Alcohol

From NIHCM Newsletter / April 2025

Alcohol & Substance Use

Learn about the latest news on substance use, including views on alcohol, and how fentanyl deaths are declining.

Alcohol Awareness: April is alcohol-awareness month and an opportunity to reflect on the impacts of alcohol use and how alcohol-related deaths have increased over the last decade, with a sharp increase during early-pandemic years. A new Pew Research Center survey explores Americans’ views on the risks and benefits of alcohol consumption. A majority of routine drinkers, 59%, say their alcohol use increases their risk of serious physical health problems at least a little.
Fentanyl Deaths Declining: Recent preliminary data from the Centers for Disease Control and Prevention (CDC) indicates a 25% decrease in opioid overdose deaths for the 12-month period ending in October 2024, compared to the same timeframe in 2023. This is driven in large part by a reduction in the number of deaths involving fentanyl. The Wall Street Journal examines the decline in a series of charts. KFF Health News discusses how misinformation about fentanyl is impacting the overdose response.
Federal Funding: A federal judge has temporarily blocked the Department of Health and Human Services (HHS) from terminating a variety of public health funds that had been allocated to states during the Covid-19 pandemic, including funding that was being used to support opioid addiction and mental health treatments. The administration also closed the office that tracked alcohol-related deaths and harms and helped develop policies to reduce them.

Resources & Initiatives

The US Surgeon General’s 2025 Advisory, Alcohol and Cancer Risk, describes the scientific evidence for the causal link between alcohol consumption and an increased risk for cancer.
NPR dives into 8 theories from experts on why fentanyl overdose deaths are declining, including increased access to Naloxone, better public health, and the waning effects of the COVID pandemic.
The National Academy for State Health Policy’s State Opioid Settlement Spending Decisions tracker shares state-level settlement funding decisions and priorities.
With support from a $5.4 million Elevance Health Foundation grant, Shatterproof created an online training curriculum for healthcare professionals that aims to dispel myths and misunderstandings about substance use disorder, and promote person-centered, culturally responsive care.

Source: https://nihcm.org/newsletter/the-relationship-between-alcohol-and-health

Filed under: Alcohol,Drug use-various effects,Health,Latest News,Prevention and Intervention,Treatment and Addiction,USA :

In the fall of 2024, the Yukon’s chief medical officer stated that the Yukon government’s first substance use surveillance report indicated that alcohol’s burden “far exceeds” other substances. The report contains data related to EMS (emergency medical services), hospital and emergency admissions and reports from the chief coroner. Dr. Sudit Ranade says that the Yukon has a more substantial burden of substance abuse than the Canadian average. (Nov. 29/2024 Yukon News).

Dr. Sudit wisely pointed out that alcohol use in the Yukon starts early and while getting treatment is good, it takes the focus away from prevention. The Yukon government spends millions on secondary prevention; primary prevention aims to prevent the onset of disease or illness and secondary prevention attempts to manage the disease and reduce progression once present.

I have lived in the Yukon since 1970, graduated from FH Collins in 1975. I started drinking when I was 15 years old, it became a problem very quickly yet I didn’t quit drinking until I was 30 years old. Alcohol and mental illness ran in my family and seven years ago I lost my son to suicide in Whitehorse; he was drinking that fateful night.

I have been a social worker and criminologist in the Yukon for the last 40 years. I have worked in Whitehorse and rural communities in the Yukon. I have seen the suffering that that both alcohol and drugs brings upon families and communities. It’s not uncommon to hear of mothers drinking themselves to death, leaving their children motherless.

We spend millions on secondary prevention programs — EMS, mental health and substance abuse programs, shelters, police, medical system — the list goes on. I would like to see a thoughtful analysis of how successful mental health and substance abuse services programs are for people with substance abuse issues. I can guarantee that we would find dismal results, we keep doing the same thing over and over again, expecting different results. Secondary prevention provides employment for a whole lot of us, but at what cost?

Primary prevention programs aimed at preventing the problem before it starts is often overlooked. The main point in me writing this letter is to encourage the Yukon government to prevent the harm and one of the ways to do that, is to educate people about the serious harm that alcohol causes.

In Nov. 2017, a federally-funded study in Yukon, which was the first of its kind in Canada, saw colourful labels affixed to all alcohol bottles and cans inside a Whitehorse liquor store. There were two types of labels: one that warned that alcohol can cause cancer, including breast and colon cancer (there are other cancers as well); another label informed purchasers of the recommended maximum number of drinks per day. But just four weeks later, the Yukon Liquor Corporation decided to “pause” the label study after hearing concerns from national alcohol organizations.

The concerns included whether Yukon had the authority to affix the warnings and possible defamation, said the minister responsible for the liquor corporation, John Streicker.

“We have to weigh the costs that we will have to put towards litigation, costs which could go towards trying to reduce the harm of alcohol and promote education,” he said.

Timothy Stockwell, a University of Victoria researcher involved in the study, said he felt “extreme disappointment’ when he learned the project was being put on hold. The liquor industry was afraid that the graphic warning labels on booze could curb alcoholism. The label phase was supposed to run for eight months followed by a survey to assess the impact. The colourful labels included graphics, as opposed to U.S. messages that are text only. There was concern about putting the word cancer on the labels yet the International Agency for Research on Cancer, a World Health Organization body, has classified alcohol as a group-one carcinogen, along with tobacco, asbestos and many other materials. (Canadian Press – Laura Kane Posted Jan. 3, 2018).

We are now being told that there is no safe level of alcohol. I am pleased to see that there appears to be increasing numbers of people who are recognizing this fact and choosing to forgo the use of alcohol. I have lived in the Yukon for over 50 years and always wondered why there was so much cancer in such a beautiful pristine land. Could alcohol use have something to do with that? Not to mention the costs alcohol misuse does to families, children, teenagers, including suicide, mental health issues, FASD, incarceration, child abuse, problems in school attendance and missing work, the list goes on. Drinking alcohol can raise your risk of developing these cancers: mouth, laryngeal, breast, liver, pharyngeal, esophageal, stomach, pancreatic and colorectal. Tobacco and alcohol together are worse for you than either on its own. (Canadian Cancer Society).

I propose that we give this study another try, for at least a year. It held promise, can’t we at least try something that would cost peanuts, putting a label on a bottle? Education is key and morally, how can we not try prevention for the sake of Yukon people’s health?

Ms. Clarke encourage your fellow MLAs to be brave and try this inexpensive primary prevention project again; it could save lives, lower health care costs and all other related costs that the Chief Medical Officer spoke about. Don’t let the liquor industry bully you, it might give Yukoners the impression that money from the sale of alcohol is more important than people’s health.

Sincerely, Cathy Deacon, Whitehorse, Canada.

Filed under: Alcohol,Canada,Culture,Latest News,Prevention and Intervention :

Photo: UNODC

Member states voting at the 68^th session of the CND.

Vienna (Austria), 14 March 2025 — The sixty-eighth session of the Commission on Narcotic Drugs (CND) concluded today after five days of intensive discussions on global drug policy, international cooperation and the implementation of international drug policy commitments. The strong engagement and high level of participation from governments and stakeholders in Vienna, 2,000 of whom gathered to exchange views and shape collective responses to evolving drug-related challenges, demonstrates the Commission’s relevance as the global platform for addressing the complexities of the world drug problem in an evidence-based, forward-looking manner.

In her closing remarks, United Nations Office on Drugs and Crime (UNODC) Executive Director Ghada Waly emphasized the importance of strengthening the CND. “In times of division and uncertainty, we need effective multilateral institutions more than ever,” she said. “And the level of engagement at this session has once again confirmed the enduring relevance of this Commission as the global forum for drug policy.”

She urged Member States to redouble their efforts, commitment and cooperation, recognizing that the evolution of the world drug problem demands a renewed and determined response. “UNODC will remain committed to working for a healthier and safer world, guided by the decisions of Member States,” she concluded.

Six New Substances under Control

In fulfilling its normative functions under the international drug control conventions, the Commission acted on recommendations from the World Health Organization (WHO), deciding to place six substances under international control. These include four synthetic opioids – N-pyrrolidino protonitazene, N-pyrrolidino metonitazene, etonitazepipne, and N-desethyl isotonitazene – which have been linked to fatal overdoses. The Commission also placed hexahydrocannabinol (HHC), a semi-synthetic cannabinoid with effects similar to THC that has been found in a variety of consumer products, under Schedule II of the 1971 Convention. Additionally, carisoprodol, a centrally acting skeletal muscle relaxant, widely misused in combination with opioids and benzodiazepines, was placed under Schedule IV of the 1971 Convention due to its potential for dependence and health risks. These scheduling decisions reflect the Commission’s ongoing efforts to respond to emerging drug threats and protect public health.

Six resolutions adopted

The Commission on Narcotic Drugs (CND) also adopted six resolutions, reinforcing global efforts to address drug-related challenges through evidence-based policies and strengthened international cooperation.

To protect children and adolescents, the Commission encouraged the implementation of scientific, evidence-based drug prevention programs, emphasizing the need for early interventions and cross-sectoral collaboration to build resilience against non-medical drug use.

Recognizing the growing impact of stimulant use disorders, another resolution promoted research into effective, evidence-based treatment options, calling on Member States to invest in innovative pharmacological and psychosocial interventions to improve care for those affected.

The importance of alternative development was reaffirmed with a resolution aimed at modernizing strategies that help communities transition away from illicit crop cultivation, ensuring long-term economic opportunities while addressing broader issues like poverty and environmental sustainability.

In response to the rising threat of synthetic drugs, the Commission adopted a resolution to protect law enforcement and first responders dismantling illicit synthetic drug labs and advocating for stronger safety protocols, enhanced training and international cooperation to reduce risks.

To strengthen the implementation of international drug control conventions and policy commitments, the Commission decided to establish an expert panel tasked with developing a set of recommendations to strengthen the global drug control system.

Additionally, recognizing the environmental damage caused by illicit drug-related activities, the Commission adopted another resolution calling on Member States to integrate environmental protection into drug policies and address the negative impacts on the environment resulting from the illicit drug-related activities.

These resolutions reflect the Commission’s commitment to providing concrete, coordinated responses and ensuring that drug control policies remain effective, adaptive and aligned with contemporary challenges.

Source: https://www.unodc.org/unodc/frontpage/2025/March/cnd-68-concludes_-six-new-substances-controlled-six-resolutions-adopted.html

Filed under: Addiction,Alcohol,Cannabis/Marijuana,Culture,Drug use-various effects,Economic,Education,Latest News,Marijuana and Medicine,Mental Health,Opioids,Others (International News),Prescription Drugs,Prevention and Intervention,Synthetics,Treatment and Addiction,Youth :

After achieving six months of sobriety, Horning has become a vocal advocate for comprehensive substance use prevention and education programs aimed at helping students in Warren County lead substance-free lives.

His initiative, developed in collaboration with Dr. Patricia Hawley-Mead and district officials, seeks to implement substance use prevention and education services across the school district. The goal of the initiative is to provide students, teachers, and parents with the education, community resources, and intervention strategies needed to prevent substance use and promote healthier lifestyle choices.

“If you were to tell me eight months ago I would be standing in front of you talking about substance abuse prevention and putting Narcan in AED boxes, I would have said you were crazy,” Horning shared with the audience during a recent school board meeting.

Horning’s passion for substance use prevention stems from his own difficult experience with addiction. He has openly shared his struggles with substance use, depression, and unhealthy coping mechanisms that led him down a painful path.

“My addiction was full of loss, hardships, and failures,” Horning explained. “Nothing seemed to work, nothing was helping me, and most importantly, I wasn’t helping myself. I’ve been in and out of psychiatrists’ offices, tried different medications, and felt completely lost. The only way I found recovery was by chance, but it shouldn’t be that way. We need a system in place to give students a way out before it’s too late.”

Looking back on his darkest moments, Horning admitted he never imagined he would be advocating for change in front of a crowd.

“I was not a great person at that moment in time,” he said, becoming emotional. “I made a lot of mistakes. My family, who is sitting behind me today, can tell you that. People inside and outside of school districts saw me at my worst. The disease of addiction is a lifelong battle that I will face until the day I die. But that does not mean it has to end in tragedy. That is why I am standing here today – to fight for others like me.”

Horning recognizes that many students turn to substances for a variety of reasons–whether out of boredom, depression, anxiety, or as a way to cope with personal struggles. His initiative is designed not only to educate students on the dangers of substance use but also to provide them with the tools and support systems they need to make better, healthier choices.

“This initiative will not only help students stay alive in case of an overdose, but it will help them find a way out of addiction and into a new life,” he emphasized. “Even if this helps just one person, it will all be worth it.”

INITIATIVE’S INSPIRATION

The inspiration behind Horning’s initiative came after a district-wide program held on September 18, 2024. During the event, public speaker Stephen Hill presented the First Choice & A Second Chance program to high school students. The program aimed to break the stigma surrounding substance use disorder, raise awareness about the ongoing drug epidemic, and encourage students to make healthier decisions.

Following the event, Horning was motivated to take action. He reached out to district administrators, safety officers, the school nurse department head, and a Family Services of Warren County drug and alcohol counselor to begin crafting a proposal for a comprehensive Substance Use Prevention and Education Service in the district.

The proposal calls for the establishment of educational programs that would teach students about the risks associated with substance use, provide early intervention services, and offer mental health support. Additionally, Horning’s plan includes provisions for Narcan to be available in school AED boxes, ensuring that life-saving measures are ready in case of an overdose emergency.

Hawley-Mead, who has worked closely with Horning on the initiative, stressed the importance of early intervention and prevention.

“The increasing prevalence of substance use among young people is a growing concern,” Mead said. “It poses a significant risk to their academic success, emotional well-being, and future prospects. Early prevention and education efforts have been shown to reduce substance use, improve student decision-making, and help create a more supportive and empathetic learning environment.”

Mead believes that by fostering a collaborative effort among educators, parents, and community partners, the district can proactively address the issue of substance use and equip students with the knowledge and support they need to thrive.

“This initiative will provide students, teachers, and parents with education, resources, and intervention strategies to support healthy choices and foster a positive, drug-free environment,” Mead said.

Horning concluded his speech with an emotional reflection on his own personal journey and the importance of offering help to others who may be struggling.

“What drove me to do this was really a lot of depression and unhealthy coping skills,” he shared. “I was not in the right mindset when I first used. I was not okay. If somebody had sat me down and told me, ‘We can help you,’ it could have saved me years of pain. That’s why we need this now. We need to offer students the opportunity to get help before it’s too late.”

Horning is determined to ensure that no student has to face the same struggles he did. His initiative is not only aimed at providing support for those already struggling with substance use but also preventing others from ever going down that difficult path.

“The only way I found recovery was by chance,” he admitted. “That’s the best way I can put it. Recovery is important, but when you are in an active addiction, it feels impossible to get through to someone. That’s why, eight months ago, I would have called you crazy if you told me I’d be standing here today. But now, I’m here. I have made myself a better person, and I want to give back for what I have found.”

Horning and district officials are now seeking approval from the school board and the community to bring this initiative to life in Warren County schools. Their goal is to integrate substance use prevention education into the curriculum, provide resources for students and families, and ensure that Narcan is available in AED boxes to help prevent potential overdose deaths.

“We don’t have to live in tragedy like other schools have,” Horning said. “We need to teach students how to use Narcan, how to stay alive, and most importantly, how to find a way out of addiction. Recovery is possible, and I want to show others that they don’t have to suffer alone.”

HORNING’S PROPOSAL

Horning’s written proposal outlines five key goals for the pilot initiative: Enhance school safety by increasing access to Narcan for emergency overdose response. Educate the school community about substance use prevention, intervention, and response strategies. Establish a student club focused on substance use awareness, prevention, and peer education to increase awareness and reduce stigma surrounding substance use disorder. Actively engage stakeholders, including students, staff, families, and community partners, to establish an anonymous and supportive program where students can learn about and advocate for substance use prevention. Create a district-sponsored club dedicated to promoting substance use prevention and education.

Hawley-Mead emphasized that while Narcan is already available in nurse’s offices during school hours, having it in AED boxes would ensure it’s accessible during after-school activities and weekend events.

“This proposal aims to make Narcan more widely available and accessible to first responders during emergencies, regardless of the time of day,” she said. “We want to ensure that this life-saving measure is available whenever and wherever it’s needed.”

Horning also reached out to Family Services of Warren County, which has expressed strong support for the initiative.

“They are very, very responsive towards this program,” Horning said. “I’ve spoken with counselors, including Nicole Neukum, executive director, and they’re all willing to give us whatever we need to make this a success.”

School board member Mary Passinger asked Horning if he felt comfortable sharing the personal story behind his addiction.

“It was really a lot of depression and unhealthy coping skills,” Horning responded. “I was not in the right mindset when I first used. If someone had told me, ‘We can help you,’ it could have saved me from years of pain.”

Board member John Wortman commended Horning for his bravery in speaking out and bringing this important issue to the district’s attention.

“There is nothing more important than standing up for what you believe in,” Wortman said. “The proposals outlined here will help make a significant, positive impact on students in Warren County. And that’s something we can all support.”

Superintendent Gary Weber also voiced his strong support for the initiative.

“We are 100% behind this initiative,” he said. “It’s clear that Jessie and Dr. Mead have worked hard to bring together stakeholders and develop a plan that will have a lasting and positive impact. We want to make sure this program is sustainable, and we’re committed to supporting it every step of the way.”

The district is currently reviewing Horning’s proposal, and community members are encouraged to get involved in supporting this critical initiative. For updates and information on how to help, individuals can reach out to district officials or Family Services of Warren County.

With this initiative, Horning hopes to not only save lives but also inspire others to break free from addiction and reclaim their futures.

“Recovery is possible,” he said. “And I want to show others that they don’t have to suffer alone.”

Source: https://www.timesobserver.com/news/local-news/2025/03/student-leads-charge-for-substance-use-prevention/

Filed under: Addiction,Alcohol,Cannabis/Marijuana,Culture,Education,Latest News,Mental Health,Opioids,Prescription Drugs,Prevention and Intervention,Treatment and Addiction,USA,Youth :

Objective: School-based health promotion programs can have a positive effect on behavioral and social outcomes among adolescents. Yet, limited classroom time and suboptimal program implementation can reduce the potential impact of these interventions. In the present randomized trial, we tested the effectiveness of a classroom-based substance use prevention program that was adapted for hybrid implementation. Method: The hybrid adaptation included eight asynchronous e-learning modules that presented didactic content and eight classroom sessions designed to facilitate discussion and practice of refusal, personal self-management, and general social skills. Nineteen high schools were randomly assigned to intervention or control conditions. Students (N = 1,235) completed confidential online pretest and posttest surveys to assess the effects of the intervention on tobacco and alcohol use and life skills. The sample was 50.7% female and 35.5% non-White with a mean age of 15.2 years. Results: Analyses revealed significant program effects on current cigarette smoking, alcohol use, drunkenness, and intentions for future use. There were also program effects for communication, media resistance, anxiety management, and refusal skills. Conclusions: Taken together, these findings suggest that hybrid approaches can produce robust prevention effects and may help reduce barriers to the widespread adoption and implementation of evidence-based prevention programs.

To access the full document: Click on the ‘Source’ link below.

Source: https://www.researchgate.net/publication/389399186_Preventing_tobacco_and_alcohol_use_among_high_school_students_through_a_hybrid_online_and_in-class_intervention_A_randomized_controlled_trial/fulltext/67c174cb207c0c20fa9ac7ba/Preventing-Tobacco-and-Alcohol-Use-Among-High-School-Students-Through-a-Hybrid-Online-and-In-Class-Intervention-A-Randomized-Controlled-Trial.pdf?

Filed under: Alcohol,Education,Latest News,Nicotine,Prevention and Intervention,USA,Youth :

Consumption of alcoholic beverages could make people more likely to experiment with other drugs

by Melissa Rudy Fox News – Published March 2, 2025

Longevity doctor reacts to alcohol cancer advisory: ‘It’s about time’

Following the U.S. surgeon general’s new advisory warning of alcohol’s link to multiple cancers, Dr. Brett Osborn, a Florida neurosurgeon and longevity doctor, speaks with Fox News Digital about alcohol’s toxic effects on the brain and body.

A vast majority of American adults say they have consumed alcohol at some point — yet experts warn that alcoholic beverages could be a “gateway drug” to more harmful substances.

More than 84% of adults in the U.S. report having drunk alcohol in their lifetime, according to the 2023 National Survey on Drug Use and Health (NSDUH).

That same survey found that among underage Americans (12 to 17 years of age), more than 21% had consumed alcohol.

What is a ‘gateway drug’?

Dr. Kenneth Spielvogel, senior medical officer at Carrara Treatment in California, defined a “gateway drug” as a substance that exposes someone to other drugs.

More than 84% of adults in the U.S. report having drunk alcohol in their lifetime, according to the 2023 National Survey on Drug Use and Health. (iStock)

Marijuana is often pegged as a “classic gateway drug,” he told Fox News Digital, as it can lead to cocaine, heroin and other “harder drugs” that present a greater threat to loss of life via impaired driving and other volatile behaviors.

“Alcohol maintains a firm grip on a large portion of the adult population.”

“Any substance that impairs judgment is potentially a gateway drug, in my opinion — however, alcohol is the king of this,” Spielvogel said. “It maintains a firm grip on a large portion of the adult population.”

“I personally have seen the ravages of this — hungover victims turn to meth, cocaine and other drugs for the ‘pick me up’ they feel they need.”

Why alcohol can be a ‘gateway’

For many young people, alcohol is the first substance they try, according to Chris Tuell, a clinical psychotherapist and a chemical and behavioral addiction specialist at the Lindner Center in Mason, Ohio. This makes them more likely to experiment with other drugs later.

“Most people can use alcohol and it does not become problematic — but for some, it is destroying their lives,” he said in an interview with Fox News Digital.

Marijuana is often pegged as a “classic gateway drug,” but one expert said that “alcohol is the king” when it comes to impairing judgment. (iStock)

Consumption of alcohol impairs judgment and decision-making, which can lead to riskier behaviors, including trying other substances, Tuell noted.

“Studies indicate that alcohol alters brain chemistry in ways that increase susceptibility to drug addiction,” the expert cautioned.

Jeremy Klemanski, addiction specialist and CEO of Gateway Foundation in Chicago, echoes his belief that alcohol is a gateway drug.

“We often hear reports from patients that they only use or started using while drinking, or that they were first exposed to alcohol and then tried other drugs for greater physical symptoms and feelings,” he told Fox News Digital.

Research from the National Institute of Drug Abuse suggests that early exposure to alcohol can “prime the brain” for heightened responses to other drugs. (iStock)

“It is also important to note that once a person has used one mind-altering substance, their general thinking skills are impaired on some level,” he went on. “Other things they might not normally do become easier to justify or accept as an idea to act on.”

There is also a neurological element that comes into play, according to Dr. David Campbell, clinical director and program director at Recover Together Bend in Oregon.

“Alcohol affects neurotransmitter systems that are involved in the reward pathways that are similarly targeted by other drugs,” he told Fox News Digital.

Research from the National Institute of Drug Abuse suggests that early exposure to alcohol can “prime the brain” for heightened responses to other drugs, perhaps increasing the risks of the “gateway effect,” Campbell added.

Other factors at play

Experts emphasized that correlation does not equal causation.

“Just because people who use harder drugs often drink alcohol first does not necessarily mean alcohol caused their drug use,” Tuell noted.

“There are few drugs where the sudden stoppage of their use can be deadly — alcohol is one of these,” an addiction specialist warned. (iStock)

Campbell agreed, noting that many “contextual factors and psychosocial stressors” should be considered within the broader context of someone’s life.

“Social environment, stressors, ease and proximity to access, social influences, mental health conditions, childhood trauma, genetics and other biological factors may all play a role,” he told Fox News Digital.

When and how to stop

Spielvogel shared some warning signs that someone may be dependent on alcohol and more susceptible to trying other harmful substances.

“One sign is if they have ever tried to cut down on their drinking and failed,” he said. “Also, they may be annoyed when asked about their alcohol consumption.”

People with alcohol dependency may also feel guilty when they drink, or they might consume alcoholic beverages in the morning, he added.

“It is very important that if someone has a use disorder, they seek professional help for their detox and recovery.”

Stopping “cold turkey” may not be the healthiest route, Spielvogel cautioned.

“There are few drugs where the sudden stoppage of their use can be deadly — alcohol is one of these,” he said.

“I cannot stress this enough; it is very important that if someone has a use disorder, they seek professional help for their detox and recovery, whether it’s a private treatment facility or going to a medical professional.”

“Do not do this on your own.”

Melissa Rudy is senior health editor and a member of the lifestyle team at Fox News Digital. Story tips can be sent to melissa.rudy@fox.com.

Source: https://www.foxnews.com/health/drinking-alcohol-can-lead-other-substance-use-addiction-experts-warn

Filed under: Addiction,Alcohol,Latest News,Prevention and Intervention,USA :

They’re not old enough yet to drink in bars, but a group of Washington students wants to make nightlife in the state safer.

A bill in the state Legislature requested by Lake Washington High School students aims to protect people from drink spiking.

The measure would require some establishments selling alcohol, including bars and nightclubs, to have testing kits on hand so patrons can see if their drinks have been drugged. Sponsors amended the bill this week in light of concerns of overreach lodged by a hospitality trade group.

Businesses covered by the proposal would also have to post a notice that test kits are available.

Bars would sell the test strips, stickers or straws to customers for a “reasonable amount based on the wholesale cost of the device.”

Usually, the tests look for drugs like Rohypnol, also known as “roofies.” When placed in alcoholic drinks, the drugs can incapacitate people unexpectedly so they can’t resist sexual assault, according to the federal Drug Enforcement Administration. The tests also detect ketamine and gamma hydroxybutyric acid.

“As a group of young women entering college, we are scared for our future,” Lake Washington senior Ava Brisimitzis told a Senate panel last week. “While nightlife is still years away, there are thousands of Washingtonians right now affected by this problem. No one should question whether or not they might return home safely.”

Senate Bill 5330 would take effect Jan. 1, 2026. It has a committee vote set for Friday.

The proposal is patterned after a similar law passed in California that went into effect last July. That law affected 2,400 establishments.

When a drink is spiked, “many times, it’s too late to prevent that person from falling victim to another crime, and that’s why prevention awareness is so important,” said Sen. Manka Dhingra, D-Redmond, the bill’s prime sponsor.

Critics said the original bill in Washington goes far beyond the California law. The initial version included taverns, nightclubs, theaters, hotels and more. The California legislation only applies to establishments like nightclubs that exclude minors and aren’t required to serve food.

Last week, Washington Hospitality Association lobbyist Julia Gorton said the bill “needs many more conversations.”

The hospitality association would support a version like California’s law, said Jeff Reading, a spokesperson for the trade group.

Now, a revised version of the bill looks to more closely align Washington’s proposal with California’s by focusing on establishments that don’t allow minors.

Washington’s unusual liquor licensing system has made drafting the bill difficult, Dhingra said. The state simply has too many types of licenses. She wants to “clean up” Washington’s liquor license statute.

“This is really not meant to be onerous, but really meant to be a partnership to make sure all the patrons are safe,” Dhingra told the Senate Labor & Commerce Committee last week.

California’s legislation also stated the signage must say “Don’t get roofied! Drink spiking drug test kits available here.” But Dhingra felt that language may be seen as blaming the victim, so the new version of the Washington bill doesn’t require specific verbiage in the sign.

A 2016 study published in the American Psychological Association’s journal Psychology of Violence found nearly 8% of 6,064 students surveyed at three universities believed they’d been drugged.

