with pre-existing mental health problems or family history is at increased risk of mental illness if they use cannabis.
In a BMJ commentary, Professor Wayne Hall, from the University of Queensland, and Professor Louisa Degenhardt, from the Burnet Institute in Melbourne, say the link is biologically plausible and more information should be given to young people about the risks. ‘The case is strengthened by evidence that regular cannabis use in adolescence predicts poorer educational outcomes, increased risk of using other illicit drugs, increased risk of depression and poorer social relationships in early adulthood’, they added.

Source: http://www.dailymail.co.uk/health/article 2nd March 2011

Young people who misuse drugs and alcohol are at a greater risk for continuing this behavior into their middle-aged years, according to research by Yasmina Molero Samuelson at Sweden’s Center for Psychiatric Research (CPF), Karolinska Institutet. They are also more likely to suffer from physical, financial and mental health problems and experience more accidents, suicide attempts and premature death.
“What we can see is that adolescent antisocial behavior, manifested through substance misuse and delinquency, significantly increases the risk of various types of psychosocial problems in adulthood, even into middle age,” said Samuelson.
Samuelson analyzed two large groups of adolescents who had been in treatment for drug use at a clinic in Stockholm, Sweden during the end of the 1960s and the beginning of the 1980s. The analysis ended in 2002, and the participants were compared to two matched samples from the average population.
The results revealed that teens treated for substance abuse continued to suffer from psychosocial problems well after treatment, even up to age 50, to a far greater extent than those in the matched samples. They also had a higher risk of experiencing several coexisting problems in adulthood.
Interestingly, females with substance abuse issues and delinquency showed an equal risk of developing psychosocial problems as adults as their male counterparts. A significant number of girls who were treated at the clinic committed crimes in both adolescence and adulthood. Overall, the crimes committed by both males and females included non-violent crimes, violent crimes, and substance-related crimes.
“This emphasizes the importance of early and effective interventions in order to prevent a negative development that risks being maintained for most of a person’s life,” said Samuelson.
The variety of problems still experienced well into adulthood suggests that treatment interventions during teen years should not only focus on the specific substance abuse or delinquency, but should also evaluate and treat problems in other areas of life as well.
“The results also clearly show the importance of not overlooking young girls in these types of contexts, since they too demonstrate severe antisocial behavior, and are equally at risk of developing problems throughout their lives as their male counterparts,” said Samuelson.

Source: www.psychcentral.com 11 Feb.2011

Individual health risks
The assessment of individual health risks includes consideration of mephedrone’s acute and chronic toxicity, its dependence potential, and similarities and differences to other reference stimulants.

Systematic data are not routinely collected in Europe on acute toxicity related to mephedrone or closely comparable recreational drugs. Therefore, information on these effects of mephedrone is limited to user reports and clinical data on individuals presenting with acute problems. The reported short-term effects of mephedrone use have much in common with those of other stimulants. Some self-reports from users favourably compare mephedrone’s effects, saying the high can be both better and longer lasting than cocaine.

The main routes of administration for mephedrone are reported as snorting (nasal
insufflation) and swallowing (oral ingestion), sometimes after dissolving with water. As mephedrone is primarily available in powder form, injecting use is reported but appears to be rare.

Adverse effects reported by users include sweating, headaches, tachycardia, palpitations, nausea, chest pain, bruxism (teeth grinding), agitation/aggression and paranoia. In addition, nasal insufflation of mephedrone is reported to be associated with significant nasal irritation and pain which has led to some users switching to oral use of mephedrone. Users report increased sexual arousal but there is insufficient information to detect whether this is associated with highrisk sexual behaviour.
Some detailed information on the patterns of acute mephedrone toxicity is available from clinical case series from poisons information services and specialist hospitals in the United Kingdom and Sweden, including one series of analytically confirmed acute mephedrone toxicity from the United Kingdom. In this data, patients typically present with sympathomimetic features (dilated pupils, agitation, tachycardia, hypertension); severe clinical features such as chest pain, significant hypertension, arrhythmias and seizures have been reported in a small number of cases to date. Similar to other stimulant drugs, it is likely that the risk of toxicity is related to the dose of mephedrone used; however there is insufficient information available from toxicity
reports to determine a ‘dose threshold’ and/or whether particular routes of use are more likely to be associated with toxicity. It is possible that certain rare, but clinically significant, severe effects are associated with mephedrone use. However, as experience of the toxicological profile of the drug is currently limited to a few hundred cases it is difficult to be sure.

Data from individuals presenting with acute mephedrone toxicity suggest that the majority of individuals have used at least one other substance together with mephedrone. However there are analytically confirmed cases of lone mephedrone toxicity. This is similar to individuals presenting with acute toxicity related to other stimulant drugs. There are two reported fatalities in which mephedrone appears to be the sole cause of death (one in Sweden and one in the United Kingdom). In addition to these cases, there are at least another 37 deaths in the United Kingdom and Ireland in which mephedrone has been detected in post-mortem blood and/or urine toxicology screening. In some of these cases it is likely that other drugs and/or other medical conditions or trauma may have contributed to or been responsible for death. The inquests into the deaths are pending for the majority of these cases
therefore it is not possible at this time to determine the contribution of mephedrone.

Strong craving for the substance is reported by some users’ self-reports, sometimes rated higher than that experienced with other stimulant drugs. This is cited as a main reason for using more mephedrone than intended, and for using for longer periods than planned. Withdrawal symptoms do not appear to be significant for most users with the primary symptoms of nasal congestion and fatigue most probably related to route of use and lack of sleep secondary to staying up late. However the other reported findings, in heavier users, would be consistent with a stimulant withdrawal syndrome. There is some evidence that the drug has a high abuse liability with over 30 % of the UK telephone survey sample reporting three or more DSM criteria
of dependence and being classified as dependent. Tolerance, loss of control, a strong urge to use and using despite problems predominate. In addition, there are reports from the United Kingdom of mephedrone dependence being reported to drug treatment services that suggest psychological rather than physical dependency similar to other stimulant drugs.
No studies have been published investigating the potential for chronic mephedrone toxicity associated with mephedrone use, including reproductive toxicity, genotoxicity and carcinogenic potential. Reports suggest mephedrone may be used as an alternative to illicit stimulants. The reasons given for using mephedrone include: value for money, product purity and consistency as well as the poor availability or low quality of other stimulants (cocaine, ecstasy/MDMA). Some users
noted a preference for mephedrone over other stimulant drugs with data from the UK clubbers rating mephedrone above ecstasy and cocaine for strength and pleasurable high. Mephedrone users in the UK telephone survey reported on the considerable impact mephedrone had on their consumption of cocaine and ecstasy, with approximately two thirds of the sample reporting that they now took less MDMA, and a third reporting that they now consumed less cocaine. Just under half of the group reported they would choose mephedrone over cocaine and only a quarter said that they would take mephedrone over ecstasy
.
The physical effects reported by mephedrone users are typical of other stimulants and may be particularly similar to MDMA. However, mephedrone’s relatively short duration of action, leading to repeat dosing, is more analogous to cocaine.
In summary, from the data sources available, it appears that the effect profile and clinical presentations of mephedrone intoxications share some features seen with MDMA and some features seen with cocaine. Additionally, there are very limited reports of fatalities directly related to mephedrone. Some users have reported negative effects and in some cases these have required medical attention. Similar to other stimulant drugs, the extent to which users experience problems requires further investigation. Data also suggest that mephedrone has a potential to cause dependency. However, more in-depth studies would be required to explore in
detail the dependence potential of this drug.

Source: excerpt from DEA report 2010

Background

The associations between age of onset of cannabis use and educational achievement were examined using data from three Australasian cohort studies involving over 6000 participants. The research aims were to compare findings across studies and obtain pooled estimates of association using meta-analytic methods.

Methods

Data on age of onset of cannabis use (<15, 15–17, never before age 18) and three educational outcomes (high school completion, university enrolment, degree attainment) were common to all studies. Each study also assessed a broad range of confounding factors.

Results

There were significant (p < .001) associations between age of onset of cannabis use and all outcomes such that rates of attainment were highest for those who had not used cannabis by age 18 and lowest for those who first used cannabis before age 15. These findings were evident for each study and for the pooled data, and persisted after control for confounding. There was no consistent trend for cannabis use to have greater effect on the academic achievement of males but there was a significant gender by age of onset interaction for university enrolment. This interaction suggested that cannabis use by males had a greater detrimental effect on university participation than for females. Pooled estimates suggested that early use of cannabis may contribute up to 17% of the rate of failure to obtain the educational milestones of high school completion, university enrolment and degree attainment.

Conclusions

Findings suggest the presence of a robust association between age of onset of cannabis use and subsequent educational achievement.

Source: www.sciencedirect.com April 2010

Academics at Northumbria University have demonstrated a link between teenage binge drinking and damage to prospective memory.

Prospective memory is an important aspect of day-to-day memory function and is defined as the cognitive ability to remember to carry out an activity at some future point in time. Examples include remembering to attend an appointment at the dentist or to carry out a task such as remembering to pay a bill on time.

In the first study to examine the effects of binge drinking on prospective memory in teenagers, researchers tested the ability of fifty students from universities in North East England to remember a series of tasks. The students were shown a 10-minute video clip of a shopping district in Scarborough and were asked to remember to carry out a series of instructions when they saw specified locations.
Twenty-one of the students were categorized as binge drinkers. For women, this meant that they drank the equivalent of six standard glasses of wine or, for men, six pints of beer, two or more times a week. The remaining 29 participants were categorised as non-binge drinkers.

The study found that the binge drinkers recalled significantly fewer location-action/items combinations than their non-binging peers. These findings were observed after screening out teenagers who used other substances (such as ecstasy, cannabis and tobacco), those who had used alcohol within the last 48 hours, and after observing no between-group differences on age, anxiety and depression.

Dr Tom Heffernan led the study. He comments: “The mechanisms that may underlie such everyday cognitive impairments associated with binge drinking are not yet fully understood. It is possible that excessive drinking may interfere with the neuro-cognitive development of the teenage brain.

“It is important to realise that there no ‘safe’ levels of drinking set for teenagers and that the amount of bingeing revealed in the present study represents a high volume of alcohol intake across the two to three bingeing sessions which were the norm in the group. The high levels of drinking amongst teenagers is particularly worrying given the mounting evidence that the teenage brain is still maturing and undergoing significant development in terms of its structure and function.
“Given that teenagers are inexperienced drinkers who have both a low tolerance for alcohol and immature neuro-physiological systems, they should therefore be drinking much less than the ‘safe’ levels recommended for adults.”

Intriguingly, one other finding of the study is that binge drinkers do not perceive themselves to have a poor memory, suggesting teenagers do not appreciate the damage that is being done.

Source: T. Heffernan, R. Clark, J. Bartholomew, J. Ling, S. Stephens. Does binge drinking in teenagers affect their everyday prospective memory? Drug and Alcohol Dependence, 2010; 109 (1-3): 73 DOI: 10.1016/j.drugalcdep.2009.12.013 Northumbria University (2010, July 29).

A new study suggests that genetic factors influence size variations in a certain region of the brain, which could in turn be partly responsible for increased susceptibility to alcohol dependence.

It appears that the size of the right orbitofrontal cortex (OFC), an area of the brain that is involved in regulating emotional processing and impulsive behavior, is smaller in teenagers and young adults who have several relatives that are alcohol dependent, according to a study led by Dr. Shirley Hill, Ph.D., professor of psychiatry, University of Pittsburgh School of Medicine.
In the research, which was published this week in the early online version of Biological Psychiatry, Dr. Hill and her team imaged the brains of 107 teens and young adults using magnetic resonance imaging. They also examined variation in certain genes of the participants and administered a well-validated questionnaire to measure the youngsters’ tendency to be impulsive.
The participants included 63 individuals who were selected for the study because they had multiple alcohol-dependent family members, suggesting a genetic predisposition, and 44 who had no close relatives dependent on drugs or alcohol. Those with several alcohol-dependent relatives were more likely to have reduced volume of the OFC.
When the investigators looked at two genes, 5-HTT and BDNF, they found certain variants that led to a reduction in white matter volume in the OFC, and that in turn was associated with greater impulsivity.
“We are beginning to understand how genetic factors can lead to structural brain changes that may make people more vulnerable to alcoholism,” Dr. Hill said. “These results also support our earlier findings of reduced volume of other brain regions in high-risk kids.”
These differences can be observed even before the high-risk offspring start drinking excessively, she added, “leading us to conclude that they are predisposing factors in the cause of this disease, rather than a consequence of it.”

Source: University of Pittsburgh Schools of the Health Sciences (2008, November 7). Impulse Control Area In Brain Affected In Teens with Genetic Vulnerability for Alcoholism

BY MARK HENDERSON, SCIENCE CORRESPONDENT

ONE in four people carries genes that increases vulnerability to psychotic illnesses if he or she smokes cannabis as a teenager, scientists have found.
A common genetic profile that makes cannabis five times more likely to trigger schizophrenia and similar disorders has been identified, increasing pressure on the Government to reverse the drug’s reclassification from Class B to Class C.

The increased risk applies to people who inherit variants of a gene named COMT who also smoked cannabis as teenagers. About a quarter of the population have this genetic make-up, and up to 15 per cent of the group are likely to develop psychotic conditions if exposed to the drug early in life.
Neither the drug nor the gene raises the risk of psychosis by itself.
The study, led by Avshalom Caspi and Terrie Moffitt, of the Institute of Psychiatry at King’s College London, offers the best explanation yet for the way that cannabis has a devastating psychiatric impact on some users but leaves most unharmed. Scientists had suspected that genetic factors were responsible for this divide, but a gene had not been pinpointed.
The findings, to be published in Biological Psychiatry, also reinforce a growing consensus that nature and nurture are not mutually exclusive forces but combine to affect behaviour and health. The King’s team has previously identified genes that raise the risk of depression or aggression, but only in conjunction with environmental influences.
Mental health campaigners said that the results vindicated their concerns about the decision last year to downgrade cannabis to a Class C drug, which means that possession is no longer an arrestable offence.
Marjorie Wallace, chief executive of the mental health charity Sane, said that it was becoming clear that cannabis placed millions of users at risk of lasting mental illness. About fifteen million Britons have tried cannabis, and between two million and five million are regular users, according to the Home Office British Crime Survey. The research suggests that a quarter could be at risk.
The evidence will be considered by a review of the drug’s classification announced last month by the Home Secretary. It may be possible to develop a test for genetic susceptibility to cannabis. “If we were able genetically to identify the vulnerable individuals in advance, we would be able to save thousands of minds, if not lives,” Ms Wallace said.
Dr Caspi, however, rejected the idea of screening based on the COMT gene. “Such a test would be wrong more often than it is right. Cannabis has many other adverse effects, especially on developing teenagers, on respiratory health and possibly on cognitive function. Effects may be pronounced among a genetically vulnerable group but that doesn’t mean we should encourage others not genetically vulnerable to use cannabis.”
The King’s team tracked 803 men and women born in Dunedin, New Zealand, in 1972 and 1973, who were enrolled at birth in a research project. Each was interviewed at 13, 15 and 18 about cannabis use, tested to determine which type of COMT genes they had inherited, and followed up at 26 for signs of mental illness.
COMT was chosen as it is known to play a part in the production of dopamine, a brain-signalling chemical that is abnormal in schizophrenia. It comes in two variants, known as valine or methionine, and every person has two copies, one from each parent.
Among people with two methionine variants, the rate of psychotic illness was 3 per cent, the background rate for the general population, regardless of whether they had used cannabis as teenagers.
Among those with two valine variants the rate was 3 per cent for non-users but 15 per cent for those who had smoked cannabis in their teens.
Dr Caspi said research had shown that the valine gene variant and cannabis affect the brain’s dopamine system in similar fashion, suggesting that they deliver a “double dose” that can be damaging. The work needs to be replicated by others to confirm the findings, Dr Caspi said. It also is possible that the gene involved is not COMT but a neighbour.
THE DRUG OF CHOICE FOR MILLIONS
• Cannabis was reclassified from a Class B to a Class C drug in January 2004. Possession remains illegal, but is not an arrestable offence. The Home Secretary has asked for a review by November
• The Home Office estimates that fifteen million people have tried cannabis, two million to five million are regular users and reclassification has saved 199,000 hours’ police work
• Liberalisation campaigners argue that millions smoke the drug with fewer ill-effects than others suffer from alcohol or tobacco
• A recent study at Maastricht University found that cannabis doubles the risk of schizophrenia, hallucinations and paranoia among a genetically susceptible group

Source: www.timesonline.co.uk 14 April 2005

Half of all U.S. children live in a house where a parent or other adult uses tobacco, drinks heavily or uses illegal drugs, according to a report released on Tuesday.
These adults are three times more likely to abuse their children and four times more likely to neglect them than parents who do not abuse alcohol or drugs or use tobacco, said the report from Columbia University’s National Center on Addiction and Substance Abuse.
“Children of alcohol and drug abusers are at increased risk of accidents, injuries and academic failure. Such children are more likely to suffer conduct disorders, depression or anxiety, conditions that increase the risk children will smoke, drink and use drugs,” the center said in a statement.
The report is an analysis of the center’s own research as well as dozens of reports from groups ranging from Alcoholics Anonymous, U.S. government surveys on families and health behavior and the Children’s Defense Fund, a nonprofit social welfare organization. It found that 35.6 million U.S. children, about half of all children in the country, live in a home where a parent or other adult uses tobacco, drinks heavily or uses illicit drugs.
More than 37 percent of U.S. children live with an adult who uses tobacco, nearly 24 percent live with a binge or heavy drinker and 12.7 percent live in a household where a parent or other adult uses illicit drugs, the report found.
Several studies show that children exposed to household cigarette smoke have a higher risk of sudden infant death syndrome, asthma and ear infections. They are more likely to have their tonsils or adenoids surgically removed and recent studies show they have a bigger risk of cancer and heart disease.
“If substance abusing parents are not concerned about what drugs, alcohol and tobacco are doing to themselves, they should be concerned about the ill effects they have on their children,” center Chairman Joseph Califano said.
“Children of substance abusing parents are much likelier to become substance abusers themselves,” he added.
“A child who gets through age 21 without smoking, using illegal drugs or abusing alcohol is virtually certain never to do so.”

Source: WASHINGTON (Reuters) Mar 29, 2005

Adolescents’ use of marijuana may increase the risk of heroin addiction later in life, a new study suggests. Researchers say the work adds to “overwhelming” evidence that people under 21 should not use marijuana because of the risk of damaging the developing brain.
The idea that smoking cannabis increases the user’s chance of going on to take harder drugs such as heroin is highly contentious. Some dub cannabis a “gateway” drug, arguing that peer pressure and exposure to drug dealers will tempt users to escalate their drug use. Others insist that smoking cannabis is unrelated to further drug use.
Now research in rats suggests that using marijuana reduces future sensitivity to opioids, which makes people more vulnerable to heroin addiction later in life. It does so by altering the brain chemistry of marijuana users, say the researchers.
“Adolescents in particular should never take cannabis – it’s far too risky because the brain areas essential for behaviour and cognitive functioning are still developing and are very sensitive to drug exposure,” says Jasmin Hurd, who led the study at the Karolinska Institute in Sweden.
But Hurd acknowledges that most people who use cannabis begin in their teens. A recent survey reported that as many as 20% of 16-year-olds in the US and Europe had illegally used cannabis in the previous month.

“Teenage” rats

In order to explore how the adolescent use of cannabis affects later drug use, Hurd and colleagues set up an experiment in rats aimed to mirror human use as closely as possible.
In the first part of the trial, six “teenage” rats were given a small dose of THC – the active chemical in cannabis – every three days between the ages of 28 and 49 days, which is the equivalent of human ages 12 to 18. The amount of THC given was roughly equivalent to a human smoking one joint every three days, Hurd explains. A control group of six rats did not receive THC.
One week after the first part was completed, catheters were inserted in all 12 of the adult rats and they were able to self-administer heroin by pushing a lever.
“At first, all the rats behaved the same and began to self-administer heroin frequently,” says Hurd. “But after a while, they stabilised their daily intake at a certain level. We saw that the ones that had been on THC as teenagers stabilised their intake at a much higher level than the others – they appeared to be less sensitive to the effects of heroin. And this continued throughout their lives.”
Hurd says reduced sensitivity to the heroin means the rats take larger doses, which has been shown to increase the risk of addiction.

Drug memory

The researchers then examined specific brain cells in the rats, including the opioid and cannabinoid receptors. They found that the rats that had been given THC during adolescence had a significantly altered opioid system in the area associated with reward and positive emotions. This is also the area linked to addiction.
“These are very specific changes and they are long-lasting, so the brain may ‘remember’ past cannabis experimentation and be vulnerable to harder drugs later in life,” Hurd says.
Neurologist Jim van Os, a cannabis expert at the University of Maastricht in the Netherlands told New Scientist the research was a welcome addition to our understanding of how cannabis affects the adolescent brain.
“The issue of cross-sensitisation of cannabis/opioid receptors has been a controversial one, but these findings show the drug’s damaging effects on the reward structures of the brain,” van Oshe says. “There is now overwhelming evidence that nobody in the brain’s developmental stage – under the age of 21 – should use cannabis.”

Source: On line edition of Neuropsychopharmacology. Reported in NewScientist.com July 2006

Children from families with a history of alcohol abuse show characteristics in their brains that may make them more susceptible to becoming problem drinkers themselves, a new study reports.
Using magnetic resonance imaging, researchers from the University of Pittsburgh found potentially significant structural differences in the brains of teenagers from families with multigenerational drinking problems. The report was published in a recent issue of Biological Psychiatry.
The lead author, Dr. Shirley Y. Hill, said the study had found that the right portion of a brain area called the amygdala appeared smaller than normal in the teenagers studied. The amygdala helps control emotions, the researchers said, and appears to play an important role in addictive behavior like gambling and drug use.
The researchers looked at 34 boys and young men whose family histories were believed to put them at high risk; their average age was 17. The study found that some of the deviations in the brain occurred even if the subjects were not using alcohol. They said that fact suggested a genetic component.
The researchers said they suspected that the teenagers’ brains would eventually develop normally if they avoided alcohol. But studies have shown that children from families with long histories of drinking start using alcohol earlier.
Source: New York Times July 12 2006

The Inextricable Link

Research substantiates the link between violence and alcohol/drug use among adolescents. This link exists not only
for the perpetrators of violence, but also for those who are victims of violence. Eliminating the State Grants portion of the Safe and Drug Free Schools and Communities (SDFSC) program will undoubtedly lead to increases in violence,alcohol and drug use among school-aged youth.

Student Alcohol Use and Violence

• Alcohol use is an independent risk factor for delinquent and violent behaviors among young people.
• Adolescents who abuse alcohol are three times more likely to commit violent offenses than those who do not drink to excess.
• Youth aged 12-17 who reported violent behaviors in the past year also reported higher rates of past year alcohol use compared with youths who did not report violent behavior.

65.9% of those youth reporting heavy alcohol use, 56.8% of those reporting binge drinking, and 43.7% of those reporting past 30-day use of alcohol had also engaged in one or more of the following delinquent behaviors: participating in a serious fight at school or at work; participating in a group-against-group fight; attacking someone with the intent to seriously hurt them; stealing or attempting to steal something worth $50 or more; selling illegal drugs; and/or carrying a hand gun within the last year.

• Alcohol use among adolescents co–occurs with a range of other risky behaviors including violence, tobacco use, sexual activity, drinking and driving and suicide.

Student Alcohol Use and Victimization

• Those who drink, including adolescents, may experience an increased risk of violence because of reduced physical coordination, poor decision-making in threatening situations and isolation while out late at night.
• Alcohol increases vulnerability to victimization above levels of vulnerability brought about other factors.

Student Drug Use and Violence

• Youths who had engaged in fighting or other delinquent behaviors were more likely than other youths to have
used illicit drugs.
• Of those students who reported carrying a gun to school during the 2005-2006 school year, 63.9% report also
using marijuana, 39.9% report using cocaine, and 36.8% report using crystal meth in the past year.
• Of those students who reported hurting others with a weapon at school, 68.4% had used marijuana, 48.3%
had used cocaine, and 44.1% had used crystal meth in the past year.
• Of those students who reported being hurt by a weapon at school, 60.3% reported using marijuana, 41.1% reported
using cocaine and 38.3% reported using crystal meth in the past year.
• Past month illicit drug use was reported by 17.3% of youths who had gotten into serious fights at school or
work in the past year compared with 7.6% of those who had not.
• The incidences of youth physically attacking others, stealing, and destroying property increased in proportion
to the number of days marijuana was smoked in the past year.
• Marijuana users were twice as likely as non-users to report they disobeyed school rules.
• Of those students who reported threatening someone with a gun, knife or club or threatening to hit, slap or kick
someone during the 2005-2006 school year, 27% also reported using marijuana, 7.8% reported using cocaine and 6.2% reported using crystal meth in the past year.
• During the 2005-2006 school year, of those students who reported any trouble with the police, 39.6% also reported
using marijuana, 12.2% reported using cocaine, and 9% reported using crystal meth in the past year.

Community Anti-Drug Coalitions of America > 625 Slaters Lane, Suite 300 > Alexandria, VA 22314 > T 800.542.2322 > cadca.org
CSSourmunity Anti-Drug Coalitions of America > 625 Slaters Lane, Suite 300 > Alexandria, VA 22314 > T 800.542.2322 > cadca.org

Footnotes

1 Komro, K.A., Williams, C.L., Foster, J.L., et al. (1999).
The relationship between adolescent alcohol use and delinquent
and violent behaviors. Journal of Child Adolescent
Substance Abuse, 9(2):13-28.
2 Fergusson, D.M., Lynskey, M.T., Horwood, L.J. (1996).
Alcohol misuse and juvenile offending in adolescence. Addiction,
91(4): 495-510.
3 Office of Applied Studies, Substance Abuse and Mental
Health Services Administration. (2005). The NSDUH report:
Alcohol use and delinquent behaviors among youths. Available:

http://www.oas.samhsa.gov/2k5/alcDelinquent/

alcDelinquent.pdf
4 Ibid.
5 Windle, M. Alcohol Use Among Adolescents. Thousand
Oaks, CA: Sage, 1999.
6 Shepherd, J.P.(1998). Emergency room research on links
between alcohol and violent injury. Addiction, 93(8): 1261–
1262.
7 Shepherd, J.P.; Sutherland, I.; Newcombe, R.G. (2006)
Relations between alcohol, violence and victimization in
adolescence. Journal of Adolescence, 29(4): 539-553.
8 Office of Applied Studies, Substance Abuse and Mental
Health Services Administration. National Survey on Drug
Use and Health: National Findings. (2005). Youth Prevention-
Related Measures: Fighting and Delinquent Behavior.
64. Available: http://oas.samhsa.gov/
nsduh/2k5nsduh/2k5results.pdf.
9 Pride Surveys. (2006). Questionnaire report for grades 6-
12: 2006 national summary. 184. Available: http://
www.pridesurveys.com/customercenter/us05ns.pdf.
10 Pride Surveys. (2006). Questionnaire report for grades 6-
12: 2006 national summary. 197. Available: http://
www.pridesurveys.com/customercenter/us05ns.pdf.
11 Pride Surveys. (2006). Questionnaire report for grades 6-
12: 2006 national summary. 199. Available: http://
www.pridesurveys.com/customercenter/us05ns.pdf.
12 Office of Applied Studies, Substance Abuse and Mental
Health Services Administration. National Survey on Drug
Use and Health: National Findings. (2005). Youth Prevention-
Related Measures: Fighting and Delinquent Behavior.
64. Available: http://oas.samhsa.gov/
nsduh/2k5nsduh/2k5results.pdf.
13 Office of National Drug Control Policy. (2006). Marijuana
Myths and Facts: The Truth Behind 10 Popular Misperceptions.
10. Available: http://www.whitehousedrugpolicy.gov/
publications/marijuana_myths_facts/
marijuana_myths_facts.pdf
14 Ibid.
15 Pride Surveys. (2006). Questionnaire report for grades 6-
12: 2006 national summary. 194. Available: http://
www.pridesurveys.com/customercenter/us05ns.pdf.
16 Pride Surveys. (2006). Questionnaire report for grades 6-
12: 2006 national summary. 195. Available: http://www.pridesurveys.com/customercenter/us05ns.pdf.ourceThe Inextricable S
Source: Cadca online Nov. 2006

June 28, 2004
Vol. 13, Issue 26

Nine behaviours and attitudes differentiate students who used marijuana before age 15 from those who had not, according to an analysis of data from the 2002 Maryland Adolescent Survey (MAS). Overall, one-fifth of Maryland 12th grade students reported using marijuana before age 15. A scale of 9 warning signs of early marijuana use among 12thgraders was developed from an analysis of the MAS data (see below). The scale also detected early use among 8th and 10th graders. The more warning signs a student had, the more likely he or she was to have used marijuana early . For example, approximately three-fourths of 12th graders with 6 or more warning signs were early marijuana users, compared to 3% of 12th graders with no warning signs. Students with more warning signs also reported using a greater number of other illegal drugs*and experiencing a greater number of serious problems **resulting from drug and alcohol use report, “Warning Signs for Early Marijuana Users Among Maryland’s Public School Students,” discusses the implications of these findings for intervening with youth and implementing prevention programs. Complimentary copies of the report can be ordered by contacting CESAR at cesar@cesar.umd.eduor 301-405-9770.

Behaviors•
Cigarette use before age 15
•Alcohol use before age 15
•20 or more unexcused absences
•Drug arrest
•Alcohol arrest
Attitudes/Opinions
•Smoking marijuana is safe
•Smoking cigarettes is safe
•My parents think it’s okay to smoke marijuana
•My parents think it’s okay to smoke

SOURCE: Maryland Drug Early Warning System (DEWS), CESAR, “Warning Signs for Early Marijuana Users Among Maryland’s Public School Students,” DEWS Investigates, June 2004. For more information, contact Dr. Eric Wish at ewish@cesar.umd.edu.

WARNING labels telling pregnant mothers they risk doing irreversible harm to their unborn children by drinking could be put on alcoholic products after the number of damaged babies has soared.
Cases of infants born with foetal alcohol syndrome (FAS) – which can cause mental retardation and birth defects if a mother drinks throughout pregnancy – have doubled in NSW from 15 in 2001 to 32 in 2004.
But experts believe the real figure is likely to be up to 10 times higher.
Research suggests even one bout of binge drinking during pregnancy could cause foetal alcohol spectrum disorders, leaving a child with behavioral and learning disabilities.
NSW Health Minister John Hatzistergos said yesterday the Government is researching new alcohol pregnancy guidelines and is considering rolling out health advisory labels.
Mr Hatzistergos said: “We need to know two things. What impact drinking during pregnancy has and what is the nature of any warning that should be provided on alcohol products.”
There is currently no national standard advice for drinking during pregnancy, but research suggests even moderate drinking late in pregnancy can cause FAS.
University of Sydney’s Professor of Paediatrics Health Dr Elizabeth Elliot said: “For every child with FAS there are 10 more with neuro-developmental problems caused by alcohol.
“We are certainly seeing new cases diagnosed every year and that is just the severe end of the spectrum.
“We also know many women are unaware a single binge early in pregnancy could damage their foetus.”
At the ministerial council on drug strategy last week, state and federal ministers discussed new, nationwide approaches to reduce the rate of FAS.
Mr Hatzistergos said a working party will examine research and discuss what alcohol warning labels would say.
He did not dismiss the possibility labels would use photographs similar to new cigarette warning labels.
He said: “Down the track that may be something. I think the best approach is to abstain, but I don’t want to create anxiety among women – there needs to be a greater level of awareness about this issue.”
New research shows 78 per cent of FAS children studied between 2000 and 2004 were exposed to drugs in addition to alcohol and the average age of diagnosis was 3.3 years old.
Alarmingly, of the 133 FAS children examined, 27 per cent had a sibling also affected by alcohol.
A new documentary, In The Womb, using unique 4D technology is now available and tracks the development of the foetus in-utero from fertilisation to birth as well as showing the impact of smoking and excess alcohol on unborn children.
One of the most expensive films of its kind, the DVD was made

Source: Daily Telegraph. Australia Dec. 18th 2006

How serious is the child and teenage alcohol problem in your area?
More than 20 children and teenagers are being treated in hospital every day for alcohol-related illnesses, including mental disorders, poisoning and liver disease, according to newly released official data.
The figures, labelled “staggering” by one of Britain’s most senior doctors, show that in the year 2005-6, during which Labour introduced 24-hour drinking, the number of under-18s seeking treatment for alcohol-related health problems leapt by 13% to 8,894, an average of 24 a day.
The research, released in parliament by Caroline Flint, the health minister, shows that the number treated has gone up by 33% since Labour came to power in 1997.
Professor Ian Gilmore, president of the Royal College of Physicians, said: “This is a staggering rise and it is only the tip of the iceberg.
“Drinks sold by supermarkets and off-licences are cheaper than ever, and those shops have been at the front of the queue for 24-hour licences, so it has never been more available.
“The younger they drink, the more likely they are to have alcohol-related problems later in life. It is now commonplace to see men and women in their twenties with end-stage alcoholic liver damage.”
The disease figures released by Flint do not include those people treated for injuries sustained in incidents such as drunken fights or drink-driving.
Separately, the government has released figures for patients treated for alcohol-related conditions in accident and emergency wards, showing that alcohol-related medical emergencies and hospital treatments have doubled since 1997.
In some parts of the country the rise is even steeper. The worst areas include the region formerly covered by Cheshire and Merseyside Strategic Health Authority, where 742 young people were treated last year, a rise of more than 25% in just a year. In Northumberland, Tyne and Wear, the number went up by a quarter.
By contrast, some southern health authorities experienced an improvement. In Bedfordshire and Hertfordshire, for example, there were only 119 cases, a fall of 30%.
In addition to the figures for children and teenagers, the Department of Health data also show that the number of people aged 18 and over treated for alcohol-related illness has gone up from 124,925 to 253,603 since 1997, a rise of more than 100%.
The data, released in a written answer, appear to contradict the government’s claims that the liberalisation of pub opening and supermarket off-sales time would lead to more responsible drinking. They bear out research published earlier this year by the British Association for Emergency Medicine, which found an increase in alcohol-related injuries treated in hospital among all age groups since the change to the drinking laws.
Ahead of its launch of 24-hour opening in November 2005, the government assured voters that there would be tougher controls on underage drinking.
It announced on-the-spot fines for children buying alcohol and tougher penalties for staff serving them.
Tessa Jowell, the culture secretary, said at the time: “The result will be more freedom for responsible adults and tougher treatment for the yobbish minority.”
Labour’s approach to teenage drinking has not always lived up to the responsible image that it likes to project.
In the run-up to the 2001 general election, the party sent text messages to first-time voters telling them, “Don’t give a XXXX for last orders? Vote Labour”. This was an allusion to advertisements for Castlemaine XXXX, the Australian beer.
Dr Gray Smith-Laing, a consultant at the Medway Maritime hospital in Gillingham, Kent, who treats patients with liver disease, said last week: “What we’re seeing is the numbers going up, the age coming down.
“The idea that (24-hour opening) just smooths out the drinking and people drink the same amount over a longer period of time is complete rubbish.”
The Department of Health says that levels of binge drinking have peaked and new facilities such as walk-in centres could explain the growth in treatment for drink-related injuries.
The department said yesterday: “The increased attendances at A&E departments, as seen in recently published figures, began some years ago. Evidence suggests that increased rate of growth of attendances predates the change in licensing laws by several years. In fact, this year growth has actually slowed.”

SOURCE: POSTED BY ALCOHOLICS ANONYMOUS UK AT 7:50 AM MON 25.12.06

The number of young people needing treatment for mental or other serious problems caused by smoking cannabis has rocketed by a third, experts revealed last night.
The NHS National Treatment Agency for Substance Misuse revealed cannabis use had taken a heavy toll on 4,400 youngsters last year – or more than ten every day.
They were referred for treatment by psychiatric services or families worried the person’s life was falling apart. In many cases, the user was aged just 18 or 19., the NTA said.
The figures come amid significant falls in the number of 18-24 year old’s needing treatment for abusing other illegal drugs – including cocaine and heroin. Experts say it reflects drug users increasingly opting for cannabis rather than other banned substances.
Four years ago, the number of youngsters with serious cannabis problems was only 3,300. Last year, it was around 3,700. Cannabis users accounted for 29 per cent of all new treatment cases aged under 25 in 2009-10, up from 18 per cent four years previously.
Young people are also turning to so-called legal highs as they seek alternatives to poor-quality cocaine on the streets. NTA chief executive Paul Hayes said: ‘As young adults turn their backs on heroin, crack and cocaine, more of the 18 to 24 age group are seeking treatment for problems with cannabis.
‘There are also indications that some who shun cocaine are taking risks with designer drugs like methedrone, dubbed a legal high until it was banned.
‘Treatment services need to be on the alert, able to respond to changing patterns of drug use and drug dependency. ‘In relation to legal highs, we don’t know what the treatment demand will be. They haven’t been around long enough, we don’t know what their potential to cause addiction is. We know they can cause health harms.’
It follows concern about the increasing availability of the super-strength skunk variety of cannabis – which now accounts for between 70 and 80 per cent of police seizures.
Doctors warn that people who smoke skunk are 18 times more likely to develop psychosis than those who use milder forms of the drug. The researchers, from the Institute of Psychiatry in London, compared data on the health and habits of almost 200 cannabis users.
More than half were being treated for psychosis, in which hallucinations and delusions leave people unable to distinguish between reality and their imagination.
Analysis showed skunk was the drug of choice of those being treated for psychosis, while hash was more likely to be smoked by those without mental health problems.
Cannabis has been linked to a string of vicious killings by young people, including the murder and mutilation of teenager Jodi Jones by her boyfriend Luke Mitchell and the stabbing of fashion designer Lucy Braham by Oxford University student William Jaggs.
In 2004, the then Home Secretary David Blunkett approved the reclassification of cannabis from Class B to Class C. The decision was reversed four years later, on the orders of Prime Minister Gordon Brown, on the grounds it was sending out the wrong message to children that cannabis was harmless.
The government has also stated a determination to crack down on the so-called legal highs. Mephedrone – also known as Meow, Bubbles and M-Cat – was banned and made a class B drug in April.
The Home Office has also announced plans for year-long bans that could be put in place quickly to take new drugs off the market while a comprehensive review of their potential harm is carried out. Roger Howard, chief executive of the UK Drug Policy Commission, said: ‘With the changing nature of drug use, we do need to pay more focus on these new emerging drugs. ‘I think that’s something that people in the field are very aware of. ‘How quickly can the system adjust?’

Source: www.dailymail.co.uk 8th October 2010

Exposure to alcohol in the womb can have devastating physical and mental effects – and children in care often suffer disproportionately
Six out of 10 children in care are there because they were abused or neglected, and parental drinking is often a significant factor. But professionals are becoming increasingly aware that some of these children may be victims of alcohol misuse twice over. An estimated 7,000 children are born with foetal alcohol syndrome (FAS) in the UK each year and experts believe that a disproportionate number of them end up in care.
FAS is caused by drinking during pregnancy and falls under the umbrella of foetal alcohol spectrum disorders (FASD), which are characterised by lifelong brain damage and physical defects. The consequences include learning disabilities, hyperactivity, autistic traits and problems with social skills, language and memory.
Life chances
Gareth Crossman, executive director of external affairs at The Adolescent and Children’s Trust (Tact), a charity provider of adoption and fostering services, says: “Young people in care have some of the worst life-chances of children, generally. They are more likely to be homeless, have mental health problems and come into contact with the criminal justice system. These issues are compounded [by FASD] because they cannot interact with the world in the same way as the rest of us.”
FASD have so far failed to register on the government’s radar, suggesting a pressing need for more integrated working between health and social care. Dr Mary Mather, medical adviser to Tact’s foetally affected children’s service, says: “Here we are doing nothing, and we suspect we have a bigger problem than other countries because we have one of the highest rates of teenage pregnancy and binge drinking in Europe.”
Research suggests that lack of diagnosis and support leads to chronic “secondary disabilities” including clinical depression with a high risk of suicide. In theory FAS is easier to diagnose than other disorders on the spectrum because of its characteristic facial features – such as small eyes, a smooth philtrum above the lip and a thin upper lip – but it depends on digital facial photography and computer analysis which is not widely available.
“You need a documented history of involvement with alcohol before birth and obstetric and neonatal records and that’s difficult with children in care,” says Mather. “When a baby is being placed for adoption it is virtually impossible to be sure of the diagnosis.”
Frequent placement breakdowns are likely to be the result. Most referrals to the FASD clinic run by Surrey and Borders Partnership NHS Foundation Trust – the only NHS diagnostic clinic – have been for adopted or fostered children, says consultant psychiatrist Dr Raja Mukherjee. “[The carers] have parented normally before but found they were struggling with this child and have sought help. The thing that causes the biggest problem lifelong is not how you look, but how you behave.”
Addressing behaviour involves using consistent routines, simple language, repetition of instructions and rules, a structured environment and constant supervision – talking therapies do not work. And what needs to be remembered, says Mather, is that “these are not children who won’t, but children who can’t”.
The Adolescent and Children’s Trust: tinyurl.com/32hhm9w
Surrey and Borders NHS partnership NHS Trust: tinyurl.com/3x5gn5z

Source: www.guardian.co.uk September 2010

Smoking cannabis is more harmful than cigarettes and more likely to
trigger cancer, according to a report.

Just three cannabis ‘joints’ a day can cause the same amount of damage to the lungs as an entire packet of 20 cigarettes.

The British Lung Foundation says that when cannabis and tobacco are
smoked together, the harmful effects are significantly worse.

Its research suggests young cannabis smokers may also be at greater risk of throat and gullet cancers.

