J. Michael Walsh, Ph.D.
October 12, 2010
The consumption of illegal psychoactive drugs (e.g. amphetamines, cocaine, marijuana, opiates, etc.) is a problem of growing concern in many countries around the world, as these substances are increasingly detected in impaired and injured drivers. Drugged driving is a serious public health concern because it puts not only the user at risk, but all others who share the road. Despite the mounting evidence that drugged driving is common, the American public seems unaware of this fact. Perhaps this is because drugged drivers are less frequently detected, prosecuted, or referred to treatment, compared to drunk drivers.
Other than alcohol, Marijuana is the most prevalent drug detected in impaired and injured drivers. Marijuana affects areas of the brain that control the body’s movements, balance, coordination, memory, and judgment abilities, and its effects last for hours after the drug is used. Evidence from both on-the-road and simulated driving studies indicate marijuana can negatively influence a driver’s attentiveness, perception of time and speed, and the ability to draw on information obtained through past experiences.
Driving is a complex task that requires continuous information processing and coordinated responses to ever-changing traffic, while operating a multi-ton vehicle. Clearly, illegal drugs like marijuana that alter a driver’s normal brain functioning can create an extremely dangerous situation.

Source: www.ofSubstance.gov/blogs Tuesday, October 12, 2010

The excerpts below are from two Rand studies, Would Legalizing Marijuana in California Help?
Beau Kilmer, Jonathan P. Caulkins, Brittany M. Bond, Peter H. Reuter 2010

And What We Do and Don’t Know About the Likely Effects of Decriminalization and Legalization by Robert J. MacCoun and Peter Reuter. 1999

Since it is often difficult to read the whole of a large study I have pulled out parts which I think may be useful to those of us fighting the legalisation of drugs – with particular reference to Prop. 19 in California

Taken together, the available evidence suggests that the nonprice impact on consumption might be on the order of a 35-percent increase in past-month use. Given the ambiguity and noisiness of the data, estimates in the range of 5 to 50 percent seem plausible.

Throughout California in 2008, there were 181 admissions to hospitals in which marijuana abuse or dependence was listed as the primary reason for the hospitalization. Even though the average charge per episode exceeded $22,000, the total cost of these episodes is just over $2 million, so relatively small vis-à-vis the other costs and savings.

Perhaps more important from a cost perspective are the additional 25,000 admissions for which marijuana is listed as a supplemental diagnosis (second, third, or fourth diagnosis). Of these cases, nearly 4,000 were for schizophrenia (with an average charge of $20,300 per episode) and another 2,300 were for psychoses (with an average cost of $12,700). As the scientific
literature is still unclear as to whether marijuana use causes these conditions or just complicates treating them, we do not consider the cost here of these nonprimary diagnoses. More research is needed before an accurate assessment can be conducted, but the implications of these research findings could be important in terms of the burden imposed. For more details
on this, see Pacula (2010a).

Dependence and Abuse
How would the number of marijuana users meeting clinical criteria for abuse or dependence change with a change in the policy? Over this decade, the number of users meeting these criteria in the previous year as a fraction of people reporting use of marijuana in the past year in nationally representative samples has been fairly stable (~16 percent). One way to project what
could happen to dependent users post-legalization is to assume that this relationship between the number dependent and past-year users remains the same.

We start by making an assumption about legalization’s effect on consumption. For this example, we consider a 58-percent increase in annual consumption and refer interested readers to Pacula (2010a) for more information about this starting value. With 525,000 users estimated to meet Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV)
criteria for marijuana abuse or dependence in California in 2009 (Pacula, 2010a), a 58-percent increase would suggest a rise of 305,000, bringing the total number of users meeting clinical criteria for abuse or dependence to 830,000. Of course, there is tremendous uncertainty surrounding this number because of uncertainty about the baseline assumptions that generated
the predicted change in annual prevalence. If we adopt alternative plausible assumptions, we generate a range of 144,000 to 380,000, implying that the total number of users meeting clinical criteria for abuse or dependence would be in the range of 669,000 to 905,000.

There are currently no estimates in the literature of the social cost of a user meeting clinical criteria for abuse or dependence; thus, it is not possible to quantify this increase’s budgetary impact on California taxpayers. But, to the extent that dependence and abuse impose costs in the form of reduced productivity, higher health-care costs, or lost time with the family, a rise
in dependence represents a real loss to the citizens of California.

Drugged Driving
While driving under the influence of marijuana or any other intoxicating substance can be risky, a question remains about whether marijuana use impairs individuals sufficiently to cause crashes and fatalities. While there is significant experimental literature suggesting a diminished effect on response rates and performance under very strictly controlled conditions, evidence
from epidemiological studies has been less conclusive (Ramaekers et al., 2004; Blows et al., 2005). The notable exception in the literature are cases in which alcohol is used in conjunction with marijuana, in which case the evidence is clear that the combined effect of these two drugs impairs driving significantly more than alcohol alone (Bramness, Khiabani, and two drugs impairs driving significantly more than alcohol alone (Bramness, Khiabani, andMørland, 2010; Jones et al., 2003; Dussault et al., 2002).

Given the current uncertainty of the science in determining the role of marijuana use alone in accidents, it is impossible to determine how much an increase in marijuana use would translate into more accidents or, worse
yet, fatal crashes. However, a simple calculation suggests that, if someone believes that marijuana is causally responsible for many crashes that involve marijuana using drivers, legalization’s effect on crashes could be a first-order concern for them. Based on Fatality Analysis Reporting System (FARS) data, Crancer and Crancer (2010) report that blood tests established that one or both drivers had used marijuana near the time of the accident in 5.5 percent of passenger-vehicle fatal crashes (2008 in California). Causality is complicated in multicar crashes, but, even just considering single-vehicle fatal crashes, Crancer and Crancer found that 126 fatalities in crashes with marijuana involved drivers, 75 percent of whom had alcohol levels below 0.08.
There is no empirical evidence concerning an elasticity of fatal accident rates with respect to marijuana price, prevalence, or quantity consumed, and, as we have underscored repeatedly, there is enormous uncertainty concerning how legalization might affect those outcomes.

However, 50- or 100-percent increases in use cannot be ruled out; nor can the possibility that marijuana-involved traffic crashes would increase proportionally with use. So it would be hard to dismiss out of hand worries that marijuana legalization could increase traffic fatalities by at least 60 per year (126 × 50% = 63)—especially since this represents increases in fatalities
associated only with single-vehicle crashes and ignores the role marijuana might play in multivehicle fatalities. See Pacula (2010a) for a more detailed analysis. There is no satisfactory way to compare the importance of some number of traffic deaths to dollar-denominated outcomes, such as tax
revenues, but, when economists are forced to come up with such a number, they often use figures on the order of $4 million to $9 million per death (Viscusi and Aldy, 2003). Whereas we are reasonably confident that additional costs of marijuana treatment and of ED mentions and hospitalizations related directly to use per se are not first-order concerns, we cannot rule out that possibility with respect to legalization’s effects on drugged driving.