Source: https://washingtonstatestandard.com/briefs/washington-could-require-bars-to-carry-spiked-drink-drug-tests/

Filed under: Alcohol,Culture,Health,Latest News,Mental Health,Sexual Behaviour,USA,Youth :

Abstract

The prevalence of substance use disorders in adults is higher if substance use is initiated during adolescence, underscoring the importance of youth substance use prevention. We examined whether the use of one substance by adolescents is associated with increased risk for using any other substance, regardless of use sequences. In 2017 we examined data from 17,000 youth aged 12–17 who participated in the 2014 National Survey on Drug Use and Health, a sample of nationally representative data on substance use among the U.S. civilian, noninstitutionalized population aged 12 or older. Descriptive analyses and multivariable logistic regression models were applied. After controlling for age, sex, and race/ethnicity, compared with youth without past-month marijuana use, youth with past-month marijuana use were 8.9 times more likely to report past-month cigarette use, 5.6, 7.9 and 15.8 times more likely to report past-month alcohol use, binge use, or heavy use (respectively), and 9.9 times more likely to report past-month use of other illicit drugs. The prevalence of past-month use of cigarettes, marijuana, and other illicit drugs was significantly higher among past-month alcohol users compared with youth without past-month alcohol use, and increased as intensity of alcohol use rose. Among past-month cigarette smokers, the prevalence of marijuana, other illicit drugs, and alcohol use were each significantly higher than youth without past-month cigarette use. Youth marijuana use, cigarette smoking, or alcohol consumption is associated with other substance use. This finding has importance for youth prevention, supporting a message no use by youth of any substance.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0091743518301658?via%3Dihub

Filed under: Alcohol,Cannabis/Marijuana,Latest News,Tobacco, smoking,Youth :

In Indiana, Marion, Vanderburgh, Madison and Lake counties had the highest number of residents who listed alcohol as their primary substance upon admission to a facility for treatment. (Adobe Stock)

Public News Service – Terri Dee, Anchor/Producer – Monday, January 6, 2025

One popular New Year’s resolution is to quit alcohol consumption.

Although easier said than done, one recovery center said there are modifications to try if previous attempts are not working. A good start is taking a hard look at what has worked and what has not.

Marissa Sauer, a licensed clinical addiction counselor at Avenues Recovery, a Fort Wayne recovery center, pointed out if there was a simple answer, everybody would use it. She added other influences are linked to alcohol and substance abuse.

“There’s genetics. Were my parents and my grandparents struggling with substances? Does someone have maybe adverse childhood experiences that have led to substances being a coping mechanism of some kind?” Sauer explained. “Maybe there are these mental health diagnoses.”

Sauer mentioned people, places, or things which could inhibit or enable someone to abuse drugs or alcohol, making it complicated to simply walk away. Medication, therapy or conversations with people who have beaten their addictions are all effective measures for recovery.

The US Surgeon General’s 2025 Advisory Report indicates alcohol consumption is the third leading preventable cause of cancer after tobacco and obesity and the public is taking notice.

There is a growing momentum of the “sober curious” movement, avoiding happy hours at bars, ordering a low or no-alcohol drinks known as mocktails, or completely abstaining from alcohol for 30 days for “dry January.” Sauer said longtime substance abusers fear change and she wants them to know there is hope.

“Whether you’re 21 or whether you’re 51, that ability to heal is there,” Sauer emphasized. “The best gift that you could give yourself for a healthy 2025 is to give your loved ones the absolute best version of yourself.”

An Indiana State Epidemiological report from 2021-2022 revealed almost 24% of residents aged 12 and older have participated in binge drinking, with the highest rate among young adults aged 18 to 25.

Source: https://www.publicnewsservice.org/2025-01-06/alcohol-and-drug-abuse-prevention/in-substance-recovery-center-supports-sober-existence/a94456-1

Filed under: Addiction,Alcohol,Latest News,Treatment and Addiction,USA :

SAM Drug Report’s Friday Fact report – 11:31 Friday 10th Jan 2025

A study that was published last week in Addictive Behaviors found that alcohol and tobacco are more likely to be used on days when marijuana is used.

The study found that individuals consumed an average of 0.45 more alcoholic drinks on days when marijuana was used, compared to days when marijuana was not used. Similarly, the study found that individuals smoked an average of 0.63 more cigarettes on days when marijuana was used. Both of these findings were statistically significant (p=0.01).

Seeking to explain these findings, the researchers posited that “the impact of cannabis use on the endocannabinoid system may reinforce the use of alcohol and tobacco through mechanisms related to psychological reward.” They added that “bidirectionality must be considered,” given that the use of one substance may influence the effect of an additional substance––it may enhance a high, for example.

The researchers noted that “the observed within-person positive associations between cannabis use and same-day alcohol consumption and cigarettes smoked are consistent with previous research that has shown a tendency for substance use behaviors to co-occur.”

Indeed, cross-tabs from the 2023 National Survey on Drug Use and Health found that those who used marijuana in the past 30 days were three times as likely to have smoked cigarettes in the past 30 days (30.8% vs. 10.4%) and 63% more likely to have used alcohol in the past 30 days (70.7% vs. 43.4%), compared to those who did not use marijuana in the past 30 days.

Source: SAM Drug Report’s Friday Fact report – 11:31 Friday 10th Jan 2025 – The Drug Report’s

Smart Approaches to Marijuana (SAM) is an alliance of organizations and individuals dedicated to a health-first approach to marijuana policy. We are professionals working in mental health and public health. We are bipartisan. We are medical doctors, lawmakers, treatment providers, preventionists, teachers, law enforcement officers and others who seek a middle road between incarceration and legalization. Our commonsense, third-way approach to marijuana policy is based on reputable science and sound principles of public health and safety.

Filed under: Alcohol,Cannabis/Marijuana,Latest News,Tobacco, smoking,USA :

Few patients know about evidence-based treatment—or have or seek access to it

Fact Sheet December 13, 2024

Projects:Substance Use Prevention and Treatment

Alcohol is the leading driver of substance use-related fatalities in America: Each year, frequent or excessive drinking causes approximately 178,000 deaths.¹ Excessive alcohol use is common in the United States among people who drink: In 2022, of the 137 million Americans who reported drinking in the last 30 days, 45% reported binge drinking (five or more drinks in a sitting for men; four for women).² Such excessive drinking is associated with health problems such as injuries, alcohol poisoning, cardiovascular conditions, mental health problems, and certain cancers.³

In 2020, many people increased their drinking because of COVID-19-related stressors, including social isolation, which led to a 26% increase in alcohol-related deaths during the first year of the pandemic.⁴

Figure 1

Alcohol‑Related Deaths Have Increased Since 2016

Growth is driven by increases in both acute and chronic causes of death

Notes: Chronic causes of death include illness related to excessive alcohol use such as cancer, heart disease, and stroke, and diseases of the liver, gallbladder, and pancreas. Acute causes include alcohol-related poisonings, car crashes, and suicide.

Source: Marissa B. Esser et al., “Deaths From Excessive Alcohol Use—United States, 2016-2021,” Morbidity and Mortality Weekly Report 73, no. 8154-61, https://www.cdc.gov/mmwr/volumes/73/wr/mm7308a1.htm#T1_down

Nationwide, nearly 30 million people are estimated to have alcohol use disorder (AUD); it is the most common substance use disorder. AUD is a treatable, chronic health condition characterized by a person’s inability to reduce or quit drinking despite negative social, professional, or health effects.⁵ While no single cause is responsible for developing AUD, a mix of biological, psychological, and environmental factors can increase an individual’s risk, including a family history of the disorder.⁶

There are well-established guidelines for AUD screening and treatment, including questions that can be asked by a person’s health care team, medications approved by the U.S. Food and Drug Administration (FDA), behavioral therapies, and recovery supports, but these approaches often are not put into practice.⁷ When policies encourage the adoption of screening and evidence-based medicines for AUD, particularly in primary care, the burden of alcohol-related health problems can be reduced across the country.⁸

The Spectrum of Unhealthy Alcohol Use

For adults of legal drinking age, U.S. dietary guidelines recommend that they choose not to drink or drink in moderation, defined as two drinks or fewer in a day for men, and one drink or fewer in a day for women.⁹ One drink is defined as 0.6 ounces of pure alcohol—the amount in a 12-ounce beer containing 5% alcohol, a 5-ounce glass of wine containing 12% alcohol, or 1.5 ounces of 80-proof liquor.¹⁰

Consumption patterns exceeding these recommended levels are considered:

Heavy drinking, defined by the number of drinks consumed per week: 15 or more for men, and eight or more for women.¹¹
Binge drinking, defined by the number of drinks consumed in a single sitting: five or more for men, and four or more for women.¹²

Alcohol use disorder is defined by The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as having symptoms of two or more diagnostic criteria within a 12-month period.¹³ The diagnostic criteria assess behaviors such as trying to stop drinking but being unable to, alcohol cravings, and the extent to which drinking interferes with an individual’s life.¹⁴ AUD can be mild (meeting two or three criteria), moderate (meeting four or five criteria), or severe (six or more criteria).¹⁵

Identifying and preventing AUD

Primary care providers are well positioned to recognize the signs of unsafe drinking in their patients. The U.S. Preventive Services Task Force recommends that these providers screen adults 18 years and older for alcohol misuse.¹⁶ One commonly used evidence-based approach, SBIRT—or screening, brief intervention, and referral to treatment—is a series of steps that help providers identify and address a patient’s problematic substance use.¹⁷

Using a screening questionnaire, a provider can determine whether a patient is at risk and, if so, can deliver periodic brief behavioral interventions in an office setting. Such interventions have been shown to reduce heavy alcohol use among adolescents, adults, and older adults.¹⁸ When a patient meets the criteria for AUD, providers can offer medication, connect them to specialty treatment, refer them to recovery supports such as Alcoholics Anonymous or other mutual-help groups, or all of the above, depending on a patient’s needs and preferences.¹⁹ When these interventions are used in primary care settings, they can reduce heavy alcohol use.²⁰

While screening for AUD is common, few providers follow up when a patient reports problematic alcohol use. From 2015 to 2019, 70% of people with AUD were asked about their alcohol use in health care settings, but just 12% of them received information or advice about reducing their alcohol use.²¹ Only 5% were referred to treatment.²²

Emergency departments (EDs) are another important setting for identifying AUD, and to maintain accreditation they are required to screen at least 80% of all patients for alcohol use.²³ Alcohol is the most common cause of substance-related ED visits, meaning many people in these settings are engaged in excessive or risky alcohol consumption and could be linked to care.²⁴

The use of SBIRT in the ED can also reduce alcohol use, especially for people without severe alcohol problems.²⁵ Providers who use SBIRT can help patients reduce future ED visits and also some negative consequences associated with alcohol use, such as injuries.²⁶

Commonly cited barriers to using SBIRT in these health care settings include competing priorities and insufficient treatment capacity in the community when patients need referrals. Conversely, SBIRT use increases with strong leadership and provider buy-in, collaboration across departments and treatment settings, and sufficient privacy to discuss substance use with patients.²⁷

Jails and prisons should also screen for AUD, as well as other SUDs, to assess clinical needs and connect individuals with care. However, screening practices may not be evidence based. A review of the intake forms used to screen individuals in a sample of jails in 2018-19 found that some did not ask about SUD at all, and of those that did, they did not use validated tools accepted for use in health care and SUD treatment settings.²⁸

Withdrawal management

Up to half of all people with AUD experience some withdrawal symptoms when attempting to stop drinking.²⁹ For many, common symptoms such as anxiety, sweating, and insomnia are mild.³⁰ For a small percentage, however, withdrawal can be fatal if not managed appropriately.³¹ These individuals can experience seizures or a condition called alcohol withdrawal delirium (also referred to as delirium tremens), which causes patients to be confused and experience heart problems and other symptoms; if untreated, it can be fatal.³² People with moderate withdrawal symptoms can also require medical management to address symptoms such as tremors in addition to anxiety, sweating, and insomnia.³³

To determine whether a patient with AUD is at risk of severe withdrawal or would benefit from help managing symptoms, the American Society of Addiction Medicine recommends that providers evaluate patients with positive AUD screens for their level of withdrawal risk.³⁴ Based on this evaluation, providers can offer or connect patients to the appropriate level of withdrawal management.³⁵

At a minimum, high-quality withdrawal management includes clinical monitoring and medications to address symptoms.³⁶ Providers may also offer behavioral therapies.³⁷ Depending on the severity of a patient’s symptoms and the presence of co-occurring conditions such as severe cardiovascular or liver disease that require a higher level of care, withdrawal management can be provided on either an inpatient or an outpatient basis.³⁸

According to the U.S. Department of Justice’s Bureau of Justice Assistance and the National Institute of Corrections, jails should also use evidence-based standards of care to address alcohol withdrawal. These standards include screening and assessing individuals who are at risk for withdrawal and, if the jail cannot provide appropriate care, transferring them to an ED or hospital.³⁹

Withdrawal management on its own is not effective in treating AUD, and without additional services after discharge, most people will return to alcohol use.⁴⁰ Because of this, providers should also connect people with follow-up care, such as residential or outpatient treatment, after withdrawal management to improve outcomes. Continued care helps patients sustain abstinence, reduces their risk of arrests and homelessness, and improves employment outcomes.⁴¹

Patients face multiple barriers to this follow-up care, however. For example, withdrawal management providers from the Veterans Health Administration cited long wait times for follow-up care, inadequate housing, and lack of integration between withdrawal management and outpatient services as reasons patients couldn’t access services.⁴² Patients have also cited barriers such as failure of the withdrawal management provider to arrange continued care, lengths of stay that were too short to allow for recovery to begin, insufficient residential treatment capacity for continued care, and inadequate housing.⁴³

Promising practices for improving care continuity include: providing peer recovery coaches—people with lived expertise of substance use disorder who can help patients navigate treatment and recovery; psychosocial services that increase the motivation to continue treatment; initiating medication treatment before discharge; reminder phone calls; and “warm handoffs,” in which patients are physically accompanied from withdrawal management to the next level of care.⁴⁴

Treating AUD

In 2023, 29 million people in the U.S. met the criteria for AUD, but less than 1 in 10 received any form of treatment.⁴⁵ Formal treatment may not be necessary for people with milder AUD and strong support systems.⁴⁶ But people who do seek out care can face a range of barriers, including stigma, lack of knowledge about what treatment looks like and where to get it, cost, lack of access, long wait times, and care that doesn’t meet their cultural needs.⁴⁷

For those who need it, AUD treatment can include a combination of behavioral, pharmacological, and social supports designed to help patients reach their recovery goals, which can range from abstaining from alcohol to reducing consumption.⁴⁸

While for many the goal of treatment is to stop using alcohol entirely, supporting non-abstinence treatment goals is also important, because reduced alcohol consumption is associated with important health benefits such as lower blood pressure, improved liver functioning, and better mental health.⁴⁹

Services for treating AUD—including medication and behavioral therapy—can be offered across the continuum of care, from primary care to intensive inpatient treatment, depending on a patient’s individual needs.⁵⁰

Medications

Medications for AUD help patients reduce or cease alcohol consumption based on their individual treatment goals and can help improve health outcomes.⁵¹ Medications can be particularly helpful for people experiencing cravings or a return to drinking, or people for whom behavioral therapy alone has not been successful.⁵² But medications are not often used: Of the 30 million people with AUD in 2022, approximately 2% (or 634,000 people) were treated with medication.⁵³

The FDA has approved three medications to treat AUD:

Naltrexone reduces cravings in people with AUD.⁵⁴ This medication is also approved to treat opioid use disorder, and because it blocks the effects of opioids and can cause opioid withdrawal, patients who use these substances must be abstinent from opioids for one to two weeks prior to starting this treatment for AUD.⁵⁵ It can be taken daily or as needed in a pill or as a monthly injection.⁵⁶ Oral naltrexone is effective at reducing the percentage of days spent drinking, the percentage of days spent drinking heavily, and a return to any drinking.⁵⁷ Injectable naltrexone can reduce the number of days spent drinking and the number of heavy drinking days.⁵⁸ Additionally, naltrexone can reduce the incidence of alcohol-associated liver disease—an often-fatal complication of heavy alcohol use—and slow the disease’s progression in people who already have it.⁵⁹
Acamprosate is taken as a pill.⁶⁰ It reduces alcohol craving and helps people with AUD abstain from drinking.⁶¹ It reduces the likelihood of a return to any drinking and number of drinking days.⁶²
Disulfiram deters alcohol use by inducing nausea and vomiting and other negative symptoms if a person drinks while using it.⁶³ It is also taken as a pill.⁶⁴ There is insufficient data to determine whether a treatment is more effective than a placebo at preventing relapses in alcohol consumption or other related issues.⁶⁵ However, for some individuals, knowing they will get sick from consuming alcohol while taking disulfiram can increase motivation to abstain.⁶⁶ As medication adherence is a challenge for patients, supervised administration of disulfiram by another person—for example, a spouse—can improve outcomes in patients who are compliant.⁶⁷

Additionally, some medications used “off-label” (meaning they were approved for treating other conditions) have also effectively addressed AUD. A systematic review found that topiramate, a medication approved for treating epilepsy and migraines, had the strongest evidence among off-label drugs for reducing both any drinking and heavy drinking days.⁶⁸ Like naltrexone, it can reduce the incidence of alcohol-related liver disease.⁶⁹

Despite the benefits that medications provide, they remain an underutilized tool for a variety of reasons—such as lack of knowledge among patients and providers, stigma against the use of medication, and failure of pharmacies to stock the drugs.⁷⁰

Behavioral therapies

Behavioral therapies can also help individuals manage AUD, and they support medication adherence:

Motivational enhancement therapy focuses on steering people through the stages of change⁷¹ by reinforcing their motivation to modify personal drinking behaviors.⁷²
Cognitive behavioral therapy addresses people’s feelings about themselves and their relationships with others and helps to identify and change negative thought patterns and behaviors related to drinking, including recognizing internal and external triggers. It focuses on developing and practicing coping strategies to manage these triggers and prevent continued alcohol use.⁷³
Contingency management uses positive reinforcement to motivate abstinence or other healthy behavioral changes.⁷⁴ It can help people who drink heavily to reduce their alcohol use.⁷⁵

All of these approaches can help address AUD, and no one treatment has proved more effective than another in treating this complicated condition.⁷⁶ Combining behavioral therapies with other approaches such as medication and recovery supports, as described below, can improve their efficacy.⁷⁷

Recovery supports

Peer support specialists and mutual-help groups can also help people achieve their personal recovery goals:

Peer support specialists are individuals with lived expertise in recovery from a substance use disorder who provide a variety of nonclinical services, including emotional support and referrals to community resources.⁷⁸ The inclusion of peer support specialists in AUD treatment programs has been found to significantly reduce alcohol use and increase attendance in outpatient care.⁷⁹
Mutual-help groups, such as Alcoholics Anonymous (AA) and Self-Management and Recovery Training (SMART), support individuals dealing with a shared problem. People may seek out these groups more than behavioral or medication treatment for AUD because they can join on their own time and at no cost, and they may better cater to people’s needs related to varying gender identities, ages, or races.⁸⁰ Observational research shows that voluntary attendance at peer-led AA groups can be as effective as behavioral treatments in reducing drinking.⁸¹

People with AUD can use recovery supports on their own, in combination with behavioral treatment or medication, or as a method to maintain recovery when leaving residential treatment or withdrawal management.⁸²

While the U.S. records more than 178,000 alcohol-related deaths each year, some populations have a higher risk of alcohol-related deaths, and others face greater barriers to treatment.⁸³

American Indian and Alaska Native communities

Despite seeking treatment at higher rates than other racial/ethnic groups, American Indian and Alaska Native people have the highest rate of alcohol-related deaths.⁸⁴

Figure 2

American Indian and Alaska Native Individuals Have Persistently Higher Alcohol‑Related Death Rates Compared With Other Racial and Ethnic Groups

Alcohol‑related deaths per 100,000 people

Risk factors that impact these communities and can contribute to these deaths include historical and ongoing trauma from colonization, the challenges of navigating both native and mainstream American cultural contexts, poverty resulting from forced relocation, and higher rates of mental health conditions than in the general population.⁸⁵ Substances, including alcohol, are sometimes used to cope with these challenges.⁸⁶

However, American Indian/Alaska Native communities also have rich protective factors such as their cultures, languages, traditions, and connections to elders, which can help reduce negative outcomes associated with alcohol use, especially when treatment services incorporate and build on these strengths.⁸⁷

For example, interviews with American Indian/Alaska Native patients with AUD in the Pacific Northwest revealed that many participants preferred Native-led treatment environments that incorporated traditional healing practices and recommended the expansion of such services.⁸⁸

To improve alcohol-related outcomes for American Indians and Alaska Natives, policymakers and health care providers must develop a greater understanding of the barriers and strengths of these diverse communities and support the development of culturally and linguistically appropriate services. The federal Department of Health and Human Services Office of Minority Health defines such an approach as “services that are respectful of and responsive to the health beliefs, practices, and needs of diverse patients.”⁸⁹

People living in rural areas

Rural communities are another group disproportionately affected by AUD. People living in rural areas have higher alcohol-related mortality rates than urban residents but are often less likely to receive care.⁹⁰ They face treatment challenges including limited options for care; concerns about privacy while navigating treatment in small, close knit communities; and transportation barriers.⁹¹

Figure 3

Alcohol‑Related Deaths Have Increased Faster in Rural Areas

2012‑22 change in alcohol‑induced death rate per 100,000 by urban and rural areas

Telemedicine can help mitigate these barriers to care.⁹² Cognitive behavioral therapy and medications for AUD can be delivered effectively in virtual settings.⁹³ People with AUD can also benefit from virtual mutual-help meetings, though some find greater value in face-to-face gatherings.⁹⁴

Despite the value of virtual care delivery, people living in rural areas also often have limited access to broadband internet, which can make these interventions challenging to use.⁹⁵ Because of this, better access to in-person care is also needed.

Next steps

To improve screening and treatment for patients with AUD, policymakers, payers, and providers should consider strategies to:

Conduct universal screenings for unhealthy alcohol use and appropriately follow up when those screenings indicate a problem. Less than 20% of people with AUD proactively seek care, so health care providers shouldn’t wait for patients to ask them for help.⁹⁶
Connect people with continued care after withdrawal management so that they can begin their recovery. People leaving withdrawal management settings should have a treatment plan that meets their needs—whether that’s behavioral treatment, recovery supports, medication, or a combination of these approaches.
Further the use of medications for AUD. With just 2% of people with AUD receiving medication, significant opportunities exist to increase utilization and improve outcomes.⁹⁷
Address disparities through culturally competent treatment and increased access in rural areas. The populations most impacted by AUD should have access to care that meets their needs and preferences.

AUD is a common and treatable health condition that often goes unrecognized or unaddressed. Policymakers can improve the health of their communities by supporting providers in increasing the use of evidence-based treatment approaches.⁹⁸

If you are concerned about your alcohol consumption, you can use the Check Your Drinking tool created by the Centers for Disease Control and Prevention to assess your drinking levels and make a plan to reduce your use.

Source: https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2024/12/americas-most-common-drug-problem-unhealthy-alcohol-use

Filed under: Addiction,Alcohol,Drug use-various effects,Drugs and Accidents,Latest News,Prevention and Intervention,Treatment and Addiction,USA :

PublishedDec 16, 2024 – Contact:Jared Culligan – jculligan@nahb.org

This December, join NAHB in recognizing National Drunk and Drug Impaired Driving Prevention Month and be aware of the devastating consequences that result from impaired driving.

From 2018 to 2022, the National Highway Traffic Safety Administration (NHTSA) recorded more than 4,700 deaths in drunk driving traffic crashes during the month of December. In addition, a study by NHTSA found more than 54% of injured drivers had some amount of alcohol or drugs in their system at the time of the incident.

Although this month focuses primarily on reducing impaired driving on the road, it’s also crucial to extend this conversation to safety in the workplace and how drunk and drug-impaired driving can impact the construction industry.

What can your organization do to prevent drunk and drug-impaired driving incidents?

Provide education and training materials on the effects of certain substances.
Perform post-incident drug and alcohol testing and have a recovery-ready workplace to engage and support employees in stopping substance misuse whenever possible.

NAHB has several Video Toolbox Talks available in English and Spanish regarding drunk and drug-impaired driving. Please be sure to check out our content and help spread awareness as we approach the holidays:

In addition, several government establishments are promoting materials during this time of year. Check out their available resources:

If you know of anybody that needs immediate help, please reach out to the 988 Suicide and Crisis Lifeline or SAMHSA’s National Helpline, 1-800-662-HELP (4357).

Source: https://www.nahb.org/blog/2024/12/promote-safe-driving-resources

Filed under: Alcohol,Crime/Violence/Prison,Drug use-various effects,Drugs and Accidents,Latest News,Prevention and Intervention,USA :

by Brian Anthony Hernandez

Published on December 28, 2024 08:00AM EST

Teen cigarette use in 2024 was the lowest ever recorded since the Monitoring the Future study started tracking it in the 1970s. A national study discovered that teens in the United States consumed significantly less alcohol and drugs in 2024 compared to past years.

Teen alcohol use has steadily decreased from 2000 to 2024 — falling from 73% to 42% in 12th grade, 65% to 26% in 10th grade and 43% to 13% in 8th grade — according to data from Monitoring the Future (MTF), an annual federally funded study.

Every year, the University of Michigan’s Institute for Social Research uses grant money from the National Institute on Drug Abuse to conduct the MTF main study, which surveys more than 25,000 8th, 10th and 12th graders to monitor behaviors, attitudes and values of adolescents.

Meanwhile, the MTF’s panel study does follow-up surveys with roughly 20,000 adults ages 19 to 65 to continue to track trends over time.

The main study found that aside from the “long-term, overall decline” in teen alcohol use, in 2024, “alcohol use significantly declined in both 12th and 10th grade for lifetime and past 12-month use. In 10th grade, it also significantly declined for past 30-day use.”

Binge drinking, which researchers defined as “consuming five or more drinks in a row at least once during the past two weeks,” among teens also declined in 2024 for all three grades compared to 2023 and the past two-and-half decades.

Since 2000, binge drinking has fallen from 30% to 9% in 12th grade, from 24% to 5% in 10th grade and from 12% to 2% in 8th grade.

Teen cigarette use in 2024 was the lowest ever recorded since the survey started tracking 12th graders in 1975 and 10th and 8th graders in 1991.

“The intense public debate in the late 1990s over cigarette policies likely played an important role in bringing about the very substantial downturn in adolescent smoking that followed,” researchers said, adding that “an important milestone occurred in 2009 with passage of the Family Smoking Prevention and Tobacco Control Act, which gave the U.S. Food and Drug Administration the authority to regulate the manufacturing, marketing, and sale of tobacco products.”

Researchers emphasized that “over time this dramatic decline in regular smoking should produce substantial improvements in the health and longevity of the population.”

Teen marijuana use (non-medical) in 2024 also declined for all three grades, with the percentage of students using marijuana in the last 12 months at 26% in 12th grade, 16% in 10th grade and 7% in 8th grade.

“Levels of annual marijuana use today are considerably lower than the historic highs observed in the late 1970s, when more than half of 12th graders had used marijuana in the past 12 months,” researchers reported.