The foundation found that tar from cannabis joints contains 50 per cent more cancer-causing toxins than cigarettes made from tobacco alone.

Eight million Britons are thought to smoke cannabis, which some experts believe is a ‘gateway’ to harder drugs such as heroin and cocaine.

Earlier this year, researchers found that 79 per cent of children
thought cannabis was safe while only 2 per cent recognised there are
health risks from smoking the drug.

Dame Helena Shovelton, chief executive of the British Lung Foundation, said the harmful effects of cannabis had been swept under the carpet.

‘People are under the illusion it is safe to smoke cannabis. Our report
shows it is very dangerous to lung health, at least as dangerous as tobacco.

‘It seems society is in the same position as when research first showed the harm caused by tobacco. It took 15 years for the Government to take notice but we don’t want to repeat the mistakes of the past.’

Dame Helena said cannabis available today is 15 times stronger than the drug smoked in the 1960s. ‘This means studies carried out at that time will probably have underestimated the effects of cannabis smoking,’ she explained.

‘Puff and inhalation volume with cannabis is up to four times higher
than with tobacco – in other words you inhale deeper and hold your
breath with the smoke for longer before exhaling.

‘This results in more poisonous carbon monoxide and tar entering into
the lungs,’ Dame Helena said.

The foundation’s report – A Smoking Gun? – analyses research from around the world.

It found cannabis smokers have a higher level of chronic and acute
respiratory-conditions such as coughingwheezing and bronchitis. ‘When cannabis is smoked together with tobacco then the effects are additive’, it says.

Some studies suggest cannabis smoking may trigger chronic obstructive pulmonary disease which kills 32,000 people in Britain every year, the foundation’s report adds.

‘Research linking cannabis smoking to the development of respiratory
cancer exists although there have also been conflicting findings.

‘Not only does the tar in a cannabis cigarette contain many of the same carcinogens as tobacco smoke, but the concentrations of these are up to 50 per cent higher in the smoke of a cannabis cigarette,’ it says.

Benzyprene, found in the tar of cannabis joints, can change the make-up of one of the genes which suppresses tumours and could therefore make cancer more likely for people who smoke joints.

There are also more than 75 case studies of young cannabis smokers with cancers of the throat and gullet – diseases usually rare in people under 60.

Source: Daily Mail
Monday 11 Nov 2002

Troubled sleep is a commonly cited consequence of adolescent drug use, but it has rarely been studied as a cause. Nor have there been any studies of the extent to which sleep behavior can spread in social networks from person to person to person. Here we map the social networks of 8,349 adolescents in order to study how sleep behavior spreads, how drug use behavior spreads, and how a friend’s sleep behavior influences one’s own drug use. We find clusters of poor sleep behavior and drug use that extend up to four degrees of separation (to one’s friends’ friends’ friends’ friends) in the social network. Prospective regression models show that being central in the network negatively influences future sleep outcomes, but not vice versa. Moreover, if a friend sleeps ≤7 hours, it increases the likelihood a person sleeps ≤7 hours by 11%. If a friend uses marijuana, it increases the likelihood of marijuana use by 110%. Finally, the likelihood that an individual uses drugs increases by 19% when a friend sleeps ≤7 hours, and a mediation analysis shows that 20% of this effect results from the spread of sleep behavior from one person to another. This is the first study to suggest that the spread of one behavior in social networks influences the spread of another. The results indicate that interventions should focus on healthy sleep to prevent drug use and targeting specific individuals may improve outcomes across the entire social network.

Source: Mednick SC, Christakis NA, Fowler JH (2010) The Spread of Sleep Loss Influences Drug Use in Adolescent Social Networks. PLoS ONE 5(3): e9775. doi:10.1371/journal.pone.0009775

It is well-known that maternal smoking during pregnancy can have long-term effects on the physical health of the child, including increased risk for respiratory disease, ear infections and asthma. New research shows that prenatal smoking also can lead to psychiatric problems and increase the need for psychotropic medications in childhood and young adulthood.

Finnish researchers found that adolescents who had been exposed to prenatal smoking were at increased risk for use of all psychiatric drugs especially those uses to treat depression, attention-deficit/hyperactivity disorder (ADHD) and addiction compared to non-exposed youths. The study was presented Tuesday, May 4 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

“Recent studies show that maternal smoking during pregnancy may interfere with brain development of the growing fetus,” said Mikael Ekblad, lead author of the study and a pediatric researcher at Turku University Hospital in Finland. “By avoiding smoking during pregnancy, all the later psychiatric problems caused by smoking exposure could be prevented.”

Ekblad and his colleagues collected information from the Finnish Medical Birth Register on maternal smoking, gestational age, birthweight and 5-minute Apgar scores for all children born in Finland from 1987 through 1989. They also analyzed records on mothers’ psychiatric inpatient care from 1969-1989 and children’s use of psychiatric drugs.

Results showed that 12.3 percent of the young adults had used psychiatric drugs, and of these, 19.2 percent had been exposed to prenatal smoking.

The rate of psychotropic medication use was highest in young adults whose mothers smoked more than 10 cigarettes a day while pregnant (16.9 percent), followed by youths whose mothers smoked fewer than 10 cigarettes a day (14.7 percent) and unexposed youths (11.7 percent).

The risk for medication use was similar in males and females, and remained after adjusting for risk factors at birth, such as Apgar scores and birthweight, and the mother’s previous inpatient care for mental disorders.

Smoking exposure increased the risk for use of all psychotropic drugs, especially stimulants used to treat ADHD (unexposed: 0.2 percent; less than 10 cigarettes/day: 0.4 percent; and more than 10 cigarettes/day: 0.6 percent) and drugs for addiction. An increased risk for use of drugs to treat depression also was seen (unexposed: 6 percent; less than 10 cigarettes/day: 8.6 percent; and more than 10 cigarettes/day: 10.3 percent).

“Smoking during pregnancy is still quite common even though the knowledge of its harmful effects has risen in recent years,” Ekblad concluded. “Recent studies have shown that smoking during pregnancy has negative long-term effects on the health of the child. Therefore, women should avoid smoking during their pregnancy.”

Source: MediLexicon International Ltd 6th May 2010
American Academy of Pediatrics

Levels of the serotonin transporter are low in the brains of users of ecstasy, according to a US National Institute of Drug Abuse-funded study by Toronto’s Centre for Addiction and Mental Health (CAMH) and The Hospital for Sick Children (SickKids) published today in the journal Brain.
Ecstasy (MDMA) is a stimulant drug widely used recreationally that is also being tested in clinical trials for the treatment of post-traumatic stress disorder.
Led by Dr. Stephen Kish at CAMH, this study provides confirmation of a previous finding from Johns Hopkins University that levels of the serotonin transporter (SERT) are low in cerebral cortex of chronic ecstasy users. The subjects were “typical” ecstasy users who used about two tablets of the drug twice a month.
SERT is a protein responsible for regulating levels of serotonin, a neurotransmitter important for mood and impulse control. Ecstasy interacts with SERT to cause the release of serotonin, an action that probably explains some of the behavioral effects of the drug such as increased sociability.
Scientists have long suspected that ecstasy might harm brain cells that use serotonin, but 12 years of brain scan studies have produced contradictory results, even within the same laboratory.
The CAMH study used a large subject size (49 drug users, 50 control subjects), confirmed by hair analysis that ecstasy users actually used the drug, and used an imaging probe that could measure SERT throughout the brain.
“We were surprised to discover that SERT was decreased only in the cerebral cortex and not throughout the brain, perhaps because serotonin nerves to the cortex are longer and more susceptible to changes. This finding is almost identical to newer data from Johns Hopkins and is the first time that one laboratory has actually been able to replicate results of another independent laboratory in a SERT study of ecstasy users.” said Dr. Kish.
Drug hair analysis indicated that many ecstasy users, probably unknowingly, also used methamphetamine, which might itself damage serotonin cells; however, low SERT was found both in ecstasy users who used and who did not use methamphetamine. Dr. Jason Lerch at SickKids showed that those ecstasy users who also used methamphetamine had a slightly thinner cerebral cortex.
Does low SERT equal “structural brain damage”? “Not necessarily” said co-author Dr. Isabelle Boileau of CAMH. “There is no way to prove whether low SERT is explained by physical loss of the entire serotonin nerve cell, or by a loss of SERT protein within an intact nerve cell.”
Dr. Kish suggests that low SERT might explain why many ecstasy users need to keep increasing the dose to experience the same effects, since SERT is necessary for the action of ecstasy. “Most of the ecstasy users of our study complained that the first dose is always the best, but then the effects begin to decline and higher doses are needed. The need for higher doses, possibly caused by low SERT, could well increase the risk of harm caused by this stimulant drug,” said Dr. Kish.
Media Contact: Michael Torres, Media Relations, CAMH ; 416 595 6015 or email media@camh.net

Source: www.camh.net 18th May 2010-30-

Researchers have discovered that ¬consuming a very high amount of alcohol in a short time can cause irreversible damage. In the long run youngsters risk becoming absent-minded and forgetful.
Previous research found that high levels of alcohol act as a poison and prevent the brain working properly. Now scientists say that excess alcohol can actually destroy grey matter called the hippocampus, which stores and recalls events and forms mental images, known as spatial reasoning.
A US team gave alcohol for one hour a day to teenage macaque monkeys, who drank until they were drunk. Their brains produced fewer cells and suffered more neural degeneration than a control group. Last year, a survey of 35 countries found the UK had the third highest number of 15 and 16-year-olds with an alcohol problem. Girls were worse than boys.
Don Shenker, chief executive of Alcohol Concern, said the Government needed “to force the drinks industry to ensure consumers are aware of the dangers”.

Source: Daily Express 1st June 2010

MULTIPLE DRUG USE NOW THE NORM, HEROIN SHUNNED BY YOUNG
Government drug policy is too centred on heroin abuse, fails to take account of the realities of current usage trends and needs to focus on individual user behaviour if it is to reflect the true picture and formulate meaningful responses, a leading academic at National University of Ireland Maynooth urged.
‘A Dizzying Array of Substances; An Ethnographic Study of Drug Use in the Canal Communities’ is the result of a long-term study which closely examined the realities of drug use in local life of Rialto, Bluebell and Inchicore, three communities served by the Canal Communities Local Drugs Task Force. It was led by principal investigator Dr A Jamie Saris and primary field researcher Fiona O’Reilly at the Department of Anthropology, NUI Maynooth.
The ethnographic research, carried out mostly in 2008 and early 2009, gives the most compelling evidence to date that multiple drug use is the norm amongst drug users in the Canal Communities and, the researchers concluded, most probably in other areas.
“The big problem is that as far as government is concerned, ‘drugs’, from a treatment perspective, has traditionally meant heroin. Thus, the apparent leveling off of the need for a very opiate-centric treatment service in the Canal Communities in recent years is deceptive” said Dr Saris.
Besides the ethnographic work, the study surveyed, on a long term basis, 92 people using either heroin or methadone in the study area. Unsurprisingly most of those surveyed were on methadone (98%). Of those surveyed:
•63% claimed to have used heroin in the previous three months
•30% had used crack cocaine
•22% had used powder cocaine
•46% had also taken street tranquilisers
•50% were on prescribed tranquillisers, and
•60% had also smoked cannabis within the past three months.
“The majority of those registered on the methadone treatment programme are also using a cocktail of other substances, very often including heroin. Multiple drug use is the reality for nearly all users, and official policy needs to have this understanding at its centre”, Saris said.
In the course of their study, the research team also noted a strong stigma against heroin use amongst the 16-25 age group who still regularly used a lot of other substances, including cocaine and off-label prescription medication. “The reality is that these people are difficult for a treatment infrastructure built around opiates to service. If they have issues, they are more difficult to address,” said Saris.
” The stress that policy-makers and community activists place on ‘crack’ or ‘heroin’ or any other single drug as clear and present social dangers obscures the ubiquity of polydrug use. It makes it appear that these users are very different from other drug-users in the rest of society including cannabis and recreational cocaine users, and it also obscures how commonly legal pharmaceuticals, such as benzodiazepines, even methadone itself, are regularly consumed ‘illegally’.”
He said that a focus on drug use alone is the mistake. “The lives we examined, however damaged by an attraction to certain pharmaceuticals, are rarely defined solely by such behaviour. These people are also sons and daughters, fathers and mothers, partners and lovers, as well as employees and community members. This sensibility does in fact inform a lot of local community activities aimed at assisting users, but such work is often difficult to justify to official funders under the rubric of ‘treatment’, as currently understood. Unless we can understand who users are, what they are taking and why, we will not be able to assign the appropriate resources, treatments or management systems.”
Tony MacCarthaigh, chairperson of the Canal Communities Local Drugs Task Force commented that “individuals and not chemicals need to become the focal point of treatment, and treatment needs to assist individuals in developing another orientation not just to drugs, but to life”.
Source: www.addictiontoday.org 9th July 2010

 Around 44 0000 people have been recorded as entering specialised drug treatment centres in Europe in 2008 in 29 countries; data mainly cover outpatient and inpatient treatment centers
 Most clients enter treatment on their own initiative or under the pressure of family and friends (43 %); 27 % go to drug treatment through health or social services, including other drug treatment centres; around 20 % are referred to treatment by the criminal justice system, and the remaining through other referral sources
 The most frequent reason for entering treatment in 2008 (or most recent year available), is the use of heroin (48 % of all drug users and around 200 000 people), followed by cannabis (21 % and around 85 000 people) and cocaine use, (17 % and around 70 000 people), use of stimulants other than cocaine (5 % and around 22 000 clients) and other drugs use, which include hypnotics and sedatives, hallucinogens, volatile and other substances
 Among those who have entered treatment for the first time in their life the proportion of heroin users is lower and that of cocaine, cannabis users and clients consuming stimulants other than cocaine (mainly amphetamine and methamphetamine) is higher
 Differences between countries are relevant with 18 countries reporting more than 50 % of primary opioid users among drug clients, 8 countries with more than 20 % of primary cannabis clients and 3 countries with more than 20 % of cocaine clients.
 Stimulants other than cocaine, which will be the subject of one of 2010 selected issue are concentrated in some countries, namely the Scandinavian countries (amphetamine), Czech Republic and Slovakia (methamphetamine)
 Clients are mainly males (4 males for every female), with a mean age 31 years (those who have entered treatment for the first time are on average 1 year younger)
 Most clients start their drug use before the age of 20, around one third of the clients inject their primary drug, and the frequency of use varies by the main drug (the highest proportion of daily users is found among opioid clients and the lowest among users of stimulants other than cocaine)
 Social conditions of drug users entering treatment are generally poorer than in the general population (education, living and labour conditions)
 Differences are reported by primary drug and by country regarding gender, age distribution and patterns of drug use

 Recent comparable data on young people’s use of alcohol and drug come largely from surveys of 15- to 16-year-old school students. The European School Survey Project (ESPAD) conducted surveys in 1995, 1999, 2003 and more recently, 2007. The 2007 survey (Hibell et al., 2009) provides comparable data from 25 EU Member States as well as Norway and Croatia. Five countries conducted their own school surveys in 2008 (Belgium-Flemish Community, Spain, Italy, Sweden, United Kingdom-England)
 The latest ESPAD survey data from 2007 reveal that the highest lifetime prevalence of cannabis use among 15- and 16-year-old school students is in the Czech Republic (45 %) (Figure EYE-1 part (ii)). High lifetime prevalence estimates, ranging from 26 % to 32 %, are also reported in Estonia, France, the Netherlands, the Slovak Republic and the United Kingdom.
 Increases in cannabis use occurred in a number of European countries between 1995 and 2003 but have, in general, come to a halt or decreased more recently. Seven countries mainly located in Northern and Southern Europe (Greece, Cyprus, Malta, Romania, Finland, Sweden, Norway) reported overall stable and low lifetime prevalence of cannabis use during the whole period. Other western European countries, as well as Croatia and Slovenia, have shown a significant increase of lifetime cannabis use up to 2003 and since then nine of these reported a decrease of more than three percentage points, two were stable and none reported an increase. In most of central and eastern Europe the increasing trend observed between 1995 and 2003 seems not to have been reversed yet. In this region, two out of eight countries report increases of more than three percentage points since 2003, six or more a stable situation and none a significant decrease. In the five countries that conducted national school surveys in 2008, all reported stable or lower lifetime prevalence of cannabis use than reported in 2007 (Table EYE-11).
 Increases in lifetime cannabis use between 1995 and 2003 in Europe were in some countries accompanied by increases in the prevalence of cigarette smoking among school students. Since 2003, both trends have reversed, suggesting a possible link between tobacco and cannabis smoking.
 Estimates of the prevalence of other drug use among school students are much lower than those for cannabis use. For example, lifetime prevalence of cocaine use among 15- to 16-year-old school students is between 1 % and 2 % in half of the 28 reporting countries. Most of the remaining countries report prevalence levels of between 3 % and 4 %, while Spain, France, and the United Kingdom report 5 %. Among the five countries that conducted school surveys in 2008, two reported a decrease of 1%, one reported an increase of 1%, and two reported no change since the last survey (Table EYE-11). However, caution is required interpreting trends with such low prevalence.
 In the countries conducting their own national school surveys, drug prevalence questions may be considered comparable to the ESPAD questions but other aspects of the method mean the data are not strictly comparable.
Source: EMDDA July 10 2010

Q: How can I tell if my child has been using marijuana?
A: There are some signs you might be able to see. If someone is high on marijuana, he or she might:

• Seem dizzy and have trouble walking;
• Seem silly and giggly for no reason;
• Save very red, bloodshot eyes; and
• Have a hard time remembering things that just happened.

When the early effects fade, the user can become very sleepy.

Parents should be aware of changes in their child’s behavior, although this may be difficult with teens. Parents should look for withdrawal, depression, fatigue, carelessness with grooming, hostility and deteriorating relationships with family members and friends.

In addition, changes in academic performance, increased absenteeism or truancy, lost interest in sports or other favorite activities, and changes in eating or sleeping habits could be related to drug use. However, these signs may also indicate problems other than using drugs.

In addition, parents should be aware of:

• Signs of drugs and drug paraphernalia, including pipes and rolling papers;
• Odor on clothes and in the bedroom;
• Use of incense and other deodorizers;
• Use of eye drops; and
• Clothing, posters, jewelry, etc., promoting drug use.

Source: The National Institute on Drug Abuse 2010

Troubled sleep is a commonly cited consequence of adolescent drug use, but it has rarely been studied as a cause. Nor have there been any studies of the extent to which sleep behavior can spread in social networks from person to person to person. Here we map the social networks of 8,349 adolescents in order to study how sleep behavior spreads, how drug use behavior spreads, and how a friend’s sleep behavior influences one’s own drug use. We find clusters of poor sleep behavior and drug use that extend up to four degrees of separation (to one’s friends’ friends’ friends’ friends) in the social network. Prospective regression models show that being central in the network negatively influences future sleep outcomes, but not vice versa. Moreover, if a friend sleeps ≤7 hours, it increases the likelihood a person sleeps ≤7 hours by 11%. If a friend uses marijuana, it increases the likelihood of marijuana use by 110%. Finally, the likelihood that an individual uses drugs increases by 19% when a friend sleeps ≤7 hours, and a mediation analysis shows that 20% of this effect results from the spread of sleep behavior from one person to another. This is the first study to suggest that the spread of one behavior in social networks influences the spread of another. The results indicate that interventions should focus on healthy sleep to prevent drug use and targeting specific individuals may improve outcomes across the entire social network.
Source: Mednick SC, Christakis NA, Fowler JH (2010) The Spread of Sleep Loss Influences Drug Use in Adolescent Social Networks. PLoS ONE 5(3): e9775. doi:10.1371/journal.pone.0009775

A recent study by investigators at the Vanderbilt Kennedy Center for Research on Human Development may help explain the long-term behavioral and neurological problems associated with prenatal exposure to cocaine. In a recent issue of the Journal of Neuroscience, Gregg Stanwood, Ph.D., and Pat Levitt, Ph.D., report that prenatal cocaine exposure in rabbits causes a long lasting displacement of dopamine receptors in certain brain cells, which alters their ability to function normally.
Though this effect has not yet been assessed in cocaine-exposed children, the findings give researchers a place to start looking.
“The hysteria surrounding the ‘crack baby’ was sort of overblown,” said Stanwood, research assistant professor of Pharmacology and lead author on the study.
Incredibly high levels of cocaine — usually coupled with the abuse of other drugs — can lead to premature labor, preterm birth and low birth weight, Stanwood said.
“But in women who have abused relatively low recreational doses of cocaine, it is actually very hard to distinguish those children at birth from children born to anyone else,” he said. “However, as those children age, they do develop deficits in their cognitive and emotional development.”
These children often exhibit attention and arousal problems, similar to children with attention deficit hyperactivity disorder (ADHD). However, the standard treatments for ADHD — Ritalin and other stimulants — are not always effective in these children.
Studying the effects of prenatal cocaine exposure on the developing brain is difficult in human populations because cocaine abusers often abuse other drugs. Animal models can help determine how prenatal cocaine exposure might influence brain development to cause these subtle cognitive impairments.
“We thought that it was important to set up an animal model that recapitulates a key feature of human abuse — that being intravenous exposure to low doses of cocaine,” Stanwood said.
A few years ago, Stanwood and Levitt, professor of Pharmacology and director of the Vanderbilt Kennedy Center, established such a model in rabbits. They found that exposure to low levels of intravenous cocaine during a very short window of time during gestation — equivalent to the late first trimester and early second trimester in humans — caused specific alterations in brain circuits that use the neurotransmitter dopamine. Additionally, these cocaine-exposed offspring showed attention problems as well as insensitivity to stimulants like amphetamine, suggesting that cocaine exposure had altered the development of the dopamine pathways in the brain.
“In collaboration with Dr. Eitan Friedman of the City University of New York, we had previously shown a decrease in signaling of a particular receptor protein, the dopamine D1 receptor,” Stanwood said. “We know that this receptor is involved in regulating the formation of cortical circuitry. It’s also involved in the behavioral effects of amphetamines and cocaine.”
“The current study was an attempt to look at the mechanism of this decrease in D1 receptor signaling,” he said.
Stanwood examined the levels of D1 receptor in brain cells taken from “teenage” rabbits that were exposed to cocaine during that short, sensitive prenatal period.
He found that cocaine exposure did not alter the total amount of D1 receptor produced in the brain. However, there was a dramatic alteration in the location of the protein within the cell.
“It’s not where it should be,” he said. D1 receptors are normally found at the cell surface, but neurons from the cocaine-exposed animals showed the receptor was predominantly sequestered inside the cells.
“The fascinating thing is that this effect appears permanent,” said Stanwood. This implies that cocaine exposure during a brief, sensitive period of neural development can lead to long-lasting effects at the cellular level.
This change also altered the growth of neuronal processes, suggesting that the altered D1 receptor trafficking may underlie the changes in neuronal architecture and behavior that Stanwood and others have previously observed.
What remains to be determined, he cautioned, is whether D1 receptor localization is affected in humans exposed to cocaine prenatally.
If found in humans, “it gives us a new way to think about helping those children as they continue to mature.” Because cocaine exposure seems to alter the distribution of the D1 receptor, Stanwood suggests that researchers might find a way to “steer” the receptor into the correct cellular location. That could provide new avenues for treating the attention problems in cocaine-exposed children, as well as in children with stimulant-resistant ADHD.
“Neither we nor anyone else has yet identified whether this mechanism occurs in the human population,” Stanwood said, “so that is a critical next step.”
Note: This story has been adapted from a news release issued by Vanderbilt University Medical Center.

Source ScienceDaily.com 13th January 2007

The Journal of Pediatrics has published a new study which brings to light another troubling consequence of smoking marijuana, particularly during pregnancy.
“Barros and her team looked at 561 infants born to adolescent mothers. Twenty-six of them had been exposed to marijuana, as revealed by tests on the mother’s hair and the infant’s stool. Just one of the mothers had reported smoking pot while pregnant.
Trained examiners, who did not know a child’s marijuana exposure status, tested the neurobehavioral responses of all infants. On average, marijuana-exposed infants scored differently on measures of arousal, regulation and excitability compared to the non-exposed infants…
..Infants exposed to marijuana in the womb show subtle behavioral changes in their first days of life, researchers from Brazil report.
These newborns were more irritable than non-exposed infants, less responsive, and more difficult to calm, Dr. Marina Carvalho de Moraes Barros and colleagues from the Federal University of Sao Paulo and colleagues report. They also cried more, startled more easily, and were more jittery. Such changes, Barros and her team say, have the potential to interfere with mother-child bonding.
Here’s the key point: “It is necessary to counter the misconception that marijuana is a ‘benign drug’ and to educate women regarding the risks and possible consequences related to its use during pregnancy,” Barros and colleagues conclude.”

Source: Journal of Pediatrics Vol.149 Issue 6 Dec. 2006

BY LORI WHITTEN, NIDA Notes Staff Writer

NIDA-supported researchers Dr. Cheryl Kirstein and Ms. Kirstie Stansfield at the University of South Florida have found that higher scores on tests of impulsivity and some behavioral responses to novelty correlate with a heightened biological response to cocaine in adolescent, but not adult, rats. The findings accord well with scientists’ widely shared view that developmental differences in brain systems that use the neurotransmitter dopamine underlie age differences in susceptibility to drug abuse.
Dr. Kirstein and Ms. Stansfield conducted a series of behavioral assays to rate rats’ relative responsiveness to novelty, then compared these results with measures of dopamine release in the reward pathway after an injection of cocaine. First, they put adolescent rats (34 days old, which is roughly equivalent to adolescence in people) and fully mature rats (59 days old, equivalent to human young adulthood) through four behavioral protocols. The tests measured activity in a new environment (how much the rat moved around when put into a new cage); impulsivity (how quickly it approached a new object placed into its cage); exploratory drive in response to a new object (how many times it approached the object in a given period of time); and attraction to new objects (what percentage of a given time interval was spent close to the object).
The researchers then injected the animals with saline and then, 2 hours later, with cocaine 20 mg/kg. Every 10 minutes, starting immediately after the saline injection and continuing until 2 hours after administering the cocaine, they measured the concentrations of the neurotransmitter dopamine and its major metabolite in the rats’ nucleus accumbens (NAc). The measurements were made using the technique of in vivo microdialysis. By the time of the last measurement, the drug had cleared the animal’s system.
ON MOST TESTS, AGE MATTERS
In their analysis, the researchers compared cocaine-induced dopamine release in animals that had responded above the mean level on each test (high responders, HR) to those who had scored below the mean (low responders, LR). The results revealed that among both the adult and adolescent rats, those that exhibited greater activity in a new environment also demonstrated enhanced dopamine release following a cocaine injection. This was the only test, however, in which age did not influence cocaine-induced dopamine release. The other behavioral assays revealed interactions between age and the response to novelty on cocaine-induced dopamine release in the NAc:
• Impulsivity—Adolescent rats with above-the-mean impulsivity scores released more dopamine in response to cocaine than their age mates who were LR. Mature rats exhibited no clear relationship between impulsivity and cocaine-induced dopamine response.
• Exploration of a new object—Adolescent rats with above-the-mean scores on this measure released more dopamine in response to cocaine than their age mates who were LR. Adult rats showed the opposite pattern: Animals with above-the-mean scores showed attenuated cocaine-induced dopamine release compared with age mates who were LR.
• Attraction to a new object—Adolescent rats exhibited no clear relationship between reactivity on this assay and cocaine-induced dopamine release. Mature rats with above-the-mean scores released less dopamine in response to cocaine compared with their age mates who were LR.
Dr. Kirstein’s finding that for all the animals, greater activity in a new environment corresponded with increased sensitivity to stimulants is consistent with earlier research. Her team’s mixed findings on the impulsivity and other novelty response tests indicates, she says, that those behaviors arise from different physiological mechanisms than does locomotor activity. “My colleagues and I think locomotor activity may reflect primarily dopamine activity in a brain circuit involved with generating and controlling movement. Novelty may instead differentially stimulate mesolimbic dopamine—a pathway implicated in attention as well as reward and motivation,” says Dr. Kirstein.
In Vivo Microdialysis
The investigators used In Vivo microdialysis to measure dopamine each animal released from its nucleus accumbens (NAc) in response to cocaine. They implanted a probe into the shell area of the NAc. The probe is a fine tube, about the size of a sewing needle, connected to a mini-pump that continuously perfuses it with artificial cerebrospinal fluid. The membrane tip of the probe captures dopamine and its metabolites. The samples collected by the needle are then analyzed using techniques, such as chromatography, that are able to isolate dopamine and its metabolites from other molecules.
INHIBITION DEVELOPS LATER
The findings on the three tests where age affected the relationship between behavior and cocaine-induced dopamine release may reflect maturation of the brain’s reward circuit. When rats are adolescents, dopamine-producing and releasing cells in this circuit may be particularly sensitive both to novelty and to pharmacological stimulation. As part of normal neurological development, areas of the brain that dampen the activity of this circuit come “online” later, explaining the age-related differences observed in Dr. Kirstein’s study. “The mesolimbic pathway and the cortical areas that inhibit it to regulate dopamine release are not yet fully matured in the adolescent, and this may explain why the adolescent brain responds to drugs differently than the adult brain,” says Dr. Kirstein.
“The results of Dr. Kirstein’s study, along with other animal research on the interaction of drugs and developmental stage, indicate that the adolescent brain is more responsive to drugs than the adult brain—both neurochemically and behaviorally,” says Dr. Nancy Pilotte of NIDA’s Division of Basic Neuroscience and Behavioral Research. Studies that identify the physiological and behavioral processes underlying age-related susceptibility to addiction complement epidemiological work on the individual and social factors contributing to adolescent vulnerability to substance abuse.

SOURCE NIDA Notes Vol. 21, No. 2 (February 2007)
Stansfield, K.H., and Kirstein, C.L. Neurochemical effects of cocaine in adolescence compared to adulthood. Developmental Brain Research 159(2):119-125, 2005.

<span style=”font-size: 10pt; font-family: Verdana;”> Abstract: The use of Cannabis sativa preparations, such as hashish and marijuana, is wide-spread among young people, including pregnant women. Despite this concern, the consequences of cannabis exposure on the brain during periods of active brain development, such as the prenatal phase and adolescence, is not well known. Several epidemiological studies support the cannabis gateway hypothesis, where early cannabis use is suggested to increase the risk of initiating use of other illicit drugs, e.g., amphetamine or heroin. However, the nature of such direct links are unclear. Therefore, the aim of this thesis was to test experimentally the cannabis gateway hypothesis, i.e., to determine whether cannabis exposure during periods of active brain development alters reward-related behavior and neurobiology for psychostimulant and opioid drugs by the use of animal models.
In the first study, we examined the effects of early adolescent exposure (postnatal day; PND; 28-32, one injection per day) with the synthetic cannabinoid CB1 receptor agonist WIN55,212-2 and the main psychoactive substance in C. sativa, Δ9-tetrahydrocannabinol (THC) on amphetamine-induced motor behavior and dopamine release in the nucleus accumbens during adolescence. No alterations were evident in the cannabinoid exposed rats, results which did not support the cannabis gateway hypothesis in relation to subsequent psychostimulant abuse.
Next, we investigated the effects of adolescent exposure on subsequent opioid reward-related behavior and the neurobiology of opioid and cannabinoid systems during adulthood. We studied THC exposure across the full adolescent period (PND 28-49), and administered the drug once every third day in order to better mimic the pattern of intermittent use seen in teenagers. The results revealed discrete opioid-related alterations within brain regions highly implicated in reward and hedonic processing (e.g., increased proenkephalin gene expression in the nucleus accumbens and increased mu opioid receptors in the ventral tegmental area). This was coupled to increased heroin intake in a self-administration paradigm and increased morphine conditioned place preference, indicating altered sensitivity to the reinforcing properties of opioids.
Furthermore, in evaluating the adolescent ontogeny of the opioid and cannabinoid systems within limbic-related brain areas, we found that active endocannabinoid- and opioid- related neurodevelopment takes place to a very high extent during this period. Most pronounced were the alterations in endocannabinoid levels in cognitive brain areas, even though alterations were also apparent in reward-related regions.
Finally, we investigated the effects of prenatal cannabis exposure (gestational day 5- PND 2) on subsequent opioid reward-related behavior and neurobiology of the opioid and cannabinoid systems in adulthood. Similar to adolescent cannabis exposure, prenatal exposure induced discrete opioid-related alterations within brain regions highly implicated in reward and hedonic processing. Moreover, elevated heroin-seeking observed during extinction and after food deprivation was evident in the THC exposed rats, suggesting an increased motivation for drug use under conditions of stress.
Taken together, this thesis presents neurobiological support for the cannabis gateway hypothesis in terms of adult opiate, but not amphetamine, abuse, with underlying long-term disturbances of discrete opioid-related systems within limbic brain regions.

<em>Source: Ellgren, Maria Karolinksa Institute Sweden ISBN: 978-91-7357-064-0  Feb.2007
</em>
<span style=”font-size: 10pt; font-family: Verdana;”>

Strategies teenagers use to minimise alcohol-related harm
• Aims: To examine strategies of harm minimization employed by teenage drinkers.
• Findings: The teenagers participating in the present study were more concerned about social than health risks. The informants monitored their own level of intoxication, but in order to reduce alcohol consumption they depended upon support from their peers. The informants preferred drinking in the company of well-known and trusted peers, and during drinking episodes they supervised and intervened in each others’ drinking to the extent that they deemed it necessary and possible. In regulating the social context of drinking they relied on their personal experiences more than on formalized knowledge about alcohol and harm, which they had learned from prevention campaigns and educational programmes.
• Conclusions: The study found that teenagers may help each other to minimize alcohol-related harm, and teenage peer groups should thus be considered a resource for health promotion.
Morten Hulvej Jørgensen, Tine Curtis, Pia Haudrup Christensen, Morten Grønbæk (2007) Harm minimization among teenage drinkers: findings from an ethnographic study on teenage alcohol use in a rural Danish community

Source: Addiction 102 (4), 554–559

Viewing videotape of themselves while experiencing delirium tremens could reduce the relapse rate in alcohol-dependent patients
• The aim of this prospective randomized controlled study was to determine whether viewing videotape of themselves while experiencing delirium tremens (DT) reduces the relapse rate in alcohol-dependent patients.
• Findings: The patients with videotape experience had a significantly lower relapse rate after the first month (0% versus 20%), 2 months (13.33% versus 46.67%) and 3 months (26.67% versus 53.33%). Patients with videotape experience had less severe relapses and consumed fewer units of alcohol than controls.
• Conclusions: Videotape exposure in delirium tremens is an original therapeutic method which seems to be effective in reducing relapse risk in patients with alcohol dependence.
Adriana Mihai, Cristian Damsa, Michael Allen, Bertrand Baleydier, Coralie Lazignac, Andreas Heinz (2007) Viewing videotape of themselves while experiencing delirium tremens could reduce the relapse rate in alcohol-dependent patients

Source: Addiction 102 (2), 226–231.

Summary

Heavy drinking and smoking as teenagers may damage the ability to remember future tasks, according to new research.
The findings are drawn from two studies exploring teenagers’ capacity for prospective memory – the ability to remember something you had intended to do in the future, such as returning a phone call or paying a bill on time.
In one study, 108 students aged 16 to 19 years old were asked to report the number of times that prospective memory had failed them recently. Teenagers who were “excessive” alcohol users were significantly less likely to remember future tasks, the researchers found.
A second study found that teenage smokers reported more memory lapses in general than non-smokers, and also reported fewer items in a prospective memory test.
The findings are being presented today at the British Psychology Society’s annual conference at the University of York.
The society said that although evidence exists suggesting alcohol abuse has a detrimental effect on memory for past events, little was known before now about its impact on prospective memory.
Thomas Heffernan of the University of Northumbria, who led the research, said: “The teenage years are important for structural and functional development of the brain.
“If our findings are confirmed, they suggest that heavy drinking and smoking in the teenage years may impede this important development. This may lead to greater problems with memory later in life.”

Source:Thursday March 22, 2007 SocietyGuardian.co.uk

Abstract:
The use of Cannabis sativa preparations, such as hashish and marijuana, is wide-spread among young people, including pregnant women. Despite this concern, the consequences of cannabis exposure on the brain during periods of active brain development, such as the prenatal phase and adolescence, is not well known. Several epidemiological studies support the cannabis gateway hypothesis, where early cannabis use is suggested to increase the risk of initiating use of other illicit drugs, e.g., amphetamine or heroin. However, the nature of such direct links are unclear. Therefore, the aim of this thesis was to test experimentally the cannabis gateway hypothesis, i.e., to determine whether cannabis exposure during periods of active brain development alters reward-related behavior and neurobiology for psychostimulant and opioid drugs by the use of animal models.
In the first study, we examined the effects of early adolescent exposure (postnatal day; PND; 28-32, one injection per day) with the synthetic cannabinoid CB1 receptor agonist WIN55,212-2 and the main psychoactive substance in C. sativa, Δ9-tetrahydrocannabinol (THC) on amphetamine-induced motor behavior and dopamine release in the nucleus accumbens during adolescence. No alterations were evident in the cannabinoid exposed rats, results which did not support the cannabis gateway hypothesis in relation to subsequent psychostimulant abuse.
Next, we investigated the effects of adolescent exposure on subsequent opioid reward-related behavior and the neurobiology of opioid and cannabinoid systems during adulthood. We studied THC exposure across the full adolescent period (PND 28-49), and administered the drug once every third day in order to better mimic the pattern of intermittent use seen in teenagers. The results revealed discrete opioid-related alterations within brain regions highly implicated in reward and hedonic processing (e.g., increased proenkephalin gene expression in the nucleus accumbens and increased mu opioid receptors in the ventral tegmental area). This was coupled to increased heroin intake in a self-administration paradigm and increased morphine conditioned place preference, indicating altered sensitivity to the reinforcing properties of opioids.
Furthermore, in evaluating the adolescent ontogeny of the opioid and cannabinoid systems within limbic-related brain areas, we found that active endocannabinoid- and opioid- related neurodevelopment takes place to a very high extent during this period. Most pronounced were the alterations in endocannabinoid levels in cognitive brain areas, even though alterations were also apparent in reward-related regions.
Finally, we investigated the effects of prenatal cannabis exposure (gestational day 5- PND 2) on subsequent opioid reward-related behavior and neurobiology of the opioid and cannabinoid systems in adulthood. Similar to adolescent cannabis exposure, prenatal exposure induced discrete opioid-related alterations within brain regions highly implicated in reward and hedonic processing. Moreover, elevated heroin-seeking observed during extinction and after food deprivation was evident in the THC exposed rats, suggesting an increased motivation for drug use under conditions of stress.
Taken together, this thesis presents neurobiological support for the cannabis gateway hypothesis in terms of adult opiate, but not amphetamine, abuse, with underlying long-term disturbances of discrete opioid-related systems within limbic brain regions.
ISBN: 978-91-7357-064-0

Source: Karolinska Institute online 9th Feb.2007

Abstract: Spano MS, Ellgren M, Wang X, Hurd YL.

Karolinska Institute, Department of Clinical Neuroscience, Psychiatry Section, S-17176 Stockholm, Sweden.

BACKGROUND: Prenatal cannabis exposure is a growing concern with little known about the long-term consequences on behavior and neural systems relevant for reward and emotional processing.
METHODS: We used an animal model to study the effects of prenatal exposure to Delta(9)-tetrahydrocannabinol (THC) on heroin self-administration behavior and opioid neural systems in adult males (postnatal day 62). Rats were exposed to THC (.15 mg/kg) or vehicle from gestational day 5 to postnatal day 2. RESULTS: Both pretreatment groups showed similar heroin intake, but THC-exposed rats exhibited shorter latency to the first active lever press, responded more for low heroin doses, and had higher heroin-seeking during mild stress and drug extinction. THC exposure reduced preproenkephalin (PENK) mRNA expression in the nucleus accumbens during early development, but was elevated in adulthood; no adult striatal changes on preprodynorphin mRNA or PENK in caudate-putamen. PENK mRNA was also increased in the central and medial amygdala in adult THC-exposed animals. THC animals had reduced heroin-induced locomotor activity and nucleus accumbens mu opioid receptor coupling.
CONCLUSIONS: This study demonstrates enduring effects of prenatal THC exposure into adulthood that is evident on heroin-seeking behavior during extinction and allostatic changes in mesocorticolimbic PENK systems relevant to drug motivation/reward and stress response.

Source: : Biol Psychiatry. 2007 Feb 15;61(4):554-63. Epub 2006 Jul 28.

Research Summary

A study of U.S. Marine Corps recruits conducted in San Diego adds further weight to previous findings that early-age drinking increases the risk of problem drinking later, MedPage Today reported Dec. 5.
The study looked at 41,482 male recruits and found that those who had begun drinking at age 13 or earlier were 5.5 times more likely to be engaging in risky drinking. Other factors associated with risky drinking included engaging in smoking, coming from a rural or small-town community, enduring childhood sexual or emotional abuse, and experiencing alcohol abuse or mental illness in the household.
Researchers led by Margaret Ryan, M.D., M.P.H., of the Naval Health Research Center, used three alcohol consumption questions on the Alcohol Use Disorders Identification Tests (AUDIT-C) to measure risky drinking. A total of 14.8% of the recruits were categorized as risky drinkers; 45.1% were non-risky drinkers and 40.2% were non-drinkers.
Some factors that were inversely associated with risky drinking in the study included being married and attending religious services at least weekly.
The researchers concluded that the study results reinforce the need for public health efforts to prevent tobacco use and child abuse. An important question to be answered is whether reducing youth smoking would also reduce risky drinking, they said.