Use of Other Substances
Legalization will reduce marijuana prices and increase marijuana use. Either effect could affect the use of other substances. We take them up in reverse order. Increased marijuana use could lead to greater use of other substances in various ways. For example, it is possible that becoming dependent on marijuana affects neural pathways in a way that increases vulnerability to abusing other substances. However, almost all the literature and
controversy concerns a possible causal effect of use short of dependence.

The use of marijuana typically precedes the use of such substances as cocaine and heroin, and people who use marijuana earlier and more heavily are more likely to go on to more and heavier use of these substances (Kandel, 2002). These facts have given rise to the so-called gateway
hypothesis—the hypothesis being that the pattern is not merely coincidence but instead reflects causal linkages, so that anything that increases or reduces use of marijuana might thereby cause an increase or reduction in use of these other substances.

Few topics in the drug-policy literature have stirred greater passions than the gateway hypothesis. While everyone agrees about the descriptive facts (e.g., cocaine use is usually preceded by marijuana use), there are sharp differences about whether the patterns reflect a causal relationship and, if so, what the causal mechanism is. Skeptics are fond of pointing out that
cocaine use is also usually preceded by drinking milk (i.e., most cocaine users tried milk before they first experimented with cocaine, but no one believes that drinking milk puts one at risk for greater cocaine use).
The gateway effect, if it exists, has at least two potential and quite different sources (MacCoun, 1998). One interpretation is that it is an effect of the drug use itself (e.g., trying marijuana increases the taste for other drugs or leads users to believe that other substances are more pleasurable or less risky than previously supposed). A second interpretation stresses peer groups
and social interactions. Acquiring and using marijuana regularly may lead to differentially associating with peers who have attitudes and behaviors that are prodrug generally, not only with respect to marijuana. One version of this is the possibility that those peers will include people who sell other drugs, reducing the difficulty of locating potential supplies. If the latter
is the explanation, then legalization might reduce the likelihood of moving on to harder drugs compared to the current situation.

Many studies have examined the gateway effect, and Room et al. (2010, p. 35) provide a concise appraisal of the international, multidisciplinary evidence:
Cannabis use is more strongly associated with other illicit drug use than alcohol or tobacco use, and the earliest and most frequent cannabis users are the most likely to use other illicit drugs. Animal studies provide some biological plausibility for a causal relationship between cannabis and other types of illicit drug use. Well-controlled longitudinal studies suggest that selective recruitment to cannabis use does not wholly explain the association between cannabis use and the use of other illicit drugs. This is supported by discordant twin studies [that] suggest that shared genes and environment do not wholly explain the association. Nonetheless, it has been difficult to exclude the hypothesis that the pattern of use reflects the common characteristics of those who use cannabis and other drugs. We say nothing more about gateway effects because there simply is no consensus about it.

Farrelly et al. (2001) use a proxy for marijuana use, and their results suggest that, when marijuana use goes up, so does tobacco use.

Cocaine. A number of studies suggest that marijuana and cocaine are economic complements, but many of these studies use the problematic decriminalization variable as a proxy for marijuana price (Thies and Register, 1993; Grossman and Chaloupka, 1998; Saffer and Chaloupka,
1999). Williams and colleagues (2006) use actual marijuana prices in their analysis of cocaine use among college students in the United States. For college students in the 1990s, they estimate the cross-price participation elasticity for cocaine to be between -0.44 and -0.49.
This means that a 10-percent decrease in the price of marijuana would increase the prevalence of cocaine use by 4.4 to 4.9 percent.

Excerpts below from the Rand Testimony to the Subcommittee on Criminal Justice, Drug Policy and Human Resources of the House Committee on Government Reform – July 13th l999 (Peter Reuter and Robert J. MacCoun

Several lines of evidence on the deterrent effects of marijuana laws and on decriminalization experiences in the United States. the Netherlands and Australia –suggest that eliminating (or significantly reducing) criminal penalties for first-time possession of small quantities of marijuana has either no effect or a very small effect on the prevalence of marijuana use.
….. Decriminalisation was not associated with any detectable changes in adolescent attitudes toward marijuana. [now, in 2010 we can already see that
So-called medical marijuana and Prop.19 in CA have changed adolescent attitudes

….The initial decriminalization (in the Netherlands) phase had no detectable impact on levels of cannabis use, consistent with evidence from the US and Australia. Survey data showed literally no increase in youth or adult use from 1976 to about l984, and Dutch rates were well below those in the US. …..But between l980 and l988 (the commercialization regime mid l980s to l995) the number of coffee shops selling cannabis in Amsterdam increased tenfold,…. .….and began to promote the drug more openly.

As commercial access and promotion increased, the Netherlands saw rapid growth in the number of cannabis users, an increase not mirrored in other nations. Whereas 15% of l8-20 year olds reported having used marijuana in l984, the figure more than doubled to 33% in 1992. Since l992 the Dutch figure has continued to rise but that growth is paralleled in the US and most other rich Western nations…..

…..Legalization would eliminate the harms caused by prohibition, but it would not eliminate the harms caused by drug use……..we believe that legalization would significantly increase the number of drug users and the quantity of drugs consumed. ……

……If legalization produced a significantly large increase in total use, total drug harm would go up, even if each incident of use became somewhat safer. Because Total Drug Harm = Average Harm Per Use x Total Use, total harm can rise even if average harm goes down………….Thus legalization is a very risky strategy for reducing drug-related harm.

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

Research Summary

Fifth-grade students who took part in comprehensive, interactive school-based prevention programs starting as early as first grade were half as likely as their peers to use alcohol or other drugs, act out violently, or engage in sexual activity, according to a new study from the National Institute on Drug Abuse (NIDA).
“This study provides compelling evidence that intervening with young children is a promising approach to preventing drug use and other problem behaviors,” said NIDA Director Nora Volkow. “The fact that an intervention beginning in the first grade produced a significant effect on children’s behavior in the fifth grade strengthens the case for initiating prevention programs in elementary school, before most children have begun to engage in problem behaviors.”
Researchers led by Brian Flay of Oregon State University studied students at 20 public elementary schools in Hawaii who had participated daily in Positive Action (PA), a comprehensive K-12 program focusing on social and emotional development. Students who had received the PA lessons the longest had the least amount of problem behaviors, the study found.
The authors will next look at whether the PA program had lasting effects on older students.