Filed under: Alcohol,Culture,Latest News,Marijuana and Medicine,Tobacco, smoking,USA,Youth :

Workplaces have a unique opportunity to make subtle yet meaningful adjustments to better support employees who may be in recovery or experiencing challenges. When businesses make small changes in their events, management style, and overall culture, they create an environment that respects and uplifts employees facing SUDs. Here are three impactful ways to make the workplace more welcoming:

# 1: Host Inclusive Gatherings with Non-Alcoholic Options

Work events can inadvertently center around alcohol, creating uncomfortable situations for employees who don’t drink and/or are in recovery. Making a few simple shifts can help ensure everyone feels included:
• Avoid holding meetings in bars or pubs. Instead, choose locations that aren’t centered on alcohol, such as coffee shops, casual restaurants, or outdoor spaces.
• Offer a variety of non-alcoholic drinks that are as enjoyable as alcoholic options. These could include mocktails, sparkling water with unique flavors, or other festive drinks. This small touch shows thoughtful consideration and signals that the event is meant for everyone.
• Consider alcohol-free events. Not every event needs to feature alcohol to be fun. Think of team-building activities like escape rooms, game nights, or cooking classes, which naturally focus on engagement without the need for alcohol.

#2: Encourage Supervisors to be Allies

Supervisors play a critical role in creating a compassionate, supportive workplace. By actively supporting employees rather than judging them, supervisors can contribute significantly to a culture of empathy and openness. Here’s how they can help:
• Listen without judgment. If an employee opens up about their challenges, supervisors should approach the conversation with empathy, focusing on support rather than consequences, while of course maintaining safety.
• Respect privacy and confidentiality. Supervisors should reassure employees that their personal issues will remain private and will only be discussed on a need-to-know basis, which helps foster trust.
• Share personal experiences if appropriate. For supervisors in recovery, sharing their stories can inspire others, showing that it’s possible to face challenges and succeed. Authentic, relatable leadership can be incredibly powerful for employees who may feel isolated.

#3: Encourage Coworkers to Support Each Other

Sometimes, coworkers are the first to notice changes in behavior or attendance. They can be crucial sources of support, helping to create a culture that’s proactive and understanding:
• Encourage open, honest communication. Rather than approaching a struggling coworker with judgment, a simple “I’m here if you need anything” can make a huge difference.
• Assist with resources. Coworkers can help each other navigate employment policies, find helpful information, or locate support groups if needed. Being informed and sharing resources can be invaluable.
• Respect boundaries and avoid gossip. Gossip or speculation only adds stigma to those facing SUDs. A culture of respect encourages coworkers to redirect conversations if someone starts gossiping or making assumptions about another’s struggles. For more on the importance of language on stigma, check out the National Institute of Drug Abuse’s resource, Words Matter as well as Drug Free America Foundation’s resource on Stigma here.

These small adjustments—hosting inclusive events, training supervisors as allies, and encouraging a supportive culture among coworkers—can help a business become a welcoming, stigma-free environment for employees with SUDs working towards recovery. By focusing on inclusivity, empathy, and respect, workplaces can create meaningful, positive changes that support both individual well-being and the company’s overall success.

Sources:

Drug Free America Foundation, Inc. “Stigma.” https://www.dfaf.org/wp-content/uploads/2024/09/Stigma-2024.pdf

O’Connor, P., PhD. (2023, November 23). Human resource departments can help or hinder employees with SUDs. Psychology Today. https://www.psychologytoday.com/us/blog/philosophy-stirred-not-shaken/202311/substance-use-disorders-and-the-work-place

Words matter: preferred language for talking about addiction | National Institute on Drug Abuse. (2023, November 15). National Institute on Drug Abuse. https://nida.nih.gov/research-topics/addiction-science/words-matter-preferred-language-talking-about-addiction

Filed under: Addiction,Alcohol,Prevention and Intervention,USA,Workplace :

November 22, 2024

One in 3 adults who responded to a new nationwide survey said they had suffered “secondhand harm” from another person’s drinking, and more than 1 in 10 said a loved one’s drug use had harmed them. PHI’s William Kerr shares insights on how secondhand harms from alcohol and drug use can affect families, relationships and communities.

“Think of it as collateral damage: Millions of Americans say they have been harmed by a loved one’s drug or alcohol use.

One in 3 adults who responded to a new nationwide survey said they had suffered “secondhand harm” from another person’s drinking. And more than 1 in 10 said they had been harmed by a loved one’s drug use.

That’s close to 160 million victims — 113 million hurt by loved one’s drinking and 46 million by their drug use, according to the survey published recently in the Journal of Studies on Alcohol and Drugs.

There are more harms than people think… They affect families, relationships and communities.William Kerr
Scientific Director, Center Director & Study Co-Author, Alcohol Research Group’s National Alcohol Research Center, Public Health Institute

He said it makes sense that risky drinking and drug use have far-reaching consequences, but researchers only began looking at the secondhand harms of alcohol in recent years. Less has been known about the damage done by a loved one’s drug use.

The new study is based on a survey of 7,800 U.S. adults. They were questioned between September 2019 and April 2020, before the pandemic became a factor in Americans’ substance use.

People were asked if they had been harmed in any of several ways due to someone else’s substance use.

In all, 34% of respondents said they had suffered secondhand harm from someone else’s alcohol use. The harms ranged from marriage and family problems to financial fallout, assault and injury in a drunken-driving accident.

Meanwhile, 14% of respondents said they’d suffered similar consequences from a loved one’s drug abuse.

The two groups overlapped, too — 30% of respondents reporting secondhand harm from alcohol also said they were affected by someone’s drug use.

Kerr said in a journal news release that the differences probably owe to the fact that drinking and alcohol use disorders are more common than drug use and disorders. But, he added, researchers want to learn more and are launching a new survey with more questions about the harms related to individual drugs.”

Source: https://www.phi.org/press/us-news-phi-study-shows-nearly-160-million-americans-harmed-by-anothers-drinking-drug-use/

Filed under: Addiction,Alcohol,Drug use-various effects,USA :

Too many families know the pain of losing a loved one to a drunk or drug-impaired driving accident. Each year, more than 10,000 Americans lose their lives in these preventable tragedies. During National Impaired Driving Prevention Month, we remind everyone that they can save lives by driving only when sober, calling for a ride, planning ahead, and making sure friends and loved ones do the same.

In 2022, over 13,000 people were killed in drunk-driving accidents. Still, millions of people drive under the influence each year, not only putting themselves in harm’s way but also endangering passengers, pedestrians, and first responders. Even just one drink or one pill can ruin lives.

My Administration is committed to preventing accidents and impaired driving. The National Highway Traffic Safety Administration has raised awareness about its risks and consequences through media campaigns, including “If You Feel Different, You Drive Different”; “Drive Sober or Get Pulled Over”; and “Buzzed Driving is Drunk Driving.” Furthermore, since the beginning of my Administration, we have dedicated over $100 billion to disrupt the flow of illicit drugs and expand access to the prevention and treatment of substance use disorder.

Reducing fatalities and injuries in impaired driving accidents also means improving the safety of our Nation’s vehicles. That is why my Bipartisan Infrastructure Law invests in technologies that can detect and prevent impaired driving and requiring new passenger cars to include collision warnings and automatic braking to prevent accidents. The Department of Transportation also released a National Roadway Safety Strategy to eliminate traffic deaths and make crashes less destructive.

This holiday season, let us recommit to doing right by our neighbors, friends, and families by driving sober. For those planning on drinking, arrange a sober ride home beforehand — ride-sharing apps are a convenient way to get home safely. If you have had alcohol or used substances, do not get behind the wheel — one accident can cost someone their life. If you are responsible for driving yourself or others, stay sober, buckle up, put the phone away, and drive the speed limit. And if you witness a friend, loved one, colleague, or anyone putting themselves or others in danger, lend a hand to keep them safe. You could save a life.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim December 2024 as National Impaired Driving Prevention Month. I urge all Americans to make responsible decisions and take appropriate measures to prevent impaired driving.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-ninth day of November, in the year of our Lord two thousand twenty-four, and of the Independence of the United States of America the two hundred and forty-ninth.

JOSEPH R. BIDEN JR.

Source: https://www.whitehouse.gov/briefing-room/presidential-actions/2024/11/29/a-proclamation-on-national-impaired-driving-prevention-month-2024/

Filed under: Addiction,Alcohol,Drug use-various effects,Drugs and Accidents,Prevention and Intervention,USA :

The martial language used by the government when presenting its plan to combat drug trafficking cannot mask the wide blind spots in its announcements, particularly in terms of health and social issues.

Published in Le Monde on November 9, 2024, at 12:46 pm (Paris), updated on November 9, 2024, at 2:14 pm 2 min read Lire en français

Gang warfare in a growing number of towns, repeated shootings punctuated by the deaths of ever-younger teenagers, drug traffickers with increased financial power and influence operating even from their prison cells… There can be little doubt that France, like other European countries, is grappling with the scourge of drugs on an unprecedented level. Criminal groups thrive on an illicit market estimated at over €3.5 billion, posing an ever-growing threat to the lives of entire neighborhoods, to public health and even to democracy.

Asymmetrical and unequal, the battle between drug traffickers prepared to do anything and a democracy based on the rule of law requires institutions and procedures to be strengthened and adapted. The announcements made in Marseille on Friday, November 8, by Interior Minister Bruno Retailleau and Justice Minister Didier Migaud are a step in this direction: The creation of a “national prosecutor” to combat organized crime, which would be subject to special criminal courts composed solely of magistrates to avoid pressure on juries. The system will also be improved for criminals who accept to collaborate with the justice system. Both of these procedures are among the logical proposals inspired by a Senate bill resulting from an inquiry commission report published in May, as well as by the former justice minister Eric Dupond-Moretti’s work.

There are, however, some grey areas surrounding this legislative measure, which is scheduled for parliamentary review in 2025, notably as regards the precise scope of the new prosecutor and the expansion of the current anti-drug office. As for the immediate measures announced on Friday, they remain imprecise, both in terms of the reinforcement of the Paris prosecutor’s office, to which a “coordination unit” would be attached, and the resources devoted to scrambling the telephone conversations of prisoners at the “top end” of the criminal spectrum, who would be assigned to specialized prison quarters.

Concrete action needed

But the martial language used by the two ministers to demonstrate their willingness to “join forces” over and above their political differences, cannot mask the blind spots in their announcements. Significantly, the health minister was not consulted. Information on addiction, risk reduction for drug users and providing care for people addicted to drugs are a few examples of these blind spots.

Cracking down on trafficking and putting pressure on the supply of illicit substances are essential, but they cannot be effective unless they are accompanied by strong action on demand and without a debate, informed by other countries, on the benefits and risks of partial decriminalization. At a time when consumption is becoming commonplace in many circles, from the most disadvantaged to the most privileged, public authorities should also strive to build and disseminate a counter-narrative to that of social ascent through trafficking.

A real “national cause,” the battle against drug trafficking requires France to build the conditions, if not for a consensus, at least for a political majority. This requires not only the addition of a strong preventive component but also that the government distances itself from the interior minister’s constant conflation of drugs and immigration.

Source: https://www.lemonde.fr/en/opinion/article/2024/11/09/france-s-drug-problem-both-repression-are-prevention-are-needed_6732224_23.html

Filed under: Addiction,Alcohol,Drug use-various effects,Education,Education Sector,Europe,Legal Sector,Prevention and Intervention,Social Affairs :

October 31, 2024

Scotland’s drug and alcohol deaths remain among Europe’s highest – despite an increase in spending and better national leadership.

The Scottish Government has made progress in increasing residential rehabilitation capacity and implementing treatment standards. However, it has been slow to progress key national strategies, such as a workforce plan and alcohol marketing reform. People in need still face many barriers to getting support. The workforce is under immense strain. And the increased focus on drug harm is shifting attention from tackling alcohol issues.

In 2023, there were 1,277 alcohol-specific deaths – the highest since 2008. And there were 1,172 drug misuse deaths, the second lowest number in the last six years. Scotland’s figures remain high compared to the rest of Europe despite alcohol and drug funding rising from £70.5 million in 2014/15 to £161.6 million in 2023/24.

Alcohol and drug services are co-ordinated by Alcohol and Drug Partnerships at a local level. But they have limited powers to influence change and direct funding, and their funding is falling in real terms due to inflation. Most alcohol and drug funding goes to NHS specialist services to treat people at crisis point. This means there is limited money to put into preventing people getting so ill in the first place.

Stephen Boyle, Auditor General for Scotland, said:

The Scottish Government needs to develop more preventative approaches to tackling Scotland’s harmful relationship with alcohol and drugs. That means helping people before they get to a crisis point.

Ministers also need to understand which alcohol and drug services are most cost-effective, and plan how they will be funded when the National Mission ends in 2026. That’s especially important at a time of increasing strain on the public finances.

With many alcohol and drug workers reporting feeling under-valued and at risk of burn-out, there is also an urgent need to put a timeline against plans to address the sector’s staffing challenges.

Christine Lester, a member of the Accounts Commission, said:

Alcohol and drug services are complex and delivered by a wide range of partners. But there needs to be more collective accountability across the system for how each body is helping people whose lives have been blighted by alcohol and drugs.

Better information is needed to inform service planning and where funding should be prioritised. There is also more to do to tailor services to individual needs, using the experience of service users. Right now, not everyone can access the services they need, and that experience is worse for people facing disadvantage.

Source: https://audit.scot/news/prevention-focus-needed-to-tackle-alcohol-and-drug-harm

Filed under: Alcohol,Drug use-various effects,Prevention and Intervention,UK :

The drug and alcohol awareness event was held at Faizen-E-Madina Mosque on Gladstone Street

Shariqua Ahmed – BBC News, Peterborough

A drug and alcohol awareness event has taken place at a mosque to encourage Muslims and families struggling with addiction to seek help.

Dozens of people, including children, attended the workshop organised by Dr Azhar Chaudhry at Peterborough’s biggest Mosque, Faizan-E-Madina.

Dr Chaudhry said the issue of drug and alcohol dependency within the city’s Muslim community was “a huge problem”, but engaging with them had been a challenge due to cultural stigma.

Raja Alyas from Peterborough-based Aspire charity, which works with harder-to-reach communities, called it “a step in the right direction”.

Dr Azhar Chaudhry has been organising awareness workshops for the community as a volunteer over the years

‘Still work to be done’

Dr Chaudhry, who works at Thistlemoor Medical Centre, said the involvement of the mosque committee, who attended and helped organise it, was “encouraging”.

He said there was still work to be done on engaging with Mosques who can support initiatives like Aspire, but appreciated their efforts to work together.

He moved to the UK in 2001 from Pakistan and is part of the British Islamic Medical Association (BIMA).

He runs other workshops on CPR, diabetes and cancer screening to raise awareness within the community as a volunteer.

“I love what I do. I am passionate about saving lives”, he said.

“You will be shocked to see how prevalent the drug and alcohol issues are in the Muslim community. I see it as a GP who works in a diverse part of the city.

“But it is difficult to engage with them, they don’t want to seek help.

“It is a sensitive issue for the community. There is a lot of stigma, so it needs to be addressed cautiously but attitudes are improving, hopefully.”

Aspire said the mosque committee has offered to help organise more regular drug and alcohol awareness events

Aspire works with Peterborough City Council, GPs and the Probation Service.

It also operates a clinic regularly at Thistlemoor Medical Centre to give people facing stigma a “discreet option” to seek help.

Mr Alyas said: “The workshop was well attended and was very interactive and great to see young people asking questions about how they can safeguard themselves.

“The young generation is being empowered with knowledge on making their decisions,” he said.

“It was good to see the attendees acknowledging that there is an issue. Previously, when we tired to set up a workshop like this it was not as well received.

“But the mosque saying they look forward to more events including for women is a step in the right direction.”

The event was organised by Dr Azhar Chaudhry and the Aspire charity and was supported by Faizan-E-Madina Mosque

Follow Peterborough news on BBC Sounds, Facebook, external, Instagram, external and X, external.

Source: https://www.bbc.co.uk/news/articles/crr92nyl7k4o

Filed under: Addiction,Alcohol,Drug use-various effects,UK :

The Pennsylvania State University Oct 12 2024

Students who feel a sense of belonging at their university are more likely to binge drink than those who do not feel the same connection, according to a new study by researchers at Penn State, the University of California, Santa Cruz and University of Oregon.

In the study, published in the Journal of Studies on Alcohol and Drugs, scientists -; including researchers in the Penn State College of Health and Human Development -; found that college students with “good” mental health who felt connected to their university were more likely to binge drink than those who did not feel as connected to their university.

Stephane Lanza, professor of biobehavioral health and Edna P. Bennett Faculty Fellow in Prevention Research, studied the topic with Danny Rahal and Kristin Perry when both were postdoctoral trainees in the Penn State Prevention and Methodology Training Program. The researchers examined the ways that both positive and negative aspects of mental health can contribute to the risk of binge drinking, cannabis use and nicotine use.

“In 2021, students at many universities were returning to campus after the COVID-19 shutdown -; and some students were attending in-person college classes for the first time,” said Rahal, lead author of this research and assistant professor of psychology at University of California Santa Cruz.

Data from that time indicated that many students felt disconnected from their school. Universities wanted to foster a sense of connectedness among their students for many good reasons, but we wanted to know if there was something positive -; specifically a sense of belonging -; that is related to substance use. Our study showed that feeling connected to one’s university is associated with higher rates of substance use.”

Danny Rahal, The Pennsylvania State University

The researchers examined data from 4,018 university students collected during the 2022-23 school year. Participants answered questions about substance use, their sense of belonging at their school and their mental health -; specifically about anxiety, depressive symptoms, perceived stress, flourishing in life and confidence in their academic success.

A statistical modeling technique called latent profile analysis allowed the researchers to simultaneously account for all these measures by combining them to identify five profiles of student mental health. In this study, a student was considered to have good mental health if they had lower levels of stress, depressive symptoms and anxiety, as well as higher flourishing and academic confidence than their peers.

The researchers found that students with average or good mental health were more likely to have engaged in binge drinking in the past month if they felt connected to their university than if they did not feel that connection.

The researchers said this does not mean that connectedness is bad for students to experience; rather, the results are nuanced.

“We want to cultivate connectedness among students,” said Perry, assistant professor of family and human services at University of Oregon. “Connectedness gets them involved. It can be a really powerful protective factor against negative mental health outcomes and can help keep students in school. But connectedness at school can go hand in hand with binge drinking if there is a culture of drinking at the school.”

Though the researchers said they expected these results about drinking, they were surprised to learn that students with poor mental health who felt connected to their university were more likely to use non-vaped tobacco products than students with poor mental health who did not feel connected to their university. The results around cannabis were less conclusive, but the researchers said the trend was clear.

“Generally, students who felt connected to their university were more likely to use substances than disconnected students with the same level of mental health,” Rahal said.

While a sense of belonging was related to substance use, it could also be part of the solution, according to the researchers.

“Cultivating belonging for all students is an important way that universities can embrace diversity and help all students thrive,” Lanza said.

Though drinking is common on university campuses, many students believe that it is far more common than it is, the researchers explained. In this dataset, slightly fewer than one-third of students reported binge drinking in the last month. Despite the fact that two-thirds of students had not engaged in binge drinking, the researchers also found that students believed a typical student consumed three to five drinks multiple times each week. The researchers said this disconnect between perception and reality points to an opportunity to change the culture -; by creating ample opportunities for all students to socially engage and participate in alcohol-free environments -; so that alcohol feels less central to student life.

Minoritized college students, in particular, often face messages that make them feel unwelcome based on their race, gender, socioeconomic status or other factors, according to the researchers.

“We cannot expect students to stay enrolled unless they are engaged with the campus community,” Lanza continued. “If universities lose students from a specific group, the campus becomes less diverse, and the entire university community becomes less rich. Additionally, when members of those groups leave school, they miss educational opportunities and the earning potential that comes with a college degree. By providing all students with diverse opportunities to build a real sense of belonging at their universities, we can improve campus life while putting people on the path to a healthier life.”

The National Institute on Drug Abuse and Penn State funded this research.

Source: https://www.news-medical.net/news/20241012/New-research-explores-how-campus-belonging-impacts-binge-drinking-and-substance-use.aspxThe Pennsylvania State University

Filed under: Addiction,Alcohol,Education,Health,Mental Health,USA,Youth :

Filed under: Alcohol,Australia,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Youth :

Submission to the Joint Select Committee on Social Media and Australian Society

Executive Summary
Social media platforms have become a major part of young Australians’ lives. While these
platforms have many benefits, they also expose youth to content that promotes substance use,
including alcohol, tobacco, e-cigarettes, and illicit drugs. This is concerning because:
1. There are often no effective age restrictions on this content.
2. Substance-related posts are widely available and mostly show drug use in a positive
light.
3. Young people are seeing alcohol related advertisements on social media every few
minutes.
4. Exposure to this content can normalise substance use by young people and undermine
the perceived harms of substance use.

The Australian government and social media companies need to work together to protect
young people from this harmful content. This could include better age verification, stricter
content policies, and using technology to detect and remove posts promoting illegal
substances.

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

To access the full document:

Click on the ‘Source’ link below.
An image – the front page of the full document will appear.
Click on the image to open the full document.

Source: National Centre for Youth Substance Use Research

Filed under: Alcohol,Australia,Cannabis/Marijuana,Drug use-various effects,Mental Health,Youth :

By Ian Webster Oct 28, 2024

Ian W Webster AO is Emeritus Professor of Public Health and Community Medicine of the University of New South Wales. He has worked as a physician in public and regional hospitals in Australia and UK and in NGOs dealing with homelessness, alcohol and drug problems and mental illness.

Please review Ian Webster’s paper which clearly shows that we need to learn from our success in the past that Prevention is the best way forward.

The second New South Wales Drug Summit will be held in regional centres for two days in October and the final two days will be in Sydney on the 4^th and 5^th December to be co-chaired by Carmel Tebbutt and John Brogden – a balance of politics.

Do summits achieve worthwhile outcomes?

The first Drug Summit in 1985 was national. It worked. It established the enduring principle of harm minimisation. It brought police, health, and education together, canvassed all drugs – including alcohol and tobacco, and it started funding for practicable and policy-based research.

It worked because Prime Minister Hawke needed it to, for family reasons. It worked because the Health Minister, Neal Blewett, needed it to work as he had carriage of its outcomes and the national response to burgeoning HIV/AIDS epidemic.

The 1999 NSW Drug Summit was in response to the rising prevalence of heroin use and opiate deaths. It worked because there was a political will to succeed. It included measures to deal with blood borne infections of HIV, hepatitis B and C; it expanded the state’s opioid treatment programs; expanded needle-syringe programs; introduced the antidote naloxone; and three seminal firsts – the first medically supervised injecting centre, drug courts, and court referral into treatment.

It worked because the Premier Bob Carr wanted it to. Which meant that the summit’s recommendations were managed through the Cabinet Office, supported by a ministerial expert advisory group. The ‘piper called the tune’ for all the state government departments; and they were made to work together.

The Alcohol Summit of 2003 was not as effective. Politicians were too close to the alcohol problem and implementation was handed to the Department of Health which meant other departments washed their hands of involvement. Police, on the other hand, carried the day with counterattacks on alcohol violence and behaviours at liquor outlets.

Contemporary drug problems

Now other substances must be dealt with – amphetamine type stimulants, especially crystalline methamphetamine, cocaine, hallucinogens, MDMA, pharmaceutical stimulants, the potent drug fentanyl, the even more potent nitrazenes, ketamine and unsanctioned use of psychiatric/neurological drugs. Cocaine is flooding the drug markets.

Heroin and alcohol remain as major problems. The Pennington Institute estimated there were 2,356 overdose deaths in 2022, 80% of which were unintended. And alcohol, not only damages the drinker, and the bystander, but creates extensive social harms in the lives of others.

NSW Ice Inquiry

Four and half years ago Commissioner, Dan Howard, reported on his Inquiry into the Drug Ice; he had started the Inquiry six years previously. His recommendations provide a scaffold for the upcoming Summit. The earlier NSW Drug Summit (1999) was followed by a strong impetus to implement its recommendations, but the Government dropped the ball 20 years ago. The last formal drug and alcohol plan was 10 years before the Ice Inquiry.

Fundamental to drug law reform is the decriminalisation of personal use and possession of drugs. This recommendation stands above all others in Dan Howard’s Report.

The thrust of the Inquiry’s recommendations centre on harm minimisation:

drug problems are health problems,
government departments across the board have responsibilities,
treatment, diversion, workforce initiatives, education and prevention programs must be adequately resourced,
accessible and timely data are needed,
Aboriginal communities, and other vulnerable communities, those in contact with the criminal justice system, all disproportionally affected by alcohol and other drugs, must be high priority population groups.

The NSW Liberal Government pushed back against decriminalising low-level personal drug use, against medically supervised injecting centres, against pill testing, cessation of drug detection dogs at music festivals, and needle and syringe programmes in prisons. Later it gave in-principle support to 86 of the recommendations.

Will the Summit achieve?

The hopes of the drug and alcohol sector are for easy access to naloxone (antidote to opiates), supervised drug-taking services, accessible sites for drug-checking, early surveillance on trends, better access to now available effective treatments, for the treatment of prisoners to equal that for all citizens, and a more equitable distribution of treatment and rehabilitation services across the state, and to ‘at-risk’ population groups.

Success will depend on the practicality of the recommendations and the preparedness of government to act on them in good faith.

It is trite to say, but this depends on political will. The will was strong in the earlier national Drug Summit (1985) and NSW Drug Summit (1999). But so far, Government responses to the Ice Inquiry have been late and weak-willed which does not bode well for the delivery of needed reforms.

There is now a Labor Government, also tardy in its response. It remains to be seen whether NSW Labor has the stomach to overturn past prejudicial stances on drug use and addiction, and whether it will put sufficient funds to this under-funded and stigmatised social and health problem.

What will not be achieved

The Summit and its outcome cannot attack the real drivers of drug problems – the incessant search by humankind for mind altering substances, the mysteries of addiction, and the abysmal treatment of people in unremitting pain.

The root causes of drug problems are socially determined. Action at this level will require an unimaginable upheaval of society and government. In western countries drug overdoses (including alcohol overdoses), suicide, and alcoholic liver disease, are regarded as ‘diseases of despair’. The desperation and despair which pervades vulnerable, and not so vulnerable, population groups, is the underground of drug use problems here and in other countries. Commissioner Howard said, we [society] are given “tacit permission to turn a blind eye on the factors driving the most problematic drug use: trauma, childhood abuse, domestic violence, unemployment, homelessness, dispossession, entrenched social disadvantage, mental illness, loneliness, despair and many other marginalising circumstances that attend the human condition.”

Somehow a better balance must be struck for law enforcement between the war on traffickers and the human rights of users. It is for the rest of us to treat drug using people as our fellow citizens.

Kind Regards

Herschel Baker

Source: Drug Free Australia

Filed under: Addiction,Alcohol,Australia,Cannabis/Marijuana,Cocaine,Drug use-various effects,Effects of Drugs,Health,Mental Health,Prevalence,Prevention and Intervention,Social Affairs :

(Spectrum News/Vania Patino)

By Vania Patino Los Angeles

Sep. 02, 2024

LOS ANGELES — Facing peer pressure can be hard, but teens at the Boys and Girls Club in Monterey Park are learning to say no to drugs and alcohol together.

What You Need To Know

- The Boys and Girls Club in Monterey Park offers a drug and alcohol prevention program for youth called Brent’s Club

- Participants are drug tested at random every week and rewarded through activities, trips and scholarships for saying no to drugs

- Earlier this year, a group of students traveled to Washington D.C to participate at the Boys & Girls Clubs of America’s Summit for America’s Youth

- The students were able to speak with elected officials about the need for continued funding toward drug prevention resources

Victoria Perez is one of the high school students who chooses to spend her afternoons at the Brent’s Club chapter offered at the Boys and Girls Club.

“I thought maybe it would just be lessons of drug and alcohol awareness, but it just it’s so much bigger than that,” Perez said.