Source: Archives of Pediatrics and Adolescent Medicine. Dec. 2006

Smoking marijuana as a teenager could raise the risk of developing schizophrenia and psychotic symptoms as a young adult, according to a new study that compared the prevalence of mental illness among marijuana users and non-users.
Bloomberg News reported March 2 that researcher John McGrath of the University of Queensland, Australia, and colleagues studied 3,801 young-adult sibling pairs and concluded that those who used marijuana the longest (six or more years) were twice as likely to develop schizophrenia or delusional disorders. They also were four times more likely than non-users to score highly on a test gauging psychotic-like experiences.
Higher scores on the test also were seen among those who used marijuana for less than three years.

Source: www.jointogether.org March 2010

 Marijuana use at a young age significantly increased the risk of psychosis in young adulthood, Australian investigators reported.

Young adults who reported a longer duration since first exposure to marijuana had a two- to fourfold greater prevalence of three different psychosis-related outcomes, John McGrath, MD, PhD, of the Queensland Center for Mental Health Research in Wacol, and colleagues concluded in an article published online in Archives of General Psychiatry.

Apart from the implications for policy makers and health planners, we hope our findings will encourage further clinical and animal model-based research to unravel the mechanisms linking cannabis use and psychosis, the researchers concluded.

Several prospective-cohort studies have demonstrated an association between early marijuana use and an increased risk of psychosis. On the basis of such studies, reviews of the issue have generally concluded that early use of marijuana, or cannabis, is a modifiable risk factor for psychosis-related outcomes, the authors wrote.

However, some concern has persisted about potential methodologic biases and unmeasured confounders in the cohort studies. In an effort to address the concern, McGrath and colleagues examined the association between cannabis use and psychosis in 3,800 participants in a long-term evaluation of pregnancy and outcomes. In contrast to prior cohort studies, the authors incorporated a subset analysis involving 228 sibling pairs.

“If a significant association between cannabis use and psychosis-related outcomes was not detected in sibling pairs, it would seriously weaken the argument that cannabis use was a risk-modifying factor for psychosis-related outcomes,” they wrote.

Participants were born between 1981 and 1984 at a single hospital in Brisbane. Mothers and their offspring were followed up at five, 14, and 21 years after birth. At the 21-year follow-up, McGrath and colleagues retrospectively assessed cannabis use among the offspring, whose age averaged 20 and ranged from 18 to 23.

Cannabis use was assessed by means of the young adults’ responses to two questions: In the last month, how often did you use cannabis, marijuana, pot, etc.? At what age did you first use cannabis?
Possible responses to the first question were never, every day, every few days, once or so, and not in the past month.

Investigators separated the cohort into four groups on the basis of self-reported cannabis use. One group included never-users, and the remaining three groups were categorized by duration since first use of cannabis: three years or less, four to five years, six years or more.

Investigators compared participants’ history of cannabis use with three psychosis-related outcomes: non-affective psychosis, hallucinations (assessed by the Computerized International Diagnostic Interview), and the Peters et al Delusions Inventory (PDI) score (Schizophr Bull 2004; 30: 1005-1022).

The authors found that 65 participants met criteria for a diagnosis of non-affective psychosis, and 233 reported at least one hallucination-related incident. The PDI has a score range of 0-21, and participants were grouped into PDI quartiles representing scores of =2, 3 or 4, 5 to 7, and =8.

The authors analyzed the results by means of two statistical models, one adjusted for participant sex and age at testing and the other adjusted for sex, age at testing, presence of hallucinations at the 14-year follow-up, and parental history of mental illness.

Using never-users as the reference, the odds ratio for non-affective psychosis increased from 1.5 to 2.1 or 2.2 in the two models as duration of first cannabis use increased. The odds for hallucinations increased from 1.4 to 2.5 and 1.5 to 2.8.

Comparing the lowest and highest quartiles of PDI scores, the authors found that the odds of a higher score increased from 1.6 to 4.0 or 4.3 as duration since first cannabis use increased.  Associations for all three psychosis-related outcomes were statistically significant in both models (P=0.001 to P<0.001).

The sibling analysis was limited to the PDI scores. For each pair, the authors calculated difference scores for duration since first cannabis use and PDI total score. The association between time since first cannabis use and PDI score remained statistically significant in the sibling subset analysis.

Limitations of the study included: retrospective self-reporting of time since first cannabis use, lack of data on cumulative exposure to cannabis, no clinical validation of non-affective psychosis diagnosis and lack of use of the instrument at the 14-year follow up, and loss of participants at the 21-year mark with significant differences in the group lost to follow up compared with those retained.

Source:. “Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults” Arch Gen Psychiatry 2010; DOI: 10.1001/archgenpsychiatry.2010.6.

My first appointment was with Dr Diana Fishbein, a Senior Fellow in behavioral neuroscience at the Research Triangle Institute (RTI) which is an international not-for-profit research organisation .

Diana is the Director of the Transdisciplinary Behavioural Science Program at RTI. In this role she focuses on bringing interdisciplinary teams of researchers together to try to answer some of the big questions that need to be asked in the behavioural sciences. Her overarching goal is to focus on the nexus between research and practice and to facilitate the “Translation of Research into Evidence Based Practice”. In fact RTI International organisational by line is Turning Knowledge into Practice.    

Diana’s personal research career has been in the area of criminology and drug abuse taking a prevention science approach.  She is particularly interested in why some young people respond well to a prevention approach while others don’t, and ultimately in determining “who responds to what treatment at what time point and why”?

To explore these questions she uses interdisciplinary methods and a developmental approach and sees the plasticity of neurobiological systems as one of the keys to finding the answer. Dr. Fishbein  pointed out that neuroplasticity enables neurobiological systems to be shaped by inputs from the environment and so can be altered for better or worse depending on the nature of these inputs. This is highly relevant to a prevention or early intervention approach and can guide the development of interventions. Research in this area is now beginning to focus on the mechanisms through which developmental risk factors impact on the developing systems and also on the type of interventions which have the most impact, how they are affecting neuroplastic change and when they are having the most effect.  

For instance there is evidence that the neurobiological functions underlying drug misuse and aggression are quite complex and include executive functioning, coping skills and affect regulation. The part of the brain associated with these functions (prefrontal-limbic brain networks) is not consolidated until early adulthood. Therefore is we can understand the type, effect and developmental timing of environmental impact on this brain function we may be able to plan intervention programs that alter negative impact and increase positive impact.  We may also need to tailor interventions to particular risk factors in the young person’s environment. Diana is confident this translational approach promises to eventually offer some direction for the design of effective interventions to prevent drug misuse and associated aggression.

This cutting-edge evidence-based research with the capacity to not only make a difference but to provide us with the scientific evidence to show how change has come about.  The message that again seems to be coming through to me is that one size is not likely to fit all. The other message is one that Professor Alan Hayes a member of the external advisory group for this project has written about in his chapter entitled Why early in life is not enough! (Hayes, 2007. In France, A & Homel, R (Eds) Pathways and crime prevention: Theory policies and practice  Willian (pps 202-225)

Dr Fishbein and I also talked about the need for parent and community involvement in interventions.  She also indicated to me that she and her organisation are very interested in innovative collaborative international research. Perhaps this is something to think about for the future.

Source: http://shapingbrains.wordpress.com  3^rd March 2010

Researchers have discovered that even a small amount of MDMA, better known as ecstasy, can be harmful to the brain, according to the first study to look at the neurotoxic effects of low doses of the recreational drug in new ecstasy users. The findings were presented today at the annual meeting of the Radiological Society of North America (RSNA).

“We found a decrease in blood circulation in some areas of the brain in young adults who just started to use ecstasy,” said Maartje de Win, M.D., radiology resident at the Academic Medical Center at the University of Amsterdam in the Netherlands. “In addition, we found a relative decrease in verbal memory performance in ecstasy users compared to non-users.”
Ecstasy is an illegal drug that acts as a stimulant and psychedelic. A 2004 survey by the National Institute on Drug Abuse (NIDA) found that 450,000 people in the United States age 12 and over had used ecstasy in the past 30 days. In 2005, NIDA estimated that 5.4 percent of all American 12th graders had taken the drug at least once.
Ecstasy targets neurons in the brain that use the chemical serotonin to communicate. Serotonin plays an important role in regulating a number of mental processes including mood and memory.
Research has shown that long-term or heavy ecstasy use can damage these neurons and cause depression, anxiety, confusion, difficulty sleeping and decrease in memory. However, no previous studies have looked at the effects of low doses of the drug on first-time users.
Dr. de Win and colleagues examined 188 volunteers with no history of ecstasy use but at high-risk for first-time ecstasy use in the near future. The examinations included neuroimaging techniques to measure the integrity of cells and blood flow in different areas of the brain and various psychological tests. After 18 months, 59 first-time ecstasy users who had taken six tablets on average and 56 non-users were re-examined with the same techniques and tests.
The study found that low doses of ecstasy did not severely damage the serotonergic neurons or affect mood. However, there were indications of subtle changes in cell architecture and decreased blood flow in some brain regions, suggesting prolonged effects from the drug, including some cell damage. In addition, the results showed a decrease in verbal memory performance among low-dose ecstasy users compared to non-users.
“We do not know if these effects are transient or permanent,” Dr. de Win said. “Therefore, we cannot conclude that ecstasy, even in small doses, is safe for the brain, and people should be informed of this risk.”
This research is part of the Netherlands XTC Toxicity (NeXT) study, which also looks at high-dose ecstasy users and aims to provide information on long-term effects of ecstasy use in the general population.

Source: Radiological Society of North America (2006, November 28).

Professor Fabrizio Schifano at the University’s School of Pharmacy, is lead author of the paper which will be published online in Neuropsychobiology.

Professor Schifano and his colleagues at St George’s, University of London’s International Centre for Drug Policy, which runs the National Programme on Substance Abuse Deaths (np-SAD), reviewed stimulant-related deaths from the np-SAD database and from the British Crime Survey 2001-2007 results and found that identified 832 amphetamine and methylamphetamine-related deaths and 605 ecstasy-related deaths. What was of more concern to Professor Fabrizio and the researchers was the fact that the fatalities from ecstasy during that period were typically identified in victims who were young and healthy.

The report, which covered an 11-year, UK-wide analysis of mortality from these drugs, noted that deaths seemed to have dropped in 2000 to peak once again over the following years and then after a drop again in 2003, it increased again over the following years.
Commenting on the findings, Professor Schifano said: “These data seem to support the hypothesis that young individuals seem to suffer extreme consequences after excessive intake of ecstasy. This is an issue of public health concern which deserves further studies.”

Source: ScienceDaily (Feb. 1, 2010

According to a new report from the National Treatment Agency for Substance Misuse (NTA), people aged 18 to 24 now account for a third of all those in England seeking treatment for cocaine addiction.
Last year, over 3,000 18 to 24-year-olds sought treatment for cocaine use, with another 745 users under the age of 18.
This is nearly double the number who sought treatment in 2005-2006.

Over 60% of all cocaine users seeking treatment remain abstinent six months after completing their treatment, the NTA says.
However, the most recent British Crime Survey estimates there are 437,000 people aged 16 to 24 in England and Wales who have used cocaine in the past year.
The survey says the number of 16 to 24-year-olds to have used cocaine in the past year rose from 5.1% to 6.6% – the highest percentage of users yet.
The Class A drug is no longer seen as the preserve of the celebrity classes and can be brought on most city streets for “pocket money” prices, starting as little as £15 a bag.
Only cannabis and alcohol are more popular, while the use of designer dance drugs like ecstasy is falling.
Tumbling prices and the lack of stigma attached to powder cocaine have also led to increasing use at every level of British society. The number of cocaine dealers is also mushrooming, with a proliferation of younger street-level dealers who are known in urban slang as “shottas”.
Drugs education charities are warning that urgent action is needed so that recreational users are made aware of the dangers.
Cocaine is a class A drug that can cause anxiety, a rise in blood pressure and heart problems, as well as long-term addiction.
Statistics in a recent NTA report show that over 50% of cocaine users will also drink alcohol while using cocaine – a particular concern, as this creates a third highly toxic chemical in the body called cocaethylene, which can cause severe harm to the liver.
The potential health hazards are exacerbated by the fact that a lot of the cocaine sold on the streets is heavily adulterated, or “bashed”, as dealers refer to it, with various substances like crushed painkiller tablets and other stimulants.

Source: The Donal MacIntyre Show, BBC Radio 5 live

Teens who smoke marijuana are at a greater risk of developing schizophrenia and psychotic symptoms in the future, a new study has found.
After observing more than 3800 youngsters, researchers learnt that people who used the drug for six or more years were twice as likely to suffer from delusional disorders than those who never used it. Researchers from Queensland Brain Institute, at the University of Queensland, quizzed 3801 young adults who were born in Brisbane between 1981 and 1984.
Among the 1272 participants who had never used marijuana, 26 (2 per cent) were diagnosed with psychosis, while the 322 people who had used marijuana for six or more years, 12 (3.7 per cent) were diagnosed with the illness. The average age of the participants was about 20. According to the authors, the study was the first to look at sibling pairs to discount genetic or environmental influence.
“This is the most convincing evidence yet that the earlier you use cannabis, the more likely you are to have symptoms of a psychotic illness,” the Sydney Morning Herald quoted Dr McGrath, a professor at the institute, as saying in a statement.
McGrath added: “The message for teenagers is: if they choose to use cannabis they have to understand there’s a risk involved.” The study noted: “Apart from the implications for policy makers and health planners, we hope our findings will encourage further clinical and animal-model research to unravel the mechanisms linking cannabis use and psychosis.”
The research has been published online by the Archives of General Psychiatry.

Source: Health Wise Feb 28 2009

Teens and young adults who are heavy marijuana users are more likely than non-users to have disrupted brain development, according to a new study that appeared last month in the Journal of Psychiatric Research.

Pediatric researchers found abnormalities in areas of the brain that interconnect regions involved in memory, attention, decision-making, language and executive functioning skills. The findings are of particular concern because adolescence is a crucial period for brain development and maturation.

The researchers caution the study is preliminary and does not demonstrate that marijuana use causes the brain abnormalities. However, “Studies of normal brain development reveal critical areas of the brain that develop during late adolescence, and our study shows that heavy cannabis use is associated with damage in those brain regions,” said study leader Manzar Ashtari, Ph.D., director of the Diffusion Image Analysis and Brain Morphometry Laboratory in the Radiology Department of The Children’s Hospital of Philadelphia.

Working with child psychiatrist Sanjiv Kumra, M.D., Ashtari and colleagues performed imaging studies on 14 young men from a residential drug treatment center in New York, as well as 14 age-matched healthy controls. All the study subjects were males, with an average age of 19. The researchers performed the imaging studies at Long Island Jewish Medical Center.

The 14 subjects from the drug treatment center all had a history of heavy cannabis use during adolescence. Most had smoked marijuana from age 13 till age 18 or 19, and reported smoking nearly six marijuana joints daily in the final year before they stopped using the drug.

The study team performed a type of magnetic resonance imaging scan called diffusion tensor imaging (DTI) that measures water movement through brain tissues. The abnormal patterns of water diffusion that were found among the young adults with histories of marijuana use suggest damage or an arrest in development of the myelin sheath that surrounds brain cells, Ashtari said. Myelin provides a coating around brain cells similar to insulation covering an electrical wire. If myelin does not function properly, signaling within the brain may be slower.

Myelin gives its color to the white matter of the brain, and covers the nerve fibers that connect different brain regions. The study’s results suggest early-onset substance use may alter the development of white matter circuits, especially those connections among the frontal, parietal and temporal regions of the brain. Abnormal white matter development could slow information transfer in the brain and affect cognitive functions

Source: the Journal of Psychiatric Research. Reported in CADCA Coalitions online Feb 24 2010

New research shows that specific variations in the cannabis receptor gene (CB1) may be associated with the development of one or more symptoms of marijuana dependence in adolescents. This is one of the first studies looking specifically at the link between marijuana dependence and CB1 variations.

Background: Marijuana is the most commonly abused illegal substance among adolescents and young adults, and those who begin using at this stage are about twice as likely as adults to become dependent. Genetic variations in the CB1 receptor—the brain target for the psychoactive ingredient in marijuana—is a logical candidate gene to study as a potential contributor to vulnerability to marijuana dependence. Therefore, researchers examined the associations between specific variants in the CB1 gene and the rates of marijuana dependence.

Study Design: The scientists collected DNA from 541 youths aged 17 or older who had used marijuana at least five times recently. After interviews to identify one or more DSM-IV symptoms of dependence, 327 were established as cases; the remaining 214 had no symptoms and served as controls. All subjects were genotyped for four specific DNA sequence variations of the CB1 gene.

What They Found: One CB1 variant (found in 21 percent of the general population) was associated with a lower rate of having one or more marijuana dependence symptoms, while two others (present in 12 percent of the general population) were linked to increased likelihood of developing dependence symptoms.

Comments from the Authors: Identifying gene variants that may afford some protection against marijuana dependence may have important implications for intervention. However, it is likely that multiple genes and their interactions with environmental events influence marijuana and other drug addictions. Therefore, some level of genetic protection may not necessarily protect an adolescent from becoming dependent on drugs or suffering other related health consequences.

What’s Next: Future studies should examine these genetic variants for other drug-related traits, as well as additional DNA sequence variations for possible drug abuse associations.

Publication: The study, led by Dr. Christian J. Hopfer of the University of Colorado, was published in volume 141B, pages 895-901 (2006) of the American Journal of Medical Genetics Part B (Neuropsychiatric Genetics).

Source:NIDA Newscan 27th Aug. 2007

Beshay M, Kaiser H, Niedhart D, Reymond MA, Schmid RA.
Division of General Thoracic Surgery, University Hospital Berne, Switzerland.

Background: We observed a remarkable increase in the number of young patients who presented with lung emphysema and secondary spontaneous pneumothorax (SSP) at our institution for over a period of 30 months; most of them have a common history of marijuana abuse. Study design: Retrospective case series. Methods: Seventeen young patients presented with spontaneous pneumothorax with bullous lung emphysema were systematically evaluated over a period of 30 months. All were regular marijuana smokers. Clinical history, chest X-ray, CT-scan, lung function test, and laboratory and histological examinations were assessed. We compared the findings of this group (group I) with the findings of non-marijuana smoking patients (group II) in the same period. The findings of this series were also compared with the findings of 75 patients presented with pneumothorax in a previous period from January 2000 till March 2002 (group III). Results: In group I, there were 17 patients: the median age of the patients was 27 years (range 19-43 years), 16 males and 1 female. All were living in Switzerland. All but one smoked marijuana daily for a mean of 8.8 years and tobacco for 11.8 years. CT-scan showed multiple bullae at the apex or significant bullous emphysema with predominance in the upper lobes only in two patients. Only two patients had reduced forced first second expiratory volume (FEV1) and one reduced vital capacity (VC) below the predicted 50%. This correlated with the subjectively asymptomatic condition of the patients. All but two patients were treated by video-assisted thoracoscopic surgery (VATS) for prevention of relapsing pneumothorax. Histology showed severe lung emphysema, inflammation, and heavily pigmented macrophages. In group II, there were 85 patients: there were 78 males, the median age was 24 years (range 17-40 years), 74 patients smoked tobacco for 13.4 years but no marijuana. CT-scan in 72 patients showed only small bullae at the apex but no significant emphysema; other clinical, laboratory, and histopathological findings showed no significant difference in group I. In group III, there were 75 patients: there were 71 males and 4 females. Mean age was 25 years (range 16-46 years). Six smoked marijuana daily for a mean of 3.2 years, and 62 smoked tobacco for 14 years. CT-scan done in 59 patients showed few small bullae at the apex but no significant lung emphysema. The presence of lung emphysema on CT-scan in group I was significantly different than in groups II and III (p=0.14). No significant difference was found among all groups in the form of clinical, laboratory, and histopathological findings. Conclusions: In case of emphysema in young individuals, marijuana abuse has to be considered in the differential diagnosis. The period of marijuana smoking seems to play an important role in the development of lung emphysema. This obviously quite frequent condition in young and so far asymptomatic patients will have medical, financial, and ethical impact, as some of these patients may be severely handicapped or even become lung transplant candidates in the future.

Source: Pubmed. Eur J Cardiothorac Surg. 2007 Oct 9;

By Randy Dotinga, Contributing Writer
Health Behavior News Service

Adding to the evidence that maternal drug use can have lasting effects, a new study finds that young schoolchildren of cocaine-using moms scored more poorly on attention tests.

Researchers looked at test scores of 415 African-American children who took tests at age 5 or 7 (now 14 to 16 years old). The mothers of 219 of the children had taken cocaine while pregnant, and the mothers of the other 196 had not. All of the mothers were poor and living in the Miami inner city.

Children born to cocaine-addicted moms showed signs of having more trouble paying attention than the other kids. They were more likely to make errors of omission and had slower reaction times on tasks.

“This study provides further evidence of a subtle but consistent effect on attention through early school-aged years,” said lead author Veronica Accornero, assistant professor of clinical pediatrics at the University of Miami.

However, the effects are minor, and one pediatric specialist suggested they pale next to the problems caused when mothers use alcohol and tobacco. In general, children born to cocaine-using mothers “are doing much better than anyone predicted, especially considering their background,” said Tamara Warner, research assistant professor at the University of Florida who is familiar with the study findings.

The study appears in the June issue of the Journal of Developmental and Behavioral Pediatrics.

During and after the crack epidemic of the 1980s, so-called “crack babies” were the subject of media coverage and concern about their futures. Researchers found, however, that the effects in general “appear to be more subtle and specific than initially believed,” Accornero said.

She said the children do not appear to have a hard time with “intellectual functioning,” although they might have difficulties with language, attention and behavior.

The future effects on these children is unclear. “Certainly, attention and the ability to maintain attention is an important skill that supports the development of other skills like language and behavior,” Accornero said. “It’s possible that because of subtle deficits we may see an effect on academic performance. We just don’t know yet.”

Source: J Developmental & Behavioural Pediatrics 28(3), June 2007

What do suffering a traumatic brain injury and using club drugs have in common? University of Florida researchers say both may trigger a similar chemical chain reaction in the brain, leading to cell death, memory loss and potentially
irreversible brain damage.

A series of studies at UF over the past five years has shown using the
popular club drug Ecstasy, also called MDMA, and other forms of
methamphetamine lead to the same type of brain changes, cell loss and
protein fluctuations in the brain that occur after a person endures a
sharp blow to the head, according to recent findings.

“Using methamphetamine is like inflicting a traumatic brain injury on
yourself,” said Firas Kobeissy, a postdoctoral associate in the College
of Medicine department of psychiatry. “We found that a lot of brain
cells are being injured by these drugs. That’s alarming to society now.
People don’t seem to take club drugs as seriously as drugs such as
heroin or cocaine.”

Working with UF researchers Dr. Mark Gold, chief of the division of
addiction medicine at UF’s McKnight Brain Institute and one of the
country’s leading experts on addiction medicine, and Kevin Wang,
director of the UF Center for Neuroproteomics and Biomarkers Research,
Kobeissy compared what happened in the brains of rats given large doses
of methamphetamine with what happened to those that had suffered a
traumatic brain injury.

The group’s research has already shown how traumatic brain injury
affects brain cells in rats. They found similar damage in the rats
exposed to methamphetamine. In the brain, club drugs set off a chain of
events that injures brain cells. The drugs seem to damage certain
proteins in the brain, which causes protein levels to fluctuate. When
proteins are damaged, brain cells could die. In addition, as some
proteins change under the influence of methamphetamine, they also begin
to cause inflammation in the brain, which can be deadly, Kobeissy said.

Kobeissy and other researchers in Gold’s lab are using novel protein
analysis methods to understand how drug abuse alters the brain. Looking
specifically at proteins in the rat cortex, UF researchers discovered
that about 12 percent of the proteins in this region of the brain showed
the same kinds of changes after either methamphetamine use or traumatic
brain injury. There are about 30,000 proteins in the brain so such a
significant parallel indicates that a similar mechanism is at work after
both traumatic brain injury and methamphetamine abuse, Kobeissy said.

“Sometimes people go to the clubs and take three tablets of Ecstasy or
speed,” Kobeissy said. “That may be a toxic dose for them. Toxic effects
can be seen for methamphetamine, Ecstasy and traumatic injury in
different areas of the brain.”

About 1.3 million people over the age of 12 reported using
methamphetamine in the previous month, according to the 2006 National
Survey on Drug Use and Health. In 2004, more than 12 million Americans
reported having tried the drug, the survey’s findings show.

People often think the effects of drugs of abuse wear off in the body
the same way common medications do, but that may not be the case, Gold
said.

“These data and the previous four years of data suggest some drugs,
especially methamphetamine, cause changes that are not readily
reversible,” Gold said. “Future research is necessary for us to
determine when or if methamphetamine-related brain changes reverse
themselves.”

Gold and Dennis Steindler, director of UF’s McKnight Brain Institute and
an expert on stem cells, are planning studies to find out if stem cells
can be applied to repair drug-related brain damage.

UF researchers are also trying to uncover all the various ways drugs
damage and kill brain cells. During their protein analysis, researchers
discovered that oxidation was damaging some proteins, throwing the
molecules chemically off balance.

“When proteins are oxidized they are not functional,” Kobeissy said.
“When proteins are not working, the cell cannot function.”

Neurologist Dr. Jean Lud Cadet, chief of the molecular neuropsychiatry
branch of the National Institute on Drug Abuse, said analyzing proteins
is important to understanding how drugs such as methamphetamine affect
the brain.

“I think saying the results of methamphetamine abuse are comparable to
the results of a traumatic brain injury is a new idea,” Cadet said. “I
agree with (the findings). Our own work shows that methamphetamine is
pretty toxic to the brains of animals. In humans, imaging studies of
patients who use methamphetamine chronically show abnormalities in the
brain.

“Abuse of methamphetamine is very dangerous.”

This research was presented at a Society for Neuroscience conference
held recently in San Diego.

Source: Science Daily (Nov. 29, 2007)

Research Summary
Ecstasy is a stimulant like various classes of amphetamines, but the popular club drug is more likely to kill young and otherwise healthy users, Reuters reported Jan. 29.
U.K. researchers who studied ecstasy and amphetamine related deaths found that ecstasy-related deaths were more common among “victims who were young, healthy, and less likely to be known as drug users.”
Study author Fabrizio Schifano of the University of Hertfordshire said that ecstasy seemed to have a higher “intrinsic toxicity,” particularly among users ages 16-24. Schifano speculated that the deaths could be related to the fact that adolescents’ brains are still developing.

Source: www.jointogether.org Feb 3 2010 published in Neuropsychobiology.

Research Summary
A genetic study has found that children who were exposed to secondhand smoke are more likely to develop lung cancer as adults, according to researchers from the National Cancer Institute and the Mayo Clinic.
Childhood exposure to secondhand smoke raised lung-cancer risk even among study subjects who never smoked themselves. Researchers drew their conclusions in part from analysis of a gene called MBL2, known to increase susceptibility to respiratory diseases.
Source: Cancer Epidemiology, Biomarkers and Prevention. December 2009

Animal studies show that daily marijuana use could permanently alter serotonin and norepinephrine levels in the brain, raising the risk of depression and anxiety, according to researcher Gabriella Gobbi of McGill University.
The Canadian Press reported Dec. 17 that Gobbi studied the brain chemistry of 18 adolescent lab rats exposed daily to marijuana and found that they had decreased levels of mood-controlling serotonin and higher levels of the stress hormone norepinephrine.
Gobbi said that the effects were magnified because the adolescent brain is still developing. “These permanent changes in the brain are also linked to certain mental illnesses, like schizophrenia,” she said. “And we showed that even if we stopped the cannabis use at the end of adolescence, the changes were still detectable in adulthood.”
A future study will concentrate on adolescent marijuana use among humans.
Source: Neurobiology of Disease. 5th Dec.2009

Comments on above article:

Posted by JBrennan on 08 Jan 10 07:25 PM EST
I smoked marijuana daily at 17 years old and have felt different ever since stopping that, I ended up having more difficulty relaxing, sleeping, and finding energy than I did before daily marijuana use. Today I take amino acids that increase the amount of serotonin and norepinephrine, and it makes me feel normal again. It’s true that my one case doesn’t necessarily prove or disprove anything about marijuana, but I find it funny that there are people who immediately dismiss evidence of marijuana’s harmful affects while immediately claiming that marijuana is harmless, as if the brain is so easy to figure out that they already know everything there is to know about marijuana’s affects on the brain.
Posted by Paula D. Gordon on 09 Jan 10 04:30 AM EST
For additional information and perspectives on the harmfulness of marijuana, see http://gordondrugabuseprevention.com and http://spiritualharmofmarijuana.com It is interesting to note that there are references to work on both website that speak about the long term effects of marijuana use.

Posted by jgogek on 08 Jan 10 03:24 PM EST
The conclusions of this research would not surprise me at all. I find it disturbing when I read the comments in JoinTogether from advocates of recreational and medical marijuana immediately trying to denigrate any new finding on neurologic and other impacts of marijuana. Caring people should be concerned about the possible health impacts of commonly used substances — if not for themselves then at least for other people. Personal beliefs about marijuana use should be trumped by public health concerns. The science on marijuana impact continues to unfold and it should guide public policy. Personal wishes about individual marijuana use should not affect public policy.

Progression to daily marijuana use in adolescence may hasten the onset of symptoms leading up to psychosis, an Emory University study finds. The study was published in the November issue of the American Journal of Psychiatry.

The researchers analyzed data from 109 hospitalized patients who were experiencing their first psychotic episode. The results showed that patients who had a history of using marijuana, or cannabis, and increased to daily pot smoking experienced both psychotic and pre-psychotic symptoms at earlier ages.
“We were surprised that it wasn’t just whether or not they used cannabis in adolescence that predicted the age of onset, rather it was how quickly they progressed to becoming a daily cannabis user that was the stronger predictor,” said Michael Compton, lead author and assistant professor of psychiatry in the Emory School of Medicine.
The study also found a gender difference: The female subjects who progressed to daily pot smoking had a greater increased risk for the onset of psychosis than the males.
Marijuana is the most abused illicit substance among people with schizophrenia, the most extreme form of psychosis, and previous research has shown that smoking pot is likely a risk factor for the disease.
The Emory study also focused on what is known as the prodromal period, when a person has symptoms such as unusual sensory experiences, which are often precursors to frank hallucinations and delusions. Prodromal symptoms can occur months, or years, before a diagnosis of psychosis. About 30 to 40 percent of prodomal teenagers will eventually develop schizophrenia or another psychotic disorder.
“The prodromal period is especially important because it’s considered to be a critical time for preventive intervention,” says Elaine Walker, a co-investigator of the study and professor of psychology and neuroscience at Emory.
The study also involved researchers from Emory’s Rollins School of Public Health and Georgia State University. It was funded by the National Institute of Mental Health.

Source: American Journal of Psychiatry, 2009; 166 (11): 1251 DOI: 10.1176/appi.ajp.2009.09030311

Canadian teenagers are among the largest consumers of cannabis worldwide. The damaging effects of this illicit drug on young brains are worse than originally thought, according to new research by Dr. Gabriella Gobbi, a psychiatric researcher from the Research Institute of the McGill University Health Centre. The new study, published in Neurobiology of Disease, suggests that daily consumption of cannabis in teens can cause depression and anxiety, and have an irreversible long-term effect on the brain.

“We wanted to know what happens in the brains of teenagers when they use cannabis and whether they are more susceptible to its neurological effects than adults,” explained Dr. Gobbi, who is also a professor at McGill University. Her study points to an apparent action of cannabis on two important compounds in the brain — serotonin and norepinephrine — which are involved in the regulation of neurological functions such as mood control and anxiety.
“Teenagers who are exposed to cannabis have decreased serotonin transmission, which leads to mood disorders, as well as increased norepinephrine transmission, which leads to greater long-term susceptibility to stress,” Dr. Gobbi stated.
Previous epidemiological studies have shown how cannabis consumption can affect behaviour in some teenagers. “Our study is one of the first to focus on the neurobiological mechanisms at the root of this influence of cannabis on depression and anxiety in adolescents,” confirmed Dr. Gobbi. It is also the first study to demonstrate that cannabis consumption causes more serious damage during adolescence than adulthood.
Dr. Gabriella Gobbi is a researcher at the neuroscience axis of the Research Institute of the McGill University Health Centre and also a psychiatrist and associate professor at the Department of Psychiatry, McGill University.

Source:
McGill University Health Centre (2009, December 20). Cannabis damages young brains more than originally thought, study finds. ScienceDaily. Retrieved December 29, 2009, from http://www.sciencedaily.com¬ /releases/2009/12/091217115834.htm

A new study from Perth’s Telethon Institute for Child Health Research has found evidence that the amount and timing of alcohol consumption in pregnancy affects child behaviour in different ways.

The study has just been published online in the international journal Addiction.
Lead author Colleen O’Leary said the analysis was drawn from a random sample of more than 2000 mothers who completed a questionnaire three months after the baby’s delivery, and were then followed up when the child was 2, 5 and 8 years of age.

“Mothers who reported what we would classify as heavy drinking in the first trimester of pregnancy were nearly three times as likely to report that their child suffered with anxiety and/or depression or somatic complaints,” Ms O’Leary said. “Those who drank moderately during that first trimester were twice as likely to report those types of behavioural issues for their child.

“Exposure to moderate or heavy levels of alcohol in late pregnancy increased the risk of aggressive types of behaviours in the child.“This research suggests that both the timing and the intensity of alcohol exposure in the womb affect the type of behaviour problems expressed.”In this study low levels of alcohol did not increase the risk of harm to the baby. However, the evidence clearly shows that the risk to the baby increases with increasing amounts consumed.

“It should also be noted that in this study moderate exposure is classified as drinking 3-4 standard drinks per occasion- that’s about two normal glasses of wine-and no more than a bottle of wine drunk over a week.” Heavy drinking included women who were drinking the equivalent of more than a bottle of wine per week. It is important that women who had consumed alcohol while pregnant are not panicked by the findings.

“Not every smoker gets lung cancer despite them being at higher risk – and in this case, not every child will be affected by prenatal exposure to alcohol. However it is important that women have this information about increased risk so that they can make informed decisions to give their child the best start to life,” Ms O’Leary said.

The National Health and Medical Research Council recommend that the safest choice for women who are pregnant or planning a pregnancy is to abstain from alcohol.
Ms O’Leary said health professionals can assist by talking to women of child bearing age about their alcohol consumption and encouraging pregnant women and women planning a pregnancy to abstain from alcohol.
Source: O’Leary et al. Evidence of a complex association between dose, pattern and timing of prenatal alcohol exposure and child behaviour problems. Addiction, November 2009

Adolescent substance abuse disorders are a predictor of young adult mortality, new research from the University of Pittsburgh concludes. Researchers found that young adult males with substance abuse disorders had a mortality rate far in excess of the norm for their non-addicted contemporaries. For example, 2 percent of the adolescents studied had died by the time the eight-year study period ended, including 23 percent of the African American males in the study.

Teens who abuse alcohol or drugs are more likely to die in early adulthood, according to a study by University of Pittsburgh researchers published in the current issue of the Journal of Adolescent Health.

The study, the first in a sample of U.S. adolescents, found that substance abuse disorders (SUDs) in adolescents significantly predicted young adult mortality. These deaths were linked to specific high-risk behaviors in adolescence, including intoxicated driving and drug trafficking.

“The fact that these were, to an extent, predictable deaths raises additional concerns about the hazards of alcohol and drug problems in teens and young adults,” said Duncan B. Clark, M.D., Ph.D., associate professor of psychiatry and pharmaceutical sciences at the University of Pittsburgh School of Medicine and director of the Pittsburgh Adolescent Alcohol Research Center at the Western Psychiatric Institute and Clinic of UPMC.

The researchers studied 870 white and African-American adolescents, ages 12 through 18, recruited from both clinical and community settings. The subjects were followed for up to eight years, starting in 1990.

Among the 870 adolescents, researchers noted 21 deaths, or about 2 percent of the group, at an average age of nearly 25 years. Fourteen of those deaths occurred in males with SUDs, or more than 10 percent of that group. Among African-American males with SUDs, 23 percent had died by the age of 25. Males with SUDs in this study group had a mortality rate far in excess of the rate of 137 per 100,000 reported for young adult males in the U.S. general population.

Socioeconomic status was not a significant predictor of survival time. Causes of death for the young adults in the study ranged from homicide and suicide to drug overdose and motor vehicle accidents.

Dr. Clark noted that these results need to be confirmed in a larger, nationally representative sample over a longer period of time. Still, he said, “The adolescent characteristics predicting death in young adulthood can be readily identified in clinical evaluations.”

Adolescents may not be oblivious to the risks their behaviors pose. Previous studies have shown that many teens who engage in alcohol and drug use and other high-risk behavior believed they would die within two years. “Unfortunately, this insight on the part of some teens apparently does not eliminate these problem behaviors,” said Dr. Clark. “Effective interventions need to be developed to prevent these predictable deaths in our young adults.”

Co-authors of the study include Christopher S. Martin, Ph.D., and Jack R. Cornelius, M.D., Ph.D., from the University of Pittsburgh. Dr. Clark was supported by funding provided by the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse.

Source: NEW UNIVERSITY OF PITTSBURGH STUDY IN THE JOURNAL OF ADOLESCENT HEALTH

Cannabis use in British teenagers has increased tenfold in the last 20 years
Children who smoke cannabis are twice as likely to get into trouble – both in the classroom and outside the school gates. Boys turn to vandalism, theft and fights, while girls misbehave at school, a four-year study of thousands of pupils aged between 11 and 15 found.
Young males are also up to twice as likely to have committed “delinquent” acts such as vandalism or carrying a knife. And teenage cannabis users have double the chance of developing emotional and psychiatric problems in later life. The finding was released as Gordon Brown comes under pressure to reverse Labour’s downgrading of cannabis.
Calling on the Government to do more to combat drug use in teenagers, researcher Laura Grant said: “Cannabis has been regarded as potentially being a gateway drug to harder drug use, leading to mental health issues, leading to memory loss or impairment and having an impact on learning and social behaviour.
“I have spoken to kids that smoke cannabis every single night, they get up and go to grammar school and get good grades. “This really is a hidden issue that needs to be tackled.”
She added: “These young people are still attending school and are at odds with the general perception of what the typical young person is like who engages in these acts.
“It is no great leap to imagine that this school-attending high risk group may be a further risk of later life problems as a result of their early drug use: mentally, socially and emotionally.” Miss Grant, a sociologist at Queen’s University Belfast, studied data tracking the health and habits of almost 4,000 Northern Irish schoolchildren.
By the age of 15, more than 40 per cent had tried cannabis – a five-fold increase on four years earlier, the British Psychological Society’s annual conference in Dublin heard. She added it was unclear why cannabis had different effects on boys and girls.
A fifth of those studied were judged to be at risk of developing mental health problems in later life, with cannabis users running up to double the risk of other children.
Cannabis use in British teenagers has increased tenfold in the last 20 years. By the age of 16, almost four in ten will have tired cannabis and almost one in ten is a regular user. In 2005, 10,000 youngsters aged between 11 and 17 were treated for cannabis use.
Previous studies have shown a clear link between cannabis use in the teenage years and mental illness in later life. It is thought that used during the developmental years, the drug may do permanent damage to the developing brain.
Source: Daily Mail 5th April 2008

Brain scans reveal that cocaine, alcohol and tobacco use during pregnancy can cause changes in the brain scan of developing fetuses, and that these changes can remain detectable for years, HealthDay News reported April 7.
“We found that reductions in cortical gray matter and total brain volumes were associated with prenatal exposure to cocaine, alcohol or cigarettes,” said researcher Michael Rivkin of Children’s Hospital Boston.
Rivkin and colleagues from Children’s Hospital and the Boston Medical Center conducted MRI scans on the brains of 35 children with an average age of 12 who had been exposed to cocaine, tobacco or alcohol before birth. Children with fetal alcohol syndrome were excluded from the study.
Researchers found that the more substances the adolescents had been exposed to, the more brain volume they lost.

Source: April 2008 issue of the journal Pediatrics.

Babies born to women who smoke during pregnancy are more likely to have heart defects that are not related to genetics, Reuters reported April 9.
Researcher Sadia Malik of the University of Arkansas for Medical Sciences and colleagues compared more than 3,000 infants born with heart defects to a similar group of infants without heart problems. They found that heart defects were more common among children of women who smoked during the month before they became pregnant or during the first trimester of their pregnancy. Moreover, the risk of babies being born with heart problems was higher when mothers smoked more.
“If even a fraction of congenital heart defects and other birth defects could be prevented by decreasing maternal tobacco use, it would result in improved reproductive outcomes and a saving of millions of health care dollars,” the researchers said.
Source: April 2008 issue of the journal Pediatrics.