Source: American Journal of Public Health June 18, 2009

Using teacher therapists to identify problem personality traits in teenagers, and help them understand their behaviour, could be the key to stopping them binge drinking and taking drugs.
Adolescent alcohol consumption has more than doubled in the past decade and 15% of pupils reported taking drugs last year.
Addiction experts believe prevention is the key – stopping young people abusing drink and drugs before they start, instead of simply treating the addiction once it has taken hold.
Researchers at the Institute of Psychiatry at King’s College, London, asked more than 1,000 13-year-olds at secondary schools in London to answer a range of questions about their personalities.
They were looking for pupils with four problem personality traits: negative thinking, anxiety, impulsiveness and sensation seeking.
Half of those teenagers were then given two tailored therapy sessions – one 90 minutes long, the second an hour. In small groups teenagers with particular personality traits were encouraged to explore their personalities – including strengths and difficulties.
They were encouraged to think about other ways to deal with the risks associated with that behaviour – techniques they hope the teenagers will then use when they come face to face with drink or drugs.
“It’s about coping with the trait rather than changing the personality – in no way do we ever suggest they stop being who they are or change who they are,” says Dr Patricia Conrod, Consultant Clinical Psychologist at King’s College.
“It’s changing how it is they’re coping with who they are and perhaps capitalising on some of the more positive sides of the trait and learning to manage some of its more difficult sides.”
The results, they say, speak for themselves – one study of 13 to 16-year-olds led to a 40% reduction in binge drinking and cut the chance of teenagers taking cocaine by 80%. It is the first school based programme outside the US to successfully prevent alcohol uptake and misuse in teenagers.
Students asked to give feedback about the sessions told the researchers they helped with controlling anger and dealing with negative thinking.
A second trial then looked at whether ordinary teachers, with no psychiatric training, could be taught to deliver the sessions.
Focusing on more than 20 secondary schools and another thousand pupils, it found that with little training: a three day workshop followed by three hours of supervised practice; teachers could do as good a job as the professionals.
Latest figures show that alcohol misuse currently costs the NHS around £2.7bn a year. Charities say as successful as treating an addiction can be, most do begin in adolescence, hence the need to attack the problem before it even exists.
“Prevention is important because we need to stop people progressing to much severer problems later in life,” says Nick Barton, the Chief Executive of Action on Addiction, who helped fund the study.
“We find for instance in our treatment centres that when we assess drinking or drug use history, that very often the onset was way back in adolescence, sometimes as young as 11 but certainly the period between 11 and 16 was when the first attraction to substance use took hold.”
The researchers believe this programme could be delivered with just two well trained counsellors per borough who would teach school staff how to lead the sessions.
It will cost money, they say, but in the long run a little bit of investment now to stop another generation of binge drinkers could save the NHS millions in the future.

Source: http://www.bbc.co.uk/news/health 25th August 2010

Media reports on illicit drugs “reduce acceptability and increase perception of risk” among young people, study finds.
Mainstream media reporting is far more likely to deter young people from using illicit drugs than encourage their use, a new Australian study has found.
But the study also found that types of reports most likely to have the strongest impact on young people – those on social and health consequences of drug taking – were underrepresented in the media.
The study by the Drug Policy Modelling Program at the National Drug and Alcohol Research Centre at the University of NSW, and funded by the Commonwealth Department of Health and Ageing, measured the impact of media reports on illicit drugs on the attitudes of over 2,000 young people aged 16 – 24.
The study also analysed 4,000 newspaper reports referring to illicit drugs and found that just over half focussed on criminal justice and legal issues, while only 24 per cent highlighted the health or social problems associated with drug taking.
Participants were shown eight different types of reports and their responses were measured.
Chief Investigator of the study Dr Caitlin Hughes, a Research Fellow at NDARC’s Drug Policy Modelling Program (DPMP), said that while drugs are one of the most common motifs in popular culture and one of the most frequently reported on there is very little research anywhere in the world on how media reporting on illicit drug issues influences attitudes or behaviour on illicit drug use..
“We know from related fields that media messages can influence people’s knowledge, attitudes and behaviour.
“It is commonly assumed that news media can incite drug use,” said Dr Hughes.
“Our research has found that the opposite is the case. Most media portrayals appear to reduce interest in illicit drugs, at least in the short term.
“They increase perceptions of risk, reduce perceptions of acceptability and reduce the reported likelihood of future drug use,” said Dr Hughes.
”But the irony is that the messages that are most effective at deterring youth interest in drugs are currently under-represented in Australian news media,” said Dr Hughes.
News items which focussed on the health and social issues – for example evidence about cannabis and psychosis or cannabis and poor educational outcomes – were more likely to have a deterrent effect than reports on drug busts and arrests.

“Our results show clearly there is an opportunity to better harness the media to shape young peoples’ attitudes to illicit drugs.
We are not saying news media is the silver bullet in drug prevention, but given news media is so pervasive we do think it ought to be recognised, both within Australian and internationally, as a potentially powerful tool for preventing illicit drug use.”

Key points:
• A total of 2,296 youth aged 16-24 years completed the survey
• All youth were shown 8 different media messages about drugs (on the two most commonly used drugs in Australia – cannabis and ecstasy)
• 66.4% and 86.5% of participants had weekly or more frequent contact with television news, online news, radio news and/or print newspapers
• Most news media messages elicited moderate to large impacts on youth attitudes. Negative health or social messages elicited large impacts on youth attitudes.
• Messages on ecstasy had greater impact on youth than messages on cannabis
• Females more likely to be deterred from use than males
• People who have never used drugs more likely to be deterred than current users
• Reports on criminal arrests significantly less persuasive than reports about negative health or social consequences
• Across all drugs, criminal justice/law enforcement topics accounted for 55% of all topics
• 60% of articles emphasised that illicit drugs lead to legal problems. 14% health problems, 10% social problems, 10% cost to society and 6% other (4% neutral and 2% benefits)
• Tabloids were more likely to emphasise legal problems: 71% compared to 61% for broadsheet
• 11 newspapers, one national, seven major metropolitan, in Sydney, Canberra, Melbourne, Brisbane and Perth and three local in Geelong, Newcastle and Sydney were reviewed

What they said: (comments from the focus groups).
Re power of media to dissuade youth drug use:
“Media is probably one of the few ways that prevention message(s) can keep being pushed.” (20 year old female)
“When I was younger… the way that that was portrayed in the media totally shaped the way that I saw drugs.” (22 year old female)
Re fatal overdose of a young person:
“I think that would convince me not to take drugs. Just „cause……I feel sorry for her.” (17 year old male)

Source: Media reporting on illicit drugs in Australia: trends and impacts on youth attitudes to illicit drug use. Drug Policy Modelling Program, September 2010. It can be accessed through: http://www.dpmp.unsw.edu.au

Scientists at the University of Liverpool have found that high levels of a stress hormone in recovering alcoholics could increase the risk of relapse.

The study showed that cortisol, a hormone produced by the adrenal gland in response to stress, is found in high levels in chronic alcoholics, as well as those recovering from the condition.

Researchers found that this could result in impaired memory, attention and decision-making functions, which could decrease the patient’s ability to engage with treatment.

Chronic alcoholism is a disabling addictive disorder, characterised by compulsive and uncontrolled consumption of alcohol despite the negative effects it has on health, relationships and social standing. Alcohol damages almost every organ of the body including the brain where it causes memory loss and impairs decision-making and attention span.

Cortisol plays an important role in the regulation of emotion, learning, attention, energy utilization, and the immune system.

The research showed that high levels of this hormone are present in alcoholic patients and continue to be elevated during withdrawal from alcohol and after long periods of abstinence.