Perez and the other participants soon realized they were not just gaining knowledge about the dangers of drugs, but were also being rewarded for actively taking those lessons into their daily decision making.

The program takes their commitment to staying drug free serious, and it’s why every week participants are drug tested at random.

So far, director of the Brent’s Club, Angel Silva, says they have not had any test results come back positive.

The deal is that those who remain drug free are rewarded through field trips, activities and also become eligible for a full four-year scholarship or partial renewable scholarships.

“Like our Maui trip that we do every summer, where we go, and we do a service project on the island of Maui,” Silva said.

The approach was designed by the Brent Shapiro Foundation, which was created by Brent’s parents after losing their son to addiction. The hope was to prevent this from happening to any other families and help reduce the risks of falling into substance abuse among youth.

This year, some participants created the TLC or Think, Lead, Create Change mental health project to advocate for continued funding toward drug use prevention, treatment and recovery resources.

Perez was one of the participants and, along with her team, was able to attend the Boys & Girls Clubs of America’s Summit for America’s Youth in Washington, D.C.

This was the first time flying for many of the participants and the first time at D.C. for all the students.

It’s experiences like those that Silva says these students would otherwise not have access to without the program.

Perez says it took a lot of preparing and researching to create the project, but was all worth it when they were able to present it to elected officials and share why this cause means so much to them.

“It was such an amazing opportunity, especially for advocating for not just alcohol and drug abuse, but for mental health and how those things merge together,” Perez said.

The advocacy and awareness the students are helping create comes as a time when fentanyl continues to be the most common cause of accidental drug overdose deaths in Los Angeles County.

“We were learning and teaching at the same time very much, because we thought we knew everything about fentanyl, but it decided to change the whole game,” Silva said.

Although, it can be tough to keep up, he says the ever-changing substance landscape makes their efforts that much more important.

Something Perez’s mother, Monica Vargas, agrees with and why she says the program has given her a peace of mind although the idea was jarring at first.

“It was a little shocking because where I come from, I’m a first generation, so we tend to come sometimes from very close or conservative families. So we think out of sight, out of mind. We don’t talk about it,” Vargas said.

However, she knew it was important for parents to communicate with their children, and this program was the perfect way to do it.

“If those additional incentives help, especially with so much pressure out there for these teens, by all means, I’m all for it. I’m 100% for it,” Vargas said.

Along with the incentives, Silva says the students have also become each other’s support system, which itself is a way to reduce the risk of substance abuse among youth.

“That’s the great part. You know, it’s not just within the clubhouse, they all go to the same school, and they hold each other accountable,” Silva said.

Source: https://spectrumnews1.com/ca/southern-california/health/2024/09/02/teens–drug-and-alcohol-prevention-

Filed under: Addiction,Alcohol,Drug use-various effects,Education,Fentanyl,Prevention and Intervention,USA,Youth :

Posted By: Staff September 9, 2024

By Marcel Gemme

September is National Suicide Prevention Month. During this month, prevention organizations, survivors, mental health advocates, and community members unite to promote suicide prevention and awareness.

One important aspect of suicide prevention is recognizing the connection between substance use and suicide. Drug addiction prevention campaigns are always working hand-in-hand with suicide prevention campaigns in local communities.

Drug and alcohol addiction, such as alcohol and opioid use disorders, for example, significantly increases the risk of suicidal ideation, attempts, and death. These are generally the two most implicated substances in suicide risk.

The risk of suicidal thoughts and behavior is elevated with acute alcohol intoxication and chronic alcohol use or dependence. The same applies to opioid use, as it can increase the risk of suicide and unintentional overdose caused by opioids alone or polysubstance use.

According to the American Foundation for Suicide Prevention, suicide is the 9^th leading cause of death in Arizona. It is the second leading cause of death among those aged 10 to 34 in the state. Unfortunately, 91% of communities in Arizona did not have enough mental health providers to serve residents in 2023. It’s estimated that almost four times as many people died by suicide in Arizona than in alcohol-related motor vehicle accidents.

Fortunately, prevention campaigns work and increase awareness surrounding substance use and suicide. Anyone can take action today by knowing simple things, such as dialing 988 for the Suicide and Crisis Lifeline, a 24-7 free and confidential support for people in distress.

Locally, there is an Arizona Statewide Crisis Hotline, where anyone can phone 1-844-534-HOPE(4673) or text 4HOPE(44673).

We must all work to change the conversation from suicide to suicide prevention. There are actions that anyone can take to help and give hope to those who are struggling. Consider some of the following pointers.

Ask, do not beat around the bush, but ask that person how they are doing and if they are thinking about suicide. Acknowledging and talking about suicide reduces suicidal ideation. Be there for that person, and they will feel less depressed, less suicidal, and less overwhelmed.

Keep them safe and help them stay connected. When lethal means are made less available or less deadly, the frequency and risks of suicide decline. Moreover, the hopelessness subsides when you help that person create a support network of resources and individuals.

Most importantly, maintain contact, follow up, and see them in person as frequently as possible. This is a critical part of suicide prevention, along with always learning more about prevention and awareness.

However, this process is not bulletproof, and we must recognize there are countless instances of individuals taking their lives and giving no indication or red flag they were suicidal. But if we can keep changing the conversation, breaking down the walls of stigma, and making the resources accessible, more people may ask for help before it is too late.

Marcel Gemme is the founder of SUPE and has been helping people struggling with substance use for over 20 years. His work focuses on a threefold approach: education, prevention, and rehabilitation.

Source: https://gilavalleycentral.net/suicide-prevention-is-an-important-part-of-drug-education/

Filed under: Addiction,Alcohol,Drug use-various effects,Mental Health,USA :

Past-year use of cannabis and hallucinogens stayed at historically high levels in 2023 among adults aged 19 to 30 and 35 to 50, according to the latest findings from the Monitoring the Future survey. In contrast, past-year use of cigarettes remained at historically low levels in both adult groups. Past-month and daily alcohol use continued a decade-long decline among those 19 to 30 years old, with binge drinking reaching all-time lows. However, among 35- to 50-year-olds, the prevalence of binge drinking in 2023 increased from five and 10 years ago. The Monitoring the Future study is conducted by scientists at the University of Michigan’s Institute for Social Research, Ann Arbor, and is funded by the National Institutes of Health.

Source: https://monitoringthefuture.org/

Filed under: Addiction,Alcohol,Cannabis/Marijuana,USA :

by Zachary Pottle |- Addiction Center

Remaining Sober In College

With August underway, many college students will be heading back to campuses across the country for another school year. For many, college is an exciting experience where young adults can learn, make friends, grow into their own, and of course attend the occasional party. However, for some students, returning to campus can present a host of challenges, especially those in recovery who may be worried about maintaining their sobriety.

It’s no secret college students experiment with substances. Now more than ever, college campuses are filled with drugs and alcohol. According to the 2023 National Survey on Drug Use and Health (NSDUH), 45.3% of male and 48.5% of female full-time college students ages 18 to 22 drank alcohol in the past month. Additionally, roughly 40% of both male and female college students said they had tried an illicit substance within the past year; with the most common being marijuana, cocaine, hallucinogens, and prescription drugs.

If you’re a student dealing with addiction, you might worry about being pressured to use drugs, attend parties where alcohol is prevalent, or spend time with people who engage in substance use. However, college doesn’t have to be overwhelming. By taking proactive steps to avoid substance use temptations, you can still enjoy your college experience.

Tips For Staying Sober On Campus

For students who are entering back into the college space after receiving treatment or in the earlier stages of recovery, campuses can be a stressful environment. Learning how to guard your sobriety while in environments ripe with drug and alcohol use can be hard, but fortunately many colleges have resources available to help keep you sober and engaged with your peers.

Avoid Popular “Party” Spots

While it likely goes without saying, avoiding places where drugs and alcohol are likely to be present is one of the best ways to stay sober in college. Many colleges have places that are synonymous with these types of activities; like popular local bars, fraternity or sorority houses, and other similar spaces. If you know that exposure to drugs or alcohol may trigger cravings or put your sobriety at risk, avoiding these spaces is key.

However, avoiding these places doesn’t mean that you have to have a “boring” college experience. For every bar or nightclub there’s an equal amount of spaces where social gatherings happen free of drugs and alcohol. Libraries, activity centers, sports facilities, and other places on campus are all great for avoiding triggers while also being a part of campus life.

Join A Club Or Campus Organization

While Greek life organizations are often associated with drug and alcohol use, many are involved in campus life and hold fundraisers, events, and other activities for all students on campus. Joining a fraternity or sorority can also be a great way to meet and connect with others, especially groups that focus on campus life and academic performance.

Many colleges also have a plethora of clubs and organizations for students to join. These include groups like student government, intramural sports, arts clubs, cultural clubs, and community service groups. Joining a group is a great way to stay involved with campus life while remaining sober.

Start An Exercise Routine

One of the most beneficial things you can do for your health is to exercise. Exercise can be especially helpful for those struggling with cravings or mental health conditions like anxiety or depression, both of which can be common for young adults struggling with their sobriety. Research shows that people who exercise regularly have better mental health and emotional wellbeing, and lower rates of mental illness.

Exercise doesn’t have to be strenuous or take a long time. Studies show low or moderate intensity exercise is enough to make a difference in terms of your mood and thinking patterns. The Centers for Disease Control and Prevention (CDC) recommends young adults aged 18-25 engage in 150 minutes of moderate-intensity physical activity a week. This can also be 75 minutes of vigorous-intensity or an equivalent combination of moderate- and vigorous-intensity physical activity. For additional benefits, the CDC recommends an extra two days of muscle-strengthening each week.

Utilize Campus Resources

Safeguarding your sobriety can be difficult, especially when your mental health is lacking. Without proper mental health care, depression, anxiety, stress or other mental health concerns can lead even the strongest of those in recovery into relapse. As our understanding of the importance of mental health has increased over the years, so too has our access to mental health care across the country.

Many colleges, especially larger state-sponsored schools with large student bodies, have counseling and other psychological services free of charge for enrolled students. Colleges that offer these types of services typically do so either online or in-person, and usually operate on a scheduling basis. If you’re unsure about whether or not your college offers counseling services, contact your admissions office or campus resource center to find out more.

Additional Resources For College Students In Recovery

While counseling services and campus organizations can both be beneficial to students in recovery, the reality is that many people experience relapses. Studies show that between 40 to 60 percent of individuals in treatment for substance abuse will relapse. It’s important to remember; however, that a relapse is not a sign of failure. Rather, relapses are a part of the recovery process.

Relapses can be a slight “bump in the road” for some, while for others relapses may require a bit of extra help to get them back on track. Treating chronic diseases requires changing long-established behaviors, and relapse doesn’t signify failure. When someone in recovery from addiction relapses, it’s a sign that they should consult their doctor to restart treatment, adjust it, or explore other options.

For students who may need extra resources, services like outpatient rehab may be a viable option to help keep you in school while also addressing relapse concerns. Outpatient programs provide young adults with the flexibility to receive treatment for part of the day while returning to campus each night. These programs vary, including day programs, intensive outpatient programs (IOP), and continued care. An addiction specialist can help determine which option best suits your needs.

Finding Help

Addiction is often seen by many as a lifelong disease; one that requires constant dedication, mindfulness, and strength. You should never be ashamed of needing support, regardless of how much or how frequent it is. If you’re struggling to stay sober, reaching out for help is always better than sacrificing your hard-earned sobriety. For additional resources and support, contact a treatment provider today to learn about your options.

Source: https://www.addictioncenter.com/community/stay-sober-college/

Filed under: Alcohol,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Education,Prevention and Intervention,USA,Youth :

Written by Ania Wellere, Master of Public Health Candidate, UNC Gillings School of Global Public Health.

As many know, drinking alcohol in a licensed premise under the age of 18 is against the law in the UK, however those aged 16 or 17 and accompanied by an adult can drink but not buy beer, wine, or cider with a meal. However, with relatively high alcohol use among children and young people in the UK, is the flexibility of this law one of many factors contributing to heavy episodic drinking among this population?

Youth drinking

According to Truque et al. (2023), 25% of adolescents in Europe begin to consume alcohol as early as the age of 13, and depending on region and gender, the prevalence of weekly alcohol consumption from adolescents is anywhere from 2%-33%. In 2021, NHS England found that the proportion of 15-year-olds who reported drinking at least once a month was 36%, with 14% saying at least weekly. Specifically in England, the World Health Organization found that the proportion of 13-year-olds who had consumed alcohol was far higher than the Health Behaviour in School-aged Children (HBSC) average – which covers 44 countries – and in Scotland and Wales.

Several factors influence children and young people’s alcohol use. One of the primary reasons young people give for why they drink at a young age is because of their peers. Drinking interest stems from failure to miss out, pressure to drink, and an attempt to improve their social status.

There are also some non-consensual factors, particularly outdoor advertising, but also advertising in magazines and television, that could be fuelling underage drinking because of its appeal to younger audiences. Children and young people do not ask to be exposed to these advertisements, and they cannot always filter the advertisements that they see through these mediums.

Despite regulatory efforts and codes that have been in place to protect children from alcohol marketing, researchers believe that attempts to protect children through the regulatory system and codes are failing. Several councils across the UK have taken the initiative to establish local policies that restrict advertisements of unhealthy commodities, including alcohol. If more local authorities follow suit in creating policies to restrict alcohol advertising, it would protect children and young people from exposure and potential alcohol-related harms.

Effect on the adolescent brain

Although youth drinking is slowly decreasing across the UK, heavy episodic drinking and its health impact is still a concern amongst adolescents, especially the effect alcohol has on the adolescent brain. Research on the effect alcohol has on the adolescent brain is limited. Research has typically focused on the impact alcohol has on the adult brain and the relationship between alcohol dependence and increased risk of dementia and other chronic diseases.

Before diving into the specific impact alcohol has on adolescent brains, it is important to lay out the process of how alcohol even travels through the body. So envision this: you take your first sip, and the alcohol makes its way through the stomach and into your bloodstream through the walls of your small intestine, where the blood will take the alcohol throughout the rest of your body. Alcohol then makes its way quickly to your brain, kidneys, lungs, and liver via the bloodstream. The way these parts of the body act is also contingent on the amount of alcohol that is in the bloodstream. For the brain, alcohol can impact your thought processes, emotions, memory, and coordination.

For an adolescent, alcohol moves through the body and breaks down slower than other age groups. The brains of adolescents have an increased likelihood of being negatively impacted compared to adult brains, according to the National Institute on Alcohol Abuse and Alcoholism. For young heavy episodic drinkers, brain development, structure, and function could possibly be altered compared to young non-heavy episodic drinkers, as seen through neuroimaging.

This impact on the brain has been noted to significantly affect the executive function of the adolescent brain. Executive function is defined as the mental processes that help an individual set and carry out their goals. Scientific evidence shows that weakened executive functions cause young people to make more errors and struggle with their shifting abilities (i.e., the ability to adapt). In the long run, this can follow young heavy episodic drinkers to adulthood.

In more technical terms, adolescent heavy episodic drinking is associated with a greater risk of reductions in grey matter during adolescence and disrupts white matter integrity, impacting neurocognitive functioning, according to Chikritzhs et al. (2024). In simple terms, the brain’s grey matter that helps individuals control movement, memory, and emotions is reduced, and white matter that allows the brain to exchange information and gives the ability to concentrate and learn is disrupted.

With these types of tissues being impacted by alcohol at a young age, there is research that has highlighted some of the risk factors that have come to disturb the lives of young heavy episodic drinkers when they become adults. A study including about 488,000 Swedish men found that heavy episodic drinking in adolescence was one of the strongest risk factors for developing early-onset dementia in adulthood.

As adolescence is a critical phase of development, more protective measures are put in place to reduce alcohol use among adolescents and, as a result, reduce alcohol-related harm to their brains. These protective measures usually include regulation of youth’s access to alcohol and alcohol advertising.

As we know, alcohol marketing is causally linked to young people drinking more and at an earlier age, and much of this marketing is non-consensual. To protect children’s rights, ‘the state must do all it can, through passing legislation and creating administrative systems, to promote and protect children’s rights’, according to the United Nations Convention on the Rights of the Child.

The brain is a vital organ to the body, and adolescent brain health is critical. With alcohol being accessible to children and young people in the UK, a ban on alcohol marketing should be taken into consideration. In addition, the normalisation of alcohol use among young people has to be put to an end, and that may start in the home with parents reshaping how they communicate alcohol use with their children and not encouraging drinking behaviour. Furthermore, future research should look at the differences between light to moderate and heavy drinking among adolescents to see if the effects on the brain are drastically different.

Source: https://www.ias.org.uk/2024/08/01/alcohol-and-its-impact-on-the-adolescent-brain/

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth,Europe,Prevalence,Youth :

Tuesday, July 30, 2024

Today, the U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of the 2023 National Survey on Drug Use and Health (NSDUH), which shows how people living in United States reported their experience with mental health conditions, substance use and pursuit of treatment. The 2023 NSDUH report includes selected estimates by race, ethnicity and age group. The report is accompanied by two infographics offering visually packaged highlight data as well as visual data by race and ethnicity.

“Each year, data from the annual NSDUH provides an opportunity to identify and address unmet healthcare needs across America. We’re pleased to see that more people received mental health treatment in 2023 than the previous year,” said Miriam E. Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA. “Also, to build upon increasing accessibility to data, this year’s release features two infographic reports: one focusing on race and ethnicity and one highlighting selected overall data.”

The 2023 NSDUH Report includes the following selected key findings.

Mental Health:

Among adults aged 18 or older in 2023, 22.8% (or 58.7 million people) had any mental illness (AMI) in the past year.
4.5 million youth (ages 12 to 17) had a major depressive episode in the past year, of which nearly 1 in 5 also had a substance use disorder.
Among adults aged 18 or older in 2023, 5.0% (or 12.8 million people) had serious thoughts of suicide, 1.4% (or 3.7 million people) made a suicide plan, and 0.6% (or 1.5 million people) attempted suicide in the past year.
Multiracial adults aged 18 or older were more likely than adults in most other racial or ethnic groups to have AMI, serious mental illness (SMI), and serious thoughts of suicide.
Estimates of suicidal thoughts and behaviors among adults in 2023 were comparable to 2022 and 2021.

Substance Use:

In 2023, 3.1% of people (8.9 million) misused opioids in the past year, which is similar to 2022 and 2021 (3.2% and 8.9 million, 3.4% and 9.4 million respectively).
Among the 134.7 million people aged 12 or older who currently used alcohol in 2023, 61.4 million people (or 45.6%) had engaged in binge drinking in the past month.
Marijuana was the most commonly used illicit drug, with 21.8% of people aged 12 or older (or 61.8 million people) using it in the past year.
American Indian or Alaska Native and Multiracial people were more likely than most other racial or ethnic groups to have used substances or to have had an SUD in the past year.
In 2023, 9.4% of people aged 12 or older vaped nicotine in the past month, up from 8.3% in 2022.
- In the past year, more people initiated vaping (5.9 million people) compared to any other substance.
- Nicotine vaping estimates from 2021 are not comparable with estimates from 2022 and 2023.

Services and Recovery:

31.9% of adolescents aged 12 to 17 (or 8.3 million people) received mental health treatment in the past year, an increase of more than 500,000 from 2022.
23.0% of adults aged 18 or older (or 59.2 million people) received mental health treatment in the past year, an increase of 3.4 million from 2022.
Among people aged 12 or older in 2023 who were classified as needing substance use treatment in the past year, about 1 in 4 (23.6% or 12.8 million people) received substance use treatment in the past year. People were classified as needing substance use treatment in the past year if they had a substance use disorder (SUD) or received substance use treatment in the past year.
30.5 million adults aged 18 or older (or 12.0%) perceived that they ever had a substance use problem. Among these adults, 73.1% (or 22.2 million people) considered themselves to be in recovery or to have recovered.
64.4 million adults aged 18 or older (or 25.3%) perceived that they ever had a mental health issue. Among these adults, 66.6% (or 42.7 million people) considered themselves to be in recovery or to have recovered.
There were no racial ethnic differences among adults aged 18 or older in 2023 who perceived that they ever had a substance use problem or problem with their mental health who considered themselves to be in recovery or to have recovered from their drug or alcohol use problem or mental health issue.

About the National Survey on Drug Use and Health

Conducted by the federal government since 1971, the NSDUH is a primary source of statistical information on self-reported substance use and mental health of the U.S. civilian, noninstitutionalized population 12 or older. For the 2023 NSDUH national tables and some reports, statistical testing was conducted between estimates from different years (e.g., past month alcohol use in 2023 vs. the estimate in 2022). Where testing involved 3 years of comparable data for 2021 to 2023, pairwise testing was conducted between estimates in these years (i.e., 2021 vs. 2022, 2021 vs. 2023, and 2022 vs. 2023). Statistical tests for overall trends from the baseline year to the current year will not be conducted until four comparable NSDUH data points are available. The NSDUH measures include:

Use of illegal drugs, prescription drugs, alcohol, and tobacco,
Substance use disorder and substance use treatment,
Major depressive episodes, suicidal thoughts and behaviors, and other symptoms of mental illness, mental health care, and
Recovery from substance use and mental health disorders.

Addressing the nation’s mental health crisis and drug overdose epidemic is a top priority of the Biden-Harris Administration and are core pillars of the Administration’s Unity Agenda. The President’s Unity Agenda is operationalized through the HHS Overdose Prevention Strategy, the HHS Roadmap for Behavioral Health Integration, and the National Strategy for Suicide Prevention.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. To learn how to get support for mental health, drug or alcohol issues, visit FindSupport.gov. If ready to locate a treatment facility or provider, go directly to FindTreatment.gov or call 800-662-HELP (4357).

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

Last Updated: 07/30/2024

Source: https://www.samhsa.gov/newsroom/press-announcements/20240730/samhsa-releases-annual-national-survey-drug-use-and-health

Filed under: Addiction,Alcohol,Cannabis/Marijuana,Cocaine,Heroin/Methadone,Mental Health,Treatment and Addiction,USA :

By Lauraine Langreo, Staff Writer, Education Week — August 28, 2024

There have been “promising” declines in high school students’ overall use of illicit substances, concludes a report from the federal Centers for Disease Control and Prevention.

Since 2013, the percentage of students who reported drinking alcohol, using marijuana, or using select illicit drugs at any point has decreased. Since 2017 and 2019, respectively, the percentage of students who had ever misused or currently are misusing prescription opioids decreased, according to the CDC’s Youth Risk Behavior Survey.

That survey draws on data collected every two years among a nationally representative sample of U.S. high school students. The 2023 survey had more than 20,000 respondents and was conducted in the spring.

The findings come as schools continue to face challenges in curbing students’ substance abuse, which could negatively affect learning, memory, and attention, according to experts. It could also be a sign of mental health challenges.

___________________________________________________________________________________________________________

Teen substance use

Percentage of high school students who ...

*Question introduced in 2017.
**Question introduced in 2019.

DATA SOURCE: CDC

____________________________________________________________________________

While student substance abuse isn’t a new challenge for school districts, the substances that adolescents are experimenting with now are much more dangerous, said Darrell Sampson, the executive director of student services for the Arlington public schools in Virginia.

“It’s not necessarily that more kids are using substances than in prior years,” Sampson said. “It’s the lethality of the substance itself that has caused higher levels of concern.”

Research has shown rising overdose deaths among teens even as their substance use is declining. Those deaths have been linked to the increase in illicit fentanyl and other synthetic opioids. School districts have been pursuing several strands of legal action against companies that manufactured and marketed addictive opioids that have led to tens of thousands of deaths and countless more addiction struggles in the last two decades.

Beyond the legal actions, schools also continue to provide prevention and education programming for students and families, Sampson said. There’s “a glimmer of hope” that those measures are working, he said, based on the declines in the CDC data.

Experts recommend starting education about substance abuse as early as possible

In the Arlington, Va., district, students in grades 6 through 10 learn about substance abuse challenges as part of the health curriculum, Sampson said. The district has also slowly expanded that program to 5th and 4th grades and are looking into whether there’s capacity to start that education as early as 3rd grade.

“We know that the more we can at least open that conversation with our families and our students, the better off our students are going to be,” Sampson said. “It’s not just a message [they’re hearing] starting in middle school, but it’s a message [they’re hearing] over time.”

The district is expanding programming with 11th and 12th graders, too, because the information they got when they were in 10th grade could be outdated by then, Sampson said.

In addition, the district has substance abuse counselors who meet with students and try to explore the reasons they might be using substances, Sampson said.

Teens are more than twice as likely to go to their friends or peers for help or support when experiencing distress from their substance use than they are to go to a behavioral health provider or a family member, according to a survey from the Bipartisan Policy Center conducted in June among 932 teens (13- to 17-year-olds) and 1,062 young adults (18- to 26-year-olds). More than a quarter of teens said they didn’t go to anyone for help or support when they experienced distress from substance use.

Sophie Szew, a junior at Stanford University and the Bipartisan Policy Center’s mental health and substance use task force youth adviser, said those survey results “really underscore the importance of investing in those peer support networks and resources.”

______________________________________________________________________________________________

Teenagers who have experienced distress from substance use

Who have teens gone to for help/support when experiencing distress from substance use?

Category Percent

Friend/peer 43

Behavioural health provider 19

Parent, care givers, other family members 18

Primary care provider 9

Religious/spiritual leader 9

School counsellor 8

Teacher 6

Coach/mentor 6

Crisis services (988, crisis text line) 5

Virtual app or website services 4

Other adult n the community 8

Other 2

No one 27

____________________________________________________________________________

Source: https://www.edweek.org/leadership/teen-substance-use-is-declining-but-more-dangerous-drug-abuse-is-emerging/2024/08

Filed under: Alcohol,Drug use-various effects,Education,Prevalence,USA,Youth :

More than 178 000 people died from excessive alcohol use in the US during 2020 to 2021, surpassing deaths from the overdose epidemic.¹ Excessive drinking is now the leading cause of preventable death in the US.¹ Alcohol use disorder (AUD) most commonly begins during adolescence, although rarely is it identified and treated at this age.² We urgently need interventions that allow us to better identify those young people at risk of developing AUD and alcohol-related complications later in adulthood. In their study of alcohol use among youths with a chronic medical condition (CMC), Weitzman et al³ describe a novel approach for alcohol prevention in a population of youths with medical vulnerability. Youths with a CMC are particularly susceptible to the effects of alcohol and warrant particular attention. Although the rate of alcohol use among these youths is similar to that of their peers, youths with a CMC have higher rates of progression to heavy alcohol use and AUD.⁴ Weitzman et al³ found that high-risk alcohol use occurred in more than 1 of 10 youths (aged 14-18 years) with a CMC seen in the specialty clinics included in their study. These youths also have an increased risk of treatment nonadherence and potential medication reactions with alcohol as a result of the underlying disease, worsening the potential effects of high-risk alcohol exposure in this population.⁴

Given these disparities, Weitzman et al³ designed a randomized clinical trial aimed at evaluating the effects of the Take Good Care (TGC) alcohol use prevention intervention over 12 months among youths with a CMC. In the specialty clinic setting, youths in the intervention group received a brief, personalized intervention consisting of a self-administered slide deck on an electronic tablet. Slides were disease tailored, and they included specific effects of alcohol use on disease processes, treatment safety, and efficacy as well as motivational information on health-protecting decisions and behaviors. Although there was no change among youths reporting no or minimal (low-risk) alcohol use, there was a 40% relative reduction in self-reported frequency of alcohol use among those receiving the TGC intervention who reported high-risk alcohol use at baseline compared with those who received treatment as usual.