A new study found a link between secondhand smoke and sudden infant death syndrome (SIDS), the Toronto Globe and Mail reported Feb. 21.
The study was conducted by researchers at Toronto’s Hospital for Sick Children and the University of Maryland.
In analyzing 44 SIDS deaths, researchers found twice the amount of nicotine levels in the lung tissue of babies whose parents acknowledged that they were smokers than in babies who died of other causes.
“It’s biochemical proof that smoke is associated with SIDS,” said Gideon Koren, lead investigator and senior scientist at the hospital’s research institute. “Some parents may feel guilty, and probably we underestimate the contribution of smoking to the risk of SIDS.”
Koren said additional research is needed to determine which of the toxic substances in tobacco smoke increases the risk for SIDS.
The study’s findings also are raising questions as to whether parents should be held responsible for exposing their babies to tobacco-filled air at home.
“In light of this new research, we and other agencies will be looking at it and rethinking our position to see if a stronger position is more feasible,” said Gail Vandermeulen of the Ontario Association of Children’s Aid Societies.
Source: Journal of Pediatrics February. 2002

The children of women who smoke during pregnancy are at increased risk of suffering strokes or heart attacks later in life, a new study concludes.
Reuters reported March 2 that children of smokers — studied as young adults — were found to have thicker walls around the carotid arteries in their necks, making them more vulnerable to stroke and heart attacks. Children of women who smoked the most during pregnancy had the thickest arterial walls, researchers found.
“There is the possibility that the compounds in tobacco smoke go through the placenta and directly damage the cardiovascular system of the fetus,” said researcher Cuno Uiterwaal at the University Medical Center Utrecht in the Netherlands. “The damage appears to be permanent and stays with the children.”
Source: Findings presented at a recent American Heart Association conference in Orlando. March 5, 2007

A study from the United Kingdom finds that children of mothers who smoke have smaller lung volumes and are more at risk for serious lung disease later in life, Reuters reported Feb. 26.
The study by researchers at the University of Bristol and the University of Glasgow involved 2,000 men and women in their 30s, 40s, and 50s whose parents smoked and took part in a study in the 1970s.
After conducting respiratory tests, the researchers found that children of mothers who smoked had smaller lungs, regardless of whether they also smoked. In addition, these children were more at risk for chronic obstructive pulmonary disease (COPD). If they themselves smoked, the risk was as high as 70 percent.
“Our results suggest that the effects of maternal smoking on lung size are permanent,” said Dr. Mark Upton, lead author of the study.
Children from households where the father smoked, but not the mother, showed poorer lung function, but not as great as those whose mothers smoked.
Source: American Journal of Respiratory and Critical Care Medicine. Feb. 15, 2004

Children exposed to secondhand smoke at home are more likely to carry the streptococcus pneumonia bacteria in their nose and throat, according to Israeli researchers.
A study involving more than 200 children and their mothers found that 76 percent of children exposed to secondhand smoke carried the bacteria in their noses and throats, compared to 60 percent of those not exposed to smoking. The bacteria can cause minor illnesses like ear infections or more dangerous conditions like sinusitis, pneumonia, and meningitis.
Among the mothers, 32 percent of smokers carried the bacteria, compared to 15 percent of nonsmokers exposed to tobacco smoke and 12 percent of nonsmokers not exposed to secondhand smoke.
“Since carriage in the nose is the first step in causing disease, the increased rate of carriage suggests more frequent occurrence of the disease. Indeed, active and passive smoking are associated with increased rate of respiratory infectious diseases,” said lead study author David Greenberg, M.D. “This should definitely encourage the parents not to smoke in the presence of their child, especially if this child has predisposing factors such as asthma.”
Source: Clinical Infectious Diseases. April 1, 2006

Researchers have found that infants as young as three months old accumulate nicotine and carcinogens in their bodies when they are exposed to tobacco smoke, the Guardian reported May 12.
Authors of the study — the first to test smoking exposure on children so young — said that parents who smoking around infants could raise children’s’ risk of addiction, cancer, and other health problems later in life. “The take-home message is that parents should not smoke around their children, because they will suffer from the exposure,” said Stephen Hecht of the University of Minnesota cancer center.
The study of 144 children (ages three months to one year) who lived with family members who smoked found that 98 percent had nicotine in their urine, and 93 percent had cotinine, a marker for nicotine metabolism. Further, 47 percent of the infants had detectable levels of NNAL, a carcinogenic metabolite of cigarette smoke.
“Persistent exposure to environmental tobacco smoke in childhood could be related to cancer later in life,” said Hecht
Source: Cancer Epidemiology Biomarkers and Prevention. May 2006

Infants with at least one parent who smokes have higher levels of a nicotine metabolite in their bodies than the children of nonsmokers, the Guardian reported June 19.
Researchers from the University of Leicester and Warwick Medical School said the study showed that smoking parents are turning their infants into passive smokers, putting them in danger of breathing problems and crib death. “Babies and children are routinely exposed to cigarette smoke by their [caregivers] in the home without the legislative protection available to adults in public places,” the authors stated.
Babies whose mothers smoked had cotinine levels four times higher than children whose parents were both nonsmokers, while babies with fathers who smoked had cotinine levels twice as high.
Cotinine levels were higher among babies who shared a bed with their parents, and during the winter. “Higher cotinine levels in colder times of year may be a reflection of the other key factors which influence exposure to passive smoking, such as poorer ventilation or a greater tendency for parents to smoke indoors in winter,” the authors said.
Source: Archives of Diseases in Childhood. June 2007

• Compared to 12- and 13-year olds who have frequent family dinners, those who have infrequent family dinners are six times likelier to use marijuana, four times likelier to use tobacco, and three times likelier to use alcohol.
• Compared to teens who attend religious services at least weekly, those who never attend services are more than twice as likely to try cigarettes, and twice as likely to try marijuana and alcohol.
• Compared to teens who have frequent family dinners, those who have infrequent family dinners are one and a half times likelier to report getting grades of C or lower in school. 

Source: www.casacolumbia.org   Sept.2009

Drinking alcohol at a young age, while the brain is still forming, causes cognitive and structural damage which could be irreversible.
“Studies have proven that alcohol causes brain atrophy,” said Dr. Nicole Gorman, a pediatrician at Village Pediatrics in Westport. “The bottom line is that alcohol stops brain cells from growing.”
Adolescence is the time when the hippocampus, the pre-frontal area of the brain located behind the forehead, is developing significant functions. These include forming its capacity for memory, thinking clearly, impulse control, spatial learning, planning and decision making. After spending more than two decades of analyzing the effects of alcohol on adolescents, the American Medical Association concurs that alcohol can produce both short term and, in many cases, long term damage.
Research studies concluded that teens who drink alcohol score considerably lower on tests involving their cognitive skills. These studies looked at their ability to process general information, including use of vocabulary and verbal and non-verbal information recall.
What is perhaps most alarming is that, according to its Web site, the brain might not be able to “catch up” once this crucial development phase is disrupted and altered by the presence of alcohol.
Dr. Joseph Russo of the Recovery Center of Westport explains that once the brain’s biochemical circuits get “hard-wired,” it’s difficult to alleviate the negative effects of substance abuse.
His colleague, Clarisse Loughrin, a substance abuse counselor, agreed. “The longer someone waits to start treatment the longer it will take,” she said. “And, when you start drinking and drugging at a younger age, the damage is greater and takes even longer.”
Along with physical consequences, alcohol also adversely affects a young person’s emotional growth. “Alcohol has a lot of depressive effects,” said Gorman. “In our practice, we already see many cases of depression in young people.” Teens who are suffering from depression might try to self-medicate themselves by binge drinking. Assuming that they are alleviating unwanted feelings, they are actually adding to their problem because alcohol is, in fact, a depressant.
Conversely, when people are abusing alcohol and drugs, it is more difficult to diagnose clinical depression, anxiety and other mood disorders. Studies have also linked underage drinking with a rise in violent behaviors and suicidal thoughts.
Gorman said that she also has young patients who come to her complaining of sleep disorders. However, this problem, too, is exacerbated by drinking alcohol”Someone might think that a drink or two will help them to sleep better but it’s actually only going to make things worse,” she said.
Characterized by risk-taking behaviors and low impulse control, adolescence is often a time when young people make poor behavioral choices. In attempting to break away from their parents and the embark on process of self actualization, teens could readily view drinking as a benign activity. In their struggle for independence, they defy parental authority with proclamations of “everyone is doing it” and “it won’t hurt me.”
Gorman cautions parents, though, about being “naive” and mistakenly thinking that an honors student or otherwise “good kid” could not be indulging in risky behaviors. “Alcohol should be placed in a locked place where kids do not have access to it,” Gorman said.
Source: www.westport-news.com 2nd Dec. 2009

Methamphetamine Abuse Linked To Underage Sex, Smoking And Drinking

Children and adolescents who abuse alcohol or are sexually active are more likely to take methamphetamines (MA), also known as ‘meth’ or ‘speed’. New research reveals the risk factors associated with MA use, in both low-risk children (those who don’t take drugs) and high-risk children (those who have taken other drugs or who have ever attended juvenile detention centres).

MA is a stimulant, usually smoked, snorted or injected. It produces sensations of euphoria, lowered inhibitions, feelings of invincibility, increased wakefulness, heightened sexual experiences, and hyperactivity resulting from increased energy for extended periods of time. According to the lead author of this study, Terry P. Klassen of the University of Alberta, Canada, “MA is produced, or ‘cooked’, quickly, reasonably simply, and cheaply by using legal and readily available ingredients with recipes that can be found on the internet”.
Because of the low cost, ready availability and legal status of the drug, long-term use can be a serious problem. In order to assess the risk factors that are associated with people using MA, Klassen and his team carried out an analysis of twelve different medical studies, combining their results to get a bigger picture of the MA problem. They said, “Within the low-risk group, there were some clear patterns of risk factors associated with MA use. A history of engaging in behaviors such as sexual activity, alcohol consumption and smoking was significantly associated with MA use among low-risk youth. Engaging in these kinds of behaviors may be a gateway for MA use or vice versa. A homosexual or bisexual lifestyle is also a risk factor.”
Amongst high-risk youth, the risk factors the authors identified were, “growing up in an unstable family environment (e.g., family history of crime, alcohol use and drug use) and having received treatment for psychiatric conditions. Among high-risk youth, being female was also a risk factor”.

Source: BMC Pediatrics (2008, October 29). Methamphetamine Abuse Linked To Underage Sex, Smoking And Drinking. ScienceDaily. Retrieved November 12, 2009, from http://www.sciencedaily.com

A recent study published in the Journal of Epidemiology and Community Health has revealed that women who continue to smoke during pregnancy are more likely to have children with behavioral problems. Disturbances caused can show signs as early as when the child is three years old.
For the sake of the study, over 14,000 mothers and child pairs were observed. The pairs were picked from the millennium cohort study. All the children observed had been born between 2000 and 2001. Professor Kate Pickett from the Hull York medical school, University of York, carried out the research.
Mothers, who were categorized as light or heavy smokers with regards to the number of cigarettes they smoked each day during pregnancy, were given a questionnaire which required them to score their children’s behavior. While 12.5% women said they smoked lightly and 12.4% said they had stopped smoking altogether when pregnant, 10% admitted to smoking heavily all throughout the term.
Based on the data collected, the study confirmed that children whose mothers smoked heavily were two times more prone to behavioral problems, a thing which kept going down as the number of cigarettes smoked during pregnancy went down. According to the study, smoking when pregnant, damages the developing structure and functioning of the fetus’s brain. Boy fetuses are more prone to damage.
Source:www.topnews.net.nz 3/11/2009

Does the use of cannabis predicate the use of other illegal drugs ? The study quoted below shows that the risk of someone using other illegal drugs is 90 times higher for 16 – 17 year olds who used cannabis at least weekly. It is essential that parents who believe their child is involved in cannabis use tackle this situation and do not turn a blind eye. Read the story (at the end of this article) by Ginger Katz….

There are two main difficulties to clarifying that marijuana is a gateway substance, but even so there is some good evidence.

The first difficulty is varying definitions of “gateway”. If one defines it as to how rare is the case of someone using other illicit drugs without ever using mj before that, there can be no dispute that a gateway effect or phenomenon exists. If one defines it as an absolute, as in, anyone who uses marijuana will use other illicit drugs, then it is clearly not true, since most who use marijuana don’t progress to other drugs. I think the meaning you’re using here, John, (correct me if not) is whether there are aspects to marijuana use that directly increase the odds that other drugs will be used, rather than just situational or reverse-correlation explanations for why other illicit drug use is so rarely found without prior marijuana use.

The second difficulty is that causality is complex and multi-faceted: even if direct causality is involved, some of the other trends that cause people to question causality (e.g. that early marijuana use is a sign of troubled development, which itself can account for increased likelihood of later use of other substances) are also true in many cases.

All the above not withstanding, one of the best studies I have seen to document the direct role of marijuana in later illicit drug use is one done in New Zealand, reported in the article “The developmental antecedents of illicit drug use: Evidence from a 25-year longitudinal study”, by David M. Fergusson, Joseph M. Boden, and L. John Horwood. The journal citation is Drug and Alcohol Dependence 96 (2008) 165-177. They looked at many potential risk factors and found predictive associations from childhood based on parental use, on the youth’s exposure to sexual abuse in childhood, on gender (male was at more risk), on novelty-seeking, and on childhood conduct disorders. They then moved into additional analysis where, “the statistical model was extended and refined by the inclusion of a series of time-dynamic covariates and controls for reverse causality.” Sifting through associations that included cannabis use, association with substance-using peers, alcohol use, cigarette smoking, and novelty-seeking, they found that except for some persistence in the novelty seeking factor, “accounting for substance use and peer factors reduced the associations
between the childhood fixed factors and illicit drug use and abuse/dependence to statistical non-significance.”

They then focus on cannabis use: “of the time-dynamic factors included in the final models, cannabis use had the largest and most complex associations. In particular, the study findings suggested an interactive relationship between age and the use of cannabis in the development of other forms of illicit drug involvement. In this relationship the effects of cannabis use were the strongest at younger ages, and declined progressively with age. Furthermore, the size of association depended on the extent of use of cannabis. The net results of these findings is that risks of illicit drug use were over 90 times higher amongst 16-17-year olds who used cannabis at least weekly when compared to non-users of cannabis. By the age of 25, these risks had reduced to nearly eight times higher. In addition, these associations were controlled for reverse causality by including a lagged measure of other illicit drug use in the model. These findings are consistent with the view that exposure to cannabis use increases risks of other forms of illicit drug use and abuse/dependence, even when allowance is taken of childhood factors and possible reverse causal associations.”

The authors note that the finding that “much of the association between childhood factors and other forms of illicit drug use and abuse/dependence was mediated via cannabis use” is important “in the light of claims that the association between cannabis and other forms of illicit drug use can be explained by common childhood factors …” “The present study suggests quite the opposite conclusion in which cannabis use mediated the effects of childhood factors on later illicit drug abuse.
Source: Alan Markwood of www.chestnut.org reporting to DrugWatch International. Oct.2009

There are two main difficulties to clarifying that marijuana is a gateway substance, but even so there is some good evidence.

The first difficulty is varying definitions of “gateway”. If one defines it as to how rare is the case of someone using other illicit drugs without ever using mj before that, there can be no dispute that a gateway effect or phenomenon exists. If one defines it as an absolute, as in, anyone who uses marijuana will use other illicit drugs, then it is clearly not true, since most who use marijuana don’t progress to other drugs. I think the meaning you’re using here, John, (correct me if not) is whether there are aspects to marijuana use that directly increase the odds that other drugs will be used, rather than just situational or reverse-correlation explanations for why other illicit drug use is so rarely found without prior marijuana use.

The second difficulty is that causality is complex and multi-faceted: even if direct causality is involved, some of the other trends that cause people to question causality (e.g. that early marijuana use is a sign of troubled development, which itself can account for increased likelihood of later use of other substances) are also true in many cases.

All the above not withstanding, one of the best studies I have seen to document the direct role of marijuana in later illicit drug use is one done in New Zealand, reported in the article “The developmental antecedents of illicit drug use: Evidence from a 25-year longitudinal study”, by David M. Fergusson, Joseph M. Boden, and L. John Horwood. The journal citation is Drug and Alcohol Dependence 96 (2008) 165-177. They looked at many potential risk factors and found predictive associations from childhood based on parental use, on the youth’s exposure to sexual abuse in childhood, on gender (male was at more risk), on novelty-seeking, and on childhood conduct disorders. They then moved into additional analysis where, “the statistical model was extended and refined by the inclusion of a series of time-dynamic covariates and controls for reverse causality.” Sifting through associations that included cannabis use, association with substance-using peers, alcohol use, cigarette smoking, and novelty-seeking, they found that except for some persistence in the novelty seeking factor, “accounting for substance use and peer factors reduced the associations
between the childhood fixed factors and illicit drug use and abuse/dependence to statistical non-significance.”

They then focus on cannabis use: “of the time-dynamic factors included in the final models, cannabis use had the largest and most complex associations. In particular, the study findings suggested an interactive relationship between age and the use of cannabis in the development of other forms of illicit drug involvement. In this relationship the effects of cannabis use were the strongest at younger ages, and declined progressively with age. Furthermore, the size of association depended on the extent of use of cannabis. The net results of these findings is that risks of illicit drug use were over 90 times higher amongst 16-17-year olds who used cannabis at least weekly when compared to non-users of cannabis. By the age of 25, these risks had reduced to nearly eight times higher. In addition, these associations were controlled for reverse causality by including a lagged measure of other illicit drug use in the model. These findings are consistent with the view that exposure to cannabis use increases risks of other forms of illicit drug use and abuse/dependence, even when allowance is taken of childhood factors and possible reverse causal associations.”

The authors note that the finding that “much of the association between childhood factors and other forms of illicit drug use and abuse/dependence was mediated via cannabis use” is important “in the light of claims that the association between cannabis and other forms of illicit drug use can be explained by common childhood factors …” “The present study suggests quite the opposite conclusion in which cannabis use mediated the effects of childhood factors on later illicit drug abuse.
Source: Alan Markwood of www.chestnut.org reporting to DrugWatch International. Oct.2009

Current figures underestimate the number of children who may be at risk of harm from parental substance use. Researchers writing in the open access journal BMC Public Health have generated new estimates using five national surveys which include measures of binge, hazardous and dependent drinking, illicit drug use and mental health.

Previous UK estimates were that 250-350,000 children live with problem drug users and 780,000 – 1.3 million with problem drinkers. However, the problem, according to the researchers, is that “these estimates are based on drug users in treatment or derive from problem drinking estimates in other countries.” The study, funded by Action on Addiction and the Wates Foundation and conducted by Dr Victoria Manning and colleagues at the National Addiction Centre, entailed a secondary analysis of national household surveys that enabled a focus on parenting and substance use. The new figures indicate that approximately 3.4 million children in the UK live with at least one binge drinking parent, 2.6 million with a hazardous drinker and around one million with a parent who uses illicit drugs.
Manning said: “In order to meet the needs of both parental substance misusers and their children, we first need to understand the true nature and scale of the problem. Without knowing the number of potentially at-risk families, we are unable to assist them until they come to the attention of agencies at crisis point.”
Around 335,000 children were estimated to be living with a drug dependent user, 72,000 with an injecting drug user, and 108,000 with an adult who had overdosed. The authors suggest the risk of harm may increase for the 500,000 children living with parents who have both mental health and substance misuse problems. According to Manning, “Whilst harm from parental substance use is not inevitable, we need to raise awareness of how recreational substance use, and in particular binge episodes, can affect parenting capacity. Substance use affects our judgement, emotions and how we respond to situations. Parental substance misuse can lead to inadequate child monitoring, modelling behaviour and poor standards of child care.”
The authors encourage the involvement of mainstream services to support vulnerable families by improving access to treatment, family interventions and parenting skills training to minimize the risk of harm.

Source: Victoria Manning, David W Best, Nathan Faulkner and Emily Titherington. New estimates of the number of children living with substance misusing parents: results from UK national household surveys. BMC Public Health, 2009;

Regardless of the explanation, the findings suggest “that there are very long-term benefits to a higher drinking age,” Norberg said.

From the Vietnam era until the mid-1980s, many states allowed people to purchase alcohol at the age of 18. However, a federal law pressured states to boost the drinking age to 21, and all did with the exception of Louisiana, which finally followed suit in the 1990s.

In the new study, Norberg and colleagues looked at surveys of 33,869 people born in the United States between 1948 and 1970. They examined the records to see if there were differences in alcoholism and drug abuse rates depending on when states allowed individuals to buy booze.

The study findings appear in an early online edition of the December issue of Alcoholism: Clinical and Experimental Research.

After adjusting their statistics to prevent things like the ethnicity of the respondents from skewing the results, the researchers found that those who lived in states that allowed drinking before age 21 were 1.3 times more likely to have suffered recently from alcoholism. They were also 1.7 times more likely to have had a recent drug abuse problem.

Norberg said lower drinking ages might have a “peer effect,” since that makes it easier to find friends of one’s age to drink with. “If the drinking age is at 21, it will be a little harder to find some friends to go out with. You’ll probably drink less often and have a smaller number of drinks.”

Maternal drug misuse can seriously affect the health of the fetus and newborn infant. The association of maternal drug misuse with prematurity, intrauterine growth restriction (IUGR) and neonatal abstinence syndrome (NAS) is well recognised, and there is growing concern about infant visual development and longer-term neuro-developmental outcome. Drug misuse is associated with changes in the visual system as measured by the visual evoked potential (VEP) in adults and animal models. A recent study has shown abnormal VEPs in newborn infants exposed to methadone in utero, consistent with reports of delayed visual development in this population. Since visual abnormalities and neuro-developmental abnormalities can be predicted by abnormal VEPs in infancy, it is postulated that the VEP may be a valuable tool in the detection of the adverse effects of maternal drug misuse upon the infant. This review summarises the impact of maternal drug misuse upon the health of the foetus and newborn infant, addresses the specific effects of maternal drug misuse upon the developing visual system and discusses the potential role of the VEP in the assessment of these infants.

Source: Archives of Disease in Childhood 2009;94:708-712

Nearly one in two teenagers knows someone who has suffered from a mental health problem like paranoia after using cannabis, a survey suggests.Forty-two percent of 11-18 year olds know someone who has experienced memory loss, panic attacks or paranoia from cannabis, drugs information service Frank said.

The survey of 27,000 teenagers found 74% were aware of the risks.

It revealed 18% of teenagers felt under pressure to try the Class B drug.

One in ten thought it made them look cool.

The research, which was carried out on networking website Habbo Hotel, found 64% of young people were aware cannabis could cause panic attacks, 41% knew it could bring on paranoia and 38% thought it could result in memory loss.

Over 50% of teenagers associated cannabis use with losing motivation and doing badly at school or college.

But one in four said they saw cannabis as a “natural” drug, despite the risks.

And 14% of 11-18 year olds admitted using the drug to help them to cope with life.

Chris Hudson, from Frank, said: “The majority of teenagers (55%) don’t want to risk their health by using cannabis, however, some people choose to take the risk; while others wrongly believe cannabis is harmless because it is a plant.

“Cannabis messes with your mind – and reactions can be more powerful with stronger strains such as skunk, which is around twice as potent,” he warned.

Source: BBC Newsbeat 6th Aug.2009

The following survey findings highlight a strong need for drug use prevention:

there is evidence that the earlier a person starts taking drugs, the greater the

likelihood that they will develop more serious health and drug problems over

time compared to those who abstain at a younger age (Lynskey et al, 2003).

Research has also shown that there are strong links between drug use and poor

academic performance (Ellickson et al, 2002), truancy (Hallfors et al, 2002) and

initiation into criminal activity (South and Teeman, 1999.

By Laura Clout
Telegraph News
06/02/2008

Researchers also found that those who took cannabis in adolescence had a greater risk of developing schizophrenia than older users of the drug.

The teenagers, aged 15 and 16, were asked about their drug use before their risk of developing a psychotic disorder was assessed by experts.

More than 5 per cent said they had used cannabis once or more, and one in 100 had used cannabis more than five times. Girls were more likely to take the drug than boys.

The study, carried out by a team at the University of Oulu in Finland, is published on Monday in the British Journal of Psychiatry.

Dr Jouko Miettunen, who led the research said: “These teenagers are likely to be vulnerable to the mental effects, which means they are probably vulnerable to developing psychosis at some point.”

Individual case reports have suggested a link between heart attack and amphetamine abuse, but this is believed to be the first epidemiological study of a large group of people on the issue, said Dr. Arthur Westover, assistant professor of psychiatry at
UT Southwestern and the study’s lead author.
  
“Most people aren’t surprised that methamphetamines and amphetamines are bad for your health,” Dr. Westover said. “But we are concerned because heart attacks in the young are rare and can be very debilitating or deadly.”

Amphetamines are stimulants that can be used to treat medical conditions such as attention-deficient disorder. They are illegally abused as recreational drugs or performance enhancers.

The researchers note that abuse of methamphetamine, a type of amphetamine often sold illegally, is increasing in most major U.S. cities.

In Texas, the researchers found greater amphetamine abuse in the north and Panhandle regions.

“This paper sounds a warning to amphetamine abusers, alerts emergency department personnel to look for amphetamine abuse in young heart attack patients, and it allows us to focus preventive efforts in geographical areas where the problems are greatest,” said Dr. Robert W. Haley, chief of epidemiology at UT Southwestern and senior author of the study. Dr. Haley holds the U.S. Armed Forces Veterans Distinguished Chair for Medical Research, Honoring America’s Gulf War Veterans.
“We’re also concerned that the number of amphetamine-related heart attacks could be increasing,” Dr. Westover said. “We’d rather raise the warning flag now than later. Hopefully, we can decrease the number of people who suffer heart attacks as the result of amphetamine abuse.”
Amphetamines may contribute to heart attacks by increasing heart rate and blood pressure and by causing inflammation and artery spasms that limit blood to the heart muscle. More research is needed to determine the exact mechanism of how amphetamines work on the heart, he said.
The current research could help doctors determine the cause of heart attacks in young adults, as well as treatment. Doctors recognizing an amphetamine-caused heart attack might choose not to administer a beta-blocker medication, a common treatment for heart attack, because it could interact with methamphetamine to make the heart attack worse.

The results could have broad implications in the general population, Dr. Westover said. Texas ranks 27th among all states in use of methamphetamine among 18- to 25-year-old adults, according to a 2006 government report.

“We’re talking about a state that is near the middle of prevalence of methamphetamine use in the United States, so it’s possible that the number of heart attacks in young adults in other states with a much higher prevalence of amphetamine abuse may be higher as well,” said Dr. Westover, who is a National Institutes of Health Multidisciplinary Clinical Research Scholar at UT Southwestern.
Dr. Paul Nakonezny, assistant professor of clinical sciences and psychiatry at
UT Southwestern, was also involved in the study.

The work was supported by a North and Central Texas Clinical and Translational Science Initiative grant from the National Center for Research Resources, a component of the National Institutes of Health.

WASHINGTON (CNN) — The earlier a young person uses marijuana the greater the risk for mental health problems later in life, the director of National Drug Control Policy said Tuesday, basing his conclusion on a survey of medical research.
 
“We’re trying to get out the word that the last 10 years of research have helped to alert us to the use of marijuana in particular is a very dangerous risk for the mental health of our young people,” John Walters said at a news conference.
He said the conclusion runs against popular culture that often considers marijuana a low-risk recreational drug.
Walters cited a government study that found a base rate of mental illness at between 8 percent and 9 percent among Americans 18 and older. For those who use marijuana, he said, “That increases to 12-and-a-half percent.”
And, he added, “For those who have used marijuana prior to age 12, the rate of mental illness jumps to 21 percent.”
The rate was half that, or 10.5 percent, for adults who first used marijuana at age 18 or older.
Those were the findings of the National Survey on Drug Use and Health, an annual survey sponsored by the Substance Abuse and Mental Health Services Administration.
Walters did not directly address the possibility of confusing cause and effect — that is, that people with mental problems might be more inclined to use drugs.
One study he cited was published last year in the Archives of General Psychiatry. It involved 600 pairs of same-sex twins, one of whom was dependent on marijuana and one of whom was not. The twin who was dependent was almost three times as likely to think about suicide and attempt suicide than his brother or sister, the study found.
Neil McKeganey, who heads the University of Glasgow’s Center for Drug Misuse Research, was at the press conference in support of Walters.
“It is leading us to look again at this so-called recreational drug,” he said. “Kids who start to use marijuana at a young age are much more likely to suffer serious, long-term mental health problems.”
The parents of a teenager who committed suicide last year were also at the news conference, and they linked their son’s death to his marijuana use.
Tanya Skaggs, of Colorado Springs, Colorado, said, “He had a severe lack of judgment that was because of the marijuana, this destructive behavior was continuing,” in the months leading up to his death.
The parents were unable to break his marijuana use, Skaggs said, despite counseling, searching his room for pot and random drug tests.
“We just never thought that something like this could happen to us. But it does, and it did,” she said. “We wish we could have helped.”
Agenda ‘detrimental to your children’
Walters downplayed whether the medical use of marijuana undercuts the impact of warnings to young people against pot use.
The question was tied to a decision by Canada last month to approve the prescription drug Sativex, an oral spray that contains the active ingredient of marijuana, to treat the symptoms of multiple sclerosis.
He responded, “We believe that there’s a clear distinction” between validated medical benefits and what he said could be “a bunch of ads where people testify that their mother, dying, smoked a joint and was saved, and that means marijuana is medicine.”
“Your children are being educated,” he said of such advertising. “But they’re being told lies. And they’re being told things that are designed to push a particular agenda which is detrimental to your children, and detrimental to the country.”
Group calls for national discussion
Meanwhile, a Washington-based nonprofit group released a report recommending changes in the way authorities handle drug offenses, citing a “disproportionate” focus on “low-level marijuana users.”
“The ‘war on drugs’ in the 1990s was, essentially, a ‘war on marijuana,’” said the report by the Sentencing Project, which was founded in 1986 to promote alternative sentencing programs.
A national analysis covering 1990 to 2002 found that, of a 450,000 rise in drug arrests during that period, 82 percent of the increase was for marijuana, and 79 percent was for marijuana possession alone.
Marijuana arrests now make up 45 percent of the nation’s 1.5 million drug arrests annually, the report said, and an estimated $4 billion is spent each year on marijuana offenders.
“The growth in marijuana arrests over the 1990s has not led to a decrease in use or availability, nor an increase in cost,” the group said. “Meanwhile, billions are being spent nationally.”
The report calls for “a national discussion regarding the zealous prosecution of marijuana use and its consequences for allocation of criminal justice resources and public safety.”
“Law enforcement has focused disproportionately on low-level possession charges as a result of the nation’s lack of a thoughtful strategy,” it said.Source:www.WordPress.com June 2008

There is significant new research concerning adolescent brain development and the effects of alcohol and other drug use on the developing brain. This emerging science is providing new insights about how teenagers make critical and life influencing decisions, including their decisions about drug use. Brain imaging studies suggest that the brain continues to develop through adolescence and into young adulthood (age 25 years). During adolescence, the parts of the brain that are responsible for expressing emotions and for seeking gratification tend to mature sooner than the regions of the brain that control impulses and that oversees careful decision making. As one expert puts it the teenage brain”has a well-developed accelerator but only a partly developed brake.”

The maturing brain of the adolescent may also pose a particular risk toward drug abuse. There is some evidence that the developing brain is prone to the deleterious effects of alcohol. One study showed that memory ability may be negatively affected by about 10% as a result of alcohol abuse.

Source   Mentor Foundation  17th Dec. 2008

A drug used to tranquillize horses, called ketamine, is gaining popularity within the dance scene in a number of countries throughout the world. That´s according to a recent report by the United Nations Office of Drugs and Crime, which warned that long-term use of ketamine use can have serious effects on the brain, the kidneys and internal organs.

Now the most abused drug by so called “clubbers” in Hong Kong, ketamine is gaining popularity across southern China. Its use is spreading throughout East Asia as well as Australia, Europe and North America. But because ketamine is a legal substance – and therefore not controlled – the true extent of its use is unclear and probably underestimated.

Nicknamed ‘Special K’, ketamine can be taken in powder, liquid or tablet form but is often mixed with other drugs or alcohol. Sometimes ketamine is laced with synthetic drugs such as methamphetamine and then sold as ecstasy because it commands a higher price than straight ketamine.

“It is a new candy for the youth “, explains UNODC expert Jeremy Douglas, who cautioned that people can be easily fooled. “Sometimes they know they’re using ketamine, sometimes they don’t”. Uncertainty about the content of tablets sold as “ecstasy” is of concern and poses particular risk.

The effect of the drug depends on the dose. With low doses, party-goers may feel euphoric, have psychedelic experiences and high levels of energy, but high doses might plunge the user into an out-of-body or near-death experience known as the “K-hole.” “It’s an anaesthetic so it can put someone in a catatonic state, a different state of being. Perception of the body, time and reality is severely altered,” Douglas said.

Long-term use may impair the memory and cognitive functions, and damage the kidneys and internal organs.

The emergence of ketamine on the synthetic drug scene has gone unnoticed in many parts of the world. Unlike illicit drugs, the trade in ketamine is not internationally controlled. This makes it hard to get a clear picture of how the drug is being diverted for illicit purposes. “We’re seeing the use of ketamine taking off, but it’s up to Member States and national governments to control it. Anyway, it seems that the use is growing both in developing countries and in the west”, Douglas says.

Source: CADCA Coalitions Online 13th Nov.2008

Recovery coaches’ effective in reducing number of babies exposed to drugs

CHAMPAIGN, Ill. — About 11 percent of the 4 million babies born in the U.S. each year have been exposed to alcohol or illicit drugs in the womb, according to a June 2006 report by the National Center on Substance Abuse and Child Welfare. If removed from the home by child protection, these children tend to remain in foster care longer, and chances are very low that they will be reunited with their parents.

However, a groundbreaking study led by Joseph P. Ryan, a faculty member in the School of Social Work at the University of Illinois, indicates that recovery coaches can significantly reduce the number of substance-exposed births as well as help reunite substance-involved families, saving state child-welfare systems millions of dollars in foster-care and other placement costs.

The study, part of a larger collaboration among the U. of I., the Department of Children and Family Services, and Treatment Alternatives for Safe Communities, appeared in the journal Child Abuse and Neglect. The sample included 931 women in Chicago and suburban Cook County who had lost temporary custody of their children to DCFS, and who were chronic substance abusers referred for alcohol and drug assessments. Sixty-nine percent of the women had given birth to at least one substance-exposed infant prior to enrollment in the study.

Although several characteristics – age, race, and cocaine or heroin use among them – place certain women at higher risk for giving birth to a substance exposed infant, mothers who have at least one prior substance-exposed infant are significantly more likely to deliver additional substance-exposed infants.
The study made use of an experimental design: Families were randomly assigned to one of two treatment conditions. The mothers assigned to the control group during the five-year study received traditional child-welfare and substance-abuse services; the mothers assigned to the experimental group received traditional services plus the services of a recovery coach. The coaches – caseworkers with special training in addiction, relapse prevention, case management and counseling – focused on getting the mothers into substance-abuse treatment and keeping them there by engaging in face-to-face contacts in the family home and with treatment-provider agencies. If a mother suffered a relapse – a common event in the recovery process – or dropped out of the program, the recovery coach helped re-engage her with treatment, and helped her meet the legal and other requirements associated with regaining custody of her children.

At the study’s conclusion, 15 percent of mothers assigned to the recovery-coach group had given birth to a subsequent substance-exposed infant compared with 21 percent of mothers assigned to the control group. Overall, mothers assigned to the recovery-coach group were more likely to access substance-abuse services, and were more likely to achieve family reunification, saving the state of Illinois $5.5 million in foster-care and other placement costs.

Reunification rates for substance-involved families typically are the lowest of all families involved with the child-welfare system. “One reason that they don’t achieve reunification is that they are unable to address the core problem of substance abuse, and that really presents an obstacle toward judges making decisions to have the children return home,” Ryan said. “A recovery coach increases the reunification rate by about 6 percent, which is a small but significant gain.”

Often, substance-involved families are grappling with several major problems – such as mental illness, inadequate housing, domestic violence and unemployment – “so it’s somewhat unrealistic to think that one case worker can effectively manage all those types of problems,” Ryan said. “No single intervention is going to solve the complex array of problems that these families encounter. But if we chip away at it – increase reunification rates, close out foster-care placements at a higher rate, decrease the likelihood of additional substance-exposed infants – it produces gains for families and for the state.”
It is important to note that one obstacle to identifying substance exposure at birth is the lack of federal or state laws that mandate testing newborns for drug exposure. A recent nationwide study found that there are no standardized testing practices or criteria for testing infants in most hospitals, and the decision to test a newborn is left to the discretion of the attending physician or the hospital.

Co-authors of the study, which appeared in the November issue of the journal, were professor Christopher R. Larrison, research specialist Pedro Hernandez and graduate student Jun Sung Hong at the U. of I., and Sam Choi, a postdoctoral scholar in the School of Social Service of Administration at the University of Chicago.

Source:  News Bureau, University of Illinois  7th Jan 2009

OBJECTIVE: To evaluate whether maternal use of recreational drugs around conception and pregnancy influences the risk of childhood neuroblastoma.
METHODS: Self-reported use of recreational drugs from one month prior to pregnancy until diagnosis was assessed among mothers of 538 children with neuroblastoma (diagnosed 1992-1994 and identified through the Children’s Cancer Group and Pediatric Oncology Group) and 504 age-matched controls (identified by random-digit dialing). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression, adjusting for age at diagnosis and household income. RESULTS: Maternal use of any illicit or recreational drug around pregnancy was associated with an increased risk of neuroblastoma in offspring (OR = 1.82, 95% CI: 1.13, 3.00), particularly use of marijuana in the first trimester of pregnancy (OR = 4.75, 95% CI: 1.55, 16.48). Marijuana use in the month before pregnancy did not increase risk. The effect of gestational marijuana exposure was strongest in subjects diagnosed before age one. Evaluation of recreational drugs other than marijuana was limited by infrequent use, and analyses of drug use by fathers were not carried out due to missing data.
 CONCLUSIONS: Maternal recreational drug use and marijuana use during pregnancy were associated with increased risk of neuroblastoma in offspring. Further examination of these drugs and the risk of childhood cancer is warranted.
Source  Cancer Causes Control. 2006 Jun;17(5):663-9.

A new study from the Telethon Institute for Child Health Research has revealed the consequences of heavy and binge drinking on pregnancy even after these drinking patterns have stopped.
 
The study, to be published in BJOG: An International Journal of Obstetrics and Gynaecology, investigated the relationship between prenatal exposure to alcohol and the effects on fetal growth and preterm birth. 
 
A random sample of 4,719 women who gave birth in Western Australia between 1995 and 1997 took part in a survey.  Data such as how often participants drank alcohol, the amount of alcohol consumed in each occasion and the types of alcoholic beverage consumed were collated.    
 
The researcher team from the Institute with the National Perinatal Epidemiology Unit at the University of Oxford found that, on average, levels of alcohol intake decreased from the pre-pregnancy period to the second and third trimester.  There was no difference in outcomes for women who drank low levels of alcohol during their pregnancy and those that abstained. 
 
The incidence of preterm birth was highest amongst women who binged (9.5%) or drank heavily, even if the mother stopped drinking prior to the second trimester (13.6%), compared with less than 6% in women who did not drink during pregnancy.  There was a 2.3-fold increased odds of preterm birth in women who drank heavily in early pregnancy but then stopped (CI 0.7, 7.7) after taking into account maternal smoking, drug use, socioeconomic status and maternal health. Researchers suggest that a possible reason why this occurs is because the cessation of alcohol consumption before the second trimester may trigger a metabolic or inflammatory response resulting in preterm birth.  There was no evidence of an increased likelihood of preterm birth at low levels of alcohol consumption. 
 
Prenatal alcohol exposure did not increase the risk of babies being born small for gestational age once maternal smoking was accounted for.
 
Researchers noted a link between smoking and alcohol consumption – they found women who smoked during pregnancy were less likely to abstain from alcohol at any time during their pregnancy than non-smokers.  Over one quarter (27.7%) of women who drank in late pregnancy also smoked, compared with 19% of women who had abstained from alcohol during pregnancy.  Other factors associated with late term pregnancy drinking include: a maternal age of 30 years and above, higher income, use of illicit drugs.
 
Institute researcher Colleen O’Leary said “Our research shows pregnant women who drink more than one to two standard drinks per occasion and more than six standard drinks per week increase their risk of having a premature baby, even if they stop drinking before the second trimester.
 
“The risk of preterm birth is highest for pregnant women who drink heavily or at binge levels, meaning drinking more than seven standard drinks per week, or more than five drinks on any one occasion.
 
“Health professionals should routinely screen pregnant women and all women of child bearing age for alcohol use/misuse.  It’s important that women should be given information about the possible risks to the baby from alcohol exposure during pregnancy.
 
“Women should be advised that during pregnancy, drinking alcohol above low levels increases the risk to the baby and that the safest choice is not to drink alcohol during pregnancy.  If pregnant women cannot stop or reduce their drinking, they should seek medical advice.”
 
[A standard drink in this analysis is the Australian standard10gm of alcohol, eg 100ml of wine]
 
Professor Philip Steer, BJOG editor-in-chief said, “This study provides useful insight into the drinking habits of a representative group of women.  It is very telling how the combination of smoking and heavy drinking can mean double trouble for pregnant mothers and their babies.      
 
“It shows the effects of high alcohol use and demonstrates that heavy and binge levels of alcohol during pregnancy increases the risk to the baby, even if drinking is stopped in the first three months of pregnancy. These findings are sobering and should act as a deterrent to heavy or binge drinking during pregnancy. However, the results also show that low levels of alcohol consumption (less than 7 standard drinks per week and no more than two on any one occasion) appeared not to constitute a significant risk of preterm birth provided all other forms of unhealthy behaviour were avoided.”  
 
Source: Telethon Institute for Child Health Research  21st Jan.2009

Doctors and drug workers in Bristol have established a link between the use of Class C drug ketamine and severe bladder and kidney problems.
A BBC investigation for Inside Out West found a rising number of ketamine users in their teens and 20s were admitted to Southmead Hospital over the past year.
Many had to undergo operations – two even needed their bladders removing. Doctors at the hospital conducted further research and discovered a similar pattern across the UK.  Ketamine is a short-acting but powerful general anaesthetic which depresses the nervous system and causes a temporary loss of body sensation.
Kidney pains
In the early 1990s the drug started becoming popular on the UK club scene as people bought it in the mistaken belief it was ecstasy. It was made illegal in January 2006 when the government classified it as a Class C drug.
 