Lead author of the review, Dr Abi Rose, from the School of Psychology, Health and Society at the University of Liverpool, said: “Both drinking and withdrawal from alcohol can affect cortisol function in humans.

“Cortisol dysfunction, including the high levels of cortisol observed during alcohol withdrawal, may contribute to the high rates of relapse reported in alcohol dependence, even after many months of abstinence.

“Drugs targeting the effects of cortisol in the brain might reduce the chances of relapse and reduce the cognitive impairments that interfere with treatment.”

The study is published in Alcoholism: Clinical & Experimental Research. The research is in collaboration with Kings College London, University of Bern, and the University of Kentucky.

Source: www.clickliverpool.com 26.09.2010

Addicts require support from other recovering addicts, said the study.
Researchers believe they have identified some of the critical factors that determine whether alcoholics and heroin users can recover.
A study of more than 200 people in Glasgow found that spending time with other recovering addicts made success more likely.
Another predictor of success was whether addicts had something else in their lives to focus on, such as work.
The findings are due to be discussed at a conference in Glasgow.
The research was led by Dr David Best, a reader in criminal justice at the University of the West of Scotland.
“We found that the quality of life maintained by people in methadone maintained recovery wasn’t as good as for people in abstinent recovery” said Dr David Best Researcher He told the BBC’s Good Morning Scotland programme: “Addiction becomes an all-consuming and all-encompassing thing for people “In order for them to meaningfully sustain a recovery, it means it’s not sufficient to have just clinical interventions.
“There have to be a range of replacement activities and the more socially and community-based they are – including things like volunteering, parenting, education and training and obviously working – the more that void is filled and the more successfully individuals manage to build up an architecture of life that replaces that time spent in active addiction.”
The study also considered the role that methadone played in recovery.
Dr Best said: “Certainly as far as our research was concerned, we found that the quality of life maintained by people in methadone maintained recovery wasn’t as good as for people in abstinent recovery.
“It fits with previous research that we’ve done which has shown that there are some long-term effects of methadone, particularly around cognitive functioning, which may act as a mechanism for blunting the aspiration and hope and quality of life.
“It doesn’t mean recovery’s not possible in methadone but there may be some limitations to the extent of it.”
The study, which marks the first Recovery Academy conference in the city, drew parallels between alcoholism and heroin addiction.
Researchers said few differences were noted in the paths to recovery.Community Safety Minister Fergus Ewing, one of the speakers at the conference, said: “The Scottish government’s national drugs strategy, the Road to Recovery, recently reconfirmed by the Scottish Parliament, provides the framework for a fundamental change in our approach to tackling problem drug use through a focus on recovery.
“The Recovery Academy conference, the first of its kind in Scotland, provides the perfect platform for assessing the progress that is being made through this enhanced focus.
“Recovery from serious drug addiction is possible and the research being presented today clearly enhances our knowledge of the challenges faced.”
The event, taking place at the city’s Woodside Halls, is part of the wider Recovery Weekend, which invites people dealing with the effects of addiction, their families and friends to gather in Glasgow to meet and share ideas.

Source: http://www.bbc.co.uk/news/uk-scotland 24th Sept.2010

Compared to teens who have frequent family dinners (five to seven per week), those who have infrequent family dinners (fewer than three per week) are more than twice as likely to say that they expect to try drugs in the future, according to The Importance of Family Dinners VI, a new report from The National Center on Addiction and Substance Abuse (CASA*) at Columbia University.

The CASA family dinners report reveals that nearly three-quarters (72 percent) of teens think that eating dinner frequently with their parents is very or fairly important. Compared to teens who have frequent family dinners, those who have infrequent family dinners are:

• Twice as likely to have used tobacco;
• Almost twice as likely to have used alcohol; and
• One and half times likelier to have used marijuana.

The report found that compared to teens who talk to their parents about what’s going on in their lives at dinner, teens who don’t are twice as likely to have used tobacco and one and a half times likelier to have used marijuana.

“The message for parents couldn’t be any clearer. With the recent rise in the number of Americans age 12 and older who are using drugs, it is more important than ever to sit down to dinner and engage your children in conversation about their lives, their friends, school – just talk. Ask questions and really listen to their answers,” said Kathleen Ferrigno, CASA’s director of Marketing who directs the Family Day – A Day to Eat Dinner with Your Children™ initiative. “The magic that happens over family dinners isn’t the food on the table, but the communication and conversations around it. Of course there is no iron-clad guarantee that your kids will grow up drug free, but knowledge is power and the more you know the better the odds are that you will raise a healthy kid.”

The report also reveals that teens who have fewer than three family dinners per week are twice as likely to be able to get marijuana or prescription drugs (to get high) in an hour or less. Teens who are having five or more family dinners per week are more likely to say that they do not have any access to marijuana and prescription drugs (to get high).

This year the trend survey found that 60 percent of teens report having dinner with their families at least five times a week, a proportion that has remained consistent over the past decade.

Family Dinners and Having Friends Who Use Substances
Teens who have frequent family dinners are less likely to report having friends who use substances.

Compared to teens who have five to seven family dinners per week, those who have fewer than three family dinners per week are:

• More than one and a half times likelier to have friends who drink regularly and use marijuana;
• One and half times likelier to have friends who abuse prescription drugs (to get high); and
• One and a quarter times more likely to have friends who use illegal drugs like acid, ecstasy, cocaine, methamphetamine and heroin.

“We have long known that the more often children have dinner with their parents the less likely they are to smoke, drink or use drugs. We can now confirm another positive effect of family dinners–that the more often teens have dinner with their parents, the more likely they are to report talking to their parents about what’s going on in their lives,” said Joseph A. Califano, Jr., CASA founder and chairman and former U.S. Secretary of Health, Education, and Welfare. “In today’s busy and overscheduled world, taking the time to come together for dinner really makes a difference in a child’s life.”

Family Ties
CASA’s 2010 teen survey took a close look at Family Ties, the bond between parents and their teens, and discovered that strong Family Ties are associated with a reduced likelihood that a teen will smoke, drink or use illegal drugs. The family dinners report found that teens who say they have an excellent relationship with their parents are less likely to use substances.

Compared to teens who have infrequent family dinners, teens who have frequent family dinners are three times likelier to say they have an excellent relationship with their father, almost three times as likely to say they have an excellent relationship with their mother, and more than twice as likely to say that their parents are very good at listening to them.

Among teens who don’t drink or use marijuana, those who have frequent family dinners are more likely to cite their parents as the reason why than teens who have infrequent family dinners.
The findings in this report come from The National Survey of American Attitudes on Substance Abuse XV: Teens and Parents, released on August 19, 2010. This year we surveyed 1,055 teenagers ages 12 to 17 (540 males, 515 females), and 456 parents of these teens via the Internet, from April 8 to April 27, 2010. Sampling error is +/- 3.1 for teens and +/- 4.6 for parents. We also conducted our usual telephone survey of 1,000 teens ages 12 to 17 (511 boys and 489 girls) in order to continue tracking trends from prior years, from April 6 to April 27, 2010. Sampling error is +/- 3.1.