The study by Weitzman et al³ highlights the potential importance of brief interventions in changing youth behavior, particularly among a group of youths who are medically vulnerable. Although a shocking 11.5% of youths with a CMC in this study reported high-risk alcohol use at baseline, nationally only a quarter of pediatricians report using validated screening tools to assess alcohol use among adolescents and only 11% of pediatricians correctly use the Screening, Brief Intervention, and Referral to Treatment (SBIRT) tool recommended by the American Academy of Pediatrics.⁵ Despite growing evidence supporting the benefit of SBIRT for pediatric populations, barriers to implementation include insufficient time and need for clinician training⁵; both of these barriers are ameliorated with the use of the self-administered, electronic intervention described by Weitzman et al.³ This study adds to the growing database highlighting the effectiveness of SBIRT in identifying and intervening in instances of substance use among youths. It presents a tool easily adopted by clinicians, with an impact on those youths at greatest risk of developing problematic alcohol use.

Considering the prevalence of alcohol use among youths with CMCs, an important aspect of the study by Weitzman et al³ is its low-touch intervention that can be easily adapted and implemented in a variety of clinical settings. Weitzman et al³ show the value of even simple, low-touch interventions in changing youth behavior. From the patient perspective, the use of an electronic tablet enhances privacy when answering questions and allows for flexibility in time spent on each piece of content. From the clinician perspective, the use of an electronic tablet requires minimal additional effort or training, standardizes the content provided, and allows for intervention completion outside of face-to-face appointment time. Yet despite its simplicity, the low-touch TGC intervention has been shown to exert a substantial effect on adolescent behavior. At 12 months, the reduction in alcohol use frequency among youths with a CMC and high-risk alcohol use represents not only a meaningful behavioral change but also an enduring one.

In contrast with traditional fear-based messages around alcohol prevention, Weitzman et al³ demonstrate the impact of a strengths-based model that engages the normal adolescent quest for independence and the examination of choice in larger contexts. The TGC intervention educated youths with a CMC on disease-specific processes, treatments, and effects of alcohol, thereby encouraging reflection around alcohol-related choices. In presenting this information for youths to consider, the intervention relayed respect for patients’ ability to engage in their own health care and health behaviors. Additionally, disease-tailored content paired with motivational information on health-protecting behaviors encouraged patients’ sense of autonomy and independence. The statistically significant effects of this approach suggest that personalized intervention resonates with youths with CMCs and is an effective tool for behavioral change. Furthermore, this delivery model allows for content to be tailored based on disease or other aspects of youths’ lived experience. Content adjusted to the needs of specific subpopulations of youths creates interventions that they connect with and are thus most greatly affected by, in both depth and longevity of impact.

Finally, key to the study by Weitzman et al³ is the intervention location; utilization of the specialty care setting for an alcohol use prevention intervention is novel and effective. Many youths with a CMC receive the majority of their care in the specialty care setting and, accordingly, often develop stronger therapeutic relationships with their specialty care physician than their primary care physician. In 41.3% of visits to their specialists, youths with a CMC present for routine preventative care,⁶ yet specialists screen for substance use at alarmingly low rates compared with their primary care counterparts (self-reported 8% vs 38%, respectively).⁷ Interventions within the specialty clinic space allow for greater potential to reach more youths with CMCs at critical moments in their health journeys, thereby curbing heavy alcohol use, its associated medication nonadherence, and potential interaction with medications. By doing so, this method of intervention may decrease disease-associated complications and mortality in addition to alcohol-associated complications and mortality among youths with CMCs, and by extension, the adults that they become. The TGC intervention and its broader application represent an exciting new paradigm for future practice.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820973 July 2024

Filed under: Alcohol,Brain and Behaviour,Prevention and Intervention,Youth :

It seems as if every community, big or small, has been impacted by the problems associated with substance use and drug overdose. Within communities, these problems can extend into the family unit, with people often becoming addicted and dying because of drugs.

However, community drug education and prevention programs can be a first line of defense. There is hope for the younger generations as they have more access to prevention and education resources to help them make informed decisions. In addition, more information is available for parents to equip them with the tools to help their kids understand the dangers and risks associated with drugs and alcohol.

In California, the California Department of Education offers information on resources for health services, student assistance programs and alcohol and substance abuse prevention. The California School-Based Health Alliance provides school-based health centers and wellness centers to prevent and treat substance use.

Fortunately, more and more people are seeking treatment. According to the California Health Care Almanac, between 2017 and 2019, the number of facilities offering residential care for substance use treatment grew by 68%, and the number of facilities offering hospital inpatient care more than doubled.

The more people who seek treatment and become aware of the dangers, the more people are saved from an overdose. According to drug abuse statistics, there is an average of 6,100 drug overdose deaths per year in the state. Overdose deaths increased at an annual rate of 10.37% over the last three years. However, this remains below the national average death rate.

Prevention and education information is valuable, especially during Fourth of July celebrations. Binge drinking around Independence Day is typical, and it is known as one of the heaviest drinking holidays of the year. In social settings, it becomes easy to consume too much alcohol, and this could potentially lead to other drug use.

Parents play an essential role when providing drug education. They can take the initiative to create an inclusive and supportive environment with their children. This can equip them with the tools they need to make knowledgeable decisions surrounding alcohol and drug use.

Teens and adults all use drugs and alcohol for different reasons. Much of their use is linked to peer pressure, whether from peers, in a social setting, or in the case of someone they look up to who they see drinking or using drugs.

Stress is also a common factor and alcohol or drugs can seem like an easy escape from the problems of life.

Additionally, environment and family history are contributing factors. Children, for example, who grow up in households with heavy drinking and recreational drug use are more likely to experiment with drugs.

Any parents wondering what to do should consider starting the conversation about alcohol and drug use early. It is also essential to be calm, loving and supportive. Seek out specialized resources, such as those offered by county or nonprofit organizations providing prevention and education.

Additionally, parents want to focus on making it safe for their children to tell them anything and never end the conversation, keeping it going regardless of age.

Local drug education resources are here to help with the goal of helping people of all ages make knowledgeable decisions about drugs and alcohol.

Jody Boulay is a mother of two with a passion for helping others. She currently works as a community outreach coordinator for DRS to help spread awareness of the dangers of drugs and alcohol. She can be reached at jboulay@addicted.org.

Source: https://eu.desertsun.com/story/opinion/contributors/valley-voice/2024/07/01/parents-talk-to-your-kids-about-drugs-and-alcohol/74233477007/

Filed under: Alcohol,Drug use-various effects,Parents,Social Affairs,USA,Youth :

Bertha Madras, a leading expert on weed, outlines the science linking it to psychiatric disorders, permanent brain damage, and other serious harms.

Young people who smoked marijuana in the 1960s were seen as part of the counterculture. Now the cannabis culture is mainstream. A 2022 survey sponsored by the National Institutes of Health found that 28.8% of Americans age 19 to 30 had used marijuana in the preceding 30 days—more than three times as many as smoked cigarettes. Among those 35 to 50, 17.3% had used weed in the previous month, versus 12.2% for cigarettes.

While marijuana use remains a federal crime, 24 states have legalized it and another 14 permit it for medical purposes. Last week media outlets reported that the Biden administration is moving to reclassify marijuana as a less dangerous Schedule III drug—on par with anabolic steroids and Tylenol with codeine— which would provide tax benefits and a financial boon to the pot industry.

Bertha Madras thinks this would be a colossal mistake. Ms. Madras, 81, is a psychobiology professor at Harvard Medical School and one of the foremost experts on marijuana. “It’s a political decision, not a scientific one,” she says. “And it’s a tragic one.” In 2024, that is a countercultural view.

Ms. Madras has spent 60 years studying drugs, starting with LSD when she was a graduate student at Allan Memorial Institute of Psychiatry, an affiliate of Montreal’s McGill University, in the 1960s. “I was interested in psychoactive drugs because I thought they could not only give us some insight into how the brain works, but also on how the brain undergoes dysfunction and disease states,” she says.

In 2015 the World Health Organization asked her to do a detailed review of cannabis and its medical uses. The 41-page report documented scant evidence of marijuana’s medicinal benefits and reams of research on its harms, from cognitive impairment and psychosis to car accidents.

She continued to study marijuana, including at the addiction neurobiology lab she directs at Mass General Brigham McLean Hospital. In a phone interview this week, she walked me through the scientific literature on marijuana, which runs counter to much of what Americans hear in the media.

For starters, she says, the “addiction potential of marijuana is as high or higher than some other drug,” especially for young people. About 30% of those who use cannabis have some degree of a use disorder. By comparison, only 13.5% of drinkers are estimated to be dependent on alcohol. Sure, alcohol can also cause harm if consumed in excess. But Ms. Madras sees several other distinctions.

One or two drinks will cause only mild inebriation, while “most people who use marijuana are using it to become intoxicated and to get high.” Academic outcomes and college completion rates for young people are much worse for those who use marijuana than for those who drink, though there’s a caveat: “It’s still a chicken and egg whether or not these kids are more susceptible to the effects of marijuana or they’re using marijuana for self medication or what have you.”

Marijuana and alcohol both interfere with driving, but with the former there are no medical “cutoff points” to determine whether it’s safe to get behind the wheel. As a result, prohibitions against driving under the influence are less likely to be enforced for people who are high. States where marijuana is legal have seen increases in car accidents.

One of the biggest differences between the two substances is how the body metabolizes them. A drink will clear your system within a couple of hours. “You may wake up after binge drinking in the morning with a headache, but the alcohol is gone.” By contrast, “marijuana just sits there and sits there and promotes brain adaptation.”

That’s worse than it sounds. “We always think of the brain as gray matter,” Ms. Madras says. “But the brain uses fat to insulate its electrical activity, so it has a massive amount of fat called white matter, which is fatty. And that’s where marijuana gets soaked up. . . . My lab showed unequivocally that blood levels and brain levels don’t correspond at all—that brain levels are much higher than blood levels. They’re two to three times higher, and they persist once blood levels go way down.” Even if people quit using pot, “it can persist in their brain for a while.”

Thus marijuana does more lasting damage to the brain than alcohol, especially at the high potencies being consumed today. Levels of THC—the main psychoactive ingredient in pot—are four or more times as high as they were 30 years ago. That heightens the risks, which range from anxiety and depression to impaired memory and cannabis hyperemesis syndrome—cycles of severe vomiting caused by long-term use.

There’s mounting evidence that cannabis can cause schizophrenia. A large-scale study last year that examined health histories of some 6.9 million Danes between 1972 and 2021 estimated that up to 30% of young men’s schizophrenia diagnoses could have been prevented had they not become dependent on pot. Marijuana is worse in this regard than many drugs usually perceived as more dangerous.

“Users of other potent recreational drugs develop chronic psychosis at much lower rates,” Ms. Madras says. When healthy volunteers in research experiments are given THC—as has been done in 15 studies—they develop transient symptoms of psychosis. “And if you treat them with an antipsychotic drug such as haloperidol, those symptoms will go away.”

Marijuana has also been associated with violent behavior, including in a study published this week in the International Journal of Drug Policy. Data from observational studies are inadequate to demonstrate causal relationships, but Ms. Madras says that the link between marijuana and schizophrenia fits all six criteria that scientists use to determine causality, including the strength of the association and its consistency.

Ms. Madras says at the beginning of the interview that she was operating on three hours of sleep after crashing on scientific projects. Yet she is impressively lucid and energized. She peppers her explanations with citations of studies and is generous in crediting other researchers’ work.

Another cause for concern, she notes, is that more pregnant women are using pot, which has been linked to increased preterm deliveries, admissions of newborns into neonatal intensive care units, lower birth weights and smaller head circumferences. THC crosses the placenta and mimics molecules that our bodies naturally produce that regulate brain development.

“What happens when you examine kids who have been exposed during that critical period?” Ms. Madras asks. During adolescence, she answers, they show an increased incidence of aggressive behavior, cognitive dysfunction, and symptoms of ADHD and obsessive-compulsive disorders. They have reduced white and gray matter.

A drug that carries so many serious side effects would be required by the Food and Drug Administration to carry a black-box warning, the highest-level alert for drugs with severe safety risks. Marijuana doesn’t—but only because the FDA hasn’t cleared it.

The agency has selectively approved cannabis compounds for the treatment of seizures associated with Lennox-Gastaut or Dravet syndrome, nausea associated with chemotherapy for cancer, and anorexia associated with weight loss in AIDS patients. But these approved products are prescribed at significantly less potent doses than the pot being sold in dispensaries that are legal under state law.

What about medicinal benefits? Ms. Madras says she has reviewed “every single case of therapeutic indication for marijuana—and there are over 100 now that people have claimed—and I frankly found that the only one that came close to having some evidence from randomized controlled trials was the neuropathic pain studies.” That’s “a very specific type of pain, which involves damage to nerve endings like in diabetes or where there’s poor blood supply,” she explains.

For other types of pain, and for all other conditions, there is no strong evidence from high-quality randomized trials to support its use. When researchers did a “challenge test on normal people where they induce pain and tried to see whether or not marijuana reduces the pain, it was ineffective.”

Ms. Madras sees parallels between the marketing of pot now and of opioids a few decades ago. “The benefits have been exaggerated, the risks have been minimized, and skeptics in the scientific community have been ignored,” she says. “The playbook is always to say it’s safe and effective and nonaddictive in people.”

Advocates of legalization assert that cannabis can’t be properly studied unless the federal government removes it from Schedule I. Bunk, Ms. Madras says: “I have been able to study THC in my research program.” It requires more paperwork, but “I did all the paperwork. . . . It’s not too difficult.”

Instead of bankrolling ballot initiatives to legalize pot, she says, George Soros and other wealthy donors who “catalyzed this whole movement” should be funding rigorous research: “If these folks, these billionaires, had just taken that money and put it into clinical trials, I would have been at peace.”

It’s a travesty, Ms. Madras adds, that the “FDA has decided that they’re going to listen to that movement rather than to what the science says.” While the reclassification wouldn’t make recreational marijuana legal under federal law, dispensaries and growers would be able to deduct their business expenses on their taxes. The rescheduling would also send a cultural signal that marijuana use is normal.

Ms. Madras worries that “it sets a precedent for the future.” She points to the movement in states to legalize psychedelic substances, for whose medicinal benefits there also isn’t strong scientific evidence. Meantime, she says it makes no sense that politicians continuously urge more spending on addiction treatment and harm reduction while weakening laws that prevent people from becoming addicted in the first place.
Her rejoinder to critics who say the war on drugs was a failure? “This is not a war on drugs. It’s a defense of the human brain at every possible age from in utero to old age.”

Ms. Finley is a member of the Journal’s editorial board.

Source: https://www.wsj.com/articles/what-you-arent-reading-about-marijuana-permanent-brain-damage-biden-schedule-iii-9660395e May 2024

Filed under: Addiction,Alcohol,Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Global Drug Legalisation Efforts,Health,Marijuana and Medicine :

By HealthDay Feb. 9, 2024, at 7:50 a.m.

By Ernie Mundell HealthDay Reporter

American teenagers cite stress as the leading reason they might get drunk or high, a new report reveals.

That only underscores the need for better adolescent mental health care, according to the research team behind the study.

Better “access to treatment and support for mental health concerns and stress could reduce some of the reported motivations for substance use,” concluded investigators from the U.S. Centers for Disease Control and Prevention.

In the study, a team led by CDC researcher Sarah Connolly looked at 2014-2020 data on over 9,500 people ages 13 to 18, all of who were being treated for a substance use disorder.

Teens were using a myriad of substances, including alcohol, marijuana, prescription painkillers (often opioids), prescription stimulants (for example, Ritalin), or prescription sedatives (such as Valium or Xanax).

The teens were also asked why they thought they were using or abusing substances. Easing stress in their lives was the leading factor cited.

“The most commonly reported motivation for substance use was “to feel mellow, calm, or relaxed” (73%), with other stress-related motivations among the top reasons, including “to stop worrying about a problem or to forget bad memories” (44%) and “to help with depression or anxiety” (40%),” Connolly’s team reported.

Stress relief wasn’t the only motivator, of course: Half of the teens reported using substances “to have fun or experiment.” This reason for using substances was more often cited for alcohol or nonprescription drug use than it was for the use of marijuana or other drugs.

Substance abuse with the aim of easing stress was most often cited for marijuana (76% of teens), prescription pain meds (61%) and sedatives/tranquilizers (55%), the study found.

Half of the teens surveyed said they often used drugs or alcohol alone, but 81% said they also used them with friends, a boyfriend or girlfriend (24%), or “anyone who has drugs” (23%).

According to the researchers, prior data has long shown that “anxiety and experiencing traumatic life events have been associated with substance use in adolescents.”

But with burgeoning rates of substance abuse and related overdoses, the consequences of turning to substances to ease stress can be tragic.

“Harm reduction education specifically tailored to adolescents has the potential to discourage using substances while alone and teach how to recognize and respond to an overdose in others,” the team said.

Such interventions might “prevent overdoses that occur when adolescents use drugs with friends from becoming fatal,” they added.

If you or a loved one is stressed by a mental health crisis, confidential 24/7 help is on hand at the 988 Suicide & Crisis Lifeline.

The findings were published in the Feb. 9 issue of the CDC journal Morbidity and Mortality Weekly Report.

More information

There’s tips to identifying stress in your teen at the American Psychological Association.

SOURCE: Morbidity and Mortality Weekly Report, Feb. 9, 2024

Tags: parenting, drug abuse, anxiety, stress, alcohol

Source: https://www.usnews.com/news/health-news/articles/2024-02-09/stress-main-factor-driving-teens-to-abuse-drugs-alcohol

Filed under: Alcohol,Parents,Prevalence,USA,Youth :

Abstract

We tested whether cannabinoids (CBs) potentiate alcohol-induced birth defects in mice and zebrafish, and explored the underlying pathogenic mechanisms on Sonic Hedgehog (Shh) signaling. The CBs, Δ⁹-THC, cannabidiol, HU-210, and CP 55,940 caused alcohol-like effects on craniofacial and brain development, phenocopying Shh mutations. Combined exposure to even low doses of alcohol with THC, HU-210, or CP 55,940 caused a greater incidence of birth defects, particularly of the eyes, than did either treatment alone. Consistent with the hypothesis that these defects are caused by deficient Shh, we found that CBs reduced Shh signaling by inhibiting Smoothened (Smo), while Shh mRNA or a CB1 receptor antagonist attenuated CB-induced birth defects. Proximity ligation experiments identified novel CB1-Smo heteromers, suggesting allosteric CB1-Smo interactions. In addition to raising concerns about the safety of cannabinoid and alcohol exposure during early embryonic development, this study establishes a novel link between two distinct signaling pathways and has widespread implications for development, as well as diseases such as addiction and cancer.

Source: https://www.nature.com/articles/s41598-019-52336-w November 2019

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth :

In 2017 Iceland received word-wide attention for having dramatically reversed the course of teenage substance use. From 1998 to 2018, the percentage of 15-16-year-old Icelandic youth who were drunk in the past 30 days declined from 42% to 5%; daily cigarette smoking dropped from 23% to 3%; and having used cannabis one or more times fell from 17% to 5%. The core elements of the model are: 1) long-term commitment by local communities; 2) emphasis on environmental rather than individual change; 3) perception of adolescents as social attributes. This presentation describes how the Iceland prevention model is built upon collaboration between policy makers, researchers, parent organizations, and youth practitioners. These groups have created a system whereby youth receive the necessary guidance and support to live fun and productive lives without reliance on psychoactive substances. The Model is being replicated in 35 municipalities within 17 countries around the globe. The Icelandic Model: Evidence Based Primary Prevention – 20 Years of Successful Primary Prevention Work was featured for the past two years at the Special Session of the United Nations General Assembly on the World Drug Problem.

Source: https://www.researchgate.net/publication/330347576_Perspective_Iceland_Succeeds_at_Preventing_Teenage_Substance_Use February 2019

Filed under: Alcohol,Cannabis/Marijuana,Methamphetamine/GHB/Hallucinogens/Oxycodone,Nicotine,Political Sector,Prevention and Intervention,Social Affairs,Youth :

US DRUG CZAR EXPLAINS CAUSES AND RSDT TOOL TO PREVENT TEEN DRUG USE AND OVERDOSE DEATH INTERVIEW WITH U.S. DRUG CZAR JOHN WALTERS

Introduction: In response to recent news of a huge increase in drug overdose deaths and arrests for drug trafficking among Fairfax County youths, Fox News TV5 reporter Sherri Ly interviewed U.S. Drug Czar John Walters for his expert views on the cause and potential cure for these horrific family tragedies. Following is a transcript of that half-hour interview with minor editing for clarity and emphasis added. The full original interview is available through the 11/26/08 Fox5 News broadcast video available at link:

WALTERS: Well, as this case shows, while we’ve had overall drug use go down, we still have too many young people losing their lives to drugs, either through overdoses, or addiction getting their lives off track. So there’s a danger. We’ve made progress, and we have tools in place that can help us make more progress, but we have to use them.

Q 1: You meet with some of these parents whose children have overdosed. What do they tell you, and what do you tell them?

WALTERS: It’s the hardest part of my job; meeting with parents who’ve lost a child. Obviously they would give anything to go back, and have a chance to pull that child back from the dangerous path they were on. There are no words that can ease their grief. That’s something you just pray that God can give them comfort. But the most striking thing they say to me though is they want other parents to know, to act. And I think this is a common thing that these terrible lessons should teach us.

Many times, unfortunately, parents see signs: a change in friends, sometimes they find drugs; sometimes they see their child must be intoxicated in some way or the other. Because it’s so frightening, because sometimes they’re ashamed – they hope it’s a phase, they hope it goes away – they try to take some half measures. Sometimes they confront their child, and their child tells them – as believably as they ever can – that it’s the first time. I think what we need help with is to tell people; one, it’s never the first time. The probability is low that parents would actually recognize these signs – even when it gets visible enough to them – because children that get involved in drugs do everything they can to hide it. It’s never the first time. It’s never the second time. Parents need to act, and they need to act quickly. And the sorrow of these grieving parents is, if anything, most frequently focused on telling other parents, “Don’t wait: do anything to get your child back from the drugs.”

Secondly, I think it’s important to remember that one of the forces that are at play here is that it’s their friends. It’s not some dark, off-putting stranger – it’s boyfriends, girlfriends. I think that was probably a factor in this case. And it’s also the power and addictive properties of the drug. So your love is now being tested, and the things you’ve given your child to live by are being pulled away from them on the basis of young love and some of the most addictive substances on earth. That’s why you have to act more strongly. You can’t count on the old forces to bring them back to safety and health.

Q 2: When we talk about heroin – which is what we saw in this Fairfax County drug ring, alleged drug ring – what are the risks, as far as heroin’s concerned? I understand it can be more lethal, because a lot of people don’t know what they’re dealing with?

WALTERS: Well it’s also more lethal because one, the drug obviously can produce cardiac and respiratory arrest. It’s a toxic substance that is very dangerous. It’s also the case that narcotics, like heroin – even painkillers like OxyContin, hydrocodone, which have also been a problem – are something that the human body gets used to. So what you can frequently get on the street is a purity that is really blended for people who are addicted and have been long time addicted. So a person who is a new user or a naïve user can more easily be overdosed, because the quantities are made for people whose bodies have adjusted to higher purities, and are seeking that effect that only the higher purity will give them in this circumstance. So it’s particularly dangerous for new users. But we also have to remember, it almost never starts with heroin. Heroin is the culmination here. I think some of the – and I’ve only seen press stories on this — some of these young people may have gotten involved as early as middle school.

We have tools so that we don’t have to lose another young woman like this– or young men. We now have the ability to use Random Student Drug Testing (RSDT) because the Supreme Court has, in the last five years, made a decision that says it can’t be used to punish. It’s used confidentially with parents. We have thousands of schools now doing it since the president announced the federal government’s willingness to fund these programs in 2004. And many schools are doing it on their own. Random testing can do for our children what it’s done in the military, what it’s done in the transportation safety industry– significantly reduce drug use.

First, it is a powerful reason not to start. “I get tested, I don’t have to start.” We have to remember, it’s for prevention and not a “gotcha!” But it’s a powerful reason for kids to say, even when a boyfriend or girlfriend says come and do this with me, “I can’t do it, I get tested. I still like you, I still want to be your friend; I still want you to like me, but I just can’t do this,” which is very, very powerful and important. And second, if drug use is detected the child can be referred to treatment if needed.

Q 3: Is the peer pressure just that much that without having an excuse, that kids are using drugs and getting hooked?

WALTERS: Well one of the other unpleasant parts of my job is I visit a lot of young people in treatment; teenagers, sometimes as young as 14, 15, but also 16, 17, 18. It is not uncommon for me to hear from them, “I came from a good family. My parents and my school made clear what the dangers were of drugs. I was stupid. I was with my boyfriend (or girlfriend) and somebody said hey, let’s go do this. And I started, and before I knew it, I was more susceptible.”

We have to also understand the science, which has told us that adolescents continue to have brain development up through age 20-25. And their brains are more susceptible to changes that we can now image from these drugs. So it’s not like they’re mini-adults. They’re not mini-adults. They’re the particularly fragile and susceptible age group, because they don’t have either the experience or the mental development of adults. That’s why they get into trouble, that’s why it happens so fast to them, that’s why it’s so hard for them to see the ramifications.

So what does RSDT do? It finds kids early– if prevention fails. And it allows us to intervene, and it doesn’t make the parent alone in the process. Sometimes parents don’t confront kids because kids blackmail them and say “I’m going to do it anyway, I’m going to run away from home.” The testing brings the community together and says we’re not going to lose another child. We’re going to do the testing in high school – if necessary, in middle school. We’re going to wrap our community arms around that family, and get those children help. We’re going to keep them in school, not wait for them to drop out. And we’re certainly not going to allow this to progress until they die.

Q 4: And in a sense, if you catch somebody early, since you’re saying the way teenagers seem to get into drug use is a friend introduces it to a friend, and then next thing you know, you have a whole circle of friends doing it. Are you essentially drying that up at the beginning, before it gets out of hand?

WALTERS: That is the very critical point. It’s not only helping every child that gets tested be safer, it means that the number of young people in the peer group, in the school, in the community that can transfer this dangerous behavior to their friends shrinks. This is communicated like a disease, except it’s not a germ or a bacillus. It’s one child who’s doing this giving it behaviorally to their friends, and using their friendship as the poison carrier here. It’s like they’re the apple and the poison is inside the apple. And they trade on their friendship to get them to use. They trade on the fact that people want acceptance, especially at the age of adolescence. So what you do is you break that down, and you make those relationships less prone to have the poison of drugs or even underage drinking linked to them. And of course we also lose a lot of kids because of impaired driving.

Q 5: And how does the drug testing program work, then, in schools– the schools that do have it. Is it completely confidential? Are you going to call the police the minute you find a student who’s tested positive for heroin or marijuana or any other illicit drug?

WALTERS: That’s what is great about having a Supreme Court decision. It is settled – random testing programs cannot be used to punish, to call law enforcement; they have to be confidential. So we have a uniform law across the land. And what the schools that are doing RSDT are seeing is that it’s an enormous benefit to schools for a relatively small cost. Depending on where you are in the country, the screening test is $10-40. It’s less than what you’re going to pay for music downloads in one month for most teenage kids in most parents’ lives. And it protects them from some of the worst things that can happen to them during adolescence. Not only dying behind the wheel, but overdose death and addiction.

Schools that have done RSDT have faced some controversy; so you have to sit down and talk to people; parents, the media, young people. You have to engage the community resources. You’re going to find some kids and families that do have treatment needs. But with RSDT you bring the needed treatment to the kids.