 
The drug comes in various forms, most commonly as a powder, but also as a liquid and a tablet.   The British Crime Survey for 2008 revealed its use was up 10% on the previous year.
The BBC researchers found many users were unaware of the long-term effects of the drug on their health.  Symptoms include pains in the stomach and kidneys, wanting to go to the toilet all the time, often getting up in the night as many as 30 times, and finding the process agonising.
‘Physically shrivelled’
During 2008 the Bristol Drugs Project said there had been a noticeable increase in the number of ketamine users asking for help.   One anonymous user, who is now waiting for bladder reconstruction surgery, told a BBC researcher: “Doctors told me the capacity of my bladder had shrunk.
“It was actually physically shrivelled and scarred, there was an awful lot of scar tissue.  “A lot of the muscle around the outside, which obviously helps your bladder contract and which is what makes you go, a lot of that had been eaten away by the ketamine.”   The programme found there are other similar cases on waiting lists in Bristol. Operations have also been carried out in London and Liverpool.
David Gillatt, a consultant urologist at Southmead Hospital, said: “This is a worrying development as major bladder operations, such as the ones they’re now carrying out, are normally performed on a much older age group.  “We have got cases who’ve had to go as far as major surgery to remove the bladder and that’s a fairly big step.  “These people are often in their teens through to 20s, maybe 30s at the oldest, and that’s something they’ll have to live with for the rest of their days.” Professor David Nutt, who chairs the government’s drug advisory panel, is being kept regularly updated on the latest developments in the research in Bristol.
 Source:  BBC News Channel  4th Feb.2009

Specialist liver services are already at full capacity and demand is growing as increasing numbers of younger people fall ill due to their drinking, according to doctors writing in the journal Clinical Medicine.
A questionnaire of gastroenterologists revealed that the majority of hospitals have only have the number of specialist doctors needed for the expected workload of an average local hospital. There is also shortages of specialist nurses, radiologists, pathologists and psychiatrists, the study said.
Author of the study Dr Michael Williams, Specialist Registrar at Derby Digestive Diseases Centre, Derby City General Hospital said the shortages will affect patient care and hospitals should be organised into networks as recommended by the National Plan for Liver Services.   Professor Ian Gilmore, President of the Royal College of Physicians, Professor of Medicine and consultant gastroenterologist at Royal Liverpool University Hospitals said: “Liver disease is increasing and the majority of the increase is alcohol-related.
“Deaths from alcohol-related liver disease are continuing to rise and across all liver disease deaths have gone up ten fold since the 1970s.  Liver disease stands out starkly as an increasingly common cause of death at a time when improvements in health are being seen in other areas. Many deaths are avoidable with specialist care but our hospitals services have not kept pace with this rising tide of liver disease.
“We need to urgently implement the national plan to remedy this.”
Prof Gilmore said the Government was taking action on alcohol labelling and selling at discounts but more needed to be done as drink has never been more available or cheaper than it is now.
He said the best way to bring down harmful alcohol consumption would be to introduce a minimum price per unit as this would not affect the middle market wines but would hit the cheap strong ciders and lagers which are often drunk to excess.

Source: www.Telegraph.co.uk  4rh Feb.2009

Adolescents and young adults who are heavy users of marijuana are more likely than non-users to have disrupted brain development, according to a new study. Pediatric researchers found abnormalities in areas of the brain that interconnect brain regions involved in memory, attention, decision-making, language and executive functioning skills. The findings are of particular concern because adolescence is a crucial period for brain development and maturation.
The researchers caution that the study is preliminary and does not demonstrate that marijuana use causes the brain abnormalities. However, “Studies of normal brain development reveal critical areas of the brain that develop during late adolescence, and our study shows that heavy cannabis use is associated with damage in those brain regions,” said study leader Manzar Ashtari, Ph.D., director of the Diffusion Image Analysis and Brain Morphometry Laboratory in the Radiology Department of The Children’s Hospital of Philadelphia.  The study appeared early last month in the Journal of Psychiatric Research. The current research builds on previous work by Ashtari and colleagues, who used the same imaging technology to analyze normal brain development in adolescent subjects.
In the current study, working with child psychiatrist Sanjiv Kumra, M.D., now at the University of Minnesota, Ashtari and colleagues performed imaging studies on 14 young men from a residential drug treatment center in New York State, as well as 14 age-matched healthy controls. All the study subjects were males, with an average age of 19. The researchers performed the imaging studies at Long Island Jewish Medical Center.  The 14 subjects from the drug treatment center all had a history of heavy cannabis use during adolescence. On average, they had smoked marijuana from age 13 till age 18 or 19, and reported smoking nearly 6 marijuana joints daily in the final year before they stopped using the drug.
The study team performed a type of magnetic resonance imaging scan called diffusion tensor imaging (DTI) that measures water movement through brain tissues. “The abnormal patterns of water diffusion that we found among the young men with histories of marijuana use suggest damage or an arrest in development of the myelin sheath that surrounds brain cells,” said Ashtari. Myelin provides a coating around brain cells similar to insulation covering an electrical wire. If myelin does not function properly, signaling within the brain may be slower.
Myelin gives its color to the white matter of the brain, and covers the nerve fibers that connect different brain regions. “Our results suggest that early-onset substance use may alter the development of white matter circuits, especially those connections among the frontal, parietal and temporal regions of the brain,” said Ashtari. “Abnormal white matter development could slow information transfer in the brain and affect cognitive functions.”
Ashtari added that the findings are preliminary. Among other limitations of the study, such as a small sample size, five of the 14 subjects with heavy cannabis use also had a history of alcohol abuse, which may have contributed an effect. Also, it is possible that the brain abnormalities may have predisposed the subjects to drug dependence, rather than drug usage causing the brain abnormalities.
“Further research should be done to investigate the relation between repeated marijuana use and white matter development,” said Ashtari. “However, our work reinforces the idea that the adolescent brain may be especially vulnerable to risky behaviors such as substance abuse, because of crucial neural development that occurs.
Source: Science Daily 5th Feb 2009

Young men who smoke marijuana are more likely to develop an aggressive form of testicular cancer than those who have never tried the drug, a study has found.

Smoking the drug at least once a week, or using it regularly from adolescence, doubled the risk of a fast-growing form of the disease called nonseminoma, which tends to strike men in their 20s and 30s, researchers said.

The US study is the first to find evidence of a link between cannabis and testicular cancer, which is the most common type of cancer among British men aged 20 to 44. More than 1,900 new cases of the disease are diagnosed in the UK each year, but it responds well to treatment, with nine in 10 men surviving.

The findings suggest that smoking the drug before the age of 18 raises the cancer risk by coaxing immature cells in the testes to become tumours later in life.

Scientists at the Fred Hutchinson Cancer Research Centre in Seattle investigated the possibility of a link after learning that the testes were one of the few organs in the body to contain receptors for the main psychoactive substance in the drug, tetrahydrocannabinol (THC). There has also been a rise in testicular cancer cases that has mirrored the rise in marijuana use since the 1950s, they said.

“Our study is not the first to suggest that some aspect of a man’s lifestyle or environment is a risk factor for testicular cancer, but it is the first that has looked at marijuana use,” said Stephen Schwartz, an epidemiologist and author on the study.

The researchers asked 369 testicular cancer patients if they had any history of marijuana use. A further 979 healthy men were asked about their use of the drug.

After accounting for any family history of the cancer and lifestyle factors, such as smoking and drinking alcohol, the study found cannabis use emerged as a significant, separate risk factor for the disease.

Being an existing cannabis user raised the risk of cancer by 70%, while men who had used the drug regularly from puberty were twice as likely to develop the disease than those who had not used the drug.

Men naturally produce a cannabinoid-like substance that is thought to protect the testes against tumours. But smoking cannabis may disrupt this and so raise the risk of cancer, the study speculates.

Source:  www.guardian.co.uk   9th Feb. 2009

Marijuana use appears to have decreased among most European and North American adolescents between 2002 and 2006, and those who went out with friends on fewer evenings of the week were less likely to report using the drug, according to a report in the February issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
“Cannabis [marijuana] use among young people is a serious public health concern,” the authors write as background information in the article. Recent evidence links marijuana use to motor vehicle accidents, injuries, inflammatory and cancerous changes in the airways and mental health problems, including depression. Long-term detrimental effects include poor academic performance and failure to complete schooling, impeding development and hampering future career opportunities.
“One factor that may help explain why adolescents engage in cannabis use is association with cannabis-using peers, which can increase the availability of cannabis and socially influence use,” the authors write. To investigate this link and also trends in marijuana use over time, Emmanuel Kuntsche, Ph.D., of the Swiss Institute for the Prevention of Alcohol and Drugs Problems, Lausanne, and colleagues analyzed data from 93,297 15-year-old students who participated in the Health Behavior in School-Aged Children study. Participants in 31 countries (mostly in Europe and North America) were surveyed in 2002 and again in 2006 about marijuana use and the number of evenings per week they usually spend out with their friends, among other topics.
During the four-year study period, marijuana use decreased in most of the countries, with the most significant declines in England, Portugal, Switzerland, Slovenia and Canada. Increases were observed in Estonia, Lithuania, and Malta and among Russian girls. The number of evenings out with friends also declined in most countries during the same time period, although there was a wide range in averages, from about one evening per week for Portuguese girls to more than three evenings per week among boys and girls in the Ukraine, Russia, Scotland, Estonia and Spain.
“The more frequently adolescents reported going out with their friends in the evenings, the more likely they were to report using cannabis,” the authors write. “This link was consistent for boys and girls and across survey years. Across countries, changes in the mean [average] frequency of evenings spent out were strongly linked to changes in cannabis use.”
Besides a decline in evenings out with friends, potential reasons for the decline in marijuana use include prevention efforts, availability or changes in teen preferences. It is more difficult to pinpoint factors behind the decline in evenings out, the authors note. New forms of communication, such as e-mail and text messaging, may have replaced some face-to-face interactions, or that the high rate of marijuana use in 2002 may have increased parental concerns about substance use and made access to the drug and evenings out more difficult.
“This overview of trends in 31 countries and regions provides policy makers with important information on the prevalence and amount of change in cannabis use among boys and girls in their countries,” the authors write. “There is a great need to learn more about the nature of evenings out with friends and related factors that might explain changes in adolescent cannabis use over time. Because there are many benefits to adolescent social interaction, it is important to determine how best to foster it without unduly increasing exposure opportunities for cannabis use.”
(Arch Pediatr Adolesc Med. 2009;163[2]:119-125. Available pre-embargo to the media at www.jamamedia.org.)
________________________________________
Editorial: Reducing Social Time for Teens Not an Ideal Prevention Method
“What we have gained from this well-designed international study is further convincing evidence that unsupervised social time is a critical ingredient for cannabis use for many young people,” write John E. Schulenberg, Ph.D., and Patrick M. O’Malley, Ph.D., of the University of Michigan, Ann Arbor, in an accompanying editorial.
“This might lead some to suggest a simple intervention of reducing unsupervised time with friends by, for example, increasing structured time with friends, increasing school and work time or increasing alone time,” the authors write. “However, this strategy may have unintended consequences for many adolescents. An important part of adolescence is exploring and forming friendships, having bonding experiences and finding a safe haven with friends away from adult supervision.”
“Thus, rather than trying to reduce socializing with friends, a more complicated but possibly more successful approach to intervention would help young people find activities together that do not promote marijuana use,” they conclude.

Source: Arch Pediatr Adolesc Med. 2009;163[2]:183-184

The damage caused by expectant mothers who drink during pregnancy is costing Canada more than $5 billion a year, a report says.
Fetal Alcohol Spectrum Disorder (FASD) impacts one in 100 children, or almost 243,000 Canadians, causing low birth weight, restricted growth, physical and mental disability and, in some cases, heart problems.
Doctors dealing with the disorder say there is a dire need for more diagnostic services and warn that even with government intervention, FASD will carry a high price tag for generations.
“We all know one drink is not going to cause FASD,” says Dr. Brenda Stade, the head of the FASD clinic at Toronto’s St. Michael’s Hospital who co-wrote the paper, published in the January edition of the Canadian Journal of Clinical Pharmacology. “Bottom line, you should abstain if you can. If you can’t, you should go to your family doctor and try to cut down.”
Eight-year-old Caitlyn Nugent was born addicted to alcohol after her mother sipped vodka coolers throughout her pregnancy. Her 10-year-old sister Chrystal isn’t as badly affected but has also been diagnosed with conditions classified under FASD, an umbrella term for a variety of mental, physical and behavioural problems linked to drinking during pregnancy, including Fetal Alcohol Syndrome.
“The children do look normal, but they don’t act normal,” says their grandfather, Doug Nugent, who with his wife Larraine have raised the girls since they were babies in Toronto. Their son is the girls’ father. “There is a lot of confusion about their behaviour … they are not spoiled brats. It’s just brain damage.”
Some FASD children bear hallmark facial features, including smaller and wide-set eyes, a thin upper lip and no groove between the nose and lip. But many don’t, which is why their behaviour is often misunderstood well into adulthood. “These people have been struggling for years and nobody can really recognize their disability,” says Stade, who has adopted a child with the disorder. The clinic opened six years ago and diagnoses about 400 patients every year, of all ages. They are expanding to meet demand.
The report by the Hospital for Sick Children, the Public Health Agency of Canada and St. Mike’s, involved interviews with 250 caregivers of children and adults with FASD on the costs of emergency medical care, health services, education and out-of-pocket spending, including medication and recreational activities. FASD is a recognized disability so the costs of the Ontario Disability Support Program were included. No one knows exactly how much alcohol causes the disorder. To prevent confusion over what could be safe, most experts advise pregnant women not to drink at all.
Every child’s condition and needs are different and complicated, Stade says. Mental impairment includes behavioural issues, problems learning and impaired social skills and judgment.
But many children with the disorder, she says, are socially adept, using small talk to fit in and, given the proper support, can function well in certain positions, including some trades. But getting to that point requires a tremendous amount of support.
Doug and his wife are both 57. But, he says, “my retirement started six years ago, once the kids came. I couldn’t go out and work full-time.”
Caitlyn and Chrystal have serious dental problems and “their immune system is zilch,” says their grandfather. They both require inhalers and are constantly battling infections. They have had speech and physical therapy and need sensory integration therapy – essentially exposing them to a barrage of sensations to teach them to respond properly to stimuli.
FASD children have trouble focusing, says Doug.
“The teachers, they can’t understand why the kids are not capable of doing work … the signal doesn’t get through properly.”
It’s easy, Doug says, for outsiders to find fault with a child affected by FASD. Caitlyn and Chrystal have difficulty understanding social cues, it’s hard for them to play with other children and they are prone to severe mood swings. “I’m a little bit scared for the girls when they start the next level of school. The social aspects of the higher-level schools scare me, because these children are so vulnerable,” he says.
Of their teenage years, Larraine says: “I’m really dreading them because they are such followers … it doesn’t matter how much you try to streetwise them. It is going to be hard.” She and her husband’s main goal is to raise awareness and get the government to provide funding for early services and therapies for kids with FASD and their families.
That is why they invited the Star into their home to speak about the girls. They have applied twice to the province’s Family Responsibility Office to get coverage for dental care and prescription medication. They were rejected both times, told incorrectly that FASD is not a recognized disability and that being grandparents disqualifies them.
“I would love to tell the government to live with these children themselves,” says their grandfather. “It’s banging your head up against a brick wall, trying to get acceptance for these children … they need assistance.”

Source: TheStar.com  3rd March 2009

Adolescents and young adults who are heavy users of marijuana are more likely than non-users to have disrupted brain development, according to a new study. Pediatric researchers found abnormalities in areas of the brain that interconnect brain regions involved in memory, attention, decision-making, language and executive functioning skills. The findings are of particular concern because adolescence is a crucial period for brain development and maturation.
The researchers caution that the study is preliminary and does not demonstrate that marijuana use causes the brain abnormalities. However, “Studies of normal brain development reveal critical areas of the brain that develop during late adolescence, and our study shows that heavy cannabis use is associated with damage in those brain regions,” said study leader Manzar Ashtari, Ph.D., director of the Diffusion Image Analysis and Brain Morphometry Laboratory in the Radiology Department of The Children’s Hospital of Philadelphia.
The study appeared early last month in the Journal of Psychiatric Research. The current research builds on previous work by Ashtari and colleagues, who used the same imaging technology to analyze normal brain development in adolescent subjects.
In the current study, working with child psychiatrist Sanjiv Kumra, M.D., now at the University of Minnesota, Ashtari and colleagues performed imaging studies on 14 young men from a residential drug treatment center in New York State, as well as 14 age-matched healthy controls. All the study subjects were males, with an average age of 19. The researchers performed the imaging studies at Long Island Jewish Medical Center.
The 14 subjects from the drug treatment center all had a history of heavy cannabis use during adolescence. On average, they had smoked marijuana from age 13 till age 18 or 19, and reported smoking nearly 6 marijuana joints daily in the final year before they stopped using the drug.
The study team performed a type of magnetic resonance imaging scan called diffusion tensor imaging (DTI) that measures water movement through brain tissues. “The abnormal patterns of water diffusion that we found among the young men with histories of marijuana use suggest damage or an arrest in development of the myelin sheath that surrounds brain cells,” said Ashtari. Myelin provides a coating around brain cells similar to insulation covering an electrical wire. If myelin does not function properly, signaling within the brain may be slower.
Myelin gives its color to the white matter of the brain, and covers the nerve fibers that connect different brain regions. “Our results suggest that early-onset substance use may alter the development of white matter circuits, especially those connections among the frontal, parietal and temporal regions of the brain,” said Ashtari. “Abnormal white matter development could slow information transfer in the brain and affect cognitive functions.”
Ashtari added that the findings are preliminary. Among other limitations of the study, such as a small sample size, five of the 14 subjects with heavy cannabis use also had a history of alcohol abuse, which may have contributed an effect. Also, it is possible that the brain abnormalities may have predisposed the subjects to drug dependence, rather than drug usage causing the brain abnormalities.
“Further research should be done to investigate the relation between repeated marijuana use and white matter development,” said Ashtari. “However, our work reinforces the idea that the adolescent brain may be especially vulnerable to risky behaviors such as substance abuse, because of crucial neural development that occurs during those years.”
Source:  www.ScienceDaily.com  3rd Feb 2009

The number of 11 to 18 years old in London admitted to hospital for alcohol-related illnesses has risen.
Admissions increased from 1,171 in 2002/03, to 1,769 in 2006/07, according to figures obtained for a report.
The ‘Highs and Lows’ report by the Greater London Alcohol and Drug Alliance said less young Londoners are using drugs, particularly cocaine.
London Mayor Boris Johnson said the fall in cocaine use over the last couple of years was encouraging.
The report said the proportion of young Londoners between 16 and 24 who reported using any drug use during the last year decreased between 2005/06 and 2007/08 – from 20.3% to 17.8%.
And the proportion of young Londoners who reported using cocaine is down from 7.1% in 2005-06 to 4.7% in 2007-08.
Widespread problems
The report also said the estimated numbers of problem drug users – those whose drug use has taken over their lives – in this age group dropped from 14,068 in 2004/05 to 11,750 in 2005/06.
Mr Johnson said: “It is encouraging to see a noticeable reduction in cocaine use among young people over the last couple of years.
“Fewer young Londoners are using drugs but we can’t be complacent. Substance abuse causes widespread problems across the city.”
The Greater London Alcohol and Drug Alliance is a partnership bringing key agencies together to analyse trends and share information reducing alcohol and drug related harm in London, and is supported by the Greater London Authority.

Source: http://news.bbc.co.uk/go/pr/fr/-/1/hi/england/london/7939368.stm  2009/03

In a new study, researchers have determined that prenatal exposure to cigarette smoking, when combined with a specific genetic variant, places children at increased risk for aggressive behavior and other behavioral problems.
The study, led by scientists at the Institute for Juvenile Research at the University of Illinois at Chicago, identified a long-lasting influence on a child’s behavior precipitated by the monoamine oxidase A (MAOA) gene variant in conjunction with prenatal exposure to tobacco. MAOA is an enzyme which regulates key neurotransmitters in the brain. 
The genetic variant responsible for increased risk of behavioral problems differs between boys and girls, researchers said. In boys exposed to tobacco smoke prenatally, the low-activity MAOA (MAOA-L) gene variant was associated with increased disruptive social interactions, aggressive behavior, and serious rule-violating.
Among girls, the high-activity MAOA (MAOA-H) gene variant was associated with increased disruptive behavior. In addition, girls with both the MAOA-H variant and prenatal exposure to cigarette smoke had an increased “hostile attribution bias” — a tendency to perceive anger in a range of facial expressions — that was not seen among boys.
There was a higher risk of disruptive behavior for both boys and girls the more their mother smoked during pregnancy, according to the study.
“The tendency to over-perceive anger suggests the possibility that the combination of prenatal tobacco exposure and the MAOA risk variant affects the brain’s processing of emotional cues,” said Lauren Wakschlag, the study’s principal investigator. “Clearly, close attention to sex differences in these patterns will be critical for future studies,” she said.

Source:Join Together. March 16th 2009

Students who regularly combine ecstasy and cannabis may harm their academic results, a recent research project has shown. The research was conducted in Barcelona and followed 120 cannabis and ecstasy users for three years. The results suggested that regular poly-drug users obtained half the marks of the non-user control group, writes Ruth Evans.
Scientists are divided over the effects of ecstasy, but there is general agreement that regular use can negatively affect long-term memory. The Spanish study contradicts previous research which suggested that people who took ecstasy alone had worse memory problems.
Dr de la Torre, who conducted the study, said that the risk of affecting their degrees should deter students from mixing drugs.
Source:  www.Nouse.co.uk    February 12, 2005

Regular users of cannabis could be putting themselves at risk of stroke, while they are still young, indicates a case report, published in the Journal of Neurology Neurosurgery and Psychiatry.

Illicit drug use is known to be associated with an increased risk of stroke in young users, with heroin, cocaine, and speed (amphetamines) the most frequently implicated.
The patient was a 36 year old primary school teacher, who had been a sporadic user of cannabis in the past. He had no known risk factors for stroke, did not use other drugs, and only drank occasionally.
The first incident occurred after he had smoked a considerable amount of cannabis combined with three or four drinks at a party. He lost his ability to speak, which was followed, a few hours later, by convulsions.
A brain scan revealed one patch of bleeding and another blood clot, but no evidence of narrowed/furred up arteries. He was treated, and recovered.
A year later, after another bout of cannabis smoking, he again lost his ability to talk and experienced weakness on one side of his body (hemiparesis). A brain scan revealed a further small patch of bleeding as well as another blood clot, but in different areas from before.
The man refrained from using cannabis for 18 months, but then smoked a reasonable amount in one go, which he combined with three or four drinks. This was followed by an inability to recognise sounds, a condition known as auditory agnosia.
A brain scan revealed a patch of bleeding as well as the damage left by the previous bleeds.
The behavioural abnormalities and increased risk of schizophrenia, associated with frequent cannabis use, are well known, say the authors. But less well known, and no less important, are the cardiovascular effects.
These include rapid heart beat (tachycardia), excessively high or low blood pressure, and the decreased oxygen carrying capability of red blood cells. Cannabis also quadruples the risk of a heart attack within an hour of consumption.
They are at pains to point out that despite the widespread use of cannabis, there have only been 15 other cases of stroke, which have been linked to cannabis consumption.
But they conclude: “Cannabis is not as safe a drug as many believe…Future studies will be needed to clarify the role of cannabis as a stroke risk factor, as it could be underestimated.”
An accompanying editorial, which discusses the possible mechanisms for the drug’s impact on the cardiovascular system, suggests that recreational users of cannabis should be told more about the potential risks to their health.
“The therapeutic potential of cannabis and its derivatives should be rigorously evaluated and the benefit to risk ratio taken into account before authorising their medical use,” writes Dr Dominique Deplanque, of the Department of Pharmacology at the University of Lille.

Source: British Medical Journal (2005, February 24). Regular Cannabis May Increase Risk Of Stroke In Young Users.

University of Adelaide Associate Professor of Pharmacology Rod Irvine said the drug could lead to a generation gripped by early onset of serotonin-depletion diseases such as Alzheimer’s and Parkinson’s.
“One big exposure” to MDMA could be enough to damage the brain permanently  “You probably don’t necessarily have to (be a user) for a very long period of time,” Professor Irvine said.   He said the liver struggled to excrete MDMA from the body after as little as one pill. “So the concentration goes much higher than you expect,” he said.
Brain neurons emitting serotonin, the neurotransmitter involved in regulating mood and memory, are attacked and disabled.   Memory and cognitive harm, and depression – referred to as “Eccie Monday” or “Suicide Tuesday” – were commonly reported by weekend ecstasy users.
“But in the US, tests on monkeys who have been exposed (to ecstasy) and then left drug-free for years . . . when you examine their brains, they’ve still got this loss of serotonin,” Professor Irvine said.  “Even if there is recovery (in the long-term), it’s very slow and the brain doesn’t make the same connections. So it’s unlikely that you’re going to have the same functionality as what you had before.”
According to the 2008 Ecstasy and Related Drugs Reporting System, an average Queensland user is 24 and employed. One in every two has tertiary qualifications, and typically, two pills are “dropped” every fortnight.
While ecstasy does not appear to be highly addictive, a 32-year-old Brisbane caller to triplej radio earlier this month told of swallowing 15 pills one night.  “It took about two days until I came down properly,” he said.
He said that after 15 years of taking the drug, his “short-term memory was shot”.  “Another strange symptom after taking MDMA is . . . paralysis – you wake up mid-REM, hallucinate and hear things. You pretty much can’t move and panic.”

 Source: www.couriermail.com.au  30th March 2009

In the first study across time into late childhood of the effects of prenatal drug exposure on sleep, prenatal drug exposure is associated with greater sleep problems in children. In addition, nicotine has a unique effect, and early sleep problems predict later sleep problems, according to a research abstract that will be presented on June 10 at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).

The study, authored by Kristen Stone, PhD, of Brown University in Providence, Rhode Island, We investigated reports across time of 139 mothers regarding the sleep of their children — from 18 months to nine years of age. Of these children, 23 had no prenatal drug exposure, 55 were exposed to cocaine alone or in combination with other drugs, and 61 were exposed to drugs other than cocaine.
According to the results, children with prenatal drug exposure — nicotine, alcohol, marijuana, opiates, or some combination of these — experienced greater difficulty sleeping than unexposed children. Analyses revealed that prenatal nicotine exposure predicted difficulty sleeping above and beyond the other substances. Early sleep problems also predicted later sleep problems.
“Studying the effects of prenatal drug exposure on sleep may provide clues regarding how drugs affect the developing brain and may explain some of the effects of prenatal drug exposure on other outcomes, such as behavior and attention,” said Dr. Stone. “For example, studies show that adolescents with prenatal nicotine exposure are more likely to start smoking earlier than their peers, but we don’t know what other factors, such as sleep, might be involved in that relationship.”

Source:  ScienceDaily (June 10, 2008)

The number of alcohol and drug abusers being treated by mental hospitals has leapt by almost a third in five years.   Doctors have also charted a rising number of patients being sectioned because of psychiatric problems – many in private hospitals at NHS expense.
Critics last night blamed the binge drink and drug culture for creating more mental health disorders, while cuts in NHS beds are increasing dependency on the private sector.  Critics blame binge drink and drug culture for creating more mental health disorders
A report by three psychiatrists in the British Medical Journal says there is concern about an era of ‘re-institutionalisation’ within mental hospitals.
The number of hospital beds dropped from 150,000 in the 1950s to less than 55,000 in 1995 in favour of community care but demand appears to be rising, they say.   The number of sectioned patients – taken into hospital under compulsory orders – has increased by 20 per cent over the last decade.
The psychiatrists found a 29 per cent rise in admissions by alcohol and drug abusers since 2003.  They say the numbers have changed the environment on psychiatric wards with reports of patients with depression feeling intimidated and even attacked by those with drink and drug problems.
Tories claimed the increase was not being helped by Labour ‘mixed messages’ on the dangers of drugs and its rolling out of 24-hour drinking.

Source:  www.MailOnline  Oct.2008

Research Summary
Children exposed to methamphetamine during pregnancy may suffer from altered brain development, Reuters reported April 15.
Researchers at the University of Hawaii, Honolulu assessed the brain structure of children who were exposed to methamphetamine during pregnancy and found that they had up to 4 percent less diffusion of molecules in brain white matter than those who were not exposed.
While it is unclear how methamphetamine exposure leads to lower brain diffusion, author Linda Chang said the condition usually indicates that nerve fibers are compacted.
“Methamphetamine use is an increasing problem among women of childbearing age, leading to an increasing number of children with prenatal meth exposure,” Chang said. “But until now, the effects of prenatal meth exposure on the developing brain of a child were little known.”
Source: Neurology. April 15, 2009

 
Research Summary
Smoking marijuana during pregnancy raises the risk of fetal brain damage, new research suggests.
Bloomberg News reported May 25 that researcher Ken Mackie of the University of Indiana led a team that studied the effects of marijuana on neurons in mouse brains. They found that the drug helps determine how brain cells make connections — a fact that could have some bearing on fetal brain development.
Previous studies have shown that babies born to marijuana-smoking mothers experience some cognitive impairment. “This is gross speculation, but if the synaptic connections are a little off, then the higher-level behavior might be a little off,” said Mackie.
Endocannabinoids are part of the brain system acted upon by marijuana; when researchers blocked the chemicals in gestating mice, it seemed to increase the formation of neural connections. “The obvious implication is that prenatal exposure to marijuana can change patterns of connectivity in the developing brain,” said Anatol Kreitzer, an assistant professor at the Gladstone Institute of Neurological Disease at the University of California at San Francisco.
Source: May 25, 2007 issue of the journal Science.

Since states began setting the legal drinking age to 21, the National Highway Traffic Safety Administration estimates over 26,000 lives have been saved. And as one of the most studied public health laws in history, the scientific research from 46 high-quality studies all found that the 21 Law saves lives.² In addition, studies show that the 21 Law reduces causes those under the age of 21 to drink less and to continue to drink less throughout their 20s.³ Of the 5,000 total alcohol-related deaths among 18-24 year-olds, 80 percent, or 4,000, were alcohol-related traffic deaths.4
“Lowering the minimum drinking age to 18 is both misguided and dangerous,” said IACP former President Ronald Ruecker, Director of Public Safety in Sherwood, Oregon. “The worst thing any police officer has to do is knock on a door in the dead of night to tell parents that their child will not be coming home because he or she is a victim of impaired driving. Lowering the national drinking age would inevitably lead to more tragedies for more families.”
The public strongly disagrees with efforts to lower the drinking age. According to a 2008 survey by Nationwide Insurance, 78 percent of adults support 21 as the minimum drinking age and 72 percent believe lowering the drinking age would make alcohol more accessible to youth.
Bill Windsor, Associate Vice President of Safety for Nationwide, said, “While advocates argue a lower drinking age will curb teen binge drinking, our survey shows only 14 percent of Americans agree and 47 percent believe it will actually make a huge problem worse. Americans feel so strongly about teen binge drinking more than half say they are less likely to vote for a politician who supports lowering the legal limit or to send their child to a known ‘party school.’”
Parents are crucial in addressing this problem and can do more by talking and listening to their son or daughter about the many challenges they will face in college. In fact, research shows that parents should educate children before they reach middle school about the dangers of alcohol. We do not want to pass the problem on to high school principals. Parents need to ask themselves whether they want their kids to have more or less access to alcohol. When searching for the right college, parents should ask questions about the college’s policies on alcohol and what the consequences are for underage drinking while on campus. MADD strongly believes parents should be notified if their son or daughter is disciplined or arrested for alcohol.
Dean-Mooney said, “Underage drinking is not just a youth problem, but an adult problem.” Parents and other adults are the key to reducing underage drinking. MADD is developing a program for parents that will give them proven-effective tools for communicating to their teens about this issue.
Source: February 23, 2009 Mothers Against Drunk Driving (MADD)

ScienceDaily (Jan. 29, 2005) — Children who are exposed to environmental tobacco smoke (passive smoking) are at a higher risk of developing lung cancer as adults, says a paper in this week’s BMJ.

Those children exposed to passive smoking on a daily basis and for many hours are the most vulnerable – facing over treble (3.63) the risk of those who grew up in smoke-free environments.
Children experiencing passive smoke a few times a week are one and a half (1.45) times more likely to develop lung cancer, and those exposed daily but not for many hours faced twice (2.08) the risk.
In one of the most comprehensive studies into passive smoking of its kind, researchers looked at 303,020 people across Europe who had never smoked, or had stopped smoking by at least ten years. Within this group, 123,479 provided information on exposure to passive smoke, and researchers followed these participants’ progress for an average of seven years.
Of those who had known exposure to passive smoke (but were not smokers themselves), 97 had developed lung cancer, 20 more had upper respiratory cancers such as cancer of the larynx, and 14 died from chronic obstructive pulmonary disease during the seven follow-up years.
Former smokers faced up to twice the risk of respiratory diseases from passive smoke than those who’d never smoked. This may be because their lungs are already damaged, making them more at risk to the effects of environmental tobacco smoke, say the researchers.
This study significantly reinforces previous research into the cancerous effects of passive smoke, the authors conclude.

Source: British Medical Journal (2005, January 29). Passive Smoking In Childhood May Increase Risk Of Lung Cancer In Later Life. ScienceDaily. Retrieved May 12, 2009, from http://www.sciencedaily.com¬ /releases/2005/01/050128223746.htm

A new report from Perth’s Telethon Institute for Child Health Research has found a strong link between childhood ear infections and exposure to tobacco smoke.

The families of 100 Aboriginal children and 180 non-Aboriginal children participated in the Kalgoorlie Otitis Media Research Project, allowing the collection of social, demographic, environmental and biological data to investigate the causes of otitis media (middle ear infections). The children had regular ear examinations from birth until 2 years of age.
Chief Investigator Dr Deborah Lehmann, who heads the Institute’s infectious diseases research, said ear infections were the most common reason that young children see a doctor and can cause life-long problems.

“Up to 20 per cent of children have more than three ear infections between 1 and 2 years of age. If their hearing is damaged, it can seriously affect their educational outcomes and social circumstances in adulthood,” Dr Lehmann said.
“In Aboriginal children, these ear infections typically start at a younger age, are much more common and more likely to result in hearing loss.”
Key findings from the project include:
  Otitis media was diagnosed at least once in 74% of Aboriginal children and 45% of non-Aboriginal children.
  64% of Aboriginal children and 40% of non-Aboriginal children were exposed to environmental tobacco smoke.
  If we eliminated exposure to tobacco smoke we estimate that we could reduce ear infections by 27% in Aboriginal children and 16% in non-Aboriginal children
  The impact of passive smoking in the home on ear infections was reduced if the children also attended day care.
Dr Lehmann said there is evidence that passive smoking can increase the adherence of bacteria in the respiratory passages and depress the immune system.
“These results highlight the importance of reducing children’s exposure to passive smoking, and this is particularly important for Aboriginal people where the rates of both smoking and otitis media are high,” she said.

“Few Aboriginal children have access to formal childcare despite studies showing that it is an effective way to improve early development and educational outcomes for disadvantaged children. The fact that it could also reduce the burden of ear infections in Aboriginal children adds weight to calls for appropriate childcare facilities to be provided.”
The results are published in the latest edition of the Medical Journal of Australia.

Source: Telethon Institute for Child Health Research (2008, May 19). Ear Infections In Children Linked To Passive Smoking. ScienceDaily. Retrieved May 12, 2009, from http://www.sciencedaily.com¬ /releases/2008/05/080519110703.htm

Frequent cannabis use during adolescence and young adulthood increases the risk of psychotic symptoms later in life, according to a new study published on bmj.com today.

The risk of developing symptoms was much higher in young people with a pre-existing vulnerability to psychosis.

The study took place in Germany and involved 2437 young people aged 14 to 24 years. Participants were assessed for substance use, predisposition for psychosis, and psychotic symptoms, and were monitored for four years.

After adjusting for influential factors, such as social and economic status and use of other drugs, tobacco, and alcohol, cannabis use moderately increased the risk of psychotic symptoms. This effect was much stronger in those with any predisposition for psychosis.

Source: ScienceDaily (Dec. 2, 2004)

There is now enough evidence to warn young people that using cannabis could increase their risk of developing a psychotic illness later in life, a collaborative Cardiff University study has found.
Cannabis, or marijuana, is the most commonly used illegal substance in most countries, including the UK and USA. In studies over the last decade up to 20 per cent of young people (aged 14-21) in different parts of the world have used cannabis regularly (at least once per week) or used heavily (on more than 100 occasions in total).
Dr Stanley Zammit in the School of Medicine’s Department of Psychological Medicine and colleagues at the Universities of Bristol, Cambridge and Imperial College, London analysed 35 studies dated up to the end of 2006. The researchers assessed the strength of evidence for a causal relationship between cannabis use and the occurrence of psychotic or other mental health disorders.
The study, funded by the Department of Health, found that individuals who had used cannabis were 41 per cent more likely than those who had never used the drug to have any psychosis (presence of delusions or hallucinations). The risk increased relative to dose, with the most frequent cannabis users more than twice as likely to have a psychotic outcome. Depression, suicidal thoughts, and anxiety outcomes were examined separately, and findings for these outcomes were less consistent, with fewer attempts made to address non-causal explanations than for psychosis.
Dr Zammit, School of Medicine said: “The studies we looked at showed a consistent association between cannabis use and psychotic symptoms, including disabling psychotic disorders such as schizophrenia.”
“Despite the inevitable uncertainty, policymakers need to provide the public with advice about this widely used drug. We believe that there is now enough evidence to inform people that using cannabis could increase their risk of developing a psychotic illness later in life.”
If having ever used cannabis increases the risk of a psychotic outcome by 41 per cent as indicated by the results of the study, about 14 per cent of psychotic outcomes in young adults in the UK would not occur if cannabis were not consumed.

Source: Cardiff University (2007, August 1). Cannabis Could Increase Risks Of Psychotic Illness By 40 Percent. ScienceDaily. Retrieved May 12, 2009, from http://www.sciencedaily.com¬ /releases/2007/07/070731125526.htm

Marijuana, a commonly abused drug among high school and college students, is linked to a severe form of vomiting syndrome and compulsive bathing behavior. This form of severe vomiting sickness is increasingly recognized with widespread abuse of marijuana. The syndrome usually subsides with strict abstinence from marijuana abuse.

This obscure clinical manifestation of severe vomiting sickness due to chronic abuse of marijuana was recognized by Dr. Sontineni and his colleagues at the Creighton University of Omaha, NE.  Recent research into the neurobiology of cannabis has led to the identification of different receptor types including two specific types that mediate neuropsychiatric and immunologic effects.

According to Dr. Sontineni, doctors and health care workers currently under recognize the syndrome leading to delayed diagnosis and expensive diagnostic investigations. Increasing consistent use of marijuana among United States populations, particularly young people, over several years will see a steady rise in the number of cases diagnosed each year.
The syndrome was first recognized in Australia around the Adelaide hills. The exact mechanism leading to generation of these symptoms, why it appears only after several years of marijuana abuse and why compulsive hot showering behavior relieves the symptoms is still under scientific investigation.
The recognition of this novel syndrome and increasing physician awareness is supported by the Department of Medicine at Creighton University Medical Center. Similarly, scientists and doctors at other institutions worldwide are beginning to identify more cases with this new syndrome as a result of chronic marijuana abuse among populations.
Source: Sontineni et al. Cannabinoid hyperemesis syndrome: Clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse. World Journal of Gastroenterology, 2009; 15 (10): 1264 DOI: 10.3748/wjg.15.1264 .. ScienceDaily. Retrieved May 12, 2009

Newborns with withdrawal symptoms up by 67% in 10 years as money for specialist rehab units runs out.
The number of babies born suffering from drug withdrawal symptoms has increased by 67 per cent in the past 10 years, according to new figures obtained by The Independent on Sunday.
In 2007-08, 1,230 babies in England suffered from symptoms including poor sleep, agitation and difficulty feeding because of serious drug use by their mothers during pregnancy.
According to the British Association of Perinatal Medicine, one in 500 newborn babies need treatment with small doses of morphine to control these symptoms.
But research by the IoS has found the number of babies affected is much higher than official figures suggest.
Last year, a total of 350 babies were born to addicted mothers in Manchester, Fife and Bradford alone. The majority recovered naturally without being prescribed medication.
Physical withdrawals occur only if the mother uses either opiates such as heroin and methadone or sedatives such as diazepam during pregnancy. So newborns who experience problems from exposure to cocaine, amphetamines and cannabis may be excluded from these statistics.
According to experts, the increase in withdrawing babies reflects the number of women abusing drugs and alcohol as well as a 60 per cent increase in the number of women seen by drug services that prescribe methadone – the legal alternative to heroin.
These findings come just weeks after Edinburgh City Council took the unprecedented step of appealing for new foster carers after the number of babies born to addicted mothers doubled between 2007 and 2008.
Professor David Field, president of the British Association of Perinatal Medicine, said: “In the mid-1990s, you rarely saw these babies but now there is always one on the ward who is withdrawing, and the numbers will grow as the rates of addiction continue to grow. Most women we see tend to be on heroin or methadone or both, but the risks to the baby from cocaine are a different kettle of fish because it can stop blood from getting to the developing organs. However, research into links between drug use in pregnancy, birth defects and developmental problems suggests it is the overall affects of a chaotic lifestyle, poor diet, smoking and alcohol which cause the damage, rather than just the drugs.”
There are 40 drug and alcohol specialist midwives in the UK who work closely with social workers and addiction services, but access to this joined-up care is patchy. The Government insists that pregnant addicts receive much better care as a result of new practice guidance and investment in maternity service.
Joyce Leggate, a drug liaison midwife in Fife, Scotland, has seen her case load quadruple since they set up the service 12 years ago. She said: “While there has been a significant rise in the number of pregnant women who misuse drugs and alcohol, the number of babies who need treatment with morphine has remained fairly static because we encourage our mothers to breastfeed which provides a natural detox for the baby as they wean. The main goal for us is stabilising mum’s drug use, because withdrawing from multiple drugs is the most dangerous thing for babies.”
The charity Action on Addiction last month opened a 23-bed rehab centre for women in response to the growing need. Half of their current clients are mothers; none has custody of their children. Guilt, shame and abuse are dominant themes in recovery.
But Bethany Lodge, the specialist mother-and-baby rehab unit, is one of 19 centres to close in the past two years and addicts find it difficult to convince health authorities to pay thousands of pounds for residential rehab. Andrew Lansley, the shadow Health Secretary, said: “This further highlights the importance that we ensure that those who are habitual and dependent drug users are directed to effective drug rehabilitation schemes which bring them off drugs completely so that we can also protect unborn children.”
Ms Leggate added: “All of our women want to do the best for their babies but there is a limited amount we can do to help them in a few months when 80 per cent were themselves abused as children. But if you really want to mess up a baby long term, then drinking alcohol in pregnancy will cause lifelong damage.”
Source: Independent on Sunday 31st May 2009

<span style=”font-size: 10pt; font-family: Verdana;”>Amid renewed calls to consider reducing the legal drinking age, a new University of Georgia study finds that lower drinking ages increase unplanned pregnancies and pre-term births among young people.
“Our findings suggest that a lower drinking age increases risky sexual behavior among young people, and that leads to more unplanned pregnancies that result in premature birth and low birth weight,” said study author Angela Fertig, assistant professor in the UGA College of Public Health. “The take-home message is that when it’s easier for young people to get alcohol, birth outcomes are worse.”