Source: http://www.casacolumbia.org   Nov 2010

Health and social services are facing a new challenge, as many illicit drug users get older and face chronic health problems and a reduced quality of life. That is one of the key findings of research published in the September issue of the Journal of Advanced Nursing.
UK researchers interviewed eleven people aged 49 to 61 in contact with voluntary sector drug treatment services.
“This exploratory study, together with our wider research, suggest that older people who continue to use problematic or illegal drugs are emerging as an important, but relatively under-researched, international population” says lead author Brenda Roe, Professor of Health Research at Edge Hill University, UK.
“They are a vulnerable group, as their continued drug use, addiction and life experiences result in impaired health, chronic conditions, particular health needs and poorer quality of life. Despite this, services for older drug addicts are not widely available or accessed in the UK.”
Figures from the USA suggest that the number of people over 50 seeking help for drug or alcohol problems will have risen from 1.7 million in 2000 to 4.4 million by 2020. And the European Monitoring Centre for Drugs and Drug Addiction estimates that the number of people aged 65 and over requiring treatment in Europe will double over the same period.
The nine men and two women who took part in the study had an average age of 57. All were currently single and their homes ranged from a caravan, hostel or care home to social housing. Key findings from the study – by the Evidence-based Practice Research Centre at Edge Hill University and the Centre for Public Health at Liverpool John Moores University – included:
• Most started taking drugs as adolescents or young adults, often citing recreational use, experimenting or being part of the hippy era. Child abuse and the death of a parent were also mentioned.
Some started taking drugs late in life due to stressful life events like divorce or death. Meeting a drug using partner was another trigger. One man started taking drugs later in life to shock his drug taking partner into stopping and ended up developing a drug habit himself.
• First drug use varied from magic mushrooms, LSD, amphetamines and cannabis to heroin and methadone. Alcohol and smoking often featured alongside drug use.
• Some increased their drug use over time, while others had periods when they tried to reduce or even abstain from drugs. All but two of the participants were taking methadone, either as maintenance or as part of a reduction strategy in order to give up drugs.
• A number of the participants said they were trying to use drugs responsibly and it was felt that their age and the influence of drug treatment services were factors in this. They also appeared more aware of the need to maintain their personal safety, based on previous experiences.
• Most recognised that their drug use was having detrimental and cumulative effects on their health, as they had developed a range of chronic and life-threatening conditions that required hospitalisation and ongoing treatment.
• Physical health conditions included: circulatory problems such as deep vein thrombosis, injection site ulcers, stroke, respiratory problems, pneumonia, diabetes, hepatitis and liver cirrhosis. Malnutrition, weight loss and obesity also featured, as did accidental injuries due to falls and drug overdoses.
• Common mental health problems included memory loss, paranoia and changed mood states, with anxiety or anger also featuring.
• All wished they hadn’t started taking drugs and would advise young people not to. A few were keen to give up, but others felt it was too hard. One man described his drug use as “disgusting and squalid” while another said that the older he got the worse his drug use got and that it was a “crazy” situation.
• All were single or divorced and drug use was a common factor in relationship breakdowns. Most lived alone, with three relying on carers who were also drug users. Pets were often important for some, providing companionship as well as a sense of responsibility and structure to their day.
• Drug use was often associated with chaotic lifestyles and relationships and some reported periods of imprisonment.
• Participants were positive about the support they received from voluntary drug services, but had mixed experiences of primary and hospital care. Some felt stigmatised by healthcare professionals, while others received compassion and acknowledgement of their drug use.
“Our population is ageing and the people who started using drugs in the sixties are now reaching retirement age” says Professor Roe.
“It is clear that further research is needed to enable health and social care professionals to develop appropriate services for this increasingly vulnerable group. We also feel that older drug users could play a key role in educating younger people about the dangers of drug use.”

Source: ww.news-medical.net/news 9th Sept 2010

More than a half of the people in Scotland with known HIV infection are drug injectors. Two studies have suggested that injecting with a consequent risk of HIV transmission is prevalent among drug misusers in prison. There is also concern over the lack of treatment for drug misuse in prison. Drug misusers attending needle exchange centres seem able to maintain a low level of risk behaviour, although their attendance may be interrupted by imprisonment.’ Little is known about their drug taking, injecting, and sharing of needles in prison. Subjects, methods, and results
A questionnaire was administered to 81 drug injectors at two Glasgow needle exchanges in January 1990. Semistructured indepth interviews were conducted
with another 19 injectors at the same exchanges in June 1990.

Of the 81 injecting drug misusers (61 men and 20 women), 56 (69%) had served at least one term in custody (median 5 terms, range 1-40), of whom 39 (31 men and 8 women, mean age 23 7 years) had served their most recent sentence during 1989. Of the 56 former prisoners, 55 were aware that other inmates had misused drugs and 36 said that they themselves had misused drugs in prison. Only four (11%) of those misusing drugs in prison had taken cannabis alone. Other drugs taken were buprenorphine, temazepam, heroin, cocaine, and valium. Forty nine had seen other inmates injecting drugs, and 14 men said that they themselves had injected drugs in prison. Forty five had seen others sharing needles in prison, and six said that they themselves had shared needles in
prison. This means that 43% (six of the 14) of those admitting to injecting also shared needles. Fifty one subjects said that they had not been offered treatment for drug problems while in custody, although 46 stated that the prison authorities knew that they were drug misusers. Four of the eight women had been
offered some form of treatment for withdrawal symptoms, but 47 of the 48 men said that they had not been offered any treatment.

All 81 subjects were asked whether they might inject and share needles in prison in the future. Sixty seven thought that they would misuse drugs and 55 that thev
would inject them; 20 thought that they would share injecting equipment. These figures are higher than those reported for actual misuse, injecting, and sharing
needles.

Comment
This study shows that most drug injectors attending Glasgow needle exchanges have been in prison. Six subjects (11%) admitted to sharing needles in prison.
The true extent of sharing may be greater as the other eight who reported injecting drugs in prison were unlikely to have had exclusive access to their own
equipment. Respondents in the semistructured interviews emphasised this fact-“When you hide your needle, someone else might find it and it gets used in
their circle, so you can’t say how many get to use it.” Estimates of the number of people sharing one needle varied between five and 100. It therefore seems highly
probable that when a drug misuser shares needles inside prison, this may occur more frequently and among a wider group of people than it would outside
prison. Little treatment seems to be offered for drug problems in Scottish prisons. Fifty one (910%) respondents said they had received no treatment at all. This contrasts with a recent study that found that only 40% of a group of 50 drug misusers in London had not received treatment while in custody. This apparent
lack of treatment offered in Scottish prisons, together with the prevalence of reported injecting drug misuse and sharing of needles are matters of serious concern.
This study was funded by the Nuffield Foundation,

Source: www.bmj.com Vol.302. Number 6791

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

Both drinking and withdrawal from chronic drinking can raise circulating glucocorticoid levels, known as cortisol in humans and corticosterone in rodents. Prolonged and high concentrations of glucocorticoids can have damaging effects on neuronal function and cognition. Evidence shows that glucocorticoids are associated with neurotoxicity during abstinence after withdrawal from alcohol dependence (AD), and that glucocorticoid receptor antagonism may represent a pharmacological option for recovery.