I tell, a lot of times, community leaders – mayors and superintendents, school board members – that if you want to send less kids into the criminal justice system and the juvenile justice system, drug test — whether you’re in a suburban area or in an urban area.

What does the testing do? It takes away what we know is an accelerant to self-destructive behavior: crime, fighting in school, bringing a weapon, joining a gang. We have all kinds of irrefutable evidence now – multiple studies showing drugs and drinking at a young age accelerate those things, make them worse, make them more violent, as well as increasing their risks of overdose deaths and driving under the influence. So drug testing makes all those things get better. And it’s a small investment to make everything else we do work better.

Again, drug testing is not a substitute for drug education or good parenting or paying attention to healthy options for your kid. It just makes all those things work better.

Q 6: And I know you’ve heard this argument before, but isn’t that big brother? Aren’t there parents out there who say to you, “I’m the parent: why are you going to test my child for drugs in school; that’s my job?”

WALTERS: I think that is the critical misunderstanding that we are slowly beginning to change by the science that tells us substance abuse is a disease. It’s a disease that gets started by using the drug, and then it becomes a thing that rewires our brain and makes us dependent. So instead of thinking of this as something that is a moral failing, we have to understand that this is a disease that we can use the kind of tools for public health – screening and interventions – to help reduce it.

Look, let me give you the counter example. It’s really not big brother. It’s more like tuberculosis. Schools in our area require children to be tested for tuberculosis before they come to school. Why do they do that? Because we know one, they will get sicker if they have tuberculosis and it’s not treated. And we can treat them, and we want to treat them. And two, they will spread that disease to other children because of the nature of the contact they will have with them and spreading the infectious agent. The same thing happens with substance abuse. Young people get sicker if they continue to use. And they spread this to their peers. They’re not secretive among their peers about it; they encourage them to use them with them. Again, it’s not spread by a bacillus, but it’s spread by behavior.

If we take seriously the fact that this is a disease and stop thinking of it as something big brother does because it’s a moral decision that somebody else is making, we can save more lives. And I think the science is slowly telling us that we need to be able to treat this in our families, for adults and young people. We have public health tools that we’ve used for other diseases that are very powerful here, like screening – and that’s really what the random testing is. We’re trying to get more screening in the health care system. So when you get a check up, when you bring your child to a pediatrician, we screen for substance abuse and underage drinking. Because we know we can treat this, and we know that we can make the whole problem smaller when we do.

Q 7: You have said there were about 4,000 schools across the country now that are doing this random drug testing. What can we see in the numbers since the Supreme Court ruling in 2002, as far as drug use in those schools, and drug use in the general population?

WALTERS: Well, what a number of those schools have had is of course a look at the harm from student drug and alcohol use. Some of them have put screening into place, random testing, because they’ve had a terrible accident; an overdose death; death behind the wheel. What’s great is when school districts do this, or individual schools do this, without having to have a tragedy that triggers it. But if you have a tragedy, I like to tell people, you don’t have to have another one. The horrible thing about a tragic event is that most people realize those are not the only kids that are at risk.

There are more kids at risk, obviously, in our communities in the Washington, DC area where this young woman died. We know there’s obviously more children who are at risk of using in middle school and high school. The fact is those children don’t have to die. We cannot bring this young lady back. Everybody knows that. But we can make sure others don’t follow her. And the way we can do that is to find, through screening, who’s really using. And then let’s get them to stop – let’s work with their families, and let’s make sure we don’t start another generation of death. So what you see in these areas is an opportunity to really change the dynamic for the better.

Q 8: Now, although nationally drug use among our youth is going down – what does it say to you – when I look at the numbers specific to Virginia, the most recent that I could find tells me that 3% of 12th graders, over their lifetime, have used a drug like heroin? What does it say to you? To me, that sounds like a lot.

WALTERS: Yeah, and it’s absolutely true. I think the problem here is that when you tell people we are taking efforts that are making progress nationwide, they jump to the conclusion that that means that we don’t have a problem anymore. We need to continue to make this disease smaller. It afflicts our young people. It obviously also afflicts adults, but this is a problem that starts during adolescence — and pre-adolescence in some cases — in the United States. We can make this smaller. We not only have the tools of better prevention but also better awareness and more recognition of addiction as a disease. We need to make that still broader. We need to use random testing. If we want to continue to make this smaller, and make it smaller in a permanent way, random testing is the most powerful tool we can use in schools.

We want screening in the health care system. We have more of that going on through both insurance company reimbursement and public reimbursement through Medicare and Medicaid for those who come into the public pay system. That needs to grow. It needs to grow into Virginia, it’s already being looked at in DC; it needs to grow into Maryland and the other states that don’t have it. We are pushing that, and it’s relatively new, but it’s consistent with what we’re seeing – the science and the power of screening across the board.

We need to continue to look at this problem in terms of also continuing to push on supply. We’re working to reduce the poisons coming into our communities, which is not the opposite of demand; that we have to choose one or the other. They work together. Keeping kids away from drugs and keeping drugs away from kids work together. And where we see that working more effectively, we’ll save more lives. So again, we’ve seen that a balanced approached works, real efforts work, but we need to follow through. And the fact that you still have too many kids at risk is an urgent need. Today, you have kids that could be, again, victims that you have to unfortunately tell about on tonight’s news, that we can save. It’s not a matter we don’t know how to do this. It’s a matter of we need to take what we know and make it reality as rapidly as possible.

Q 9: Where are these drugs coming from? Where’s the heroin that these kids allegedly got coming from?

WALTERS: We do testing about the drugs to figure out sources for drugs like heroin. Principally, the heroin in the United States today has come from two sources. Less of it’s coming out of Colombia. Colombia used to be a source of supply on the East Coast, but the Colombian government, as a part of our engagement with them on drugs, has radically reduced the cultivation of poppy and the output of heroin. There still is some, but it’s dramatically down from what it was even about five years ago. Most of the rest of the heroin in the United States comes from Mexico. And the Mexican government, of course, is engaged in a historic effort to attack the cartels. You see this in the violence the cartels have had as a reaction. So we have promising signs. There are dangerous and difficult tasks ahead, but we can follow through on that as well.

Most of the heroin in the world comes from Afghanistan; 90% of it. And we are working there, of course, as a part of our effort against the Taliban and the forces of terror and Al Qaeda, to shrink that. The good news is that last year we had a 20% decline in cultivation and a 30% decline in output there. Most of that does not come here, fortunately. But it has been funding the terrorists. It’s been drained out of most of the north and the east of the country. It’s focused on the area where we have the greatest violence today, in the southwest. We’re working now – you see Secretary Gates talking to the NATO allies about bringing the counter-insurgency effort together with the counter-narcotics effort to attack both of these cancers in Afghanistan. We have a chance to change heroin availability in the world in a durable way by being successful in Afghanistan. We’ve started that path in a positive way. Again, it’s a matter of following through as rapidly as possible.

Q 10: Greg Lannes, the father of the girl in Fairfax County who died, told me that one of his main efforts, as you imagined, was to let people know that those drugs, they’re coming from where it is produced, outside our country; that they’re getting all the way down to the street level and into our neighborhoods– something that people don’t realize. So when you hear that they busted a ring of essentially teenagers who have been dealing, using and buying heroin, what does that say to you as the man in charge of combating drugs in our country?

WALTERS: Well again, we have tools that can make this smaller. But we have to use those tools. And we have multiple participants here. Yes we need to educate. And we need to make sure that parents know they need to talk to their children, even when their children look healthy and have come from a great home. Drugs – we’ve learned, I think, over the last 25 years or more, drugs affect everybody; rich or poor, middle class, lower class or upper class. Every family’s been touched by this, in my experience, by alcohol or drugs. They know that reality– we don’t need to teach them that.

What we need to teach them is the tools that we have that they can help accelerate use of. Again, I think – there is no question in my mind that had this young woman been in a school, middle school or high school that had random testing – since that’s where this apparently started, based on the information I’ve seen in the press – she would not be dead today. So again, we can’t go back and bring her to life. But we can put into place the kind of screening that makes the good will and obvious love that she got from her parents, the obvious good intentions that I can’t help but believe were a part of what happened in the school, the opportunities that the community has to have a lot of resources that she didn’t get when she needed them. And now she’s dead. Again, we can stop this: we just have to make sure we implement that knowledge in the reality of more of our kids as fast as possible.

Q 11: Should anyone be surprised by this case? And that such a hardcore drug like heroin is being used by young people?

WALTERS: We should never stop being surprised when a young person dies. They shouldn’t die. They shouldn’t die at that young age, and we should always demand of ourselves, even while we know that’s sometimes going to happen today, that every death is a death too many. I think that it is very important not to say we’re going to accept a certain level. Never accept this. Never! That’s my attitude, and I know that’s the president’s attitude as well here. Never accept that heroin’s going to get into the lives of our teenagers. Never accept that our children are going to be able to use and not be protected. It’s our job to protect them. They have a role, also, obviously in helping to protect themselves. But we need to give them the tools that will help protect them.

When I talk to children and young adults in high school or college, they know what’s going on among their peers. And in some ways, when you get them alone and they feel they can talk candidly, they tell us they don’t understand why we, as adults who say this is serious, don’t act. They know that we see children who are intoxicated; they know that we must see signs of this, because as kid’s lives get more out of control, they show signs of it. They want to know why we don’t act.

We can use the tools of screening, and we can use the occasion of a horrible event like this to bring the community together and say it’s time for us to use the shock and the sorrow for something positive in the future. I haven’t met a parent of a child who’s been lost who doesn’t say I just want to use this now for something positive. And that’s understandable, and I think we ought to honor that wish.

Q 12: Well, I guess I’m not asking should we accept that this is in our schools, but is it naïve for people not to understand or realize that these hardcore drugs are in our schools, and in our communities, and in our neighborhoods.

WALTERS: Yeah. Where it is naïve, I think, is to not recognize the extent and access that young people have to drugs and alcohol. I think we sometimes think that because they come from a home where this isn’t a part of their lives now, that it’s not ever going to be part of their lives. Look, your viewers should go on the computer. Type marijuana into the Google search engine and see how many sites encourage them to use marijuana, how to get marijuana, how to grow marijuana, the great fun of marijuana. Go on YouTube and type in marijuana, and see how many videos come up using marijuana, joking around about marijuana. And then when you start showing one, of course the system is designed to show you similar things. Type in heroin. See what kind of sites come up, and see what kind of videos come up on these sites. Young people spend more time on these sites than they do, frequently, watching television. Remember, there is somebody telling your children things about drugs. And if it’s not you, the chances are they’re telling them things that are false and dangerous. So there is a kind of naiveté about what the young peoples’ world, as it presents itself to them, tells them about these substances. It minimizes the danger, it suggests that it’s something that you can do to be more independent, not be a kid anymore.

We, from my generation — because I’m a baby boomer — unfortunately have had an association of growing up in America with the rebellion that’s been associated with drug use. That’s been very dangerous, and we’ve lost a lot of lives. We have to remember that it’s alive and well, and has become part of the technological sources of information that young people have. I also see young people in treatment centers who got in a chat room and somebody offered them drugs or offered them to come and buy them alcohol and flattered them, and got them involved in incredibly self-destructive behavior. The computer brings every predator and every dangerous influence into your own child’s home – into their bedroom in some cases, if that’s where that computer exists. You wouldn’t let your kids go out and play in the park with drug dealers. If you have a computer and it’s not supervised, those drug dealers are in that computer. Remember that. And they’re only a couple of keystrokes away from your child.

Q 13: And you talk about the YouTube and the computers and all those things. What about just the overall societal image? Because we have this whole image with heroin, of heroin chic. How much does that contribute to the drug use, and how difficult does it make your job, when a drug is being made out to be cool in society by famous people?

WALTERS: There are still some elements of that. It was more prominent a number of years ago. I would say you see less of that now glamorized in the entertainment industry, or among people who are celebrities in and out of entertainment. You see more cases of real harm. But it’s still out there. The one place that I think is replacing that, just to get people ahead of the game here, is prescription pharmaceuticals. Those have been marketed to kids on the internet as a safe high. They falsely suggest that you can overcome the danger of an overdose because you can predict precisely the dosage of OxyContin, hydrocodone, Vicodin. And there are sites that suggest what combination of drugs to use. We’ve seen prescription drug use as the one counter example of a category of drug use going up among teens. We’re trying to work on that as well, but that’s something that’s in your own home, because many people get these substances for legitimate medical care. Young people are going to the medicine cabinet of family or friends, taking a few pills out and using those. And those are as powerful as heroin, they’re synthetic opioids, and they have been a source of overdose deaths.

So let’s not forget – while this Fairfax example reminds us of the issues of heroin chic and of the heroin that’s in our communities, the new large problem today is a similar dangerous substance in pill form in our own medicine cabinets. Barrier to access is zero. They don’t have to find a drug dealer; they just go find the medicine cabinet. They don’t have to pay a dime for it because they just take it and they share that with their friends. We need to remember, that’s another dimension here. Keep these substances out of reach – under our control when we have them in our home. Throw them away when we’re done with them. Make sure we talk to kids about pills. Because people, again, are telling them that’s the place to go to avoid overdose death, is to take a pill.

Q 14: When you see a lot of these celebrities checking in and out of rehab, does it sort of glamorize it for kids? And teach them hey, you can use, you can check into rehab, you can come back, you can – you know. Is there a mixed message there?

WALTERS: There is. Some young people interpret it the way you describe; of it’s something you do and you can get away with it by going into rehab. We do a lot of research on young people’s attitudes for purposes of helping shape prevention programs in the media, as well as in schools and for parents. We do a lot with providing material to parents. I would say that compared to where we’ve been in the last 15 or 20 years, there’s less glamorization today.

I think we should also remember the positive, because we reinforce that. A lot of young people – obviously not all or we wouldn’t have this death – believe that taking drugs makes you a loser. They’ve seen that a lot of those celebrities are showing their careers going down the toilet because they can’t get away from the pills and the drugs and the alcohol. And I think they see that even among some of their peers. That’s a good thing. We should reinforce that as parents: teaching our kids that drug and alcohol use may be falsely presented to you as something you do that would make you popular, make you seem like you should have more status in society generally. But actually, look at a lot of these people; they’ve had enormous opportunities, enormous gifts, and they can’t stop themselves from throwing them away. And they may not stop themselves from throwing away their lives.

I think you could use these events as a teachable moment. It can go two ways. Help your child understand what the truth is here. And I tell young people – and I think parents have to start this more directly – this is the way this is going to come to you: Somebody you really, really want to like you; somebody you really, really like; someone you may even love — or think you love — they’re going to say come and do this with me. If you can’t find any other reason to not do this with them, say, “Before we do this, let’s go to a treatment center. Let’s go talk to people who stood where we stood and said it’s not going to happen to me.” If everybody, when they got the chance to start, thought of an addict or somebody who was dead, they wouldn’t start. The fact is that does not enter their mind.

Many people in treatment centers understand that part of the task of recovery is helping other people avoid this. So they’re willing to talk about it. In fact, that’s part of their path of staying clean and sober, which not many kids are going to be able to do on their own. But it makes them think that what presents itself as something overwhelmingly attractive has behind it a horrible dimension, for their friends as well as for themselves. And more and more, I think kids understand this.

We can use the science of this as a disease, and the experience of many families. Remember, uncle Joe didn’t used to be like this. Especially Thanksgiving, when we have families getting together and all of a sudden mom’s going to get loaded and become ugly in the corner. We also have to remember we have an obligation to reach out to those people, and to get them help. We can treat them. Nobody gets sober, in my experience, by themselves. They have to take responsibility. But you have to overcome the pushback, and addiction and alcoholism have, as a part of the disease, denial. When you tell somebody they have a problem, they get angry with you. They don’t say hey thanks, I want your help. They don’t hit bottom and become nice. That’s a myth. They need to be grabbed and encouraged and pushed. Almost everybody in treatment is coerced – by a family member, by an employer, sometimes by the criminal justice system.

So remember that, when you find your child using and they want to lie to you up down and sideways saying, “It’s the first time I’ve ever done it.” No, no, no, no, no, that’s the drugs talking. That shows you, if anything, you have a bigger problem than you realized and you need to reach out, get some professional help. But don’t wait!

Source: National Institute of Citizen Anti-drug Policy (NICAP)

DeForest Rathbone, Chairman, Great Falls, Virginia, 703-759-2215, DZR@prodigy.net

Filed under: Alcohol,Brain and Behaviour,Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,Education,Education Sector,Effects of Drugs,Heroin/Methadone,Internet,Political Sector,Prescription Drugs,Prevention and Intervention,Social Affairs,Synthetics,Treatment and Addiction,USA,Youth :

Summary

Background

Adolescence represents a crucial developmental period in shaping mental health trajectories. In this study, we investigated the effect of the COVID-19 pandemic on mental health and substance use during this sensitive developmental stage.

Methods

In this longitudinal, population-based study, surveys were administered to a nationwide sample of 13–18-year-olds in Iceland in October or February in 2016 and 2018, and in October, 2020 (during the COVID-19 pandemic). The surveys assessed depressive symptoms with the Symptom Checklist-90, mental wellbeing with the Short Warwick Edinburgh Mental Wellbeing Scale, and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Demographic data were collected, which included language spoken at home although not ethnicity data. We used mixed effects models to study the effect of gender, age, and survey year on trends in mental health outcomes.

Findings

59 701 survey responses were included; response rates ranged from 63% to 86%. An increase in depressive symptoms (β 0·57, 95% CI 0·53 to 0·60) and worsened mental wellbeing (β −0·46, 95% CI −0·49 to −0·42) were observed across all age groups during the pandemic compared with same-aged peers before COVID-19. These outcomes were significantly worse in adolescent girls compared with boys (β 4·16, 95% CI 4·05 to 4·28, and β −1·13, 95% CI −1·23 to −1·03, respectively). Cigarette smoking (OR 2·61, 95% CI 2·59 to 2·66), e-cigarette use (OR 2·61, 95% CI 2·59 to 2·64), and alcohol intoxication (OR 2·59, 95% CI 2·56 to 2·64) declined among 15–18-year-olds during COVID-19, with no similar gender differences.

Interpretation

Our results suggest that COVID-19 has significantly impaired adolescent mental health. However, the decrease observed in substance use during the pandemic might be an unintended benefit of isolation, and might serve as a protective factor against future substance use disorders and dependence. Population-level prevention efforts, especially for girls, are warranted.

Funding

Icelandic Research Fund.

Source: Depressive symptoms, mental wellbeing, and substance use among adolescents before and during the COVID-19 pandemic in Iceland: a longitudinal, population-based study – The Lancet Psychiatry June 2021

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects,Nicotine,Youth :

A pilot study by Addiction Switzerland traced the alcohol incentives on the routes of 16 to 19-year-old adolescents in everyday life and in social networks. On average, the test subjects in the five largest Swiss cities encountered an alcohol incentive every five minutes. Alcohol was also omnipresent in social networks, transported by friends and influencers, who are often paid for it. The study showed the frightening normality of alcohol in the everyday life of adolescents.

Alcohol marketing is aimed strongly at young people, as they are the customers of tomorrow. A pilot study by Addiction Switzerland , financed by the Federal Customs Administration, looked into the question of how much adolescents are actually exposed to alcohol stimuli. The study layout was partly based on an earlier study on tobacco marketing : Here, too, the typical routes and activities taken by young people in everyday life and when going out in Geneva, Lausanne, Bern, Basel and Zurich were traced. All alcohol incentives encountered were systematically recorded. In addition, the alcohol incentives encountered by the young people in social networks were recorded.

At least half of the incentives are intentional

On average, the distances (including activities such as sports, cinema, restaurant, etc.) were covered within six hours each. 73 alcohol stimuli were recorded per trip, which means, on average, a reminder of the alcohol every five minutes! It should be said that the investigation in autumn 2020 came at a time when the Covid measures were becoming stricter again and the exit bars were closing again, and fewer events were taking place in public spaces. It can be assumed that advertising activity has been reduced accordingly during this period.

Half of the stimuli recorded related to alcohol advertising or the promotion of alcoholic beverages. The other half consisted of apparently random alcohol stimuli: Empty bottles and cans in public spaces, depictions of where alcohol plays a role (e.g. an occasion where people drink), what is offered on a menu card, etc.

In addition, all perceived prevention messages should be recorded. But it turned out that these were almost completely absent on the paths of the young people.

On social media: the power of images and influencers

Alcohol marketing has partly shifted to the internet. 85% of young people between the ages of 12 and 19 spent an hour or more per day on the Internet in 2019 , the majority of them are also on social networks, which has probably increased during the pandemic . On Snapchat, Instagram and Tiktok in particular, they receive numerous pictures and messages from friends and acquaintances who have alcohol as their topic. The alcohol advertising by influencers is also noticeable.

A society banalizing alcohol does not protect its youth

The results of this pilot study impressively show how strongly young people are already confronted with alcohol. It becomes normal for them to include alcohol. This is alarming in view of the around 400 young people who are admitted to hospital in Switzerland every year because of alcohol poisoning. A large part of these alcohol stimuli is consciously placed or at least it is tolerated that adolescents are also advertised. Sucht Switzerland therefore calls for the measures to be taken to protect young people to be stepped up. These include the restriction of alcohol advertising and thus the reduction in the attractiveness of alcohol among young people.

Source: mportner-helfer @ suchtschweiz.ch May 2021

Filed under: Alcohol,Internet,Youth :

Highlights

Alcohol intake is associated with smaller grey matter volumes across the brain.
It is also associated with lower FA and increased functional connectivity
Binge drinking steepens association between alcohol and total grey matter volume.
Findings suggest even 7–14 units of alcohol weekly may be associated with brain differences.

Abstract

Moderate alcohol consumption is widespread but its impact on brain structure and function is contentious. The relationship between alcohol intake and structural and functional neuroimaging indices, the threshold intake for associations, and whether population subgroups are at higher risk of alcohol-related brain harm remain unclear. 25,378 UK Biobank participants (mean age 54.9 ± 7.4 years, 12,254 female) underwent multi-modal MRI 9.6 ± 1.1 years after study baseline. Alcohol use was self-reported at baseline (2006–10). T1-weighted, diffusion weighted and resting state images were examined. Lower total grey matter volumes were observed in those drinking as little as 7–14 units (56–112 g) weekly. Higher alcohol consumption was associated with multiple markers of white matter microstructure, including lower fractional anisotropy, higher mean and radial diffusivity in a spatially distributed pattern across the brain. Associations between functional connectivity and alcohol intake were observed in the default mode, central executive, attention, salience and visual resting state networks. Relationships between total grey matter and alcohol were stronger than other modifiable factors, including blood pressure and smoking, and robust to unobserved confounding. Frequent binging, higher blood pressure and BMI steepened the negative association between alcohol and total grey matter volume. In this large observational cohort study, alcohol consumption was associated with multiple structural and functional MRI markers in mid- to late-life.

Source: Alcohol consumption and MRI markers of brain structure and function: Cohort study of 25,378 UK Biobank participants – ScienceDirect May 2022

Filed under: Alcohol,Brain and Behaviour :

Abstract

Background:

Cardiovascular anomalies are the largest group of congenital anomalies and the major cause of death in young children, with various data linking rising atrial septal defect incidence (ASDI) with prenatal cannabis exposure.

Objectives / Hypotheses:

Is cannabis associated with ASDI in USA? Is this relationship causal?

Methods:

Geospatio/temporal cohort study, 1991–2016. Census populations of adults, babies, congenital anomalies, income and ethnicity.

Drug exposure data on cigarettes, alcohol abuse, past month cannabis use, analgesia abuse and cocaine taken from National Survey of Drug Use and Health (78.9% response rate). Cannabinoid concentrations from Drug Enforcement Agency. Inverse probability weighted (ipw) regressions.

Analysis conducted in R.

Results:

ASDI rose nationally three-fold from 27.4 to 82.8 / 10,000 births 1991–2014 during a period when tobacco and alcohol abuse were falling but cannabis was rising. States including Nevada, Kentucky, Mississippi and Tennessee had steeply rising epidemics (Time: Status β-estimate = 10.72 (95%C.I. 8.39–13.05), P < 2.0 × 10 − 16). ASDI was positively related to exposure to cannabis and most cannabinoids.

Drug exposure data was near-complete from 2006 thus restricting spatial modelling from 2006 to 2014, N = 282. In geospatial regression models cannabis: alcohol abuse term was significant (β-estimate = 19.44 (9.11, 29.77), P = 2.2 × 10 − 4 ); no ethnic or income factors survived model reduction.

Cannabis legalization was associated with a higher ASDI (Time: Status β-estimate = 0.03 (0.01, 0.05), P = 1.1 × 10 -3). Weighted panel regression interactive terms including cannabis significant (from β-estimate = 1418, (1080.6, 1755.4), P = 7.3 × 10 -15). Robust generalized linear models utilizing inverse probability weighting interactive terms including cannabis appear (from β-estimate = 78.88, (64.38, 93.38), P = 1.1 × 10 -8).

Marginal structural models with machine-aided Super Learning association of ASDI with high v. low cannabis exposure R.R. = 1.32 (1.28, 1.36). Model e-values mostly > 1.5.

Conclusions:

ASDI is associated with cannabis use, frequency, intensity and legalization in a spatiotemporally significant manner, robust to socioeconomic demographic adjustment and fulfilled causal criteria, consistent with multiple biological mechanisms and similar reports from Hawaii, Colorado, Canada and Australia. Not only are these results of concern in themselves, but they further imply that our list of the congenital teratology of cannabis is as yet incomplete, and highlight in particular cardiovascular toxicology of prenatal cannabinoid and drug exposure.

Albert Stuart Reece and Gary Kenneth Hulse

Source: BMC Pediatrics volume 20, Article number: 539 (2020) https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02431-z November 2020

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Global Drug Legalisation Efforts,Nicotine :

One way to deter harmful recreational drug use by teenagers is to treat them like adults. Rather than simply tell them to “Just Say No” to alcohol, tobacco or illicit drugs, it may be more helpful to explain how these substances create unique risks for them risks that arise due to the changing state of the adolescent brain.

It’s an approach recommended by Dr. Robert DuPont, the first director of the National Institute of Drug Abuse, the second White House “drug czar” and the current head of the Institute for Behavior and Health.

Scientists have long recognized that people who use alcohol, tobacco, marijuana and other drugs while adolescents are far more likely to use more dangerous drugs in their 30s and 40s. Back in 1984, researchers writing in the American Journal of Public Health reported that “the use of marijuana is a good predictor of the use of more serious drugs only if it begins early” and that early drinking is a similar “predictor of marijuana use.”

It should come as no surprise, then, that Americans in their 30s and 40s who used recreational drugs as teenagers are the group most severely affected by opioid overdoses today.

Unfortunately, neither the media nor popular culture adequately informs young people about the neurological damage alcohol, nicotine, and marijuana can inflict on the brain. On the contrary, despite strong evidence that early recreational drug use increases the likelihood of future drug addiction, the media and today’s culture often describe marijuana use as an “organic,” “natural” approach to anxiety and stress management. Indeed, Northern Michigan University launched the nation’s first medicinal plant chemistry major, offering students the chance to focus on marijuana-related studies. What message does that send to the still-developing minds of college students?

One group is taking a non-traditional approach to convincing students otherwise.

One Choice is a drug prevention campaign developed for teenagers by the Institute for Behavior and Health. It relies on cutting-edge neuroscience to encourage young Americans to make decisions that promote their brain health.

Pioneered by Dr. DuPont, One Choice specifically advocates that adolescents make “no use of any alcohol, nicotine, marijuana or other drugs” for health reasons. The theory is that adolescents who make the decision not to use alcohol, nicotine, or marijuana at all that make “One Choice” to avoid artificial, chemical brain stimulation are far less likely to wind up addicted to drugs such as opioids later on.