Fertig, who is also a public service assistant in the university’s Carl Vinson Institute of Government, co-authored the study with Tara Watson, assistant professor of economics at Williams College in Massachusetts. Their results appear in the May issue of the Journal of Health Economics.

The team examined birth records and survey data on alcohol use for the years 1978 to 1988, a period when state minimum drinking age laws were in flux. Fertig said the consensus among researchers is that a higher minimum drinking age reduces fatal car crashes and alcohol consumption among young adults, but there is little data on how drinking age laws influence infant health. The researchers found that a drinking age of 18:
Increases prenatal alcohol consumption among 18- to 20-year-old women by 21 percent;
Increases the number of births to 18- to 20-year-olds by 4.6 percent in white women and 3.9 percent in 18- to 20-year-old African-American women;
Increases the likelihood of women under age 21 having a low-birth weight baby by 6 percent (4 percent for white women and 8 percent for African-American women); and
Increases the likelihood of premature birth by 5 percent in white women under age 18 and by 7 percent in African-American women under age 18.

Fertig noted that in many cases the impact of a reduced drinking age disproportionately falls on African-Americans. The researchers found that a drinking age of 18 increases the probability of an unplanned pregnancy by 25 percent for African-American women, for example.

The team’s analysis revealed that the negative birth outcomes associated with a lower drinking age aren’t the direct result of prenatal alcohol consumption on fetal health. Instead, a lower minimum drinking age results in more unplanned pregnancies, which are known to be associated with poorer infant health outcomes.

“Teenagers who get pregnant unexpectedly are less likely to receive good prenatal care and may not take as much interest in the child as someone who tried to get pregnant,” Fertig said. “As a result of these behaviors on the mom’s part, the child ends up with worse outcomes.”

Last year, a group known as the Amethyst Initiative comprised of more than 100 college and university presidents and chancellors signed a statement encouraging discussion about lowering the legal drinking age. Fertig said her study broadens the debate by adding a new dimension that until now has not been considered.

“There are consequences to lowering the drinking age beside traffic fatalities,” Fertig said. “There’s this potentially big effect on birth outcomes, and to me that argues that we should leave the minimum drinking age where it is.”

Source:  HealthNewsDigest.com  21st May 2009

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Far more babies may be damaged in the womb as a result of their mother’s drinking habits than was assumed, the British Medical Association warned today as it backed the government’s call for pregnant women and those trying for a baby to give up alcohol completely.
Only babies with full-blown foetal alcohol syndrome tend to be diagnosed and counted by doctors in the UK. But a BMA report published today called for data to be collected on a much wider and sometimes less obvious category of damage, called foetal alcohol spectrum disorders.
Around 0.2 per 1,000 UK babies suffer from foetal alcohol syndrome, which impairs the brain, causes abnormal facial features and leads to low birth weight. However, the wider foetal alcohol spectrum disorders were found to affect around 10 per 1,000 babies in Canada, one of the few countries to collect statistics on the latter category.
“We want to make it clear that people should be more prepared to make the diagnosis, not just of foetal alcohol syndrome but of the whole spectrum of disorders,” said Vivienne Nathanson, head of science and ethics at the BMA.
“There is good evidence that it is being under-diagnosed in the UK because there isn’t a specific test.”
Babies born with the spectrum of disorders have some but not all of the problems that foetal alcohol syndrome brings. They may suffer from hyperactivity, be unable to concentrate, have a short attention span, or be slow to develop.
The BMA notes that there is still controversy in the UK about the existence even of foetal alcohol syndrome, which may explain, the report says, why data on the spectrum of disorders is not collected.
But, said Dr Nathanson, “it is so important that the discussions need to go on in parallel with getting women into treatment.”
The BMA recognises that there is no evidence that a low level of drinking – one to two units a week – harmed the unborn child. But, said Dr Nathanson, “the fact that we haven’t yet got the evidence doesn’t mean that there isn’t evidence of a link. It may be that it is just very difficult to get.”
It has been shown that alcohol reaches the foetus across the placental barrier, and also that low levels of exposure to alcohol have an effect in animals.
Women who are thinking of having a baby should not drink because significant damage can be done in the weeks before a woman knows she is pregnant. “I have a couple of patients whose mothers were binge drinking heavily at the weekends before they knew they were pregnant, and they have full foetal alcohol syndrome,” said Dr Raja Mukherjee, a consultant psychiatrist for people with learning disabilities at the Surrey and Border Partnership Trust.
The BMA report, titled Fetal Alcohol Spectrum Disorders, says it is very difficult for anybody to know how many units of alcohol they are drinking. Bottles of wine have risen from 8% to 12% proof and measures of wine and spirits vary considerably in pubs and restaurants. The BMA is calling for all bottles of alcohol and pub and restaurant drinks to be labelled with the number of units they contain.
Source: guardian.co.uk, Monday 4 June 2007

New research suggests that individuals who begin drinking alcohol as teenagers are more likely than those who start drinking after age 21 to suffer alcohol-related harm as adults.
Reuters reported June 5 that researchers Ralph Hingson and Wenxing Zha from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that adults who began drinking at age 16 or younger drove drunk, suffered unintentional injuries, and became dependent on alcohol at about twice the rate as those whose onset of drinking occurred at age 21 years or older.
Source: Pediatrics. May 26, 2009

Beginning at age three to four, children of mothers who used cannabis heavily while pregnant have demonstrated deficits in memory, verbal and perceptual skills, and verbal and visual reasoning after adjusting for potentially confounding variables Impaired performance in verbal and quantitative reasoning and short-term memory has also been found among six-yearold children whose mothers
reported smoking one or more marijuana cigarettes per day, after controlling for significant covariates

In children around the age of nine, prenatal cannabis exposure has been linked with impaired abstract and visual reasoning, poor performance on tasks reflecting executive functioning, and deficits in reading, spelling, and achievement, independent of various covariates

Porath and Fried (2005) reported that 16- to 21-year-old offspring (particularly males) of cannabis
users were at increased risk, in a dose-related manner, for the initiation of cigarette smoking and
cannabis use, and daily cigarette smoking, compared to offspring of non-using mothers, independent
of potential prenatal confounds.

Findings from brain imaging studies of young adults aged 18–22 indicate that in utero cannabis exposure negatively impacts the neural circuitry involved in aspects of executive functioning, including response inhibition and visual spatial working memory

See paper on NDPA website section ‘Papers’

Source: . Maternal Cannabis Use During Pregnancy http://www.ccsa.ca/ 2009

The number of young people being admitted to hospital because of illegal drug-taking has soared over the past decade.
There was a 41% rise in the number of under-16s admitted to hospital with drug poisoning, from 596 admissions to 839.
And the proportion of 16 to 24-year-olds admitting cocaine use in the previous year rose to more than 6% for the first time, according to figures from the NHS Information Centre.
The rise in the number of young people admitted to hospital for drug-related mental or behavioural disorders is shocking. 
While the proportion who admitted using cocaine at any stage in their lives rose over 11% for the first time, cannabis use fell to less than 21%.
Among all age groups, the total number of hospital admissions primarily connected with a drug-related mental health and behavioural disorder fell slightly over the period – from 7,584 to 6,743.
But the number of admissions where the secondary diagnosis was related to drug use pushed the overall figures up.
In another worrying sign, the report also showed that men accounted for 79% of the 1,573 deaths from illicit drug use in England and Wales in 2006.
“(We are) concerned that more than twice as many young men were admitted as young women, which suggests men may be more likely to self-medicate with illicit drugs to manage their emotional distress,” said Marjorie Wallace of mental health charity Sane.
“Many of these admissions may be related to other, pre-existing mental health problems, such as depression or feelings of alienation, for which we need much earlier intervention and support when families and others express their concerns.”
NHS Information Centre CEO, Tim Straughan, said: “This bulletin paints a picture of wide discrepancy between the number of men who take, are treated, or even die from drug use compared to the number of women.
“The fact more than 1,500 people died due to drug use in 2006 is extremely saddening in itself, but the fact so many of these deaths are male raises many questions about gender and drug misuse.”
Source: Sky news Aug. 15th 2008

Research Summary
A Penn State researcher says that parents who let teens drink alcohol may be setting their kids up for binge drinking in college, but the study by Caitlin Abar of the school’s Prevention Research and Methodology Center makes no distinction between parents who simply let kids drink some wine during meals and those whose permissiveness extends to drinking outside the home.
Science Daily reported June 11 that Abar surveyed 300 college freshmen and correlated their alcohol use to the drinking rules set down by their parents. Abar found that students whose parents never allowed them to drink were less likely to report heavy drinking in college.
On the other hand, “the greater number of drinks that a parent had set as a limit for the teens, the more often they drank and got drunk in college,” said Abar.
Abar said the research argues in favor of “zero tolerance” for teen drinking and against the theory that parental restrictions on drinking casts alcohol as attractive “forbidden fruit” and leads to greater temptation to drink in college. Whether or not parents themselves drank had little impact on college binge drinking, Abar added.
Thirty-one states allow parents to legally serve alcohol to children under age 21.
The research was presented at the recent and.
Source: annual meeting of the Society for Prevention Research ,to be published in the journal Addictive Behaviors June 24, 2009

Yellow areas in the brain of a heavy marijuana user show brain regions with the most significant abnormalities. These areas correspond with those under development during normal adolescent years. Credit: Ashtari et al., Children’s Hospital of Philadelphia

The term pot-head takes on new meaning with a study that suggests adolescents and young adults who smoked a lot of marijuana are more likely than non-users to have disrupted brain development.
Using brain scans, researchers found abnormalities in areas of the brain that interconnect brain regions involved in memory, attention, decision-making, language and executive functioning skills.
The findings are of particular concern because adolescence is a crucial period for brain development and maturation, the researchers note.
“Studies of normal brain development reveal critical areas of the brain that develop during late adolescence, and our study shows that heavy cannabis use is associated with damage in those brain regions,” said study leader Manzar Ashtari of the Children’s Hospital of Philadelphia.
The findings are considered preliminary, however, and more research is needed to confirm the work.
This is not the first research to suggest marijuana damages the brain. In previous reseach involving memory skill stests, subjects who’d smoked too much did poorly. But brain imaging can reveal specifics.
In an admittedly small study, Ashtari and colleagues performed imaging studies on 14 young men (average age 19) from a residential drug treatment center in New York State, as well as 14 healthy men of the same age.
The 14 subjects from the drug treatment center all had a history of heavy cannabis use during adolescence. On average, they had smoked marijuana from age 13 till age 18 or 19, and reported smoking nearly 6 marijuana joints daily in the final year before they stopped using the drug.
The brain scans measureed water movement through brain tissues.
“The abnormal patterns of water diffusion that we found among the young men with histories of marijuana use suggest damage or an arrest in development of the myelin sheath that surrounds brain cells,” Ashtari said.
Myelin provides a coating around brain cells similar to insulation covering an electrical wire. If myelin does not function properly, signaling within the brain may be slower. Myelin gives its color to the white matter of the brain, and covers the nerve fibers that connect different brain regions.
“Our results suggest that early-onset substance use may alter the development of white matter circuits, especially those connections among the frontal, parietal and temporal regions of the brain,” Ashtari said. “Abnormal white matter development could slow information transfer in the brain and affect cognitive functions.”
Study shortcomings
Ashtari pointed out shortcomings in the study, however.
For one, it involved a small number of subjects. Also, five of the 14 subjects with heavy cannabis use also had a history of alcohol abuse, which may have contributed an effect. Also, it is possible that the brain abnormalities may have predisposed the subjects to drug dependence, rather than drug usage causing the brain abnormalities.
“Further research should be done to investigate the relation between repeated marijuana use and white matter development,” Ashtari said. “However, our work reinforces the idea that the adolescent brain may be especially vulnerable to risky behaviors such as substance abuse, because of crucial neural development that occurs during those years.”
The work was funded by the National Institute of Mental Health.
Source: Journal of Psychiatric Research Feb. 2009

The official figures also show that 10 children under 12 needed treatment because they were dependent on heroin. The extent of the problem was revealed as a survey showed that one in four 16- and 17-year-olds said that they drank alcohol “for something to do”.
In total, 11,294 children under the age of 16 were treated for alcohol and drug dependency last year.
Of these, 4,005 were being treated for alcohol addiction, 57 of them under the age of 12, in 2007-08, the figures obtained by the Conservatives from the National Treatment Agency for Substance Misuse (NTA) show. Another 6,075 were treated for cannabis dependency, including 102 under-12s, and 93 for heroin addiction, including 10 under-12s.
In 2006 it was revealed that four children under 11 had been treated for heroin addiction in Scotland, after a 11-year-old girl collapsed in her school classroom after taking the drug. One in four 16- and 17-year-olds say that they drink alcohol “for something to do”, a new survey shows.
More than two thirds, 71 per cent, said they drank at least once a week, while three fifths, 60 per cent, said that they had started to drink alcohol because it was part of “being young and socialising”. On average, teenagers said that they had their first drink at 13 and were just 14 the first time they became properly drunk.
The teenagers were less concerned about getting drunk than about leaving education without any qualifications, having unsafe sex or taking recreational drugs, the survey, by the charity Drinkaware, which is funded by the alcohol industry, found.
Andrew Lansley, the shadow health secretary, said: “It’s a sad indictment of our broken society that so many are turning to things like drug and alcohol abuse at such a young age. “The Government needs to take action now, before it’s too late.
“Tackling these problems has been low on their priority list and Labour’s irresponsible decision to roll out 24-hour drinking on our towns and communities has not helped.” Norman Lamb, the Liberal Democrat health spokesman, said: “These figures are horrific and serve as a stark warning of the scale of drink and drug use amongst our children.
“Labour’s policies have been completely ineffective at stemming the tide of young people’s addictions.
“We now have thousands of children whose long-term health is being put at risk by this culture of drink and drug dependency.
Chris Sorek, chief executive of Drinkaware, said: “Many young people unintentionally put themselves at risk when they drink alcohol and it is crucial that young people are given the facts about drinking and its effects.
“Under-18s need to know what drinking does to their body and appearance – as well as how to avoid peer pressure and stay safe.”
Source: www.telegraph.co.uk 6th July 2009

More than 8,000 children a year are being treated on the NHS for cannabis misuse, according to figures.
Pupils under 16 are being given treatments at the rate of more than 150 a week to beat addictions, or combat effects of the drug on their mental health.
Critics have blamed a sharp rise in cannabis use on Labour’s relaxation of laws against the drug’s use in January 2004.
David Blunkett, former Home Secretary, reclassified it from a class B to a class C drug, despite fears it would trigger an increase in usage. The Government reversed the decision last year after health experts raised concerns that excessive use was damaging teenagers’ mental health.
Figures obtained by Richard Spring, Conservative MP for West Suffolk, in a Parliamentary question show 6,075 children were treated for problems linked solely with cannabis use in 2007/08. A further 2,075 were treated for damage to health caused by cannabis and other drugs or alcohol.
Although there are no figures for under-16s in earlier years, data from the National Treatment Agency for Substance Abuse show teenage cannabis-related illness has soared. Between 2005 and 2007, the number of under-18s in England needing treatment soared from 13,408 to more than 26,000.
A spokesman for Adfam, the charity that supports families of drug users, said: “Cannabis use causes a great deal of stress and worry to parents and families. We would encourage any parent worried about their child to seek help and support.”
Source: www.telegraph.co.uk 19th May 2009

Children of drug users are at high risk for developing substance use disorders themselves later in life. From 1991 to 1993, researchers funded by NIDA recruited families, with a parent in methadone treatment for heroin addiction and at least one young child, into a randomized trial of the Focus on Families (FOF) intervention, which includes relapse prevention services and parent training skills. Results from the original analysis of the trial showed that FOF both reduced parents’ drug use and improved children’s delinquent behavior compared with participants in the control group, who only received standard services provided by methadone clinics. To assess whether FOF continued to have an effect on children as they grew up, the researchers performed a 12-year followup study—85 percent of the children originally enrolled in the trial participated. Of those, 59 percent had met the criteria for a substance use disorder at some point in their life. Overall, the rates of substance use and dependence were similar between childhood participants in the FOF and control groups. However, when the results are broken down by gender, males who received the FOF intervention had a significantly lower risk of developing a substance use disorder—specifically, alcohol and marijuana disorders—than those in the control group. This may be because the FOF intervention focuses on teaching parents to handle externalizing problem behaviors (such as getting into fights), which are more common in boys than girls, explain the authors. Of concern was the fact that at the time of the followup study, 32 percent of the parents in the FOF group had died, compared to 13 percent of parents in the control group. High mortality is typical in long-term studies of patients on methadone, though the researchers could not find evidence that higher exposure to the FOF intervention was related to mortality in this study. In fact, the highest mortality rate was found among families who were assigned to FOF but never participated in the skills training or case management. FOF participants who attended 75 percent or more of the assigned sessions had about the same mortality rate as participants in the control group.

Source: Haggerty KP,et al. Long-term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment. Addiction. 2008 Oct 8

Children with fetal alcohol spectrum disorders (FASD) have a high risk of psychiatric problems, particularly attention deficit hyperactivity disorder (ADHD), conduct disorder, or both. Often children with FASD are initially diagnosed with ADHD. A new study is the first to examine a range of cognitive factors and social behavior in children with FASD and ADHD, finding that those with FASD have significantly weaker social cognition and facial emotion-processing abilities.

Results will be published in the October issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

“Behaviorally, FASD and ADHD can look quite similar, particularly with respect to problems with very limited attention, physical restlessness, and extreme impulsivity,” explained Rachel Greenbaum, a clinical psychologist with the Children’s Mental Health Team at Surrey Place Centre in Toronto, who conducted the study as part of her doctoral dissertation.

“However, social deficits in children with neurodevelopmental disorders may have different underlying mechanisms,” noted Piyadasa W. Kodituwakku, associate professor of pediatrics and neurosciences at the University of New Mexico School of Medicine. “For example, children with ADHD experience social problems because of poor self-regulation rather than deficient knowledge of appropriate social behavior. In other words, a child with ADHD may accurately recite social rules, but fail to apply them. In contrast, social difficulties in a child with autism may result from a fundamental deficit in social sense, referred to as mind-blindness. Thus, when delineating qualitative differences in social phenotypes of neurodevelopmental disorders, it is important to assess not only observable behaviors, but also their underlying cognitive mechanisms.”

This study looked specifically at social-cognition and emotion-processing abilities, said Joanne Rovet, a professor at the University of Toronto and senior scientist in neurosciences and mental health at the Hospital for Sick Children, and supervisor of the fetal alcohol research program.

“‘Social cognition’ refers to the ability to consider and differentiate between the beliefs, thoughts, feelings, and intentions of oneself and others,” said Rovet, who is also the study’s corresponding author. “This involves understanding the meaning of social information and knowing how to interact appropriately. These abilities are important for communicating and relating successfully with others. ‘Emotion processing’ refers to understanding and processing information related to feelings. This includes the ability to recognize and differentiate between varied emotions in others and in oneself. These skills are also important for relating and communicating socially with other people.”

Greenbaum and her colleagues recruited three groups of children – 33 (16 boys, 17 girls) with FASD, 30 (24 boys, 6 girls) with ADHD, and a “normal” control group of 34 (18 boys, 16 girls) – from a pre-existing data pool, clinics, communities, and schools in the greater Toronto area. The mean age was 9.2, 9.3 and 8.9 years, respectively. All completed tasks were designed to measure social cognition and emotion processing. Additionally, parents and teachers used standard questionnaires and scales to assess the children’s behavioral problems and social skills.

“Our findings show that … overall, children with FASD have more severe behavioral problems,” said Rovet. “In terms of social cognition and emotional processing, the core deficit in FASD appears to be in understanding and interpreting another’s mental states and emotions.”

Rovet added that a “profile” of children with FASD would include items such as high distractibility and restlessness, as well as behaviors often described as “out of control” and juvenile. “Based on previous work from our lab, children and adolescents with FASD were more likely than children with ADHD to engage in antisocial behaviors, such as cheating, stealing and acting young, as well as sociopathic behaviors including lying and stealing,” she said. “Importantly, the findings from our present study, specifically the significant differences in social cognition and emotional processing between children with FASD and ADHD, may underlie the severe conduct problems observed in children prenatally exposed to alcohol.”

“In other words,” said Kodituwakku, “children with FASD and ADHD have social difficulties, but what is contributing to these difficulties may be different. For example, a child with ADHD may be able to predict how another child would feel in a certain situation, but he or she may do something to hurt that child’s feelings despite this ability. On the other hand, a child with FASD may do something to hurt someone else’s feelings because of an inability to appreciate that person’s reactions. This difference has implications for the development of social-skills training programs. That is, a training program designed for a child with ADHD may include procedures targeting how to translate what the child already knows into actions, while a program designed for a child with FASD may address both building specific cognitive skills and practicing appropriate actions.”

“One of the major contributions of this study pertains to understanding what children with FASD look like from a truly clinical perspective,” said Greenbaum, “helping to clarify for clinicians trying to diagnose and treat them the full extent and specific nature of their previously unidentified problems, thus extending treatment possibilities that may help alleviate some of their more debilitating antisocial and behavioral problems.”

One finding with potential for immediate action was that children with FASD have difficulty interpreting social information, including emotions in faces, said Rovet. “These difficulties predict their behavior problems and are linked to their social development,” she emphasized. “It is imperative that these children receive assistance in social and emotional processing domains, specifically targeting interventions to deal with their unique deficits.”

Source: www.MedicalNewsToday l8th July 2009
University of New Mexico School of Medicine Alcoholism: Clinical & Experimental Research

Adolescent alcohol use and behavior problems are influenced by a combination of genetic and environmental factors. A new study has found that socio-regional factors moderate the importance of genetic influences on early adolescent behavior problems in a way that parallels moderating effects observed for alcohol use later in adolescence.
This paper adds to a growing and very promising area of research showing that child and adolescent behavioral problems emerge from an interplay of inherited vulnerabilities and life experiences,” noted Lisa Legrand, research psychologist at the University of Minnesota. “While inherited factors may place an individual at increased risk, psychosocial or environmental exposures may either aggravate or protect against this risk. Moreover, certain environments may actually modify gene expression such that the influence of genes varies by circumstances.”
“Much of the research on environmental influences on alcohol use and behavior problems focuses on the impact of parents and peers,” added Dick. “While these are clearly critical environmental influences, we have also found that socio-regional, or neighborhood influences, also have big impacts on adolescent behavioral outcomes, and these environmental effects have not received as much attention historically.”
Researchers used data from FinnTwin12, a population-based study of health-related behaviors and correlated risk factors that has followed more than 5,000 twins identified in Finland’s Population Registry Center as having been born in the years 1983 through to 1987. Drawing from previous findings that community-level factors such as urban/rural residency, migration rates, and prevalence of young adults can moderate the importance of genetic effects on alcohol use among 16- to 18-year olds, this study looked at their influence on behavior problems at 12 and alcohol use at 14 years of age.
“One of the key reasons this study is important is that it contributes to the growing body of literature showing that environmental influences play an important role in the expression of an individual’s genetic predispositions,” said Dick. “In this case, how important genetic influences are on behavior problems in young girls can vary quite a bit as a function of neighborhoods factors.”
Certain environments appeared to encourage gene expression while others constrained it, observed Legrand. “The environments that produced higher heritability estimates for female behavioral problems were urban, had a relatively mobile population, and were marked by a higher percentage of older adolescents,” she said. “Conversely in rural, stable, and low-adolescent settings, preadolescent behavior problems appeared to be more influenced by the rearing environment.”
It could be that girls are more susceptible than boys to certain environmental influences, Legrand added. “For example, rural females may remain closer to their parents and under the influence of their monitoring and control for a longer time than rural males,” she said. “This is an intriguing area for future research.”
“There is now converging evidence across a number of different studies that behavioral problems in kids are associated with both concurrent and future alcohol problems,” said Dick. “There is evidence accumulating from genetic studies that behavior problems may be one of the first signs of an individual at increased susceptibility for developing alcohol problems.”
Taken together, she cautioned, a key message from this kind of research is that genes are not destiny. “We’re not all equally predisposed to develop alcohol or behavior problems,” she said, “and the environment can be a key factor in whether or not an individual ever develops problems.”
Legrand concurred. “This research offers added evidence that certain environmental factors can modify genetic effects,” she said. “Regardless of an individual’s genetic endowment, Dick’s findings suggest that there are social or environmental factors that can tip the scales and either encourage or inhibit the expression of a genetic predisposition. Thus, her results serve as a reminder that the heritability statistic is always situation specific and that even highly heritable traits can be environmentally influenced.”

Source: Alcoholism: Clinical & Experimental Research (2009, July 20). Genes And The Environment Interact To Influence Adolescent Alcohol Use

A potent form of cannabis can cause healthy people to develop psychotic illnesses, a new British study has proved.

The researchers found that the “extent of psychotic reaction” was not related to “the degree of anxiety or congnitive impairtment” in the men
Photo: PA
The results appear to confirm a link between psychosis and skunk cannabis, which now accounts for 80 per cent of street seizures of the drug.

Scientists at the Institute of Psychiatry in King’s College London made the discovery after running tests on 22 healthy men, aged in their late 20s.

They injected them with THC – a major component of skunk cannabis which has been blamed for increasing psychosis among heavy users.

By giving a dummy injection to some, and a dose of THC to others, the scientists were able to establish a link between THC and psychosis, in which hallucinations and delusions leave sufferers unable to tell between the real and imagined.

The team, led by Dr Paul Morrison, concluded: “These findings confirm that THC can induce a transient acute psychological reaction in psychiatrically well individuals.”

The researchers found that the “extent of psychotic reaction” was not related to “the degree of anxiety or congnitive impairtment” in the men.

Mary Brett, vice president of Europe Against Drugs, said: “This shows that anyone who is healthy can become psychotic by smoking cannabis.
They don’t already have to have a mental illness. Healthy people can become psychotic.”

The potency of skunk cannabis has increased from six per cent THC – or Delta-9-tetrahydrocannabinol – content in 1995 to 14 per cent in 2005, and has been linked to increased instances of psychosis, particularly among young men.

Today’s skunk cannabis also contains virtually no traces of another chemical, called CBD (cannabidiol), which appears to counteract the damaging effects of THC.

The research is the first time that the dangers of skunk cannabis have been tested in the UK. Previous experiments have been run by experts in the US, Holland and Brazil.

Dr Morrison said the findings offered “additional evidence that can elicit temporary psychotic-like effects in some people”, but stopped short of suggesting they proved a direct link between psychosis and THC.

He said: “Much more research is needed to clarify if skunk is actually more harmful than traditional cannabis.” More work needed to be carried out on the beneficial effects of CBD in balancing the damaging results of THC.

Earlier this year then-Home Secretary Jacqui Smith restored cannabis from class C to class B status after concerns about adverse health effects, against the advice of her drugs advisers.

Last year The Daily Telegraph revealed how a BBC reporter Nicky Taylor was injected with THC at the institute. One source who witnessed the effects on Miss Taylor said the effect was “dramatic, it was unpleasant”.

A survey of 200 users, published in July 2008, found that those who smoked skunk cannabis were 18 times more likely to develop psychosis than those who smoke milder forms of the drug.

A Home Office spokesman said: “We have always been clear that cannabis is a harmful drug which should not be taken. Its use can lead to physical and psychological harms, and the mental health effects of cannabis use are real and significant.

“We are taking comprehensive action to tackle cannabis use, from increased enforcement to reduce the supply, along with effective education and early intervention for those most at risk.”
Source: /www.telegraph.co.uk/science/science 28th July 2009

Acute and chronic health problems
As alcohol-related diseases such as liver cirrhosis, cancers and heart disease take time to develop; chronic effects resulting directly from alcohol misuse are rarely seen among young people. Thus it is the shorter-term acute effects of alcohol consumption that are more evident in this population. In particular, acute intoxication can occur rapidly and by surprise in children and young people which is probably due to a combination of physiological factors (e.g. limited ability to metabolise alcohol and lower body weight) and socio-cultural reasons (including a lack of experience of the effects of alcohol and drinking in unsupervised contexts). The most common impacts of alcohol intoxication are vomiting ( 60% of children hospitalized for alcohol use) and coma, which in cold environments can result in fatal hypothermia .

Acute health problems
Newburn and Shiner (2001) report that it is highly likely that children’s inexperience of the effects of alcohol intoxication, and the fact that they are more likely to consume alcohol in ‘risky’ environments brings with it an increased risk of accidents and need for hospitalisation . Alcohol use may be a significant contributor to injury in
adolescence and may play a role in more than 50% of traumatic brain injuries in adolescents. Alcohol use was also linked to 80% of adolescent deaths from homicides, suicides and unintentional injuries and to an increased risk of illness and death at an early age, predominantly caused by suicide and violent accidents. Irwin and Millstein (1986) reported that adolescents who were involved in drowning, falls and burns had a greater frequency of blood alcohol levels over 0.10% . It should be noted that reviews in this area are often unclear as to whether hospital presentations relate to acute alcohol effects such as alcohol poisoning, to the consequences of drinking, such as injury or to chronic conditions although the latter are rare in young people20% of young people admitted to hospital for alcohol intoxication. This high risk group consisted of mostly boys from lower socio-economic status groups, who before the acute episode of drunkenness had shown signs of ‘psychiatric insufficiency’, or extreme shyness and a retiring disposition, or restlessness, impulsiveness and aggressive behaviour
.
Such individuals often had difficulties in social adjustment, including problems at school. These children had also been brought up in homes characterized by insecurity, broken families with only one parent (who was often an ‘exhausted’ mother), with an alcoholic or a mentally disturbed parent or in a home marked by disorganization with few good emotional relations. It was also reported that the children had been using alcohol before the acute episode (no information given on use). They were often apprehended on a week day and neither they themselves nor their parents showed notable anxiety reaction with regard to the admission to hospital. This review concluded that in this ‘high risk’ group of children the acute episode of alcohol intoxication was a warning signal for future problems. This compares to a low-risk group (comprising about 50-55%) of cases that would be seen as healthy children from a psychiatric point of view, from secure homes that have shown no previous signs of social maladjustment. They are generally admitted to hospital on a Friday or Saturday night and both they themselves and their parents show anxiety reactions in connection with the event

The current review found very little evidence relating to liver disease in young
people. Saunders and Bailey (1993) reported that the overwhelming majority of deaths from liver disease occur in the over 21’s . Moreover, Clark et al. (2002) reported that serum liver enzymes were typically only modestly elevated in adolescents with alcohol problems. However, Zeigler et al. (2005) later found that serum enzymatic markers of liver damage were elevated in alcohol-abusing adolescents . Whilst there is great inter-individual variability in susceptibility to alcohol-related liver disease, two notable risk factors are the dose of alcohol consumed and the length of time of heavy drinking . Deaths from alcoholic hepatitis or decompensated cirrhosis are rare in patients under 25, but when these
deaths do occur, they are as a result of several years of heavy drinking . Thus although there is no direct evidence that adolescent livers are more susceptible to alcohol than adult livers, the consequences of heavy drinking in adolescence are now being seen in early adulthood with devastating consequences
Source: Impact of Alcohol Consumption on Young People: A Review of Reviews Oct.2008

There is growing policy and practice interest in the effect of parental substance misuse – both drugs and alcohol – on children. Despite this, young people are often neglected in both policy discussion and service provision. This qualitative study was undertaken in Scotland and explored the lives of 38 young people between the ages of 15 and 27 years whose parents have or had a drug and/or alcohol problem. It found:

• Parental drug and alcohol misuse created considerable problems for most of the young people. Many felt that their parents were unable to provide consistent practical or emotional care. While the effects of drug and alcohol abuse were similar, the former brought with it more anxiety and social stigma and the latter was more associated with violence and parental absence.

• Many of the young people felt their childhood was shortened through having to assume early responsibility for their own and others’ wellbeing.

• Although the young people in this study lived in a range of circumstances, they showed resilience and adaptation in finding ways to deal with their difficulties.

• A sense that others, especially parents, cared about them even when they did not care for them helped them keep going.

• Informal relationships – with extended family members, neighbours, friends and friends’ families – were very important. But such support was seldom either reliable or unconditional.

• Where experienced, a strong personal relationship with a service worker was highly valued.

• The young people shared similar goals and dreams – of jobs, houses and families – but not all were on the way to achieving this. Education and work were key factors in putting them in a position to achieve their goals.

In the UK there are estimated to be between 250,000 and 350,000 dependent children living with parental drug misuse, and 920,000 living with parental alcohol misuse. Parental substance misuse can cause considerable harm. Children are at risk from emotional and physical neglect as they grow up. They also risk developing emotional and social problems later in life. Both outcomes are of growing concern to policy and practice. Older children, especially those aged 16 and over, are often neglected in policy discussion and in service provision. More needs to be known about their lives so that effective policy and service support can be developed.

The study involved interviews with 38 young people between the ages of 15 and 27 years old (most were between 16 and 21) who had been affected by parental substance misuse. The late teens and early twenties is a period of transition to adulthood, and interviews explored past experiences and present situations, before asking interviewees to consider the future.

While most of the young people came from socio-economically disadvantaged backgrounds, six had middle-class backgrounds. Some of the young people appeared to be managing well for themselves, and within this group several were in higher education. Others had relatively chaotic or precarious lives. Twelve had serious drug problems; most of this group were receiving treatment.

• ways to support continued ties with a parent or parent-figure where this is desired by the young person while at the same time supporting the young person in independent living above the age of 16.

• Young people should be involved in debates about the kinds of support they need and value. It is important to recognise their own ability to manage adverse life circumstances.

• Children who care for adults and siblings, and foster carers within the immediate family, should be supported. Young carers’ groups were especially appreciated by those involved with them. Non-stigmatising acknowledgement of the situation of the young carers together with informal and unobtrusive support can prove extremely helpful.

• Youth work could do more to help young people set themselves up as independent people. An expansion of such services might help support young people affected by parental substance misuse as they grow up.

The study was based at the Centre for Research in Families and Relationships at the University of Edinburgh. Data was collected using in-depth qualitative interviews conducted by Sarah Wilson. Interviewees were recruited from a wide range of drug, youth work and homelessness services, and through leafleting and ‘snowballing’.

How to get further information

The full report, Parental drug and alcohol misuse: Resilience and transition among young people by Angus Bancroft, Sarah Wilson, Sarah Cunningham- Burley, Kathryn Backett-Milburn and Hugh Masters, is published by the Joseph Rowntree Foundation as part of the Drug and Alcohol series (ISBN 1 85935 248 0, price £13.95)..

Marijuana use leads to difficulty in concentrating and thinking. It also decreases the user ability to memorize things. (1—4). In addition, user’s of marijuana have an increased tendency to ‘remember’ things that did not happen. (5,6) Most marijuana users do not realize that these effects of marijuana on mental ability persist for up to 6 hours after the last use of the drug. The user may not feel high, but his reaction times are slower and memory skills are decreased. These changes can decrease ability in sports, other physical activities, and in studies.

Marijuana may be more detrimental to memory function than is alcohol or cocaine. (7) This effect may be due to the presence of cannabinoid receptor sites (activation of these receptors interrupts normal brain motor and cognitive function) in the areas of the brain which control memory.
(8,9)

The results of a 1992 study of 48 adult male subjects who smoked marijuana then completed standardized, paper—and—pencil tests of educational development and ability, learning, associative processes, abstraction, and psychomotor performance indicate that all capabilities were impaired except abstraction and vocabulary. (10,11)

Referenses:
1. Andreasson S, Allebeck et al. Cannabis and schizophrenia; A longitudinal study of Swedish conscripts. Lancet 1987 Dec 26; :2483—6.
2. Schwartz RH. Heavy marijuana use and recent memory impairment. Psychiatric Annals 2992 Feb;21(2) :80—2.
3. Abood ME, Martin BR. Neurobiology of marijuana abuse. Trends In Pharmacological Sciences 1992 May; 13(5) :201—6.
4. Nahas G, Latour C. The human toxicity of marijuana. Medical Journal Of Australia 1992 Apr 6;156(7) :495-7
5. Pfefferbaum A, Darley CF, Tinklenberg JR, Roth NT, Kopell BS. Marijuana and memory intrusions. J Nerv Ment Dis
1977;l65(6) :381—6.
6. Block RI, Wittenborn JR. Marijuana effects on associative processes. Psychopharmacol 1985;85:426—30.
7. Brown J, Kranzler HR. Delboca FK. Self—reports by alcohol and drug abuse inpatients — factors affecting reliability and validity. British Journal Of Addiction 1992 Jul;87(7) :10]3—24.
8. Matsuda LA, Bonner TI, Lolait SJ. Localization of cannabinoid receptor messenger RNA in rat brain. Journal of Comparative Neurology 1993 Jan 22;327(4) :535—50.
9. Heyser CJ, Hampson RE, Deadwyler SA. Effects of delta—9—tetrahydrocannabinol on delayed match to sample performance in rats — alterations in short—term memory associated with changes in task specific firing of hippocampal cells. Journal Of Pharmacology And Experimental Therapeutics 1993 Jan;264 (1) 294-307.
10. Block RI, Farinpour 1k, Braverman K. Acute effects of marijuana on cognition — relationships to chronic effects and smoking techniques. Pharmacology Biochemistry And Behavior 2992 Nov;43(3) :907—17.
11. Azorlosa JL, Heishman SJ, Stitzer ML, Mahaffey JM. Marijuana smoking — effect of varying delta—9—tetrahydrocannabinol content and number of puffs. Journal Of Pharmacology.

Source:www.cesar.umd.edu/metnet, Nov 1998

“Drugs and sex are interrelated,” Dr. Porio stressed as the 2002 Young Adult Fertility and Sexuality Study 3 (YAFS 3) disclosed that the youngsters who indulge in drugs have the ‘gnawing desire’ for sex.

In fact, the YAFS 3 showed that there was a high incidence of drug use among females as it almost tripled from one percent in 1974 to 3.2 percent in 2002. The drug prevalence among females reached 19.7 percent in 2002 from 10.9 percent in 1994.

As these figures increased, Dr. Porio said that paying attention to reproductive health education is an important act that must be done right away asserting, “there’s a need to mainstream practical reproductive health education campaigns and activities.”

She also disclosed that drugs have parallel effects to the increase of crime index nowadays as 65 percent of prison inmates are in jail for drug-related crimes with 70% percent of drug-related cases filed in court.

A growing number of teenagers and preteens are being treated at emergency rooms or are entering drug treatment as a result of using a highly potent type of marijuana, government officials say.

The Los Angeles Times reported April 26 that although marijuana use by youths has declined overall since the mid-1990s, the latest statistics show an increase in more serious problems related to the drug. According to federal health officials, the number of marijuana-related emergency room visits for children ages 12 to 17 more than tripled since 1994, to 7,535 in 2001, the most recent year for which figures were available.

Most of the hospital visits were for an “unexpected reaction” to the drug, while “overdose” was listed in 10 percent of the cases, “chronic effects” in 6 percent, and “accident or injury” in 4 percent.

“The stereotypes of marijuana smoking are way out of date,” said Michael Dennis, a research psychologist in Bloomington, Ill. “The kids we see are not only smoking stronger stuff at a younger age but their pattern of use might be three to six blunts — the equivalent of three or four joints each — just for themselves, in a day. That’s got nothing to do with what Mom or Dad did in high school. It might as well be a different drug.”

According to federal officials, the marijuana being taken by youngsters today is nearly twice as potent as it was in the 1980s. “There is no question marijuana can be addictive; that argument is over,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “The most important thing right now is to understand the vulnerability of young, developing brains to these increased concentrations of cannabis.”

Australian researchers have found that one in three teenagers who smoke marijuana become psychologically dependent on the drug by their early 20s, the Independent reported April 1.

But the study also found that the dependence is mental, rather than physical. In examining marijuana dependence among 1,601 20- and 21-year-olds, the researchers found that the key factor in becoming dependent was frequency of use.

One of the first studies to use brain scans to examine marijuana’s effects has found that smoking it may be associated with changed brain activation patterns more than a month afterward.

The study may come as a surprise to proponents of marijuana legalization, as it contradicts several previous results showing that there are no significant long-term effects of marijuana use.