A review of this evidence will be published in the December 2010 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
“Prolonged and elevated levels of glucocorticoid hormones can damage or destroy neurons, and lead to an increased vulnerability to other situations that can damage neurons, such as raised excitatory amino acid activity,” explained A.K. Rose, a lecturer in psychology at the University of Liverpool and corresponding author for the review. “This can underlie loss of memory functions.”
“High levels of brain cortisol associated with stress have long been linked to deficits in neuronal function, which can be seen in aging,” added John Littleton, a professor in the department of pharmaceutical sciences at the University of Kentucky.
Among the review’s key points:
Brain glucocorticoid concentrations increase and glucocorticoid receptor occupancy decreases during prolonged abstinence after withdrawal from alcohol.
“Our evidence shows that brain concentrations of corticosterone remain raised for long periods after alcohol withdrawal, even after the blood concentrations return to normal levels,” said H.J. Little, a professor in addiction science at King’s College London and who conducted this research. “Furthermore, the corticosterone concentrations remained increased in rodent brains for up to two months, approximately five human years, following cessation of prolonged alcohol drinking.”
“One of the most important questions for research and treatment is why alcoholics can relapse after many months of abstinence,” observed Littleton. “Partly this can be attributed to the effects of conditioning in which ‘cues’ provoke craving for alcohol, as well as a ‘protracted withdrawal syndrome’ which includes anxiety, sleep disturbances, and general feelings of being unwell. Prolonged high levels of brain cortisol after withdrawal from alcohol may explain the strength of these cues, and many of the symptoms of protracted withdrawal.”
Increased glucocorticoid levels in the brain after alcohol treatment are associated with cognitive deficits seen during abstinence, affecting both treatment efficacy and quality of life.
“Cessation of drinking is clearly linked to cognitive deficits,” said Little. “For example, visuospatial learning can be worse in abstinent alcoholics than in those still intoxicated, and memory and learning deficits have been found in rats after alcohol withdrawal, but not during alcohol intake. Furthermore, greater neuronal degeneration has been reported after cessation of chronic alcohol intake than during its consumption, and multiple withdrawal episodes cause greater neuronal damage than a single withdrawal episode.”
“This point is important because cognitive deficits in alcoholics during attempted abstinence can interfere with treatment options such as ‘cognitive behavior therapy’ and also drug treatment,” said Littleton. “Drugs targeting the effects of cortisol in the brain might therefore both reduce the chances of relapse and reduce the cognitive deficits that interfere with treatment.”
Glucocorticoids are involved in the neuropathological consequences of AD.
“Animal and cell-culture research show very convincingly that cortisol/corticosterone can increase neurotoxicity associated with periods of alcohol withdrawal,” said Littleton. “Since the highest cortisol levels were found in the prefrontal cortex and hippocampus, this may explain why these areas are damaged in alcoholics. This makes the brain cortisol glucocortcoid receptors a potential target for prevention of alcohol-induced brain damage.”
“If cognitive impairments could be reduced, patients would be more likely to engage in, and thus benefit from, psychosocial treatments,” added Rose. “Better cognitive function coupled with better treatment engagement is likely to produce better treatment outcomes and quality of life. A person with greater cognitive function is likely to be more able to find work and re-build relationships.
“In summary,” said Littleton,” stress, the hypothalamo-pituitary adrenal axis, and cortisol are very important determinants of the natural history of alcoholism — affecting an individual’s drinking behavior, the effects on cognition and memory, and the likelihood of relapsing into alcoholism during abstinence. We can also see that hypotheses applicable to animals can now be applied to inform new human research.”
Add’l Contact: H.J. Little, Ph.D. hilary.little@sgul.ac.uk 44.207.848.0436 (England) King’s College London

Source: Alcoholism: Clinical & Experimental Research, 7 SEP 2010 DOI: 10.1111/j.1530-0277.2010.01298.x

Cocaine is one of the oldest drugs known to humans, and its abuse has become widespread since the end of the 19th century. At the same time, we know rather little about its effects on the human brain or the mechanisms that lead to cocaine addiction. The latest article by Dr. Marco Leyton, of the Montreal Neurological Institute (MNI), McGill University and the McGill University Health Centre, which was published in the journal Biological Psychiatry on May 15, 2009, not only demonstrates a link between cocaine and the reward circuits in the brain but also associates the susceptibility to addiction with these mechanisms.

The results of this study show that sniffing cocaine triggers high levels of dopamine secretion in a central region of the brain called the striatum. Dopamine is known to play a critical role in the brain’s response to reward as well as in its response to addictive drugs.
This study was carried out in ten non-addicted users of cocaine, all of whom sniffed cocaine on one test day and placebo powder on another. Participants underwent blood tests before and after taking the drug, and dopamine release in the brain was measured using PET scans.
“The ability of cocaine to activate dopamine release varies markedly from person to person. Our study suggests that this is related to how much of the drug the person consumed in the past,” explained Dr. Leyton. The more cocaine someone has used in his or her lifetime, the more the brain will secrete dopamine during subsequent cocaine use. “It’s possible therefore that the intensity of the reward-circuit response is related to increased susceptibility to addiction,” stated Dr. Leyton.
Although the relationship between the intensity of dopamine secretion and the frequency of drug use has been demonstrated, researchers still do not fully understand its mechanism of action. Is it the repeated stimulation of the reward circuit that leads to addiction, or is it an inherent sensitivity to addiction that leads to the increased secretion of dopamine? This question is not easy to answer, especially since other factors come into play, such as other aspects of the subject’s personal history.
Whatever the answer, the relationship between dopamine and cocaine means that this hormone could be a potential target for treatment against addiction. More research is required before treatments are available, but this study opens a new door in this direction.
This study was funded with a grant from the Canadian Institutes for Health Research. Salary support was given by the Fond de recherche en santé du Québec
This study is a collaboration between several laboratories of the McGill University Health Centre and McGill University, involving : Dr Sylvia M.L. Cox, Dr Chawki Benkelfat, Dr Alain Dagher, Dr J. Scott Delaney, France Durand, Samuel A. McKenzie, Dr Theodore Kolivakis, Kevin F. Casey, Dr Marco Leyton.

Source: McGill University Health Centre (2009, May 20).

Environmental conditions play a major role in treating drug addiction and in preventing relapses, according to new research. For the first time, researchers from the Institut de physiologie et biologie cellulaire (CNRS/Université de Poitiers) have shown that positive and stimulating environmental conditions make it easier to treat cocaine addiction.