The One Choice approach is evidence-based. In 2017, scientists at Mclean Hospital and Harvard Medical School published their findings on the impact of early substance use on cognitive development. They explained that the brains of teenagers are still developing and can be negatively impacted by substance use. Adolescent brains are still forming the communication routes that regulate motivation, stress and habit-formation well into adulthood. As such, it is easier for substances to hijack and alter those routes in developing brains than in adult brains.

Hindering the vital attributes of habit formation, stress management and motivational behavior can drastically affect a young person’s academic performance. Collectively, and in the long run, that can impair the competitiveness of a national economy. Thus, it is crucial that young Americans learn to prioritize brain health.

The timing for the innovative One Choice approach is propitious. Today’s young Americans are more interested in biology, psychology and health sciences than ever before. According to the National Center for Education Statistics, the field of “health professions and related programs” is the second most popular major among college students, with psychology and biological or biomedical sciences following as the fourth and fifth most popular, respectively. By explaining developmental neuroscience to teenagers, One Choice engages young people on a topic of interest to them and presents the reality of a pressing public health issue, instead of throwing moral platitudes and statistics at them.

Pro-marijuana legalization organizations, such as the Drug Policy Alliance, agree: “The safest path for teens is to avoid drugs, doing alcohol, cigarettes, and prescription drugs outside of a doctor’s recommendations.” And certainly honesty, along with scientific accuracy, is critical if we are to persuade adolescents not to use drugs.

Brain health is critical to the pursuit of happiness. And leveraging scientifically accurate presentations and testimonies to convince young Americans to prioritize their own brain health early on can prevent future substance abuse.

Source: Using Neuroscience to Prevent Drug Addiction Among Teenagers | The Heritage Foundation January 2019

Filed under: Alcohol,Brain and Behaviour,Cannabis/Marijuana,Nicotine,Prevention and Intervention,Youth :

A meta-analysis of all studies worldwide showing association between marijuana use and schizophrenia:

Moore TH, Zammit S, Lingford-Hughes A, et al. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet. 2007;370:319–328.
http://dirwww.colorado.edu/alcohol/downloads/Cannabis_and_behavior.pdf

“There was an increased risk of any psychotic outcome in individuals who had ever used cannabis…with greater risk in people who used cannabis most frequently. There is now sufficient evidence to warn young people that using cannabis could increase their risk of
developing a psychotic illness later in life.”

The most recent study conducted in the United States (Columbia University, New York), showing a high risk (odds ratio, “OR”) for schizophrenia spectrum disorders, particularly in those who become cannabis-dependent:

Davis GP, Compton MT, Wang S, Levin FR, Blanco C. Association between cannabis use, psychosis, and schizotypal personality disorder: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Schizophr Res. 2013 Dec;151(1-3):197-202.
“There was a similar dose-response relationship between the extent of cannabis use and schizotypal personality disorder (OR=2.02 for lifetime cannabis use, 95% CI 1.69-2.42; OR=2.83 for lifetime cannabis abuse, 95% CI 2.33-2.43; OR=7.32 for lifetime cannabis dependence, 95% CI 5.51-9.72). Likelihood of individual schizotypal features increased significantly with increased extent of cannabis use in a dose-dependent manner.”

Studies that corrected for general genetic background effects and many non-cannabis environmental variables by comparing siblings. The risk ratios are somewhat lower than general population studies, because genetic predisposition is more or less controlled for:

McGrath J, Welham J, Scott J, Varghese D, Degenhardt L, Hayatbakhsh MR, Alati R, Williams GM, Bor W, Najman JM. Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults. Arch Gen Psychiatry. 2010; 67(5):440-7.
“Longer duration since first cannabis use was associated with multiple psychosis-related outcomes in young adults… the longer the duration since first cannabis use, the higher the risk of psychosis-related outcomes…
Compared with those who had never used cannabis, young adults who had 6 or more years since first use of cannabis (i.e., who commenced use when around 15 years or younger) were twice as likely to develop a nonaffective psychosis…
This study provides further support for the hypothesis that early cannabis use is a risk-modifying factor for psychosis-related outcomes in young adults.”

Giordano GN, Ohlsson H, Sundquist K, Sundquist J, Kendler KS. The association between cannabis abuse and subsequent schizophrenia: a Swedish national co-relative control study.
Psychol Med. 2014 Jul 3:1-8. [Epub ahead of print]
http://journals.cambridge.org/download.php?file=%2FPSM%2FS0033291714001524a.pdf&code=79f795824a92c8eead870197ef071dd8

“Allowing 7 years from initial CA registration to later diagnosis, the risk for schizophrenia in discordant full sibling pairs remained almost twofold….The results of this study therefore lend support to the etiologic hypothesis, that CA is one direct cause of later schizophrenia.”

Those diagnosed with schizophrenia who also use recreational drugs are much more likely to be violent, including those who use cannabis:

Fazel S, Långström N, Hjern A, Grann M, Lichtenstein P. Schizophrenia, substance abuse, and violent crime. JAMA. 2009 May 20;301(19):2016-23.
“The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of violent crime among such patients (adjusted OR, 4.4; 95% CI,3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 violent offense; adjusted OR,1.2; 95% CI, 1.1-1.4; P<0.001 for interaction).”

Fazel S, Gulati G, Linsell L, Geddes JR, Grann M. Schizophrenia and violence: systematic review and meta-analysis. PLoS Med. 2009 Aug;6(8):e1000120. doi: 10.1371/journal.pmed.1000120. Epub 2009 Aug 11.
“The effect of comorbid substance abuse was marked with….. an OR of 8.9” (as compared to the general population)

Arseneault L, Moffitt TE, Caspi A, Taylor PJ, Silva PA. Mental disorders and violence in a total birth cohort: results from the Dunedin Study. Arch Gen Psychiatry. 2000;57(10):979-86.
“for having more than two of these disorders at once…..the OR (odds ratio for violence) was, …..for marijuana dependence plus schizophrenia spectrum disorder, 18.4”

Harris AW, Large MM, Redoblado-Hodge A, Nielssen O, Anderson J, Brennan J. Clinical and cognitive associations with aggression in the first episode of psychosis. Aust N Z J Psychiatry. 2010 Jan;44(1):85-93.
‘The use of cannabis with a frequency of more than fourfold in the previous month was the only factor that was found to be associated with serious aggression’

Self-report of psychotic symptoms by otherwise healthy users (12% to 15%):

Thomas H. A community survey of adverse effects of cannabis use. Drug Alcohol Depend. 1996 Nov;42(3):201-7.
“This survey estimates the frequency of various adverse effects of the use of the drug cannabis. A sample of 1000 New Zealanders aged 18-35 years were asked to complete a self-administered questionnaire on cannabis use and associated problems. The questionnaire was derived from criteria for the identification of cannabis abuse which are analagous to criteria commonly used to diagnose alcoholism. Of those who responded 38% admitted to having used cannabis. The most common physical or mental health problems, experienced by 22% of users were acute anxiety or panic attacks following cannabis use. Fifteen percent reported psychotic symptoms following use.”

Barkus EJ, Stirling J, Hopkins RS, Lewis S.. Cannabis-induced psychosis-like experiences are associated with high schizotypy Psychopathology 2006;39(4):175-8.
“In the sample who reported ever using cannabis (72%) the means for the subscales from the CEQ were as follows: ……Psychotic-Like Experiences (12.98%).”

Rates of psychotic symptoms in those with cannabis dependence as compared to non-dependent users and nonusers:

Fergusson DM, Horwood LJ, Swain-Campbell NR. Cannabis dependence and psychotic symptoms in young people. Psychol Med. 2003 Jan;33(1):15-21.
“Young people meeting DSM-IV criteria for cannabis dependence had elevated rates of psychotic symptoms at ages 18 (rate ratio = 3.7; 95% CI 2.8-5.0; P < 0.0001) and 21 (rate ratio = 2.3; 95% CI 1.7-3.2; P < 0.0001).”

Smith MJ, Thirthalli J, Abdallah AB, Murray RM, Cottler LB. Prevalence of psychotic symptoms in substance users: a comparison across substances. Compr Psychiatry. 2009 May-Jun;50(3):245-50. doi: 10.1016/j.comppsych.2008.07.009. Epub 2008 Sep 23.
“more than half of the respondents who were dependent on cocaine (80%), cannabis (63.5%), amphetamines (56.1%), and opiates (53.1%) reported psychotic symptoms. Among all users of substances without a diagnosis of abuse or dependence, cannabis users reported the highest prevalence of psychotic symptoms (12.4%)……. There was also a marked increase in the risk for psychotic symptoms when dependence became moderate or severe for cannabis (OR=25.1, OR=26.8; respectively).”

Studies on the psychotomimetic properties of THC administered to healthy individuals in the clinic:

D’Souza DC, Perry E, MacDougall L, Ammerman Y, Cooper T, Wu YT, Braley G, Gueorguieva R, Krystal JH. The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: implications for psychosis. Neuropsychopharmacology. 2004 Aug;29(8):1558-72.
“∆-9-THC (1) produced schizophrenia-like positive and negative symptoms; (2) altered perception;(3) increased anxiety; (4) produced euphoria; (5) disrupted immediate and delayed word recall, sparing recognition recall; (6) impaired performance on tests of distractibility, verbal fluency, and working memory (7) did not impair orientation; (8) increased plasma cortisol. These data indicate that D-9-THC produces a broad range of transient symptoms, behaviors, and cognitive deficits in healthy individuals that resemble some aspects of endogenous psychoses.”

Morrison PD, Nottage J, Stone JM, Bhattacharyya S, Tunstall N, Brenneisen R, Holt D, Wilson D, Sumich A, McGuire P, Murray RM, Kapur S, Ffytche DH. Disruption of frontal θ coherence by ∆9-tetrahydrocannabinol is associated with positive psychotic symptoms. Neuropsychopharmacology. 2011;;36(4):827-36.
“Compared with placebo, THC evoked positive and negative psychotic symptoms, as measured by the positive and negative syndrome scale (p<0.001)…… The results reveal that the pro-psychotic effects of THC might be related to impaired network dynamics with impaired communication between the right and left frontal lobes.”

Bhattacharyya S, Crippa JA, Allen P, Martin-Santos R, Borgwardt S, Fusar-Poli P, Rubia K, Kambeitz J, O’Carroll C, Seal ML, Giampietro V, Brammer M, Zuardi AW, Atakan Z, McGuire PK. Induction of psychosis by ∆9-tetrahydrocannabinol reflects modulation of prefrontal and striatal function during attentional salience processing. Arch Gen Psychiatry. 2012 Jan;69(1):27-36. doi: 10.1001/archgenpsychiatry.2011.161.
“Pairwise comparisons revealed that 9-THC significantly increased the severity of psychotic symptoms compared with placebo (P<.001) and CBD (P<.001).”,

Freeman D, Dunn G, Murray RM, Evans N, Lister R, Antley A, Slater M, Godlewska B, Cornish R, Williams J, Di Simplicio M, Igoumenou A, Brenneisen R, Tunbridge EM, Harrison PJ, Harmer CJ, Cowen P, Morrison PD. How Cannabis Causes Paranoia: Using the Intravenous Administration of ∆9-Tetrahydrocannabinol (THC) to Identify Key Cognitive Mechanisms Leading to Paranoia. Schizophr Bull. 2014 Jul 15. pii: sbu098. [Epub ahead of print]
“THC significantly increased paranoia, negative affect (anxiety, worry, depression, negative thoughts about the self), and a range of anomalous experiences, and reduced working memory capacity.”

For data on dose-response (a very large study by Zammit et al., and another by van Os et al.) and the greater risk for psychosis posed by high strength marijuana (DiForti et al.):

Zammit S, Allebeck P, Andreasson S, Lundberg I, Lewis G, 2002, Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study. BMJ. 2002 Nov 23;325(7374):1199. http://www.bmj.com/content/325/7374/1199.full.pdf
“We found a dose dependent relation between frequency of cannabis use and risk of schizophrenia, with an adjusted odds ratio for linear trend across the categories of frequency of cannabis use used in this study of 1.2 (1.1 to 1.4, P < 0.001). The adjusted odds ratio for subjects with a history of heaviest use of cannabis ( > 50 occasions) was 3.1 (1.7 to 5.5)………………Cannabis use is associated with an increased risk of
developing schizophrenia, consistent with a causal relation. This association is not explained by use of other psychoactive drugs or personality traits relating to social integration.”

van Os J, Bak M, Hanssen M, Bijl RV, de Graaf R, Verdoux H. Cannabis use and psychosis: a longitudinal population-based study. Am J Epidemiol. 2002 Aug 15;156(4):319-27.
“…..further evidence supporting the hypothesis of a causal relation is demonstrated by the existence of a dose-response relation.. between cumulative exposure to cannabis use and the psychosis outcome……. About 80 percent of the psychosis outcome associated with exposure to both cannabis and an established vulnerability to psychosis was attributable to the synergistic action of these two factors. This finding indicates that, of the subjects exposed to both a vulnerability to psychosis and cannabis use, approximately 80 percent had the psychosis outcome because of the combined action of the two risk factors and only about 20 percent because of the action of either factor alone.”

DiForti M, Morgan C, Dazzan P, Pariante C, Mondelli V, Marques TR, Handley R, Luzi S, Russo M, Paparelli A, Butt A, Stilo SA, Wiffen B, Powell J, Murray RM. High-potency cannabis and the risk of psychosis. Br J Psychiatry. 2009,195(6):488-91.
“78% (n = 125) of the cases group preferentially used sinsemilla (skunk) compared with only 31% (n = 41) of the control group (unadjusted OR= 8.1, 95% CI 4.6–13.5). This association was only slightly attenuated after controlling for potential confounders (adjusted OR= 6.8, 95% CI 2.6–25.4)………. Our most striking finding is that patients with a first episode of psychosis preferentially used high-potency cannabis preparations of the sinsemilla (skunk) variety…… our results suggest that the potency and frequency of cannabis use may interact in further increasing the risk of psychosis.”

DiForti M, Marconi A, Carra E, Fraietta S, Trotta A, Bonomo M, Bianconi F, Gardner-Sood P, O’Connor J, Russo M, Stilo SA, Marques TR, Mondelli V, Dazzan P, Pariante C, David AS, Gaughran F, Atakan Z, Iyegbe C, Powell J, Morgan C, Lynskey M, Murray RM. Proportion of
patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. Lancet Psychiatry, online February 18, 2015, http://dx.doi.org/10.1016/S2215-0366(14)00117-5.
“In the present larger sample analysis, we replicated our previous report and showed that the highest probability to suffer a psychotic disorder is in those who are daily users of high potency cannabis. Indeed, skunk use appears to contribute to 24% of cases of first episode psychosis in south London. Our findings show the importance of raising awareness among young people of the risks associated with the use of high-potency cannabis. The need for such public education is emphasised by the worldwide trend of liberalisation of the legal constraints on cannabis and the fact that high potency varieties are becoming much more widely available.”

For data on percent of those with marijuana-induced psychosis who go on to receive a diagnosis of a schizophrenia spectrum disorder:

Arendt M, Mortensen PB, Rosenberg R, Pedersen CB, Waltoft BL. Familial predisposition for psychiatric disorder: comparison of subjects treated for cannabis-induced psychosis and schizophrenia. Arch Gen Psychiatry. 2008;65(11):1269-74. http://archpsyc.ama-assn.org/cgi/reprint/65/11/1269
“Approximately half of the subjects who received treatment of a cannabis induced psychosis developed a schizophrenia spectrum disorder within 9 years after treatment…… The risk of schizophrenia after a cannabis-induced psychosis is independent of familial predisposition……. cannabis-induced psychosis may not be a valid diagnosis but an early marker of schizophrenia……. Psychotic symptoms after cannabis
use should be taken extremely seriously.”

Niemi-Pynttäri JA, Sund R, Putkonen H, Vorma H, Wahlbeck K, Pirkola SP. Substance-induced psychoses converting into schizophrenia: a register-based study of 18,478 Finnish inpatient cases. J Clin Psychiatry. 2013 74(1):e94-9.
“Eight-year cumulative risk to receive a schizophrenia spectrum diagnosis was 46% for persons with a diagnosis of cannabis-induced psychosis ….. chances for amphetamine-, hallucinogen-, opioid-, sedative- and alcohol-induced (schizophrenia spectrum diagnoses) were 30%, 24%, 21%, and 5% respectively.”

For cause and effect (which comes first: psychosis or marijuana use):
Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE, 2002, Cannabis use in
adolescence and risk for adult psychosis: longitudinal prospective study.BMJ. 2002 Nov 23;325(7374):1212-3.
“Firstly, cannabis use is associated with an increased risk of experiencing schizophrenia symptoms, even after psychotic symptoms preceding the onset of cannabis use are controlled for, indicating that cannabis use is not secondary to a pre-existing psychosis. Secondly, early cannabis use (by age 15) confers greater risk for schizophrenia outcomes than later cannabis use (by age 18). Thirdly, risk was specific to cannabis use, as opposed to use of other drugs….”

Henquet C, Krabbendam L, Spauwen J, et al. Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. BMJ. 2005;330:11–15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC539839/pdf/bmj33000011.pdf
“Exposure to cannabis during adolescence and young adulthood increases the risk of psychotic symptoms later in life. Cannabis use at baseline increased the cumulative incidence of psychotic symptoms at follow up four years later…but has a much stronger effect in those with evidence of predisposition for psychosis……….Predisposition for psychosis at baseline did not significantly predict cannabis use four years later..”

and also:

Kuepper R, van Os J, Lieb R, Wittchen HU, Höfler M, Henquet C. Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study.BMJ. 2011 Mar 1;342: d738 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047001/pdf/bmj.d738.pdf
“In individuals who had no reported lifetime psychotic symptoms and no reported lifetime cannabis use at baseline, incident cannabis use over the period from baseline to T2 increased the risk of later incident psychotic symptoms over the period from T2 to T3 (adjusted odds ratio 1.9, 95% confidence interval 1.1 to 3.1; P=0.021)…………There was no evidence for self medication effects, as psychotic experiences at T2 did not predict incident cannabis use between T2 and T3 (0.8, 0.6 to 1.2; P=0.3).”

For data on those who quit using when psychotic symptoms develop (further evidence against self-medication):

Fergusson DM, Horwood LJ, Ridder EM. Tests of causal linkages between cannabis use and psychotic symptoms. Addiction. 2005;100(3):354-66.

For degree of risk relative to other drugs:

Another angle on the potential confound of self-medication: genetic predisposition for schizophrenia does not predict cannabis use:

Veling W, Mackenbach JP, van Os J, Hoek HW. Cannabis use and genetic predisposition for schizophrenia: a case-control study. Psychol Med. 2008 Sep;38(9):1251-6. Epub 2008 May 19.
“BACKGROUND: Cannabis use may be a risk factor for schizophrenia. RESULTS: Cannabis use predicted schizophrenia [adjusted odds ratio (OR) cases compared to general hospital controls 7.8, 95% confidence interval (CI) 2.7-22.6; adjusted OR cases compared to siblings 15.9 (95% CI 1.5-167.1)], but genetic predisposition for schizophrenia did not predict cannabis use [adjusted OR intermediate predisposition
compared to lowest predisposition 1.2 (95% CI 0.4-3.8)].”

For data on potential benefits of cessation:

González-Pinto A, Alberich S, Barbeito S, Gutierrez M, Vega P, Ibáñez B, Haidar MK, Vieta E, Arango C. Cannabis and first-episode psychosis: different long-term outcomes depending on continued or discontinued use. Schizophr Bull. 2011 May;37(3):631-9. Epub 2009 Nov 13. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080669/pdf/sbp126.pdf
“OBJECTIVE: To examine the influence of cannabis use on long-term outcome in patients with a first psychotic episode, comparing patients who have never used cannabis with (a) those who used cannabis before the first episode but stopped using it during follow-up and (b) those who used cannabis both before the first episode and during follow-up….. CONCLUSION: Cannabis has a deleterious effect, but stopping use after the first psychotic episode contributes to a clear improvement in outcome. The positive effects of stopping cannabis use can be seen more clearly in the long term.”

Kuepper R, van Os J, Lieb R, Wittchen HU, Höfler M, Henquet C. Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study.BMJ. 2011 Mar 1;342: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047001/pdf/bmj.d738.pdf
“The finding that longer exposure to cannabis was associated with greater risk for persistence of psychotic experiences is in line with an earlier study showing that continued cannabis use over time increases the risk for psychosis in a dose-response fashion. This is also in agreement with the hypothesis that a process of sensitisation might underlie emergence and persistence of psychotic experiences as an indicator of liability to psychotic disorder.”

For data on marijuana use resulting in an earlier age of onset of schizophrenia (suggestive of causality), see Dragt et al. and a meta-analysis (see Large et al.,); also: a very extensive (676 schizophrena patients) and therefore more statistically powered analysis (see DeHert paper); two papers showing that the age-of-onset effect may be specific to those without a family history (see Scherr et al. and Leeson et al., papers); two studies that evaluate the age of onset specific to gender (Veen et al. and Compton et al. ) which is important because comparing across genders can be confounded by the greater tendency of males to engage in risky behavior (the conclusions are not the same in terms of gender; the gender distribution was slightly better in the Veen et al. study) and finally, two papers of relevance to specificity of age of onset effect to cannabis, a meta-analysis of published studies on age of onset that shows another drug of abuse (tobacco) is not associated with
a decreased age of onset (Myles et al.) and a study showing that ecstasy, LSD, stimulants, or sedatives did not have an effect to lower age of onset whereas cannabis use did (Barnes et al.) :

Large M, Sharma S, Compton MT, Slade T, Nielssen O. Cannabis Use and Earlier Onset of Psychosis: A Systematic Meta-analysis. Arch Gen Psychiatry. 2011 68(6):555-61. http://www.ncbi.nlm.nih.gov/pubmed/21300939
“The results of meta-analysis provide evidence for a relationship between cannabis use and earlier onset of psychotic illness, and they support the hypothesis that cannabis use plays a causal role in the development of psychosis in some patients. The results suggest the need for renewed warnings about the potentially harmful effects of cannabis.”

Dragt S, Nieman DH, Schultze-Lutter F, van der Meer F, Becker H, de Haan L, Dingemans PM, Birchwood M, Patterson P, Salokangas RK, Heinimaa M, Heinz A, Juckel G, Graf von Reventlow H, French P, Stevens H, Ruhrmann S, Klosterkötter J, Linszen DH; on behalf of the EPOS group.Cannabis use and age at onset of symptoms in subjects at clinical high risk for psychosis. Acta Psychiatr Scand. 2011 Aug 29. doi: 10.1111/j.1600-0447.2011.01763.x. [Epub ahead of print]
“Cannabis use and age at onset of symptoms in subjects at clinical high risk for psychosis. Objective: Numerous studies have found a robust association between cannabis use and the onset of psychosis. Nevertheless, the relationship between cannabis use and the onset of early (or, in retrospect, prodromal) symptoms of psychosis remains unclear. The study focused on investigating the relationship between cannabis
use and early and high-risk symptoms in subjects at clinical high risk for psychosis. Results: Younger age at onset of cannabis use or a cannabis use disorder was significantly related to younger age at onset of six symptoms (0.33 < r(s) < 0.83, 0.004 < P < 0.001). Onset of cannabis use preceded symptoms in most participants. Conclusion: Our results provide support that cannabis use plays an important role in the development of psychosis in vulnerable individuals.”

De Hert M, Wampers M, Jendricko T, Franic T, Vidovic D, De Vriendt N, Sweers K, Peuskens J, van Winkel R.Effects of cannabis use on age at onset in schizophrenia and bipolar disorder. Schizophr Res. 2011 Mar;126(1-3):270-6.

“BACKGROUND: Cannabis use may decrease age at onset in both schizophrenia and bipolar disorder, given the evidence for substantial phenotypic and genetic overlap between both disorders….RESULTS:… Both cannabis use and a schizophrenia diagnosis predicted earlier age at onset. There was a significant interaction between cannabis use and diagnosis, cannabis having a greater effect in bipolar patients….DISCUSSION:…. Our results suggest that cannabis use is associated with a reduction in age at onset in both schizophrenic and bipolar patients. This reduction seems more pronounced in the bipolar group than in the schizophrenia group: the use of cannabis reduced age at onset by on average 8.9 years in the bipolar group, as compared to an average predicted reduction of 1.5 years in the schizophrenia group.”

Scherr M, Hamann M, Schwerthöffer D, Froböse T, Vukovich R, Pit schel-Walz G, Bäuml J.. Environmental risk factors and their impact on the age of onset of schizophrenia: Comparing familial to non-familial schizophrenia. Nord J Psychiatry. 2011 Aug 31. [Epub ahead of print]
“Background and aims: Several risk factors for schizophrenia have yet been identified. The aim of our study was to investigate how certain childhood and adolescent risk factors predict the age of onset of psychosis in patients with and without a familial component (i.e. a relative with schizophrenia or schizoaffective disorder). Results: Birth complications and cannabis abuse are predictors for an earlier onset of schizophrenia in patients with non-familial schizophrenia. No environmental risk factors for an earlier age of onset in familial schizophrenia have been identified.”

Leeson VC, Harrison I, Ron MA, Barnes TR, Joyce EM. The Effect of Cannabis Use and Cognitive Reserve on Age at Onset and Psychosis Outcomes in First-Episode Schizophrenia. Schizophr Bull. 2011 Mar 9. [Epub ahead of print] http://schizophreniabulletin.oxfordjournals.org/content/early/2011/03/09/schbul.sbq153.full.pdf+html
“Objective: Cannabis use is associated with a younger age at onset of psychosis, an indicator of poor prognosis, but better cognitive function, a positive prognostic indicator. We aimed to clarify the role of age at onset and cognition on outcomes in cannabis users with first-episode schizophrenia as well as the effect of cannabis dose and cessation of use……Conclusions: Cannabis use brings forward the onset of psychosis in people who otherwise have good prognostic features indicating that an early age at onset can be due to a toxic action of cannabis rather than an intrinsically more severe illness. Many patients abstain over time, but in those who persist, psychosis is more difficult to treat.”

Veen ND, Selten JP, van der Tweel I, Feller WG, Hoek HW, Kahn RS. Cannabis use and age at onset of schizophrenia. Am J Psychiatry. 2004 Mar;161(3):501-6. http://ajp.psychiatryonline.org/cgi/reprint/161/3/501
“The results indicate a strong association between use of cannabis and earlier age at first psychotic episode in male schizophrenia patients.”

Compton MT, Kelley ME, Ramsay CE, Pringle M, Goulding SM, Esterberg ML, Stewart T, Walker EF. Association of pre-onset cannabis, alcohol, and tobacco use with age at onset of prodrome and age at onset of psychosis in first-episode patients. Am J Psychiatry. 2009 Nov;166(11):1251-7. Epub 2009 Oct 1. http://ajp.psychiatryonlie.org/cgi/reprint/166/11/1251
“Whereas classifying participants according to maximum frequency of use prior to onset (none, ever, weekly, or daily) revealed no significant effects of cannabis or tobacco use on risk of (editor’s note: “timing of”) onset, analysis of change in frequency of use prior to
onset indicated that progression to daily cannabis and tobacco use was associated with an increased risk of onset of psychotic symptoms. Similar or even stronger effects were observed when onset of illness or prodromal symptoms was the outcome. A gender-by-daily-cannabis use interaction was observed; progression to daily use resulted in a much larger increased relative risk of onset of psychosis in females than in males.”