Normally human memory formation is associated with a specific pattern in a part of the brain called the hippocampus. The pattern is abnormal in teenagers with a history of marijuana use, Yale University researchers found based on the study.

The marijuana users in the study also performed worse on a simple working-memory tests in which the participants heard a list of words and periodically were asked to repeat a word that was one or two words back on the list. The marijuana users had stopped taking the drug for more than one month before the tests.

Their research, published on June issue of the Annals of the New York Academy of Sciences, involved seven teenagers with a history of marijuana use and 14 without such a history. The authors said the results should be taken with caution: because of the small sample size, the research is merely a “pilot study” and further studies are needed to confirm the findings.

The university’s Leslie Jacobsen and colleagues used functional magnetic resonance imaging in the research, a type of brain scan technology that registers blood flow to functioning areas of the brain. The technique is supposed to reveal which parts of the brain are active at any given time.

NEW YORK (Reuters Health) – Large doses of marijuana might in rare instances lead to stroke in teenagers, according to a new report.

Although it is unusual for teens to suffer a stroke, and there have been few reports of stroke linked to marijuana use, the cases of three teenage boys suggest the association is real, researchers report.

The boys all had a similar type of stroke in a brain region called the cerebellum shortly after smoking marijuana. Their strokes could not be explained by blood clots that traveled from the heart, blood vessel inflammation or other potential causes. There may be some unique features of bingeing or sporadic use of large amounts of marijuana that might put the adolescent brain at risk, Dr. Thomas Geller of St. Louis University School of Medicine in Missouri told Reuters Health. “This is obviously very rare,” he added. Geller and his colleagues report on the cases in the April issue of the journal Pediatrics.

Past research has shown that marijuana use can lead to excessively low blood pressure, slowed heart rate, dizziness and balance problems. According to Geller and his colleagues, there have been a few reports of marijuana-associated stroke, which have all been in males between the ages of 15 and 34. In these latest cases, all of the boys showed similar symptoms shortly after smoking pot, including severe and worsening headache and problems seeing and walking. One boy had slurred speech and appeared drunk.

Two of the teens died less than 24 hours after being admitted to the hospital. Autopsies confirmed that the boys had strokes caused by disrupted blood flow to the cerebellum, as did biopsy from the third teen, who survived. All of the boys admitted to having recently smoked marijuana, and appeared to use the drug occasionally rather than regularly. The teen who survived suffered his stroke symptoms after heavy marijuana use.

There is research evidence that inexperienced marijuana users have a short-term drop in blood flow to the brain after smoking the drug, the authors note in the report. Geller said his team’s hypothesis is that irregular but high-volume use of marijuana- or a contaminant they were unable to find- might prevent the cerebellum from getting enough blood to meet its needs.

“We think that adolescents- maybe only male ones- who binge on marijuana may put themselves at a risk that they are not aware of,” Geller said.

Children with asthma who have at least one parent who smokes are twice as likely to have asthma symptoms all year long compared with children of non-smokers, according to researchers from the University of Michigan (U-M) Health System.The involved in-depth telephone interviews with 896 parents of asthmatic children ages 2 to 12 years old in 10 states. “We set out to look at children who have seasonal asthma symptoms, but found that a substantial percentage have symptoms year-round,” said Kathryn Slish, a researcher in the U-M Department of Pediatrics. “We looked more closely and found a strong relationship between parents’ smoking status and the likelihood that their child would have problems all year long.”

“The only other factor that was associated with year-round symptoms was Medicaid insurance coverage,” added Cabana.

With well-publicized information that secondhand smoke can trigger asthma in children, Slish said, “it’s astounding that so many parents smoke around their asthmatic kids, and don’t stop even though their children are having trouble breathing all year.”

The researchers recommended that pediatricians, family physicians, and nurses address the subject of smoking with the parents of any child diagnosed with asthma and to provide resources to encourage them to quit.

The study’s findings were presented May 4 at the Pediatric Academic Societies annual meeting.

Drug  trafficking groups are using the Internet to distribute the “date rape” drug, GHB, and its derivative drugs, GBL and 1, 4 Butanediol 1,4 BD.) GHB, GBL and 1,4 BD are abused to produce euphoria, intoxication and hallucinogenic states, and for their alleged role as a muscle growth hormone. These substances are also used as “date rape” drugs, acting as central nervous system depressants, which cause drowsiness, dizziness, nausea, loss of inhibition, memory loss and visual disturbances. Higher doses of these substances will cause unconsciousness, seizures, severe respiratory depression, coma and even death. DEA has documented 72 deaths relating to GHB and its derivatives.

Exposure before birth to methamphetamine, an increasingly popular “club” drug, renders males, even as adults, much more susceptible to the drug’s brain—damaging effects, reveals a study performed in mice by researchers at the University of Chicago. If males who were prenatally exposed to methamphetamine take the drug themselves as teens or adults, the increased toxicity could hasten the onset of brain disorders such as Parkinson’s disease. No one who values his or her brain should take this drug;” cautions neurotoxicologist Alfred Heller, M.D., Ph.D., professor of neurobiology, pharmacology and physiology at the University of Chicago and director of the study. “If you’re male, and if your mother took methamphetamine and it’s difficult to be certain she didn’t  you should not go near this drug.” Methamphetamine also known as ‘meth’ or ‘chalk,’ or when smoked as ‘crystal,’ ‘crank’ or ‘ice’ is the world’s second most widely used illicit drug, according to the World Health Organization, and is rapidly gaining popularity. After claiming a foothold in the Southwest in the early 1990s, it has spread across much of the United States. “We now are seeing high levels of methamphetamine abuse in many areas of the Midwest,” notes an alert on the National Institute of Drug Abuse (NIDA) web site, “in both urban and rural settings, and by very diverse segments of the population.”

Cheap, long-lasting, easy to make, easy to take and perceived as relatively safe, this stimulant is widely used by young women because it elevates mood, boosts energy, suppresses appetite and helps with weight loss. Researchers have long known that methamphetamine has multiple side effects. It damages neurons that use the neurotransmitter dopamine to relay signals. Women who abuse the drug during pregnancy have increased risk of premature delivery. Their newborns are often unusually irritable. But because the drug has only recently become so popular, there is limited information about its long-term effects on users’ offspring. Last spring, recognition of  methamphetamine’s blossoming popularity among young women, and the uncertainty about its effects on an exposed fetus, provoked NIDA to call for research on how the drug affects brain development for those exposed in utero.

Heller’s group at the University of Chicago had already developed a mouse model of prenatal methamphetamine exposure. They determined the dose that exposed the mouse fetal brain to similar concentrations of methamphetamine as in human infants and then studied its effects on the exposed mice and their offspring. The key finding was that male mice who were exposed to the drug before birth and then exposed again as adults (at 11 weeks old), were significantly more vulnerable to methamphetamine’s neurotoxic effects. These males suffered damage to the dopamine-using neurons, particularly in areas of the brain known as the substantia nigra and the striatum, the system that is damaged in Parkinson’s disease. Why the effect was so much greater in males than females is unclear. It may be connected with the rise in body temperature associated with use of the drug. The amount of brain damage was closely associated with this increase in body temperature in exposed mice. Methamphetamine increases core temperatures more in males than in females.

The researchers also suggest that a likely mechanism for the increase in brain damage is that fetal exposure to methamphetamine increases the release of dopamine from adult brain cells by methamphetamine. When stimulated later in life by this drug, these preconditioned nerve cells release abnormal amounts of dopamine, which accumulates outside the cells, where it can be chemically altered or oxidized. Heat exacerbates this dopamine secretion, When the altered neurotransmitters are taken back up into these nerve cells, they can be toxic. In fact, drugs that block re-uptake can prevent this toxicity. The enhanced neurotoxicity in response to methamphetamine in male animals exposed in utero “may be an additional risk factor in the development of parkinsonism,” note the authors. “With age, the persistent damage to the dopaminergic system may predispose these individuals to brain disorders.” Although Parkinson’s disease doesn’t immediately appear in these animals, or in most human drug users, the drug may be setting the stage for early disease onset. People begin to exhibit symptoms, such as slowed movements, rigidity and tremors, only after losing more than 80 percent of the dopamine-producing cells in the substantia nigra. “Regular methamphetamine users, or those at increased risk because of prenatal exposure, may have a head start on this process,” suggests Heller.

 High estrogen  levels make drug dangerous

Young women taking the synthetic drug ecstasy are much more likely to die than any other group, according to new research. The drug is more dangerous for women of reproductive age because of high levels of the female hormone estrogen in their bodies, said researchers at Kings College, London. ‘The way that young women, in particular, respond to ecstasy places them at risk, though these effects can apply to anyone who takes the drug,” neuroendocrinology professor Mary Forsling told the paper. “Ecstasy is especially dangerous because of the circumstances in which people take it,” Forsling was quoted as saying. “Dancing raises the body temperature, you drink a lot, your hormones tell your body to retain water,.you drink more. It is something of a vicious cycle,” she added. Known as MDMA, ecstasy is an illegal amphetamine-based drug that causes euphoric and mildly hallucinatory effects. As ecstasy is broken down within the body it produces another chemical, known as HMMA which causes the release of a hormone encouraging the body to drink. The resulting imbalance of sodium levels in the body can be fatal.

A NIDA supported study has provided the first direct evidence that chronic use of MIDMA, popularly known as “ecstasy” causes brain damage in people. Using advanced brain imaging techniques, the study found that MDMA harms neurons that cause serotonin, a brain chemical thought to play an important role in regulating memory and other functions. In a related study, researchers found that heavy MDMA users have memory problems that per for at least 2 weeks after they have stopped using the drug. Both studies suggest that the extent of damage is directly correlated with the amount of MDMA use. “The message from these studies is that MDMA does change the brain and it looks like there are functional consequences to these changes”, says Dr. Joseph Frascella of NIDA’s Division of Treatment Research and Development. That message is particularly significant for young people who participate in large, all-night dance parties known as “raves,” which are popular in many cities around the nation.

Findings from another Johns Hopkins/ NIMH study now suggest that MDMA use may lead to impairments in other cognitive functions besides memory, such as the ability to reason verbally or sustain attention. Researchers are continuing to examine the effects of chronic MDMA use on memory and other functions in which serotonin has been implicated, such as mood, impulse control, and sleep cycles. How long MDMA-induced brain damage persists and the long-term consequences of that damage are other questions researchers are trying to answer. Animal studies, which first documented the neurotoxic effects of the drug, suggest that the loss of serotonin neurons in humans may last for many years and possibly be permanent. “We now know that brain damage is still present in monkeys 7 years after discontinuing the drug,” Dr. Ricuarte says. “We don’t know just yet if we’re dealing with such a long lasting effect in people.

A new study provides the first epidemiological evidence that young marijuana smokers are substantially more likely than non-smokers to be presented with the opportunity to try hallucinogens. The study was performed by researchers from the Johns Hopkins Bloomberg School of Public Health. Once the opportunity for hallucinogen use occurs, marijuana smokers are more likely than non-smokers to actually try it. The study appears in the April issue of Drug and Alcohol Dependence. “Research in the past has focused on the causal relationships of drugs, but our study is the first to support the idea of two separate mechanisms linking marijuana and hallucinogen use – that of increased opportunity and increased use once given the opportunity,’ says lead author Holly Wilcox, a doctoral candidate in the department of mental hygiene at the Johns Hopkins Bloomberg School of Public Health. “Insight into this area teaches us about mechanisms that might help guide new progress for prevention of drug problems.” For the investigation, the researchers used self-report data from more than 40,000 young participants in the 1991 to 1994 National Household Surveys on Drug Abuse (NHSDA), From this data, they were able to extract information about the age at which young people first had the opportunity to use different drugs and the age at which they first tried them. They focused on the availability and use of two drugs: marijuana (cannabis, reefer, blunts, hash oil, or any other form of marijuana use) and hallucinogens (LSD, mescaline, mixed stimulant-hallucinogens, and PCP).

The results showed that by age 21, almost one-half of the teenagers who had smoked marijuana had a chance to try a hallucinogen, compared to only one in 16 of the teenagers who had never smoked marijuana. Within a time period of one year after the first chance to use a hallucinogen, two-thirds of marijuana smokers actually tried it, compared to only one in six of the teenagers who had never smoked marijuana. “This large difference between marijuana smokers and non-smokers may be attributed to the social influences in a marijuana smoker’s life. Young people who are using marijuana sometimes develop contacts with illegal drug dealers who may try to push other drugs like Ecstasy or LSD,” explains James C. Anthony, PhD, a professor of mental hygiene, psychiatry and epidemiology at the Johns Hopkins Bloomberg School of Public Health and School  of Medicine. ‘Also, marijuana smokers often are members of social circles where drug use and experimentation is more common, and friends are likely to share drugs. In addition to trying to persuade young people to not use drugs, it may be worthwhile for us to persuade users to not share their drugs with friends.” The authors say further research is needed to account for variations in exposure opportunities experienced by marijuana smokers and to understand why some marijuana smokers choose not to use hallucinogens once given the opportunity. “Such research should lead toward new ideas for prevention of hallucinogen use,’ concludes Ms. Wilcox.

Disturbing evidence is emerging that the increasingly popular drug ecstasy can be linked to users suffering long term brain damage . University of Adelaide researchers have found that ecstasy taken on a few occasions could cause severe damage to brain cells, with the potential to cause future memory loss or psychological problems. Dr Rod Irvine, an internationally regarded ecstasy expert from the University’s Department of Clinical and Experimental Pharmacology, says with 7% of 17 year olds reporting use of ecstasy major health problems could be expected in the future. For many years it has been known from animal experiments that small doses of ecstasy-even if only taken on only a few occasions-can cause severe damage to certain brain cells,” he says. “More recently, evidence has started to accumulate suggesting that this damage may also occur in humans. Brain scans ar psychological assessment of ecstasy users have been used to obtain this information. “If our suspicions are proved correct, it will mean many of our young people will have memory loss or psychological problems in the future.’

Dr Irvine’s research on brain damage caused by ecstasy shows that the drug seems to work mainly through its effects on one type of brain cell, and even through one molecule in those cells. It also seems likely that the way  body reacts chemically to ecstasy is important in producing adverse effects, as is the surrounding temperature, which can lead to users over heating. Adelaide’s reputation as having the highest per capita death rate from ecstasy in Australia-and perhaps even the world-forms another component of Dr Irvine’s research. Dr Irvine is looking at the shorter-term consequences of ecstasy ‘overdoses’, and has established t the high rate of death is due to a different strain of ecstasy appearing on the Adelaide market in the mid l990s.

Normal ecstasy contains the pharmacological ingredient known as MDMA as its main ingredient, but the Adelaide strain often contained no MDMA but rather a more potent chemical known as PMA. “PMA hasn’t been around since the early 1970s when it was responsible for the deaths of several people in Ontario, Canada, and now it’s reappeared here in Adelaide,” Dr Irvine says. ‘We don’t know where the PMA came from, but we do know that it has been prevalent in Adelaide since the mid 1990s.”

Ecstasy fans beware: long-term use of methylenedioxymethamphetamine (MDMA) may lead to memory loss or impairment, according to findings reported today in the journal Neurology. Over the course of a year, researchers studied 15 ecstasy users ranging in age from 17 to 31 who took the drug 2.4 times a month on average. They found that tests linked the use of ecstasy with different aspects of memory decline. The ability to recall a story after a brief delay, for example, dropped by about 50 percent between the first and second evaluations.

Konstantine Zakzanis of the University of Toronto, a co-author of the report, warns that the study relied on self-reporting by patients, which can yield misleading results. He further notes that the makeup of street drugs is variable. Still, “for those who use ecstasy repeatedly, there is preliminary evidence to suggest memory processes can be impaired with continued use of the drug,” he remarks, “For those that use ecstasy once or twice in a lifetime, to date, there is no evidence suggesting impairment of memory function that is progressive or permanent in nature, although the jury of ecstasy researchers are still deliberating the matter.

Clubbers who take ecstasy are 25% more likely to have a mental health disorder, compared to the general population, a survey has found. The UK average is one in five. Its findings back up previous scientific concerns over a link between ecstasy and mental health problems.
Ecstasy users are also twice as likely to have seen a doctor about a mental health problem compared to the rest of the population. half of them asked about depression, which scientists believe could be linked to use of the Class A drug. But one in 10 users believed that taking ecstasy had made their lives worse overall. Both ecstasy and cocaine have been linked with mental health problems such as paranoia, panic attacks and depression.

Widespread drug use

The extent of drug use amongst clubbers is graphically illustrated by the fact 97% of 1,000 people surveyed said they had tried both E and cannabis at least once. Eleven per cent have tried heroin.
Mixmag estimates 1.5m people take ecstasy every weekend. But it says consumption has dropped by 13% among regular users. Ecstasy use had resulted in unplanned sex for one in three, one in 100 of which resulted in pregnancies. Half said their performance at work had been affected
because of the drug. But the survey also found clubbers had developed a novel way of ensuring Ecstasy got into their bloodstream as quickly as possible – by taking it as a suppository. One in 15 surveyed by Mixmag admitted they had taken the drug in this way, a 200% increase compared to last year. Inserting it into the rectum allows the body to absorb it more quickly because of the large number of blood vessels in the anus.

Cocaine

Cocaine use fell 4%, though 45% of those surveyed said they still took the drug on a regular basis. Almost a third of cocaine users reported suffering a nosebleed after snorting the drug. Drug use appeared to be linked closely with high levels of alcohol use. More than a third of men who responded to the survey spent more than four nights a week in the pub. All respondents were three-and-a-half times more likely to injure themselves on alcohol than on ecstasy. They were also two-and-a-half times more likely to end up in the local casualty department. The survey also showed one in three said they had been violent on alcohol, compared with one in l0 on ecstasy. Twice as many had driven on ecstasy than on alcohol but drink drivers had a higher accident rate.

Sexually active young adults report that drinking and drug use affect the decisions they make about sexual intercourse. Overall,80% of young adults age 18-24 have had sexual intercourse. Of these, more than one-third (37%) reported that alcohol or drugs have influenced their decisions about sex and thirty percent said that drinking or using drugs had caused them to do more sexually than they had planned. Nearly one-fourth (24%) reported that they had not used a condom during sex because they were drinking or using drugs.Drugs and alcohol were used by 16% of young adults in order to feel more comfortable with their sexual partner, and one in ten (11 %) were under the influence of either drugs or alcohol the most recent time they had intercourse. These findings are consistent with those of previous studies of alcohol and drug-related sexual behavior among U.S. high school students.
Percentage of Sexually Active Young Adults (age 18-24)Reporting Alcohol or Drug Related Sexual Behaviors, 2003(N=829) Alcohol or drugs influenced their decision to do something sexual 31%
Ever done more sexually than they had planned because they had been drinking or using drugs 30%
Ever had unprotecetd sex because they were drinking or using drugs 24%
Ever used alcohol or drugs to help them feel more comfortable with a sexual partner 16%
Were drinking or using drugs the most recent time they had sexual intercourse 11%

The National Survey of Adolescents and Young Adults is a nationally representative telephone survey of 1,854 youths and young adults age 13-24 conducted between November 2001 and February 2002.

Source: Adapted by CESAR from Kaiser Family Foundation, Hoff T., Greene L., Davis L,
National Survey of ‘Adolescents and Young Adults: Sexual Health Knowledge, Attitudes and Experience.
The Henry J. Kaiser Family Foundation 2003.,

      WHAT IT MEANS: Stimulant drugs like methylphenidate work to raise levels of extracellular dopamine, a key chemical in motivation, which can enhance interest in performing an academic task. A better understanding of this mechanism may lead to the development of other medications that have similar chemical effects in the brain, and help people with ADHD improve focus on and motivation for performing academic tasks. The study findings also support developing educational strategies that make schoolwork more interesting as a nonpharmacologic way to treat ADHD.

A study of 201 15-16 year-old students (from a sample of 2641) who reported using marijuana at least 40 times were the basis of this study. The authors found that three clusters of “heavy cannabis users emerged,” i.e., a small group of those where were distinguished by antisocial behavior, another group who had depression, low self-esteem and poor relationships with parents and friends, and a third group perceived to be “ordinary.” Those in the “ordinary” group were found to be less likely than those in the other two clusters to use other illicit drugs.

The authors reviewed numerous previous studies on the relationship between cannabis and the use of other drugs and concluded “In particular, cannabis use and dependence were highly associated with increased risks of other substance dependence.”

While parents of children with asthma take many steps to change environmental factors to improve their child’s breathing, a study shows that they often overlook cigarette smoking in the house, one of the major triggers of asthma, Reuters reported Aug. 17. The study by Michael Cabana, M.D., a pediatrician at the University of Michigan, found that 25% of the parents surveyed had a smoker who lived in the same house as the child with asthma, but did nothing to ban smoking inside the house. The study’s findings are published in the August 2004 issue of the Journal of Allergy and Clinical Immunology.

A study from the United Kingdom finds that children of mothers who smoke have smaller lung volumes and are more at risk for serious lung disease later in life, Reuters reported Feb. 26.

The study by researchers at the University of Bristol and the University of Glasgow involved 2,000 men and women in their 30s, 40s, and 50s whose parents smoked and took part in a study in the 1970s.

After conducting respiratory tests, the researchers found that children of mothers who smoked had smaller lungs, regardless of whether they also smoked. In addition, these children were more at risk for chronic obstructive pulmonary disease (COPD). If they themselves smoked, the risk was as high as 70%.

“Our results suggest that the effects of maternal smoking on lung size are permanent,” said Dr. Mark Upton, lead author of the study.

Children from households where the father smoked, but not the mother, showed poorer lung function, but not as great as those whose mothers smoked.

A new government study concludes that people with alcohol and other drug addictions are more likely to have antisocial personality disorders, conduct disorders, and adult antisocial behavior disorders.

Previous studies have shown that nearly half of all addicted individuals have some sort of antisocial disorder; the latest research found an association between nearly all drugs of abuse and antisocial disorders, according to researchers from the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) who conducted an epidemiological survey of 43,000 adults.

“The strong and significant association between substance abuse or addiction and conditions such as antisocial personality disorder, conduct disorder, and adult antisocial behavior suggests that prevention and treatment strategies need to apply an integrated approach,” said NIDA Director Nora D. Volkow. “By also treating antisocial syndromes, particularly those that develop in adolescence or persist over time, we may be able to substantially reduce substance abuse and addiction.”

Researchers said that the risk for having both an addiction and an antisocial personality disorder or adult antisocial behavior were higher for women than men. People who were dependent on tranquilizers, sedatives, marijuana, inhalants, or hallucinogens were more likely to have antisocial personality disorders; those who abused sedatives, amphetamines, alcohol, cocaine, or hallucinogens were more likely to have adult antisocial behavior problems.

Cannabis use and suicidal behaviour are causes of adolescent morbidity and mortality worldwide. Changing trends in these behaviours in younger age groups, higher incidence, gender differences and sociocultural variations present an enormous challenge. There is no consensus whether these complex relationships are either a direct or an indirect effect due to other mental disorders, or a social response of disclosure of drug taking habits to family members and school authorities. This paper reviews the epidemiology of suicidal behaviour and cannabis use among adolescents and looks at the relationship of these behaviours regionally and internationally. The Caribbean islands have an established use of cannabis with higher suicidal rates, which provides an ideal setting to investigate the interrelationship of these disorders. Preliminary research findings in Trinidad indicate high rates of cannabis use among school students with higher rates in vocational schools compared to grammar schools. Utilising the CAPE questionnaire, depressive and psychotic experiences were common findings in adolescent cannabis users with a significant preponderance of depressive experiences (p<0.01). Our findings suggest that there is a convincing relationship between suicidal behaviour and cannabis use, the latter awakening depressive experiences. Suicidal behaviour and cannabis use are major public health problems and require a multidimensional approach with culturally competent preventive interactions. School based prevention programmes are necessary at the levels of parent-teacher partnership and classroom intervention. The treatment of adolescent disorders remains a major challenge of the future. Double disorders such as cannabis use and suicidal behaviour are uncharted areas and need novel approaches.

Early alcohol use can contribute to later sexual and alcohol-related risk behaviors. To examine this association among urban youth — a group with a high prevalence of sexual risk behaviors — researchers surveyed 1034 African American and Hispanic students from Brooklyn. Subjects completed questionnaires in the 7th grade and then again in the 10th grade. Analyses were adjusted for some potential confounders (e.g., age, ethnicity, early sexual initiation).

• In the 7th grade, approximately 25% of students reported ever drinking alcohol; 9%  reported drinking in the past month.
• In the 10th grade, prevalence of use greatly increased: 63% reported ever drinking alcohol and 29% reported drinking in the past month.
• Students who had drunk in the 7th grade (versus those who had abstained) were more likely in the 10th grade to report alcohol use, binge drinking, drunkenness, and having an alcohol or drug problem.
• They were also more likely to report a greater number of sexual partners, unprotected sex, pregnancy, and being drunk or high during sex. Female students who had drunk during the 7th grade were also more likely in the 10th grade to report having had sex.

Comments by Joseph Conigliaro, MD, MPH:

Although analyses were not adjusted for psychosocial risk factors, the results confirm the dangers of early alcohol use. The high prevalence of drinking in 7th graders suggests that screening and prevention programs must begin well before the teenage years. These programs should emphasize alcohol’s influence on risky sexual behaviors and related consequences, including exposure to HIV and other sexually transmitted diseases.

Reference: Steve A, O’Donnell LN. Early alcohol initiation and subsequent sexual and alcohol risk behaviors among urban youths. Am J Pub Health. 2005;95(5):887-893.

Researchers at the Johns Hopkins Bloomberg School of Public Health and other institutions found high rates of herpes simplex virus 2 and syphilis among young drug users in Baltimore, Md. The study found that women had significantly higher rates compared to their male counterparts, but did not find significant differences between injecting drug users and non-injection drug users. Few of the infected study participants were aware of their sexually transmitted infection.“We found a high rate of sexually transmitted infections among the injection and non-injection drug users we recruited, which indicates the extent of sexual risk behaviors among both of these populations. Non-injection heroin and/or crack users are rarely the target of sexual or drug risk reduction interventions. Sexually transmitted infection prevention and treatment programs need to target drug users,” said Susan G. Sherman, MPH, PhD, corresponding author of the study and an assistant professor in the Department of Epidemiology at the Bloomberg School of Public Health.

The researchers examined herpes simplex virus 2 and syphilis test results in 543 heroin, cocaine and crack users from Baltimore, Md., aged 18-30 years old. Almost 73 percent of the study participants, who were part of a larger study known as the Risk Evaluation and Assessment of Community Health III cohort, were also injecting drug users. The study authors found that over half (58 percent) of the female study participants and a little more than 20 percent of male participants were infected with herpes simplex virus 2. Women were also more likely to have syphilis than men in the study – 4 percent versus less than 1 percent, respectively.

“The sexual behavior of both injection drug users and non-injection drug users is an important public health issue. Intervention and outreach programs for young drug users should offer sexually transmitted infection testing and education, as well as promote safe-sex messages in order to decrease the further spread of all sexually transmitted infections,” said Sherman.

“Herpes simplex virus 2 and syphilis among young drug users in Baltimore, Maryland” was supported by a grant from the National Institute of Drug Abuse.

Teenagers and young adults who occasionally smoke cannabis over long periods are more likely to turn to more addictive drugs such as heroin, according to a study.

While it has been assumed that the brain is almost fully formed by the time children reach their teens, there is evidence that the brain continues to develop until as late as 25.

Experiments on rats by Prof Yasmin Hurd, of the Karolinska Institute, Sweden, show that chronic periodic use of cannabis can interfere with brain development.

If confirmed, the findings suggest that children and young adults who use the drug over long periods would be more prone to anxiety and more dependent on anxiety-reducing drugs.

“The developing brain is definitely more sensitive,” she said. “Many people think that all cannabis does is to give you a calm, relaxed feeling and no long term effects.” Given the brain effects and link between smoking and lung cancer, she questioned “why governments would want to decriminalise this drug”.

Despite its widespread use, Prof Hurd believes there is much still to be learnt about cannabis. “Cannabis may be less addictive than, for example, cocaine or heroin, but it is still a drug.”

Prof Robin Murray, of the Institute of Psychiatry in London, said: “Clearly it needs to be replicated but there is already evidence that, in animals, cannabis and amphetamine show cross-tolerance. So that rodents given THC, the active ingredient of cannabis, show greater effects when given amphetamine.

“This suggests that it may be easier to come to grief when you try heavy drugs if you have already sensitised your brain receptors with cannabis.

We need more basic and clinical research into the long-term effects.”

The sites in the brain where cannabis act, called cannabis receptors, affect both the production of the brain’s “feel good chemicals” linked with rewards.

Prof Hurd’s experiments show that, after training to self administer heroin by pushing a lever, rats exposed to THC took more heroin as adults than those not given the chemical. They were more sensitive to lower concentrations of heroin than unexposed rats and took more in response to stress.

Rand Corporation, Drug Policy Research Center 2004. The study used survey data from 5,833 California and Oregon middle-school students. The participants completed the surveys six times over a 10-year period between ages 13 and 23. About 44% also responded to survey questions at age 29 with data from age-matched abstainers. 
Findings:

• Report suggests that people who abstain from smoking marijuana appear to have a better quality of life and higher levels of educational achievement than marijuana users

• Early use of marijuana was associated with lowered income and reduced health later in life

• The abstainers had an overall higher level of educational attainment, better health, greater life satisfaction and a lower rate of other drug use

• Those reporting a relatively high level of use at age 13 fared significantly worse than all other groups on over-all health and yearly earnings. The results show that people underestimate the harm marijuana can cause.

A Chronicle probe has revealed teenagers as young as 14 are ending up in secure hospital units because of the drug.

And doctors fear that if young people are not given more thorough warnings about cannabis, more will end up with lasting mental health problems.

Dr Paul McArdle, a consultant child and adolescent psychologist based at Newcastle’s Flemming Nuffield Unit, said: “Most of the young people we see with mental health problems are heavy users or dependent on cannabis, and many are using it to an extent that they are permanently intoxicated.

“Numbers of psychosis in the city are still small ( we’re talking say 15 a year) but when they manifest they are very dramatic.”

Dr Jamie Dibdin, also a consultant child and adolescent psychologist, works with young people who have got in trouble with the police and are being supervised by the Newcastle Youth Offending Team.

He said: “We’re not talking about an epidemic, but there are significant numbers of young people badly affected by cannabis in the North East.

“I think young people have got mixed messages about the drug’s legal status. They think because it’s been decriminalised, it’s acceptable.

“But studies show that if people start smoking it before the age of 15, they seriously increase their risk of developing psychotic illness.

“Young people need to know what they’re letting themselves in for and what the risks really are.”

He added: “We’ve known for a long time that cannabis has a direct effect on mental health and on depression and that people who are depressed often use it to self-medicate.

“But it seems as though there’s something new that’s happening with young people who are developing more potentially serious mental health problems from using cannabis.”

Dr David Ward, consultant adolescent psychiatrist at Newcastle General Hospital’s Young Persons’ Unit, explained: “Young people are particularly vulnerable to the effects of cannabis. They are still undergoing neurological development.

“Brain development is greatest up to the age of 25 so if people are using cannabis at 13, 14 or 15, they could seriously affect their development.

“We are seeing more young people in the unit who’ve got there because of cannabis.”

Mental health charity Re-think is campaigning for more to be done to protect young people from the dangers of cannabis.

Source: Evening Chronicle – Newcastle-upon-Tyne

Marijuana and Suicidal Thoughts.

Marijuana and Schizophrenia.

Do we have your attention? As parents and caregivers, you probably never thought you’d see marijuana associated with these mental health problems … but it is. New research is giving us better insight into the serious consequences of teen marijuana use, especially how it impacts mental health.

Today’s teens are smoking a more potent form of marijuana and starting use at increasingly younger ages during crucial brain development years.¹ There is plenty of evidence indicating the ways pot impedes, even changes, the mental health of adolescents. In fact, those changes in the brain are similar to those caused by cocaine, heroin and alcohol.² The overall impact that pot has on the brain can have long term consequences, and it’s up to you to influence your teen’s life when it comes to drugs.

Depression

Weekly marijuana use increases the risk of depression later in life. Research shows people who were not depressed and used marijuana at the beginning of one study were four times more likely to suffer from depression at follow up.³ Those who were depressed, but did not use marijuana at the beginning of the study, were no more likely to use it at follow up. This figure is higher in teen girls. Female marijuana users, with no predisposition for depression or anxiety, are five times more likely to be depressed at 21 than non-users.⁴

Suicidal Thoughts

Marijuana can also be linked to suicidal thoughts. A study based on data from the National Household Survey on Drug Abuse found that teenagers 12 to 17 who smoke marijuana weekly are three times more likely to have thoughts of committing suicide.⁵ The same study linked increased anxiety and panic attacks to past year marijuana use.⁶

Schizophrenia

Several studies have documented marijuana’s link with symptoms of schizophrenia and report that cannabis is an independent risk factor for schizophrenia. Heavy users of marijuana at age 18 increased their risk of schizophrenia later in life by six times.⁷ Further reports have found marijuana use increased the risk of developing schizophrenia among people with no prior history of a disorder, and that early use of marijuana (age 15 vs. age 18) increased the risk even more.⁸ In addition, youth with a personal or family history of schizophrenia are at an even greater risk of marijuana-induced psychosis.⁹

Let your teens know you don’t want them using marijuana. Their mental health may depend on it.

1. El Sohly, M.A. University of Mississippi Potency Monitoring Project, 2004

2. Marijuana: Facts Parents Need to Know, Revised, NIDA, November 1998

3. Bovasso, G.B. (2001), Cannabis abuse as a risk factor for depressive symptoms. Am J Psychiatry 158, 2033-2037

4. Patton, G.C., Coffey C, Carlin J.B., Degenhardt L., Lynskey M., Hall W. (2002) Cannabis use and mental health in young people: cohort study. BMJ 325, 1195-1198

5. Greenblatt, J. (1998), Adolescent self-reported behaviors and their association with marijuana use. National Household Survey on Drug Abuse, 1994-1996 SAMHSA 6. Ibid.

7. Andreasson, S. et al. Cannabis and schizophrenia: A longitudinal study of Swedish conscripts. Lancet, 26: 1483-1486, 1987

8. Arseneault L., et al. Causal association between cannabis and psychosis: examination of the evidence. British Journal of Psychiatry, 184: 110-117, 2004

9. van Os et al. (Dec. 2004) Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people, British Medical Journal, 330

New research by scientists at Edinburgh University has found that young drug users can suffer brain damage similar to the early stages of Alzheimer’s disease. The research claims that young injecting drug users are up to three times more likely to suffer brain damage than non-users. The studies suggest that intravenous use of heroin or methadone can be linked to premature ageing of the brain. It revealed that some drug users sustained a level of brain damage normally seen only seen in much older people and similar to the early stages of Alzheimer’s disease.

What risk factors influence teenagers to start experimenting with marijuana or to move from experimental to regular use?

Involvement with other substances (alcohol and cigarettes), delinquency and school problems have been established as the three most important risk factors in identifying teenagers at risk of continued involvement with marijuana by a Cardiff University scientist, in collaboration with a colleague in the USA.

The study, Risk Factors Predicting Changes in Marijuana Involvement, led by Dr Marianne van den Bree, Department of Psychological Medicine, School of Medicine and Dr Wallace Pickworth, National Institute on Drug Abuse (NIDA) in the USA assessed over 13,700 school students at high schools throughout the USA (aged 11-21 years). The students were participating in the National Longitudinal Study of Adolescent Health in the USA twice (in 1995 and in 1996) over a one year period.

Over half of the students in the study who indicated use of marijuana in 1995 were still using it one year later. Twenty-one well-established risk factors of adolescent substance use/abuse, including personality, family variables and religion, were used to predict five stages of marijuana involvement: (1) initiation of experimental use, (2) initiation of regular use, (3) progression to regular use, (4) failure to discontinue experimental use, and (5) failure to discontinue regular use.

Dr van den Bree said: “We found assessment of use of other substances and peer substance use, school, and delinquency factors to be key to identifying individuals at high risk for continued involvement with marijuana. The combined presence of these three risk factors greatly increased risk of experimental (by 20 times) and regular marijuana use (by 87 times) over the next year. Prevention and intervention efforts should focus on these areas of risk.”

The study included 307 patients with intracerebral haemorrhage (ICH) – a stroke caused by a blood vessel bursting inside the brain. Of the 75 patients 49-years- old or younger, 20 percent had drugs in their system.

“The dominant drug of abuse was cocaine, long recognized as a risk factor for ICH,” said Michael Hoffmann, MD lead author of the study and director of the stroke program at the University of South Florida-Tampa General Hospital. Marijuana was another frequently abused drug and is beginning to emerge as a risk factor for stroke. Amphetamines also were commonly abused.

How these drugs make brain blood vessels prone to rupture is not clear, but is being studied, Dr. Hoffmann said.

The study analyzed the causes and outcomes of ICH patients. Twenty-four percent of ICH patients in a registry at Tampa General Hospital were ages 18 to 49. Half were women, about two thirds were Caucasian, 15 percent were black and 12 percent were Hispanic.

ICE is often linked with high blood pressure in people over age 50, and in this study, 57 percent of those age 50 and older had it. Only 33 percent of ICH patients ages 18 to 49 had high blood pressure.

Of the younger patients in the study, 41 percent had malformed blood vessels, known as arteriovenous malformations, aneurysms or other vascular disorders. Cerebral arteriovenous malformation occurs when blood vessels in the brain develop in an abnormal tangle in which the arteries connect directly to the veins without the normal capillaries between them. A cerebral aneurysm is the bulging of the wall of an artery in the brain. Both these conditions weaken blood vessels and increase the risk of a haemorrhagic (bleeding) stroke.

The good news is that patients under age 50 who experience this vessel rupture inside the brain have better outcomes than older patients. “Surprisingly our study showed a low mortality rate compared to population studies,’ said Dr. Hoffmann, professor of neurology at USF.

The 30-day mortality was 14.6 percent for the younger group, significantly lower – than for older patients, whose mortality rate was 21 percent, he said. Previously, national population studies have found a high 30-day mortality rate for stroke patients with ICH. Some epidemiological data have suggested a 45 percent to 50 percent mortality rate, Dr. Hoffmann said.

ICH has traditionally been associated with o!der age groups and higher mortality rates.

Dr. Hoffmann attributes the low mortality rate in younger ICH patients to intensive neurocritical care management at Tampa General. The protocol includes decreasing intracranial pressure and using drains to prevent hydrocephalus, mechanical ventilation, sepsis control, blood pressure control and cooling.

The younger patients came into the emergency room, then were rapidly transferred to a neurocritical care unit within six hours. Typically, patients are hospitalized in the neurocritical care unit for one to eight weeks. Patients were evaluated by MRI, CT and angiography.

“This new way of thinking about how to manage patients with ICH is an important approach, and patients are reaping benefits,” Dr. Hoffrriann said. Most of the younger patients were able to live independently three to six months after their ICH, with only mild to moderate cognitive impairment that tends to improve overtime, he said.

Dr. Hoffmann said the degree and nature of disability at six months is now the focus of the extension of this study.

“Intensive neurocritical care is the key to successful outcome” Dr. Hoffrnann said. “Good medical care can salvage a high quality of life after a stroke.”

The study was funded by LJSF Health and the Tampa General Hospital Stroke Registry. Co-author is Ali Malek, MD, USF assistant professor of neurology.

Every week in Great Falls, Montana, a baby is born who tests positive for methamphetamine. Meth babies spend their first weeks asleep, some barely waking to feed. Within four to six weeks, they begin crying uncontrollably, irritated by normal sounds and lights. But just like their babies, addicted parents have plenty of problems to overcome even after kicking the habit. Meth’s pull is like no other drug. Because it permanently alters the brain’s chemistry, treatment takes two years, not 12 weeks. Addicts don’t feed themselves, let alone their kids. They go days without sleeping and then crash. Breastfeeding babies share meth with their moms. If someone is cooking meth in the house, babies are exposed to hazardous and explosive chemicals.

A study led by University of California researchers found that paternal smoking appeared to raise the risk of acute myeloid leukemia (AML) in children, and might also be linked to an elevated risk of acute lymphoblastic leukemia (ALL). Maternal smoking, on the other hand, did not seem to be related to leukemia risk among children.

Researcher Jeffrey S. Chang and colleagues noted that the findings on AML were based on a small group of research subjects, but said the study could provide an incentive for men to quit smoking.

A new study confirms that marijuana use in early adolescence is related to multiple problems, including delinquency and other substance abuse in later adolescence.  “Our findings suggest that early marijuana use is correlated with later deviance beyond the effect of earlier similar behavior,”   said the authors of the study.
The study was based on interviews with about 1,200 inner-city young people five years after they responded to a questionnaire about drug use, attitudes towards drugs, behavior difficulties and family issues.  The researchers found a significant increase in problem behaviors, such as violence, inability to function at work or school, risk-taking and dropping out of school, among adolescents who reported marijuana use at least once per month during the initial survey.
According to Brook, the link between early marijuana use and long-term substance abuse was highlighted “by an almost four-fold increase in the likelihood of problems with cigarettes and a more than doubling of the odds of alcohol and marijuana problems.”
Researchers recommended the creation of effective treatment strategies to help reduce current and future problems for early users of marijuana.