Even though numerous data exist on the mechanisms of cocaine addiction, there are as yet no effective therapies, making it very urgent that new strategies for treating the disease be developed. According to a study by Marcello Solinas and Mohamed Jaber, carried out by a group of researchers at the Institut de physiologie et biologie cellulaire in Poitiers, exposing mice to an “enriched environment (1)” during cocaine withdrawal removes abnormal behavior related to addiction. An enriched environment, for mice, is an environment which stimulates their curiosity, providing social and physical activity as well as exploration.
After addicting animals to cocaine, the researchers then exposed them to an enriched environment made up of large cages with a small house, a running wheel, tunnels and other appealing toys which were changed weekly.
Three models of animal addiction were used:
behavioral sensitization, which measures the progressive increase in the stimulating effects of cocaine after chronic administration;
the location preference, which measures the ability of a context (associated with cocaine consumption) to lead to drug-seeking behavior, and the renewal of this drug-induced location preference;
measurements of cocaine’s ability to lead to a relapse after a period of withdrawal.
The result was that after thirty days of exposure to an enriched environment, addiction behavior typical of these three models had disappeared.
To identify the brain areas involved in the beneficial effect of an enriched environment, the researchers used an approach from functional neuro-anatomy. They showed that the absence of relapse in “enriched” mice was associated with a decrease in the cocaine-induced activation of a set of brain structures involved in dopaminergic transmission and associated with relapse.
These results, which have both a medical and societal impact, suggest that the living conditions of drug addicts should be taken into account in determining their therapy. A real effort should be made to create enriched environmental conditions, providing patients with different types of social, physical and intellectual stimulation. This also suggests that under deprived environmental conditions, treating addiction can be very challenging.
Note:
1) A number of earlier studies had shown that when animals are raised in an enriched environment prior to drug exposure, their vulnerability to addiction was reduced. In such conditions, the enriched environment can be seen as preventive.

Source: Proceedings of the National Academy of Sciences, 2008; 105 (44): 17145 DOI: 10.1073/pnas.0806889105

Addictive drugs are known to induce changes in the brain’s reward circuits that may underlie drug craving and relapse after long periods of abstinence. Now, new research in the September 9 issue of the journal Neuron, uncovers a specific neural mechanism that may be linked to persistent drug-seeking behavior and could help to guide strategies for development of new therapies for cocaine addiction.

Previous research has shown that the ventral tegmental area (VTA) is a brain region that is activated when cocaine users experience a craving for cocaine after being exposed to cocaine-associated cues. The medial prefrontal cortex (mPFC), which receives input from the VTA via circuits that use the “reward” neurotransmitter dopamine, has also been implicated in drug craving after cocaine withdrawal. Further, increases in the level of brain-derived neurotrophic factor (BDNF) have been observed in the VTA and mPFC in rats after withdrawal from repeated cocaine exposure.
“BDNF plays a key role in modulating the structure and function of synapses, the sites of communication between neurons. Therefore, increased BDNF after cocaine withdrawal may drive synaptic changes that contribute to compulsive drug seeking behavior,” explains senior author, Dr. Mu-ming Poo from the University of California, Berkeley. “It has been shown that increased BDNF in the VTA after cocaine withdrawal in rats promotes the drug-dependent motivational state. However, nothing is known about the potential BDNF effect on synaptic function and plasticity in mPFC neurons after cocaine withdrawal.”
Dr. Poo and colleagues designed a study to examine how BDNF and the mPFC might contribute to relapse after cocaine addiction. The researchers found that the gradual increase in BDNF expression in the rat mPFC after terminating repeated cocaine exposure significantly enhanced the activity-induced potentiation of specific synapses. Dr. Poo’s group went on to uncover the specific cellular mechanism linking increased BDNF with enhanced synaptic plasticity and demonstrated that interference with the key molecule in the BDNF signaling process reduced behavioral sensitivity after cocaine withdrawal in rats.
“In short, our results demonstrate that elevated BDNF expression after cocaine withdrawal sensitizes the excitatory synapses in the mPFC to undergo activity-induced persistent potentiation that may contribute to cue-induced drug cravings and drug-seeking behavior,” concludes Dr. Poo. Although a clear correlation between rat and human behaviors of cocaine craving and relapse remains to be established, the cellular mechanism uncovered in this study does appear to have behavioral relevance and may represent a direct brain sensitization that is involved in triggering relapse.
The researchers include Hui Lu, Pei-lin Cheng, Byung Kook Lim, Nina Khoshnevisrad, and Mu-ming Poo, University of California, Berkeley, Berkeley, CA.

Source: . Neuron, 67(5) pp. 821 – 833 DOI: 0.1016/j.neuron.2010.08.012

Scottish police forces have seized almost £40m worth of cannabis plants since 2006.
A campaign is being launched to encourage the public to help weed out cannabis factories. The Scottish Crime and Drug Enforcement Agency (SCDEA) wants people to provide anonymous information on houses and flats they suspect are being used to cultivate cannabis.
The campaign comes as new figures showed police forces have seized almost £40m worth of the plants since 2006. The SCDEA is spending £25,000 on the campaign.
Cultivations have been detected by all eight police forces across Scotland in both rural and urban settings and in a variety of properties, including flats, houses, farm buildings and industrial premises. The public are being asked to use their “natural senses” to look out for signs which may indicate the presence of a cannabis factory.
‘Tell-tale signs’
These include blacked-out windows, occasionally with condensation on them, or curtains or blinds that are permanently closed.
Another sign is when premises appear unoccupied most of the time but there are people, often of south-east Asian appearance, seen visiting late at night.
Cannabis farm tell-tale signs
• Blacked-out windows
• Curtains or blinds that are permanently closed
• A strong, sweet distinctive smell
• Unusual levels of heat coming through walls and floors
• A hum or loud buzzing sound caused by fans
• Premises seem unoccupied most of the time but people are seen visiting late at night
Since 2006, police in Scotland have detected 278 commercial cannabis cultivations and seized 130,716 plants valued at £39.2m. Of the 304 people arrested, 74% were Chinese and 22% were Vietnamese.
Launching the campaign, Justice Secretary Kenny MacAskill said: “Even the smallest piece of information about an individual or group’s activity can be the key that unlocks the door to disrupting an entire criminal empire.
“The fact that so many of the individuals involved in cannabis cultivation are of south-east Asian origin should not be seen as us targeting a community. “Nine out of 10 of those arrested for these particular crimes are of south-east Asian descent and it would be negligent if we refused to acknowledge that reality. These are not the kind of neighbours anyone wants or needs” Gordon Meldrum SCDEA director general added: “But I hope that we will also get the support of those communities with family ties to that region of the world.”
‘Safety risks’
The agency has warned that cannabis factories pose serious safety risks, with properties often destroyed internally to maximise space for plants.
It has also argued they represent a serious fire and electrocution risk because electricity supplies are interfered with and powerful lighting is left on for long periods of time. SCDEA director general Gordon Meldrum said: “These illegal and highly dangerous cultivations are quite literally on people’s doorsteps. These are not the kind of neighbours anyone wants or needs.”
Police said anyone who wanted to report suspicious activity should call Crimestoppers or give information anonymously online at www.crimestoppers-uk.org.