New research from Sapparo, Japan, suggests that youngsters who smoke, suffer significant damage to their hearts and blood vessels at a  much earlier age than had previously been thought; even though they appeared healthy on standard cardiac diagnostic tests.
                                                                                                                                                 Source:  The Times, 18 June 2002

More Teens – Nearly 88,000 – in Treatment for Marijuana Than For Any Other Drug Including Alcohol.
Legalization or decriminalization of non-medical marijuana would pose a serious threat to millions of America’s children, increasing their use of this dangerous drug and taking away critical support for parents, teachers and others attempting to steer kids away from drugs, a new report released today by The National Center on Addiction and Substance Abuse at Columbia University (CASA) concludes.
Sounding an alarm for parents, the report finds that in 1996 (the latest numbers available) more teens age 19 and younger entered treatment for marijuana abuse and dependence than for any other drug including alcohol.  In fact, nearly as many teens and children were admitted to treatment for marijuana as were admitted for abuse and dependence on all other substances combined.
Of the 181,784 teens and children who entered treatment in 1996, nearly half – 48.2% or 87,687 – were admitted for abuse or addiction to marijuana (the primary drug): 19.3% (35,069) were admitted for alcohol with a secondary drug; 11.9% (21,594) for alcohol alone; 2.9 % (5,323) for smoked cocaine, 2.4% for methamphetamines (4,354); and 2.3% (4,166) for heroin, also the primary drugs.  More than half the teens in treatment for marijuana were between the ages of 15 and 17.
“Teens who smoke marijuana are playing a dangerous game of Russian roulette.  The potential of marijuana as a dangerous drug for our children in and of itself, as a gateway to other drug use, and as a signal of trouble is a matter of the most serious concern for American parents,” said former HEW Secretary Joseph A. Califano, Jr., CASA President and Chairman. Experimentation with marijuana should not be considered a casual rite of passage.”
The 66-page White Paper, Non-Medical Marijuana Passage or Russian Roulette?, is the most comprehensive report ever published on non-medical marijuana, making clear the critical distinction between medical and general use of marijuana. The report recognizes that the determination of the medical value of marijuana should be made by physicians and scientists, but finds that any such determination has no relevance to prohibition of the general use of marijuana.
“Marijuana legalization proponents like to play doctor and prescribe marijuana by political referendum. Medical marijuana should not be the nose under the tent leading to the drug’s general legalization, as some proponents hope, any more than the medical use of cocaine or opiates has been regarded as an opening move in the direction of general use of those drugs,” said Califano.
CASA’s report comes just as the summer season gets fully underway when many children and teens are less likely to be closely supervised. CASA’s research has shown that a child who gets through age 21 without smoking, using marijuana or any other illegal drug, or abusing alcohol is virtually certain never to do so. Decriminalization or legalization of non-medical marijuana would increase use among the nation’s teens and children, heightening the risk of physical and psychological dependence and the likelihood of children moving on to other illegal drugs such as LSD, cocaine or heroin.
CASA’s own surveys show that marijuana is already readily available to teens. CASA’s 1998 teen survey reported that 19% of middle school students and 45% of high school students say they can buy marijuana in an hour or less.
In light of the discussion of the medical use of marijuana, the report stresses the serious consequences of non-medical marijuana use, especially by children, which include:
  -  impairment of short-term memory, concentration and motor skills, critical for a child’s intellectual and social development.
  -  greater likelihood of use of another illegal drug such as cocaine or heroin, increased likelihood of having unprotected sex or sex with multiple partners, leaving them at greater risk of pregnancy, AIDS and other sexually-ransmitted diseases.
  -  possible long term physical and psychological dependence.
  -  slowed reaction time, impaired coordination and decreased attention span, leading to increased highway accidents and fatalities.
Recent studies at universities in California, Italy and Spain reveal that marijuana affects levels of dopamine (the substance that gives pleasure) in the brain in a manner similar to heroin and cocaine. “While scientists have not yet uncovered the smoking gun, they have certainly found the trigger finger. Parents who mistake the absence of proof for the proof of absence are playing Russian roulette with their children’s lives,” said Califano.
The report also suggests that a policy that decriminalizes or legalizes marijuana for adults while continuing to ban it for minors is unlikely to be effective. Although the sale of tobacco is prohibited for those under 18 and alcohol for those under 21, the report noted that the use of these drugs by adolescents far exceeds that of marijuana, clearly demonstrating that age restrictions on the use of substances which are available to the entire population are difficult to enforce. Despite the massive public education campaign against smoking, tobacco use among young people has remained virtually constant from 1978-98, while over the same time period, marijuana use has decreased by approximately 50%.
Among the report’s conclusions:
  -  The statistical link between marijuana and other drugs like LSD, cocaine or heroin is tighter than between smoking and lung cancer, high cholesterol and heart disease, and asbestos and lung cancer. For example, 12- to 1 7-year-olds who smoke marijuana are 85 times more likely to use cocaine than those who do not. The correlation in the 1964 Surgeon General’s report between smoking and lung cancer was nine to 10 times; in the Framingham Heart Study between cholesterol and heart disease, two to four times, and in the Selikoff Study between asbestos and lung cancer, five times.
  -  The higher THC content available in today’s marijuana makes psychotic and other reactions (anxiety, agitation, delusions, amnesia, confusion and hallucinations) more likely.
  -  One pot cigarette causes more damage to lungs than one tobacco cigarette.
  -  Because the law has a normative as well as punitive function, decriminalizing marijuana will decrease its perceived harmfulness and lead to more widespread use, especially among children.
While the report disputes claims that the nation’s prisons are jammed with low level marijuana offenders, it recommends reform of current criminal justice policies, including an end to mandatory sentences; giving prosecutors and judges more discretion in dealing with low level offenders; assigning public health and substance abuse experts to support prosecutors and judges; expanding drug courts, and providing treatment to all alcohol and drug addicts in and out of prison.
“Laws that prescribe mandatory sentences for possession of small amounts of marijuana are overkill,” says Califano. “In general, mandatory sentences, especially those requiring drug and alcohol abusers and addicts to serve their entire sentence, are counterproductive and are particularly insidious where they concern teens convicted of marijuana possession. Mandatory sentences remove any potential that the threat of incarceration or early release might hold as an incentive for such an inmate to enter treatment. We need all the carrots and sticks we can muster to help these individuals shake their habit.”
The National Center on Addiction and Substance Abuse at Columbia University is the only national organization that brings together under one roof all the professional disciplines needed to study and combat all types of substance abuse as they affect all aspects of society. CASA’s missions are to: inform Americans of the economic and social costs of substance abuse and its impact on their lives; assess what works in prevention, treatment and law enforcement; encourage every individual and institution to take responsibility to combat substance abuse and addiction; provide those on the front lines with tools they need to succeed, and remove the stigma of substance abuse and replace shame and despair with hope.

A new study focusing on America’s adolescents shows a high percentage of youth ages 12 to 17 with posttraumatic stress disorder (PTSD), major depressive episodes, and alcohol and other drug dependency, according to an Aug. 4 press release from the Medical University of South Carolina.

For the study, researchers from the National Crime Victims Research and Treatment Center at the Medical University of South Carolina interviewed 4,023 youth nationwide. The results show that 16 percent of the boys interviewed and 19 percent of the girls met the criteria for at least one of the disorders.

“Nearly 4 percent of the boys and over 6 percent of the girls reported PTSD symptoms during the preceding six months, indicating that a high percentage of youth in the United States encounter traumatic events and experience significant emotional responses associated with these events,” said study lead author Dean G. Kilpatrick, Ph.D.

The study further found alcohol and other drug misuse and addiction prevalent in 8.2 percent of the boys and 6.2 percent of the girls. Major depression was found in 7.4 percent of the boys and 13.9 percent of the girls.

Furthermore, more than three fourths of all adolescents with PTSD also met the criteria for major depression, alcohol and other drug misuse or dependency, or both.

The prevalence of marijuana use among young people has risen rapidly in recent years, causing concern over the potential impact on academic performance of such use. While recent studies have examined the effect of alcohol use on educational attainment, they have largely ignored the potential negative effects of other substances, such as marijuana. This paper examines whether the relationship between the initiation of marijuana use and the decision to drop out of high school varies with the age of dropout or with multiple substance use. Data are from a longitudinal survey of 1392 adolescents aged 16-18 years. The results suggest that marijuana initiation is positively related to dropping out of high school. Although the magnitude and significance of this relationship varies with age of dropout and with other substances used, it is concluded that the effect of marijuana in on the probability of subsequent high school dropout is relatively stable, with marijuana users odds of dropping out being about 2.3 times that of non-users. Implications of these conclusions are considered for both policy makers and researchers.
Source: Author Bray, Zarkin et al Research Triangle Institute NC USA July 1999

Recent findings by a group of researchers from Trintity College in Dublin Ireland affirms the findings of Gabrial Nahas, MD, PhD, that Tetrahydrocannabinol (THC), the principal psychoactive component of marijuana, induces cell death (apoptosis) prematurely in the brain and reproductive cells as well as in macrophages and cortical neurories, and suggests that this phenomenon may underlie abnormalities seen in the central nervous systems of infants exposed to marijuana n the womb.
The proclivity of cannabinoid receptors to induce apoptos in neonatal neurones may reflect the role of endogenous cannabinoids in development of the CNS 22 [ nervous system] and may also underlie the central nervous system abnormalities that occur in infants exposed to marijuana inutero.22

Crack cocaine has replaced ecstasy and heroin as the drug of choice among many young adults in the United Kingdom. In particular the use of crack cocaine has increased among ravers and prostitutes, the Observer reported Dec. 29.
“Tackling Crack’ a new report from Britain’s Home Office, shows that the use of crack cocaine has grown more than 200 percent over the past three years. The biggest increase has been within the sex industry.
In addition, DrugScope, an anti-drug group, reports that many club goers have switched to crack over fears of the effects of ecstasy use.
“There is growing evidence that clubbers are under the mistaken belief that cocaine is a safer option,” said a spokesman for the charity. “Because they haven’t seen scare stories about cocaine or crack, they believe that it is a better option than ecstasy.”
In Scotland, police said that crack cocaine is the drug of choice for middle class club-going teenagers. According to Tom Wood, deputy chief constable of Lothian and Borders Police, there has been a 200% increase in the use of the drug.
Crack cocaine is an emerging threat,” said Wood. He added that dealers sell young people smaller ‘clubbing rocks.’
U.K. drug officials said the spread of crack cocaine is a result of Jamaican dealers who have introduced the drug in London and other major cities.

UK DRUG DEATHS SOAR

LONDON: British deaths from ecstasy, cocaine and amphetamines have rocketed 47 per cent in the past year.The toll topped 1500 for the first time, fuelled by a rise in so-called “recreational hard drugs taken by weekend users.
Ecstasy, cocaine and speed are increasingly used by young people who take cocktails of drugs every weekend.The findings emerged in a study of coroners reports which suggested stronger tablets, easier availability, falling prices and the growing popularity of drug cocktails were behind the rising death toll.
Dr Fabrizio Schifano, who led the research at the European Centre for Addiction Studies at St George’s Hospital Medical School in South London, said recreational users did not see themselves as addicts or considered they were at risk of dying’  Schifana said.
Many weekend users took a cocktail of drugs and alcohol in sessions of up to 12  hours.In dozens of fatal cases, the victims also smoked cannabis.Cocaine was involved in 147 deaths lost year, a 47 per cent rise on 2001, Amphetamines were linked to 53 deaths, a 60 per cent rise. There were 64 ecstasy-related deaths, up 34 per cent.
Dr Schifono so that even a small amount of a drug could kill a hardened user who had built up a tolerance over months or years. In a process called “reverse tolerance”, the user suddenly become acutely sensitive and died.The first death in Britain from a new synthetic form of morphine called Oxycontin was recorded ast year.Called “hillbilly heroin” it has killed hundreds in the US.Overal drug-related deaths rose by about 6 per cent on 2001 last year – from 1495 to 1583, About 45 per cent were due to heroin, morphine and other drugs.The greatest increase in drug-related deaths were in West London. Brcdgend and Glamorgan Volleys, West Yorkshire, Nottinghamshire, North Northumberland and East Lancashire.

Cannabis doubles the risk of schizophrenia and other psyciatric conditions
Harald Wychgel,an expert at the Trimbos addiction Institute claimed that cannabis use leads to 200 additional cases of schizophrenia each year in the Netherlands. He said that about 400,000 young Dutch people regularly smoke cannabis and of these 400 fall victim to psychiatric difficulties or schizophrenia.About half of young Dutch mules come into contact with cannabis as do about 30 percent of young women, This group more frequently suffers from mental conditions due to daily cannabis use,Wychgel claimed

Source:Expatica news Oct 2003

Yale Study Terms Addiction a Developmental Disorder

Because drugs affect the brains circuitry, Yale University School of Medicine researchers say adolescent drug addiction should be considered a developmental disorder. As adolescents develop, the researchers said, the changing motivational circuitry of their brain makes them vulnerable to the effects of alcohol and other addictive drugs. For the research, lead author Dr. R. Andrew Chambers analyzed three factors of teen behavior and their relationship to brain functioning. They included attraction to novelty, less-than-adult levels of judgment, and an overriding interest in sex.

According to Chambers, the brain’s complex motivational circuitry consists of chemical reactions that make certain experiences more enjoyable than others. At the center of this circuitry is the chemical dopamine, which has been linked to the addictive effects of drugs.In a teenagers brain, Chambers said, the circuitry that releases chemicals associated with new experiences and the motivation to repeat them develops much faster than the brain mechanism that restrains urges and impulses.You have a situation where the motivational brain areas are particularly active, Chambers said, and the part of the brain that is supposed to inhibit impulses is not working well, because it is sort of under construction.
As a result, Chambers said, teenagers are more likely to try drugs than other groups. Furthermore, experimenting with drugs during adolescence has more of an impact on the brain.

Even short term use of cannabis can damage the lungs of young people, say researchers.
A team from Queen Elizabeth Hospital, Birmingham, conducted tests on smokers, non-smokers and cannabis users. Non-smokers had the healthiest lungs. But cannabis users showed more signs of damage than those who stuck to cigarettes. A British Thoracic Society meeting heard less than six years cannabis use was enough to cause significant damage.
Dr Sarah Nuttall, a research fellow from the Department of Clinical Pharmacology at Queen Elizabeth Hospital, said: “The consensus among many  young people who use cannabis seems to be that they will not suffer any long-term effects as long as they stop smoking it early enough “However this is clearly not the case – our study shows that even short-term use of cannabis in addition to tobacco use does have an impact and makes a serious difference to lung function.”
Dr John Harvey, chairman of the BTS communications committee, said: “It is vital that young people understand the dangers of both cigarette and cannabis smoking since these habits can start having a serious impact on their lungs at an early stage.”
A British Medical Journal study published earlier this year warned that regular cannabis use may be as dangerous as smoking in the long term.
Professor John Henry, a toxicologist at Imperial College London, feared that deaths attributable to cannabis could soar.
There are currently an estimated 3.2 million people in the Britain who smoke cannabis regularly, compared with 13 million tobacco smokers.

Cannabis dependence assessed at age 18 and 21 increased from 6.6% for 18 to 9.6% at 21. unemployment or violent behavior more frequent with cannabis use at 21 years.

“The only real way to tackle youth smoking is to make it no longer seem like the norm in adult society. That means more smoke-free places, no tobacco advertising and more adults quitting.”
New research from Sapparo in Japan sugge that young people who smoke start to suffer significant damage to their hearts and blood vessels at a much earlier age than had previously been thought.An advanced new scanning technique revealed that smokers aged between 18 and 35 showed signs of damage associated with coronary heart disease even though they appeared healthy on standard cardiac diagnostic tests. Most previous research had suggested that such effects began to accumulate in a significant way only after many years of smoking.

People who begin using marijuana early are more likely than others to become dependent, new findings show.
In a study of over 2700 marijuana users in Ontario, Canada, those who started smoking at 17 years or later were twice as likely to eventually quit compared with those who started at 14 years or younger. “We believe this study has uncovered important information regarding the effects of patterns of marijuana use on the risk of desistance and progression to marijuana- related harm Dr. David J. DeWit, of the Centre for Addiction and Mental Health, in London, Ontario.
“We observed a significant.. relationship between frequency of lifetime marijuana use and marijuana desistance,” the authors say.
Compared with infrequent use, a lifetime frequency of 100 to 199 uses predicted an almost five fold higher likelihood of developing marijuana disorders, they report.
Prevention programs that are effective in delaying initiation of marijuana use until the age of 16 and beyond may greatly diminish the likelihood of prolonged consumption and consequently serve to avert serious problems later in life” DeWit and colleagues conclude.

People who begin using marijuana early are more likely than others to become dependent, new findings show.
In a study of over 2700 marijuana users in Ontario, Canada, those who started smoking at 17 years or later were twice as likely to eventually quit compared with those who started at 14 years or younger. “We believe this study has uncovered important information regarding the effects of patterns of marijuana use on the risk of desistance and progression to marijuana- related harm Dr. David J. DeWit, of the Centre for Addiction and Mental Health, in London, Ontario.
“We observed a significant.. relationship between frequency of lifetime marijuana use and marijuana desistance,” the authors say.
Compared with infrequent use, a lifetime frequency of 100 to 199 uses predicted an almost five fold higher likelihood of developing marijuana disorders, they report.
Prevention programs that are effective in delaying initiation of marijuana use until the age of 16 and beyond may greatly diminish the likelihood of prolonged consumption and consequently serve to avert serious problems later in life” DeWit and colleagues conclude.

SOURCE: Preventive Medicine 2000;31 :455-464

The federal government recently announced that the growing potency of America’s most popular illegal drug, marijuana, and the number of kids seeking help to get off the drug (one in five users) worried them so much that they were soliciting new marijuana-research proposals and urging local law enforcement to crack down on those who sell the drug.

The pro-marijuana lobby was furious and immediately charged the feds with fear-mongering and clamoring to protect their (not so glamorous, actually) jobs in Washington. Their cries rested on claims that more potent marijuana is not tantamount to more dangerous marijuana and that the rise in the number of treatment beds for marijuana users is due to criminal justice referrals, not the drug’s harmfulness.

But the evidence shows the government may indeed have it right. The pro-drug movement, fuelled with the motivation to legalize harmful substances and angry at the attack on its values of “drug use for all,” is putting kids at risk by downplaying the known dangers of marijuana.

Although not as destructive as shooting heroin or smoking crack, marijuana use is unquestionably damaging. Today’s more powerful marijuana probably leads to greater health consequences than the marijuana of the 1960s: Astonishingly, pot admissions to emergency rooms now exceed those of heroin. Visits to hospital emergency departments because of marijuana use have risen steadily, from an estimated 16,251 in 1991 to more than 119,472 in 2002. That has accompanied a rise in potency from 3.26 percent to 7.19 percent, according to the Potency Monitoring Project at the University of Mississippi.

More potent marijuana is also seen as more lucrative on the market. Customs reports claim that a dealer coming north with a pound of cocaine can make an even trade with a dealer traveling south with a pound of high-potency marijuana. It makes sense that people pay more for stronger pot because the high is better.

A flurry of very recent research studies – concerning withdrawal, schizophrenia and lung obstruction, for example – have also shown marijuana’s unfortunate consequences. These conclusions were not being reached in the ’70s and ’80s (legalizers often point to the Nixon-commissioned Shafer report, which said nice things about the drug as evidence of marijuana’s harmlessness), because marijuana from that era was weaker and less dangerous than today’s drug. The May 5 issue of the Journal of the American Medical Association reported that the number of marijuana users over the past 10 years stayed the same while the number dependent on the drug rose 20 percent – from 2.2 million to 3 million.

And although a majority of kids in treatment for marijuana are referred there by the criminal justice system, it still remains only a slight majority – about 54 percent. The rest is self-, school or doctor referral.To paint the picture that the reason marijuana dependence looks higher is because of the criminal justice system is disingenuous (especially because most people who use only marijuana never interact with law enforcement as a result of that use).

Some still argue that it’s wrong to arrest kids and force them into treatment. It seems like the government can never win: If it arrests and locks people up, legalizers kick and scream that we’re not giving users “alternatives to incarceration.” If it arrest kids as a way to get them help, and not as a punishment mechanism, all of a sudden the government is giving in to George Orwell.

It’s too bad that pot apologists don’t see what most parents do see: Marijuana is a harmful drug with serious consequences, and mechanisms – even a brush with the law to help a user realize that what he’s doing is harmful – to help stop the progression of use should be seen as a good thing. That’s not government propaganda. That’s common sense.And it may save a few lives.

Source: Kevin A. Sabet recently stepped down as senior speechwriter to America’s drug czar, John P. Walters. A Marshall Scholar, he is writing a book on drug policy and is also a Ph.D. candidate at Oxford University.

If state legislators wrote a bill outlawing a critical remedy to help kids avoid a disease like tuberculosis, there would probably be a major effort to boot every single one of them out of office. Recently, the state Senate did something just as asinine — except the condition in question was drug use by kids, far more prevalent than TB. Bowing to pro-drug interest groups, a bill is making its way to the governor’s desk that would stymie efforts by local schools to test students for drugs. Unlike lawmakers in other states, Sacramento bureaucrats would like to control the way schools drug-test students, making such testing voluntary and placing restrictions on how it is administered.

Drug testing sounds costly, unnecessary, uncompassionate, even unconstitutional. Those who want to legalize and legitimize drug use caricature drug testing as a draconian policy designed to catch kids using drugs and throw them into jail.

It’s time to set the record straight. At a time when drug abuse in California plagues many students, it makes sense to drug-test students as a part a comprehensive drug-prevention program (which includes after-school programs). Since addiction is spread from peer to peer, drug testing gives a student another more credible reason to say “no” when offered drugs by his or her friend.

Unfortunately, the sponsors of Senate Bill 1386 miss the point of random drug testing when they assume that the practice is unnecessary because it is already easy to detect drug use: “You come into class, your eyes are red, you’re falling asleep, and yesterday you weren’t like that,” argues Assemblywoman Jackie Goldberg, D-Los Angeles, who coauthored the bill with Sen. John Vasconcellos, D-Santa Clara.

But drug testing is not meant to catch the kid who “everyone knows” is using drugs. The purpose of testing is to get those kids who have yet to show symptoms of their drug use the help they need before their “recreational fun” turns into dependence or addiction. It’s meant to prevent the scenario described above so that the student and his or her peers don’t have to live with the consequences of their classmate coming to school on drugs.

Drug testing is also not intended to detect drug use for punitive purposes — in fact, the U.S. Supreme Court prohibited that in its recent landmark ruling defending random drug tests for kids involved in activities at school. No student goes to jail as a result of a positive drug test. Instead, the family’s privacy is respected and the child is referred to get help to stop his or her use. Consequences entail being denied involvement in sports or other extra curricular activities during the treatment period and until the child tests negative for drugs.

Employing this carrot-and-stick method works. For example: After two years of a drug testing program, Hunterdon Central High School in New Jersey saw significant reductions in 20 of 28 drug use categories, including a drop in cocaine use by seniors from 13 percent to 4 percent. The U.S. military saw drug-use rates drop from 27 percent in 1981 to 3 percent today, thanks to the introduction of random drug testing. Schools like St. Patrick’s High in Chicago are seeing a total change in the culture of education at their school as a result of drug testing.

Compared to other health interventions, drug testing is cheap. It costs roughly $10 to $50 per student, per year. Most parents would gladly pay that small fee in exchange for knowing that their child was safe. In addition, the federal government has proposed $25 million to help school districts offset the costs.

Unfortunately, opponents of random drug tests (many of whom carry mission statements dedicated to legalizing drugs) can claim some victories in our state. Already, schools such as Bret Harte Union High School in Angels Camp (Calaveras County) have said that they will pull their effective drug testing program if SB1386 passes.

Principals, teachers and parents who employ an effective drug-testing program at school realize it is a valuable tool to deter kids from delving into drug use in the first place and to refer troubled teens to help. Our elected officials should not make that tool harder to use with this misguided legislation.

Source: Kevin A. Sabet. Former chief speechwriter for the Bush administration’s drug czar. A Marshall scholar at Oxford University, Sabet and is writing on book on drug use.

Nation’s Youth Turning Away from Marijuana, as Perceptions of Risk Rise; Most Adults with Substance Abuse Problems Are Employed

Secretary Tommy G. Thompson announced today that there is a five percent decline in the number of American youth between the ages of 12 and 17 who have ever used marijuana. Current use of marijuana plummeted nearly 30 percent among 12 and 13 year olds. The findings were included in the 2003 National Survey on Drug Use and Health released today at the annual Recovery Month press conference.

The findings, released by HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA), show that while overall, the change in the category “current use of any illicit drug” was not statistically significant, the use of some drugs decreased sharply. For youth, 12-17, past year use of Ecstasy and LSD dropped precipitously, by 41 percent for Ecstasy and 54 percent for LSD. Overall, 19.5 million Americans ages 12 and older, 8 percent of this population, currently use illicit drugs. The data indicate that of the 16.7 million adult users (18 and older) of illicit drugs in 2003, about 74 percent were employed either full time or part time.

SAMHSA Administrator Charles Curie said: “Employers who think alcohol and drug abuse will never be a problem in their workplace need to consider that more than three quarters of adults who have serious drug and or alcohol problems are employed. Encouraging employees to find help when they need it can result in fewer accidents and fewer workers absent on Monday morning. It may even save an employee’s life, family, or job. Creating a drug-free workplace program or enhancing an existing program can lead to a healthier, more productive work force and be an important part of solving one of our nation’s most persistent problems.”
The survey found that of the 19.4 million adults (age 18 and over) characterized with abuse of or dependence on alcohol or drugs (19.4 million) in 2003, 14.9 million (77 percent) were employed either full or part time. This amounts to over ten percent of full-time workers as well as over ten percent of part-time workers.

Marijuana continues to be the most commonly used illicit drug, with 14.6 million current users (6.2 percent of the population). The study shows that there were an estimated 2.6 million new marijuana users in 2002. About two thirds of these new users were under age 18, and about half were female.

An important positive change detected by the survey was an increase in the perception of risk in using marijuana once a month or more frequently. Both youth and young adults reported a significant increase in their awareness of the risks of smoking marijuana. Particularly striking was the 20 percent decline between 2002 and 2003 in the number of youth that were “heavy users” of marijuana (those smoking either daily or 20 or more days per month). Perceived availability of the drug also declined significantly among youth.

The results of this year’s survey demonstrate that anti-drug messages inside and outside of school, participation in religious and other activities, parental disapproval of substance use and positive attitudes about school are linked to lower rates of youth marijuana use. For example, those exposed to anti-drug messages outside of school had rates of current marijuana use that were 25 percent lower than those not reporting such exposure (7.5 percent vs. 10.0 percent). Youth who believe that their parents would “strongly disapprove” of marijuana had use rates fully 80 percent lower than those who reported that their parents would not “strongly disapprove” (5.4 percent vs. 28.7 percent).

The numbers of binge and heavy drinkers did not change between 2002 and 2003. About 54 million Americans ages 12 and older participated in binge drinking at least once in the 30 days prior to being surveyed. These people had five or more drinks on one or more occasion in the past month. There were 16.1 million heavy drinkers, who had five or more drinks on five or more occasions in the past month. The highest prevalence of binge and heavy drinking in 2003 was among young adults ages 18-25, with both binge and heavy drinking at their peak at age 21.

There were 10.9 million drinkers under legal age (ages 12-20) in the month prior to the survey interview in 2003. This is 29 percent of this age group. Of these, nearly 7.2 million (19.2 percent) were binge drinkers and 2.3 million (6.1 percent) were heavy drinkers.

Drunk driving declined from the 2002 survey, but drugged driving remained similar to that reported in the 2002 survey. An estimated 13.6 percent of persons aged 12 or older drove under the influence of alcohol at least once in the 12 months prior to their interviews (32.3 million people) in 2003, a decrease from 14.2 percent (33.5 million) in 2002. An estimated 10.9 million persons reported driving under the influence of an illicit drug during the past year. This is 4.6 percent of the population ages 12 and older.

Against the backdrop of generally good news, the non-medical lifetime use of prescription pain relievers showed a five percent increase for the population 12 and older, with young adults (18-25) experiencing a 15 percent increase in lifetime, as well as current use. Over all, current use of prescription pain relievers non-medically remained stable from 2002-2003. There was a statistically significant increase in lifetime non-medical use of Vicodin, Lortab, or Lorcet from 13.1 million to 15.7 million. Percocet, Percodan, or Tylox misuse in a lifetime increased from 13.1 million to 15.7 million people. Hydrocodone lifetime non-medical use increased from 4.5 million people to 5.7 million; OxyContin lifetime misuse increased from 1.9 million people to 2.8 million; non-medical methadone use increased from 0.9 million to 1.2 million; and non-medical use of Tramadol increased from 52,000 to 186,000 from 2002 to 2003.

Estimates for persons who currently used psychotherapeutic drugs taken non-medically are similar in 2003 to estimates for 2002. There were 6.3 million persons currently using prescription medications non-medically in 2003, about 2.7 percent of the population ages 12 or older. Of these, an estimated 4.7 million used prescription pain relievers; 1.8 million used tranquilizers; 1.2 million used stimulants, including methamphetamine; and 0.3 million used sedatives.

There were an estimated 2.3 million persons who currently used cocaine in 2003, 604,000 of whom used crack. One million persons used hallucinogens, including LSD, PCP, Ecstasy and other substances, and 119,000 people were estimated to currently use heroin. These projections are all similar to estimates for these drugs in 2002. But, past month inhalant use among youth ages 16 or 17 increased from 0.6 percent in 2002 to 1.0 percent in 2003. Methamphetamine use did not change significantly between 2002 and 2003, with 600,000 past month users each year.

The survey reported 21.6 million Americans in 2003 classified with dependence on drugs, alcohol, or both (9.1 percent of the population ages 12 and older). Over 20 million persons needed but did not receive treatment for an alcohol or drug problem in 2002 and 2003, but the number receiving specialized substance abuse treatment declined from 2.3 million in 2002 to 1.9 million in 2003. Of the 20 million people in need of treatment in 2003 who did not receive it, about 1 million recognized that need. Only 273,000 tried to obtain treatment and were unable to access it. The other 764,000 made no effort to get treatment.

The report found a major correlation between serious mental illness and substance dependence and abuse. In 2003, an estimated 4.2 million adults suffered from serious mental illness and substance dependence or abuse in the past year. Adults who used illicit drugs were more than twice as likely to have serious mental illness, compared to adults who did not use an illicit drug. In 2003, 18.1 percent of adult past-year users of illicit drugs had serious mental illness that year, while the rate was 7.8 percent among adults who had not used an illicit drug. Among adults with substance dependence or abuse, 21.6 percent had serious mental illness, compared to 8.0 percent among those who did not have dependence or abuse.

Among adults with serious mental illness in 2003, 21.3 percent (4.2 million people) were dependent on or abused alcohol or illicit drugs. The rate among adults without serious mental illness was only 7.9 percent.

Tobacco use rates in the past month remained essentially the same from 2002 to 2003, with 70.8 million people reporting current use of a tobacco product. Of these, 60.4 million smoked cigarettes in the past month, 12.8 million smoked cigars, 7.7 million used smokeless tobacco and 1.6 million smoked tobacco in pipes. There were significant declines in past year and lifetime cigarette use among youths ages 12 to 17 between 2002 and 2003, and a decline in the rate of cigarette smoking among young females.

The 2003 survey is based on interviews with 67,784 respondents ages 12 and older who were interviewed in their homes. This includes persons residing in dormitories or homeless shelters. Not included in the survey are persons on active military duty, in prisons, or other institutionalized populations or people who are homeless but not in shelters. Lifetime use is defined as ever used a substance in one’s lifetime. Past year use is having used the substance at least once in the past 12 months. Current use is use in the past 30 days.

Cocaine abusers are more likely than nonusers to suffer from HIV, hepatitis, sexually transmitted diseases, and other infections. Most of this increased incidence is the result of conditions and behaviors–for example, injecting drugs, poor nutrition, and unsafe sex–that are often are associated with drug abuse. Now, NIDA-supported investigators at the McLean Hospital Alcohol and Drug Abuse Research Center in Belmont, Massachusetts, have found that cocaine itself has a direct biological effect that may decrease an abuser’s ability to fight off infections.

Dr. John H. Halpern, along with colleagues at McLean Hospital and Harvard Medical School, found that a key immune system component, a protein called interleukin-6 (IL-6), responded less robustly to an immunological challenge in male and female abusers injected with cocaine than in those who received placebo. “When your body detects a foreign object, IL-6 helps trigger the release of a cascade of other immune system components that isolate and neutralize the threat,” explains Dr. Halpern. “If the balance of this response is disrupted, your body cannot fight infection as effectively as it should.”
The study involved 30 participants (16 women, 14 men, ages 21-35) with a history of cocaine abuse, including at least one drug administration within the past month. The investigators placed an intravenous catheter in one arm of each participant and measured IL-6 levels. The catheter is detected as foreign by the body’s immune system and triggers an immune response. After 30 minutes, the researchers injected cocaine or saline solution (0.4 mg/kg) into each participant’s other arm; 4 hours later, they measured IL-6 levels again. In participants given saline, IL-6 levels had more than quintupled in response to the presence of the catheter, increasing from an average of less than 2 trillionths of a gram (picograms, or pg) per milliliter of blood to an average of more than 11 pg/ml. In men and women who received cocaine, however, IL-6 levels barely doubled–from less than 2 pg/ml to an average of 3.8 pg/ml.

“The findings in this study show that in people with a history of cocaine abuse, exposure to the drug establishes conditions that can lead to immediate harm,” Dr. Halpern says. “In such subjects, we found that cocaine impairs the body’s defense system for at least 4 hours. We can’t rule out the possibility that IL-6 response returns to normal shortly after that time. But even if the blunted immune response lasts only a few hours, it makes it more likely that an infection like HIV or just a common cold can take hold,” Dr. Halpern says.

“This research suggests a link between cocaine use and compromised immune response and could help explain the high incidence of infectious disease among drug abusers,” observes Dr. Steven Grant of NIDA’s Division of Treatment Research and Development. “It reminds us that the health consequences of drug abuse reach far beyond disruption of the brain systems involved in abuse and addiction.”

The findings also have significance in another context, Dr. Grant adds. “The IL-6 findings are a small but possibly significant part of a much larger study designed to gather a wide range of information on the acute and chronic effects of abused drugs on the brain, endocrine system, and immune function. This kind of discovery-based research can yield unexpected, sometimes important, insights.”

Individuals who are addicted to the nicotine in smokeless tobacco can find help on a new website called Chewfree.com, the East Carolinian reported Sept. 2.

Created by the Oregon Research Institute (ORI) and funded by the National Institute of Health, the website provides smokeless-tobacco users with information and resources. Visitors looking for help can submit an e-mail to Chewfree.com and an ORI representative will e-mail back a password that provides access to the site’s many resources.

“The neat thing about Chewfree.com is that it’s available 24 hours a day, seven days a week,” said Herb Severson, a member of the ORI.

The website provides quit plans, information on smokeless tobacco, and access to chats with other users trying to quit.

The website is also part of a study into whether the Internet can be used as a smoking-cessation tool; it hosts smokeless tobacco programs that have been effective in other formats.

The term “blunts” is street slang for a marijuana and tobacco cigar. It comes from the users’ cigar of choice, the Phillies Blunt. Tobacco is removed from the cigar and replaced with marijuana. It holds more marijuana than a typical hand-rolled joint, looks legal and burns slower. Phillies Blunts are now making flavored ones. The sweet-flavoured wraps are obviously aimed at kids and even though you have to be 18 to buy them, kids manage to get them

The number of admissions to substance abuse treatment for adolescents ages 12 to 17 increased again in 2002, continuing a ten-year trend. These data were released today in the “Treatment Episode Data Set: National Admissions to Substance Abuse Treatment Services 1992-2002″ by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The new data show that the number of adolescents ages 12 to 17 admitted to substance abuse treatment increased 65 percent between 1992 and 2002. In 1992, adolescents represented 6 percent of all treatment admissions. By 2002, this proportion had grown to 9 percent. This report expands upon data published in May in the “Treatment Episode Data Set (TEDS) Highlights 2002.”

The increase in substance abuse treatment admissions among 12 to 17 year olds was largely due to the increase in the number of admissions in this age group that reported marijuana as their primary drug of abuse. Between 1992 and 2002, the number of adolescent treatment admissions for primary marijuana abuse increased 350 percent. In 1992, 23 percent of all adolescent admissions were for primary marijuana abuse. By 2002, 63 percent of adolescent admissions reported marijuana as their primary drug.

“The youthfulness of people admitted for marijuana use shows that we need to work harder to get the message out that marijuana is a dangerous, addictive substance, SAMHSA Administrator Charles Curie said. All Americans must begin to confront drug use and drug users honestly and directly. We must discourage our youngsters from using drugs and provide those in need an opportunity for recovery by encouraging them to enter and remain in drug treatment.”

Forty-eight percent of all adolescent treatment admissions in 2002 involved the use of both alcohol and marijuana. Admissions involving these two substances increased by 86 percent between 1992 and 2002.

In 2002, more than half (53 percent) of adolescent admissions were referred to treatment through the criminal justice system. Seventeen percent were self- or individual referrals, and 11 percent were referred through schools.

The TEDS report provides detailed data on admissions to substance abuse treatment for all age groups. The 2002 data show that polydrug abuse (abuse of more than one substance) was more common among TEDS admissions than was the abuse of a single substance. Polydrug abuse was reported by 55 percent of all admissions for substance abuse treatment in 2002. Alcohol, marijuana and cocaine were the most commonly reported secondary substances. For marijuana and cocaine, more admissions reported these as secondary substances than as primary substances.

This new report provides information on the demographic and substance abuse characteristics of the 1.9 million annual admissions to treatment for abuse of alcohol and drugs in facilities that report to individual state administrative data systems. The report also includes data by state and state rates.

Cannabis use by children increases the risk of aggressive behaviour, but does not lead to them becoming withdrawn, a Dutch study says.

Previous research on the drug has linked it to “internalised” problems such as depression.

But the British Journal of Psychiatry study of 5,000 children said it was more likely to cause external problems such as delinquency and aggression.

UK experts said the “jury was still out” about such an effect.

The findings comes as figures show more UK children are being exposed to cannabis.

Last year, a report by the Schools Health Education Unit, a government research team which has been tracking young people’s experience of drugs since 1987, found over half of 14 and 15-year-olds had been offered cannabis, with one in four having taken it.

The latest study, by a team at the Trimbos Institute, a mental health research centre in the Netherlands, analysed the results of questionnaires filled in by 5,551 young people aged 12 to 16.

They found 17% had used the drug in the previous year.

Researchers found the strength of the link increased with higher use of cannabis.

However they found children who had used cannabis, but not in the previous year, were not at higher risk that those who had never used cannabis.

They also found more heavy cannabis users – children who used the drug 40 times a year or more – reported poorer school grades than those who did not use the drug.

Liberal

And researchers added that, while no link was found between cannabis and mental health problems such as depression, that did not mean there was no connection between the two for some vulnerable people

Previous studies has found that long-term cannabis use can increase the risk of depression.

Report author Harald Wychgel said the findings could be even more acute in countries which did not have such a liberal approach to cannabis – the drug is not illegal in the Netherlands.

He said: “At young ages the use of cannabis is already strongly associated with delinquent and aggressive behaviour even after controlling for strong confounders such as alcohol and smoking.”

Paul Corry, of mental health charity Rethink, said researchers were beginning to look at the links between aggression and mental health.

“There have been some studies which have found similar things, but I would say the jury is still out. What is not clear is where it is cause or effect. “Are these children already aggressive and the environment they are in increases the risk of them using cannabis?

“We have much more evidence that cannabis use is linked to feelings of anxiety and hallucinations.”
Source: BBC News January 2006

By Timothy Wilens, M.D.,Psychiatric Times.
The overlap between attention-deficit/ hyperactivity disorder and alcohol or drug abuse or dependence (referred to here as substance use disorders [SUDs]) in adolescents has been an area of increasing clinical, research and public health interest. Appearing in early childhood, ADHD affects from 6% to 9% of children and adolescents worldwide (Anderson et al., 1987) and up to 5% of adults (Kessler, in press). Longitudinal data suggest that childhood ADHD persists into adolescence in 75% of cases and into adulthood in approximately one-half of cases (for review, see Weiss, 1992). Substance use disorders usually appear in adolescence or early adulthood and affect between 10% to 30% of U.S. adults and a less defined, but sizable, number of juveniles (Kessler, 2004). The study of comorbidity between SUDs and ADHD is relevant to both research and clinical practice in developmental pediatrics, psychology and psychiatry with implications for diagnosis, prognosis, treatment and health care delivery.

Overlap Between ADHD and SUD

Structured psychiatric diagnostic interviews assessing ADHD and other disorders in substance-abusing groups have indicated that from one-third to one-half of adolescents with SUDs have ADHD (DeMilio, 1989; Milin et al., 1991). For example, aggregate data from government-funded studies of mainly cannabis-abusing youth indicate that ADHD is the second most common comorbidity with from 40% to 50% of both girls and boys manifesting full criteria for ADHD. Data largely ascertained from adult groups with SUDs also show an earlier onset and more severe course of SUD associated with ADHD (Carroll and Rounsaville, 1993; Levin and Evans, 2001).

Summary

There is a strong literature supporting a relationship between ADHD and SUDs. Both family/genetic and self-medication influences may be operational in the development and continuation of SUDs in ADHD. Adolescents with ADHD and SUDs require multimodal interventions incorporating addiction and mental health treatment. Pharmacotherapy in individuals with ADHD and SUDs needs to take into consideration timing, misuse and diversion liability, potential drug interactions, and compliance concerns.

While the existing literature has provided important information on the relationship of ADHD and SUDs, it also points to a number of areas in need of further study. The mechanism by which untreated ADHD leads to SUDs, as well as the risk reduction of ADHD treatment on cigarette smoking and SUDs, needs to be better understood. Given the prevalence and major morbidity and impairment caused by SUDs and ADHD, prevention and treatment strategies for these adolescents need to be further developed and evaluated.
Source: Psychiatric Times January 2006 Vol. XXV Issue 1