Source: www.bbc.co.uk 30th August 2010

A third of 14 to 16-year-olds drink every weekend.
Children should learn first aid skills to help friends who become dangerously drunk, the British Red Cross has said.
Its survey of 2,500 11 to 16-year-olds found 10% had been left with a drunk friend who was sick, injured or unconscious and 14% said they had been in an alcohol-related emergency.
The Red Cross wants to promote a broad range of first aid skills, but says the effects of alcohol are a key concern. The charity Drinkaware backed the call, but said parents needed to give advice.
Official figures show that there were more than 7,000 hospital admissions between 2006 and 2009 involving under-15s and alcohol.
Many youngsters told the survey that they drank – 23% of 11 to 16-year-olds said they have been drunk, while one in three 14 to 16-year-olds said they drank most weekends.
Many of those who said they had witnessed an alcohol-related emergency said they had panicked, or did not know what to do. Almost half said they were worried about their friend choking on vomit or simply not waking up.
Joe Mulligan, from the British Red Cross, said: “We need to ensure that every young person, irrespective of whether they have been drinking, has the ability and confidence to cope in a crisis.”
The agency hopes new online training materials, including videos on YouTube, will reach children directly. Its campaign, called Life – Live It, is also sending Red Cross trainers into schools and offering first aid packs to teachers.
Children can learn skills including the recovery position, to avoid someone choking on their own vomit, and resuscitation techniques.
Chris Sorek, from charity Drinkaware, said the findings reinforced the need for children of all ages to be educated about alcohol misuse. “It’s not surprising that children under 16 don’t know how to deal with alcohol emergencies. Ideally they should enjoy an alcohol-free childhood, so we wouldn’t expect them to know what to do.
“But with the young people who drink alcohol drinking at very high levels, it’s important they are equipped with the tips they need to keep themselves and their friends safe.”
But he said that parents played a vital role in educating their children about the dangers of alcohol misuse.
First aid has been part of the school curriculum for two years, but the survey also found that only 5% of those surveyed had received first aid training at school. As well as dealing with alcohol-related problems, the campaign aims to help teach children how to help people with asthma attacks, head injuries, choking and epileptic seizures.

Source: BBC News 13th Sept.2010

A third of 14 to 16-year-olds drink every weekend Children should learn first aid skills to help friends who become dangerously drunk, the British Red Cross has said.
Its survey of 2,500 11 to 16-year-olds found 10% had been left with a drunk friend who was sick, injured or unconscious and 14% said they had been in an alcohol-related emergency.
The Red Cross wants to promote a broad range of first aid skills, but says the effects of alcohol are a key concern. The charity Drinkaware backed the call, but said parents needed to give advice.
Official figures show that there were more than 7,000 hospital admissions between 2006 and 2009 involving under-15s and alcohol.
Many youngsters told the survey that they drank – 23% of 11 to 16-year-olds said they have been drunk, while one in three 14 to 16-year-olds said they drank most weekends.
Many of those who said they had witnessed an alcohol-related emergency said they had panicked, or did not know what to do. Almost half said they were worried about their friend choking on vomit or simply not waking up.
Joe Mulligan, from the British Red Cross, said: “We need to ensure that every young person, irrespective of whether they have been drinking, has the ability and confidence to cope in a crisis.”
The agency hopes new online training materials, including videos on YouTube, will reach children directly. Its campaign, called Life – Live It, is also sending Red Cross trainers into schools and offering first aid packs to teachers.
Children can learn skills including the recovery position, to avoid someone choking on their own vomit, and resuscitation techniques.
Chris Sorek, from charity Drinkaware, said the findings reinforced the need for children of all ages to be educated about alcohol misuse. “It’s not surprising that children under 16 don’t know how to deal with alcohol emergencies. Ideally they should enjoy an alcohol-free childhood, so we wouldn’t expect them to know what to do.
“But with the young people who drink alcohol drinking at very high levels, it’s important they are equipped with the tips they need to keep themselves and their friends safe.”
But he said that parents played a vital role in educating their children about the dangers of alcohol misuse.
First aid has been part of the school curriculum for two years, but the survey also found that only 5% of those surveyed had received first aid training at school. As well as dealing with alcohol-related problems, the campaign aims to help teach children how to help people with asthma attacks, head injuries, choking and epileptic seizures.

Source: BBC News 13th Sept.2010

Impact of Parental Substance Misuse on Children’s Educational Attainment, A One Day Conference, Thursday 2nd December 2010, Glasgow

This conference organised by the University of Glasgow will focus on drug and alcohol misuse in families and its impact on educational attainment. Key experts with explore current trends and issues, new research, new approaches to supporting children and provide practical information which can be implemented in the work setting.

The conference should be of interest to anyone working with children and young people who are affected by drug or alcohol misuse from health, education and social care settings.

For a conference leaflet visit
http://www.gla.ac.uk/departments/developmental/cpd/newcourses/ or telephone
0141 201 9264/9353

Methadone for drug addicts costs the taxpayer £105m in four years
METHADONE for drug addicts has cost the Scottish government more than £105million in just over four years, it was revealed yesterday.
An average of £67,838 was spent every day buying and dispensing the heroin substitute since March 2006 – despite experts claiming it does not work.
More than 100 people have died of methadone overdoses in that time.
And there are fears that addicts are being “parked” on the substance as Scotland’s drug problems spiral out of control. Rehabilitation workers have joined politicians in calling for a radical overhaul of treatments.
Professor Neil McKeganey, of the Centre for Drug Misuse Research in Glasgow, described the bill as “staggering”. He said: “Scotland needs to address its reliance on methadone, which has become our main drug treatment – but it is costly and delivering dubious results. It is becoming difficult to persuade the Scottish government to look at alternatives. The solution is to get people off drugs and into drug treatment services. But that can’t be done by putting people on methadone indefinitely.”
Mark Hepburn, clinical director of the Alexander Rehabilitation Clinic at Oldmeldrum in Aberdeenshire, said: “My criteria for recovery is not for a drug-maintained life, but a drug-free one. But we are just parking people on it.”
Former Aberdeen heroin addict Barry Glaze, 29, was on methadone for five years and now believes it made coming off drugs harder. He said: “I started taking heroin when I was 16 and was first prescribed methadone when I was 19. It wasn’t until I was 25 that I came off it and that was after I asked my GP. If I hadn’t, I would probably still be on it.”
Labour justice spokesman Richard Baker said: “There have been too many cuts in services that work with addicts, and unless we see support for these services then these figures will not go down”.
The government spent £20.5million prescribing the drug in 2006-07, £24.7million in 2007-08, £27.5million in 2008-09 and £27.9million in 2009-10.
A government spokesman said: “We know that the annual cost of drug misuse in the wider context of total economic and social costs is estimated at £3.5billion.
“That’s over £60,000 per problem drug user – a cost for the whole community. However, these costs typically decrease by tens of thousands of pounds once an individual engages in treatment to support their recovery.
“That’s why we are providing a record £28.6million investment in frontline drug treatment services in 2010-11 and our view is that the overarching aim of all drug treatment services should be recovery and this is at the core of our drugs strategy.”

Source: http://www.dailyrecord.co.uk/news 30.09.10