Myles N, Newall H, Compton MT, Curtis J, Nielssen O, Large M. The age at onset of psychosis and tobacco use: a systematic meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2011 Sep 8. [Epub ahead of print]
“Unlike cannabis use, tobacco use is not associated with an earlier onset of psychosis.”

Barnes TR, Mutsatsa SH, Hutton SB, Watt HC, Joyce EM. Comorbid substance use and age at onset of schizophrenia. Br J Psychiatry. 2006 Mar;188:237-42. http://bjp.rcpsych.org/content/188/3/237.full.pdf+html
“Alcohol misuse and any substance use (other than cannabis use) were not significant in relation to age at onset….. those patients in the sample who reported that they had used cannabis had an earlier age at onset of psychosis than other patients who did not report cannabis use but who shared the same profile with regard to the other variables (e.g. comparing men who reported alcohol misuse and use of both cannabis and other drugs with men who had the same characteristics apart from the fact that they had not used cannabis).”

Data from other cultures

Sarkar J, Murthy P, Singh SP. Psychiatric morbidity of cannabis abuse. Indian J Psychiatry. 2003 Jul;45(3):182-8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952166/pdf/IJPsy-45-182.pdf
“The paper evaluates the hypothesis that cannabis abuse is associated with a broad range of psychiatric disorders in India, an area with relatively high prevalence of cannabis use. Retrospective case-note review of all cases with cannabis related diagnosis over a 11 -year period, for subjects presenting to a tertiary psychiatric hospital in southern India was carried out. Information pertaining to sociodemographic, personal, social, substance-use related, psychiatric and treatment histories, was gathered. Standardized diagnoses were made according to Diagnostic Criteria for Research of the World Health Organization, on the basis of information available.Cannabis abuse is associated with
widespread psychiatric morbidity that spans the major categories of mental disorders under the ICD-10 system, although proportion of patients with psychotic disorders far outweighed those with non-psychotic disorders. Whilst paranoid psychoses were more prevalent, a significant number of patients with affective psychoses, particularly mania, was also noted.”

Rodrigo C, Welgama S, Gunawardana A, Maithripala C, Jayananda G, Rajapakse S. A retrospective analysis of cannabis use in a cohort of mentally ill patients in Sri Lanka and its implications on policy development. Subst Abuse Treat Prev Policy. 2010 Jul 8;5:16. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910013/pdf/1747-597X-5-16.pdf
”BACKGROUND: Several epidemiological studies have shown that cannabis; the most widely used illegal drug in the world, is associated with schizophrenia spectrum disorders (SSD)……. CONCLUSIONS: Self reported LTC (editor’s note: life time cannabis) use was strongly associated with being diagnosed with SSD (editor’s note: schizophrenia spectrum disorders”.

Population study showing change in incidence rate in young when drug laws are eased

Ajdacic-Gross V, Lauber C, Warnke I, Haker H, Murray RM, Rössler W. Changing incidence of psychotic disorders among the young in Zurich. Schizophr Res. 2007 Sep;95(1-3):9-18. Epub 2007 Jul 16.
“There is controversy over whether the incidence rates of schizophrenia and psychotic disorders have changed in recent decades. To detect deviations from trends in incidence, we analysed admission data of patients with an ICD-8/9/10 diagnosis of psychotic disorders in the Canton Zurich / Switzerland, for the period 1977-2005. The data was derived from the central psychiatric register of the Canton Zurich. Ex-post forecasting with ARIMA (Autoregressive Integrated Moving Average) models was used to assess departures from existing trends. In addition, age-period-cohort analysis was applied to determine hidden birth cohort effects. First admission rates of patients with psychotic
disorders were constant in men and showed a downward trend in women. However, the rates in the youngest age groups showed a strong increase in the second half of the 1990’s. The trend reversal among the youngest age groups coincides with the increased
use of cannabis among young Swiss in the 1990’s.”

Estimates of how many men aged 20-40 would have to avoid regular marijuana use for one year in order to prevent one case of schizophrenia in that same year (but for number relevant to a 20 year avoidance of schizophrenia by avoiding regular marijuana use during
20 years, divide by 20):

Hickman M, Vickerman P, Macleod J, Lewis G, Zammit S, Kirkbride J, Jones P. If cannabis caused schizophrenia–how many cannabis users may need to be prevented in order to prevent one case of schizophrenia? England and Wales calculations. Addiction. 2009;104(11):1856-61.

“In men the annual mean NNP (number needed to prevent) for heavy cannabis and schizophrenia ranged from 2800 [90% confidence interval (CI) 2018–4530] in those aged 20–24 years to 4700 (90% CI 3114–8416) in those aged 35–39”.

Key studies interpreted to diminish the connection between marijuana and schizophrenia:

Proal AC, Fleming J, Galvez-Buccollini JA, Delisi LE. A controlled family study of cannabis users with and without psychosis. Schizophr Res. 2014 Jan;152(1):283-8.
“The results of the current study, both when analyzed using morbid risk and family frequency calculations, suggest that having an increased familial risk for schizophrenia is the underlying basis for schizophrenia in these samples and not the cannabis use. While cannabismay have an effect on theage of onset of schizophrenia it is unlikely to be the cause of illness.”

Rebuttal: Miller CL. Caution urged in interpreting a negative study of cannabis use and schizophrenia. Schizophr Res. 2014 Apr;154(1-3):119-20.
“The morbid risk reported for the relatives of the non-cannabis-using patients (Sample 3) was actually 1.4-fold higher than the cannabis using patients (Sample 4), but the study did not have enough power to statistically confirm or refute a less than 2-fold difference. An increase in sample size would be required to do so, and if the observed difference were to be confirmed, it would explain not only why the Sample 4 data fits poorly with a multigene/small environmental impact model but also would give weight to the premise that cannabis use significantly contributes to the development of this disease.”

Power RA, Verweij KJ, Zuhair M, Montgomery GW, Henders AK, Heath AC, Madden PA, Medland SE, Wray NR, Martin NG. Genetic predisposition to schizophrenia associated with increased use of cannabis. Mol Psychiatry. 2014 Jun 24. doi: 10.1038/mp.2014.51. [Epub ahead of print] http://emilkirkegaard.dk/en/wp-content/uploads/Genetic%20predisposition%20to%20schizophrenia%20associated%20with%20increased%20use%20of%20cannabis.pdf
“Our results show that to some extent the association between cannabis and schizophrenia is due to a shared genetic aetiology across common variants. They suggest that individuals with an increased genetic predisposition to schizophrenia are
both more likely to use cannabis and to use it in greater quantities.”

Rebuttal: Had this paper been titled “The causal genes for schizophrenia have been discovered” it would never have been published. In the absence of a consistent finding of genes of major effect size for schizophrenia, this study of inconsistently associated genes of low effect size is meaningless.

Buchy L, Perkins D, Woods SW, Liu L, Addington J. Impact of substance use on conversion to psychosis in youth at clinical high risk of psychosis. Schizophrenia Res 156 (2-3): 277–280.
“Results revealed that low use of alcohol, but neither cannabis use nor tobacco use at baseline, contributed to the prediction of psychosis in the CHR sample”.
Rebuttal: The study was small in size and the age range of their subjects at study onset was large (12 to 31) which included both subjects that had not reached the peak age of risk for schizophrenia even by the end of the study as well as subjects who were well past the peak age of onset of schizophrenia. The fact that the study screened out psychotic individuals was problematic for the latter group, in that those who were most vulnerable to the psychosis inducing effects of cannabis would already have converted to psychosis by that age.

Overview of Key Public Health Issues Regarding the Mental Health Effects of Marijuana

For the monetary cost of schizophrenia to the U.S. annually ($63 billion in 2002 dollars):

Wu EQ, Birnbaum HG, Shi L, Ball DE, Kessler RC, Moulis M, Aggarwal J. The economic burden of schizophrenia in the United States in 2002. J Clin Psychiatry. 2005 Sep;66(9):1122-9.

For the trends in adolescent drug, alcohol and cigarette use, showing an upward tick in marijuana use as medical marijuana has become more prevalent, and that the mind-altering drug legal for adults (alcohol) is still more commonly used by teens than is marijuana:

Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2012). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2011. Ann Arbor, MI: Institute for Social Research, The University of Michigan.

For a summary of Sweden’s drug law experience:
Hallam C., 2010, Briefing paper 20, The Beckley Foundation: What Can We Learn from Sweden’s Drug Policy Experience? www.beckleyfoundation.org/pdf/BriefingPaper_20.pdf
“in the case of Sweden, the clear association between a restrictive drug policy and low levels of drug use is striking. In his foreword to the article on Sweden’s Successful Drug Policy, Antonio Maria Costa is frank enough to confess that, “It is my firm belief that the generally positive situation of Sweden is a result of the policy that has been applied to address the problem”.

For data showing the relationship between drug enforcement policies in Europe and drug use, such that Sweden has a zero tolerance policy on drugs and has one of the lowest rates of “last month use” in Europe (1%), 4-fold lower than the Netherlands and 7-fold lower than Spain and Italy, two countries that have liberalized their enforcement policies so that marijuana possession carries no substantive penalty.

European Monitoring Centre for Drugs and Addiction, 2012 Annual report
http://www.emcdda.europa.eu/attachements.cfm/att_190854_EN_TDAC12001ENC_.pdf

Source: Microsoft Word – 2015- Summary of literature on marijuana and psychosis.doc (momsstrong.org) January 2016

Filed under: Alcohol,Brain and Behaviour,Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,Effects of Drugs,Nicotine,Political Sector,Social Affairs :

The 2018 Monitoring the Future College Students and Young Adults survey shows trends in the use of marijuana, alcohol, nicotine, and synthetic drugs in college students and non-college peers.

Marijuana Use

Annual Marijuana Use at Historic Highs among College and Non-College Peers*
Marijuana use is nearly the same for college students and their non-college peers at about 43%. This is approximately a 7% increase over five-years for college students. These rates for both groups are the highest in 35 years.

Daily/Near Daily Use** of Marijuana Twice as High among Non-College Group
Approximately one in nine non-college respondents reporting daily or near daily use, (11.1%) compared to about one in 17 college students (5.9%).

** Used on 20 or more occasions in the past 30 days

Past Month Nicotine Vaping Doubles Among College Students

This jump is among the greatest one-year increase seen for any substance in the history of the survey.
Between 2017 and 2018, nicotine vaping increased in college students from 6.1% to 15.5% and from 7.9% to 12.5% in non-college adults.

Rx Drug Misuse has Mixed Results

Rx Opioid Misuse: Significant Five Year Drop in Both Groups
Past year misuse of prescriptions opioids dropped from 5.4% in 2013 to 2.7% among college students and from 9.6% in 2013 to 3.2% among non-college adults.

Adderall® Misuse: Significant Gender Differences
Past year misuse rates of Adderall® were 14.6% among college men and 8.8% among college women. Rates were higher, however, in non-college women than in non-college men (10.1% and 5.3% respectively).

Overall Adderall® misuse is higher among college students (11.1%) than their non-college peers (8.1%)

Binge Drinking (five or more drinks in a row in the past two weeks) Fell Below 30% for the First Time among College Students

In 2018, binge drinking declined among college students (28%) and non-college adults (25%).

*Please note, the college-age adults are ages 19-22.

Source: Drug and Alcohol Use in College-Age Adults in 2018 | National Institute on Drug Abuse (NIDA) (nih.gov) September 2019

Filed under: Alcohol,Cannabis/Marijuana,Nicotine,Political Sector,Synthetics :

As with any addiction, alcoholism is closely connected with stress. And while plenty of people first started drinking as a way to cope with stress or even just wind down after a long day, developing an alcohol use disorder can end up causing significant stresses of its own. If you’re thinking about pursuing alcohol use disorder treatment for yourself or for a loved one, it can be helpful to understand how alcohol is connected to stress.

Present Stress That Can Lead to Alcohol Use

While stresses from your past can certainly contribute to alcoholism, plenty of people also start to develop alcohol use disorder as they struggle to cope with current stress. Often, people end up turning to alcohol in order to try to manage the stresses of day-to-day life. These can include pressure at work or at school, marriage, and divorce, moving, and financial issues.

Minority stress is also an important consideration. If you’re a minority (either in terms of race/ethnicity or sexual orientation), you face unique stresses. You might stress about being passed over for a promotion at work, and you also might fear harassment or becoming the victim of a hate crime.

It’s important to note that stress alone typically does not cause a substance use disorder. However, significant stresses may place you at higher risk of developing one, and high stress levels in sobriety can also make relapse more likely. High stress is a risk factor for alcoholism, along with the following:

One or more close relatives who have an alcohol use disorder
Depression and other mental health disorders
Heavy drinking over time (which can sometimes result in alcohol-induced dementia)
Social factors (like the way alcohol is viewed or treated in your community)
A history of past traumas

Past Stress That Can Lead to Alcohol Use

Unfortunately, it isn’t just current stressful events that can predispose you to drink more. Stresses and traumas from your past can also play a role in alcoholism. Several studies point to childhood abuse and neglect as being a significant factor in the development of an alcohol use disorder. One study found that emotional abuse and neglect were most commonly seen in men and women seeking help for alcoholism. The severity of their alcoholism correlated with the severity of the abuse.

Past traumas, even if they were not experienced in childhood, may also make someone more likely to experience alcoholism. Many people with an alcohol use disorder also have PTSD. As with other mental health diagnoses, the relationship between alcoholism and PTSD becomes a vicious cycle. Alcohol use makes PTSD symptoms worse, and the PTSD symptoms make alcoholism worse.

If you have experienced trauma and are also struggling with alcohol use disorder, it’s easy to feel as though there is no hope. But at Granite Recovery Centers, we offer evidence-based therapies including trauma therapy. In therapy for trauma and PTSD, you will be able to process your trauma and develop healthier coping strategies to help you avoid self-destructive behaviors. With these therapies, you’ll be able to break the cycle of worsening symptoms and experience a greater quality of life.

How Can Alcohol Use Cause Stress?

While it might seem logical that alcohol use can cause stress, there’s also a good bit of biochemical evidence to explain, at least in part, how alcohol shapes your stress response. Even in the short term, alcohol consumption increases levels of cortisol. Cortisol is known as the stress hormone, and your body also releases it during periods of intense anxiety or fear. In the short term, a cortisol release can be helpful — it increases alertness and focus, which was helpful evolutionarily because it helped humans and animals get themselves out of dangerous situations.

However, having elevated cortisol over a long period of time can be detrimental, exhausting, and even dangerous. And in chronic heavy drinkers and those with alcohol use disorder, cortisol isn’t just elevated during intoxication — it stays elevated through withdrawal. In fact, one study even found that cortisol increased as intoxicated people started moving toward withdrawals. If you’ve ever experienced intense anxiety when withdrawing from alcohol, you’ve felt this cortisol surge firsthand.

Because most people with an alcohol use disorder go through a near-constant cycle of intoxication and withdrawal, cortisol can remain elevated for years on end. Chronically elevated cortisol can cause a number of ill health effects:

Slow healing (of wounds, broken bones, etc.)
Acne
Thinning skin
Weight gain
Extreme fatigue
Irritability
Trouble focusing
Muscle weakness
Headaches
Elevated blood pressure

Chronically elevated cortisol may cause other health problems as well, but more research is needed to determine exactly what these effects are. Of course, the physical stresses of elevated cortisol combined with chronic heavy drinking can mean your body is put through a lot of physical stress as well as emotional stress.

You already know that plenty of people use alcohol to alleviate stress, but over time, alcohol can cause its own significant stresses. As mentioned above, the elevated cortisol you experience while intoxicated and in withdrawal can cause significant emotional distress. When your body is under stress, and elevated cortisol is effectively causing a constant stress response, it becomes significantly more difficult to handle even everyday stresses.

And in some cases (like when you are intoxicated enough to experience blackouts or respiratory suppression), being intoxicated can be a stressful experience in itself. And for many people with an alcohol use disorder, that stressful experience is something they experience on a daily or near-daily basis. Some of the physical effects of heavy drinking — including dizziness, nausea, headaches, and dehydration — can compound the emotional stress you’re already feeling.

Many people also consciously or unconsciously use alcohol to self-medicate psychiatric disorders, including depression and bipolar disorder. However, in many cases, alcohol use worsens the symptoms of mental health issues, which can cause considerably more emotional distress on a daily basis. In some cases, heavy alcohol use can even contribute to the development of new mental health diagnoses.

If you’ve been using alcohol to help manage a mental health diagnosis (or to help manage a mental health issue that has not yet been diagnosed), Granite Recovery Centers’ dual diagnosis treatment program can help you. With this approach, medical and recovery professionals work with you to find better treatments and coping mechanisms for your mental health diagnosis while also helping you manage your alcohol use disorder. In many cases, this treatment approach will greatly improve your quality of life, as you’ll be much better equipped to manage both diagnoses.

Regardless of whether you have a mental health diagnosis or not, heavy alcohol use can begin to cause stress as it starts to affect the rest of your life. For example, you may constantly worry whether someone will smell alcohol on your breath at work, or you may worry about when you can take another drink. For many people with an alcohol use disorder, it can start to feel like leading a double life, which becomes exhausting and highly stressful over time. And as a person starts to drink more, they often become more socially isolated. Feeling isolated can increase stress, and the person may then continue drinking heavily to cope with that stress.

If you struggle with an alcohol use disorder or other substance use disorder, you already know just how stressful day-to-day life can become. If you have to drink to get rid of withdrawal symptoms and can’t control your drinking once you start, it’s easy to feel trapped, which is, of course, a major stress in itself. If you feel this way, you aren’t alone — taking the first steps to get help can free you from the seemingly unending cycle of alcohol use.

How Do I Know If I’ve Developed an Alcohol Use Disorder?

If you have started using alcohol as a way to cope with stress, it can be difficult to tell whether you have developed an alcohol use disorder or if you are beginning to develop one. While you’ll need to consult a medical professional if you’re looking for a definite diagnosis, you can look for some of the common signs:

Spending a lot of time both drinking and recovering from drinking
Not being able to control how much you drink once you start
Continuing to drink even when you experience negative consequences
Giving up on hobbies or responsibilities in order to drink
Developing an alcohol tolerance
Craving alcohol or becoming preoccupied with drinking when you can’t drink
Experiencing withdrawal symptoms when you don’t drink (or drinking to ensure you avoid these symptoms)
Using alcohol when it is dangerous to do so (like when you’re driving)

Binge drinking can also be a sign of a developing alcohol use disorder. Binge drinking is defined as consuming five or more standard drinks in two hours for men and consuming four or more standard drinks in two hours for women. On its own, binge drinking doesn’t necessarily indicate an alcohol use disorder, but it could be a sign that one is starting to develop.

It’s important to keep in mind that alcohol use disorders are on a spectrum. Milder cases tend to have fewer symptoms present, while more severe cases have more. Even if you think you only have a mild case, you can still benefit tremendously from treatment. Most cases of alcohol use disorder become progressively worse over time.

How Can Treatment Help?

If you’re unfamiliar with substance use disorder treatment, you may think residential treatment’s only benefit is preventing you from accessing your substance of choice. This couldn’t be further from the truth. A good residential treatment program takes a holistic approach to help you improve your life.

In most cases (and definitely in severe cases), a stay at a residential treatment center begins with a medical detox program. In medical detox, you’ll be supervised by a doctor and likely given medication to prevent seizures and other complications of alcohol withdrawal. Withdrawing from alcohol on your own can be very dangerous, and inpatient detox can ensure that you’re safe. Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency.

Once you’re in treatment, you’ll work with counselors and medical professionals to help you identify issues that make you want to drink. These professionals will help you develop healthier coping mechanisms to deal with stress so you’ll be less likely to turn to alcohol in the future. You may get to participate in cognitive behavioral therapy and dialectical behavioral therapy, as well as trauma therapy if needed.

Nutritional deficiencies developed while drinking heavily can add to stress and feeling generally unwell, so residential rehabilitation includes healthy food and ample exercise opportunities. And if you have a co-occurring mental health condition, on-site professionals will help you develop an effective treatment plan.

Ready to Take the Next Step?

Alcohol is an easy answer to stress for many people. But if you have an alcohol use disorder, chances are good that alcohol only causes more stress and worsens the stress you already have. And if the prospect of quitting by yourself seems like too much, don’t worry—the professionals working with Granite Recovery Centers will be helping you every step of the way. If you’re ready to change your life, give us a call at 855-712-7784 today!

Source: https://www.graniterecoverycenters.com/resources/the-connection-between-stress-and-alcoholism/ April 2021

Filed under: Alcohol,Brain and Behaviour,Health,Treatment and Addiction :

Cannabis Use in Pregnancy – A Tale of 2 Concerns

In an article in JAMA, Corsi and colleagues present the results of a retrospective cohort study of 661 617 women designed to assess associations between maternal cannabis use during pregnancy and adverse obstetrical and birth outcomes.

In a matched analysis designed to control for confounding, the investigators compared 5639 self-reported cannabis users with 92 873 nonusers and found elevated rates of preterm birth (defined as gestational age <37weeks) among those who reported cannabis use. Specifically, the rates of pre term birth in the matched cohort were 10.2% vs 7.2% (risk difference, 2.98% [95% CI, 63%-3.34%]; relative risk, 1.41 [95%CI, 1.36-1.47]). While similar risks were observed for small-for-gestational-age birth and placental abruption, there appeared to be a small protective association between cannabis use and preeclampsia and gestational diabetes.

In another article in JAMA, Volkow and colleagues report findings on cannabis use among 4400 pregnant women and 133,900 nonpregnant women aged 12 to 44 years who participated in the National Survey on Drug Use and Health from 2002 to 2017. The authors documented an increase in the adjusted prevalence of cannabis use during pregnancy from 3.4%in 2002 to 7.0%in 2017—almost of all which appeared to be explained by nonmedical use.

These studies send a straightforward message: cannabis use in pregnancy is likely unsafe; with an increasing prevalence of use (presumably related to growing social acceptability and legalization in many states), its potential for harm may represent a public health problem.

This message is based on the sound, if imperfect, epidemiology of these studies and is heightened by a misperception that marijuana is safe, as evidenced by its direct marketing to pregnant women for morning sickness despite accumulating evidence of harm.

However, there is an additional series of equally legitimate concerns, rooted more in history than epidemiology. These historical concerns relate to past and ongoing discourses on alcohol use in pregnancy and to the cocaine “epidemic that wasn’t” of the 1980s.

Both of these histories, although imperfect comparators with the emerging data on cannabis, illustrate points that provide important context to the present studies published in JAMA

First, there are issues involving the epidemiology. Randomized designs are impractical for studying risks and harms, and observational studies are prone to unmeasured confounding.

In this respect, the study by Corsi and colleagues is no different

From any other cohort study; it is, however, further limited by use of registry data, derived primarily from clinical encounters, to assess cannabis exposure. Although the investigators performed some internal validity checks on their measurement of exposure, clinical data in the field of substance use tend to lack validation (and thus are prone to mis- classification error), particularly when unaccompanied by biological markers . Compounding this limitation is the inability to glean from the data the timing of cannabis exposure or a dose-response relationship between exposure and out comes, both of which represent fundamental epidemiologic principles to support causality.

There was also no assessment of birth weight, which tends to be measured more accurately than gestational age. Despite these limitations, the study is consistent with previous studies that have assessed the association between cannabis use in pregnancy and birth outcomes and provides important, population-based data.

Second, the historical context requires consideration. What has been learned from the debates about alcohol and cocaine use in pregnancy? Although it is accepted that heavy alcohol drinking during pregnancy poses an unacceptable risk to the developing foetus, the effect of moderate alcohol consumption continues to be controversial.

On one side of this argument, those who interpret the data using a strict, by-the-numbers approach conclude that there is only minimal evidence that moderate alcohol consumption poses a demonstrable risk.

On the other side of the argument are those who interpret the data more broadly to conclude that without an empirically proven safe level of exposure, abstinence is the only reasonable advice the medical community can give to pregnant women.

One lesson of the current alcohol debate—which is often couched in terms of women’s ability to enjoy wine with dinner and thus assumes the perception of an issue that predominantly affects the privileged—is that two reasonable perspectives can be applied to the same body of opposing, non literature and reach stigmatizing conclusions.

In other words, the issue is not the data but the values that individuals bring to the data and to whom the data are thought to be most relevant.

Extrapolating this logic to the data Corsi et al present on cannabis, some might choose to focus on the reported 41% increased relative risk of pre -term birth as unacceptably high; others might choose to focus on the 2.98% absolute risk difference to be such that cannabis-related relaxation or improvement in morning sickness may not be worth abstaining from this drug.

The study by Corsi and colleagues could also be interpreted through a slightly different lens. Perhaps it represents part of an emerging story of an in utero substance exposure that is neither highly prevalent nor extremely rare, an outcome that is consequential more on a population than individual level, and an association between exposure and outcome that is moderate in both its magnitude and degree of certainty.

Unlike the “wine with dinner” debate, the dialogue on cannabis use is likely to be relevant to many sectors of society and may end up focusing on young people, especially those of colour, among whom use is markedly increasing. In these respects, a comparison with certain aspects of the history of cocaine use in pregnancy may be instructive. In 1985, the first “scientific” observation of the relationship between in utero cocaine exposure and neonatal outcomes was published. Even by the standards of its day, this study (and many that followed) were fundamentally flawed. Yet they provided “evidence” for those in the medical community and lay press to publicly exaggerate risks of cocaine in pregnancy and to attribute (both implicitly and explicitly) lifelong disability to a large cohort of primarily minority children, for whom subsequent research demonstrated similar outcomes to unexposed children raised in similar environments.

Perhaps worse, this exaggerated risk amplified judgment and stereotype, leading to the enduring racist social constructs of the “cocaine mother” and “crackbaby” and to criminalization of substance use among pregnant women. Regrettably, the exaggerated dialogue on cocaine did little to shed light on the sequelae of urban poverty and legacy of racism in the United States. It is possible to argue that the comparisons of cannabis vs alcohol and cocaine are not entirely fair. Cocaine in particular is biologically more destructive than cannabis, universally illegal in the United States, and without health benefit.

Furthermore, the dialogue on cocaine was defined by exaggeration; so far, the dialogue on cannabis has largely been defined by a false perception of safety. While these are fair criticisms, some historic lessons of both alcohol and cocaine apply: it is impossible to separate data from the values that individuals bring to those data, no group is immune to the judgment of others, and women and minority groups (particularly pregnant women of colour) tend to bear the greatest burden of many of these judgments.

While an obvious reaction to these new data on in utero cannabis exposure is that more research is necessary, more epidemiology is unlikely to completely resolve the complex issue of potentially safe moderate use or to completely remove the tendency to imbue data interpretation with implicit biases about groups of people.

Perhaps the best reflection that can be offered is a reprise of that offered by Mayes et al in 1992. This commentary acknowledged the potential harms of prenatal cocaine exposure, dispassionately delineated the methodologic problems with the state of the literature at the time, and expressed concern that premature conclusions attributing irremediable damage in children to exposure to a single substance (isolated from the broader social milieu) were, in and of themselves, harmful. This harm, the commentary argued, accrued by way of permanently lowered expectations and by a discourse that focused on judgment and attribution as opposed to prevention and positive intervention.

The current data reported by Corsi et al and Volkow et al should spark genuine concern about the association of cannabis use in pregnancy with pre term birth. However, there should be additional concern about whether such findings may ripple through society and re-create some of the mistakes of the past.

Source: Cannabis Use in Pregnancy: A Tale of 2 Concerns – PubMed (nih.gov) June 2019

Filed under: Alcohol,Cannabis/Marijuana,Cocaine,Drug use-various effects on foetus, babies, children and youth :

A growing number of countries are deciding to ditch prohibition. What comes next?

In an anonymous-looking building a few minutes’ drive from Denver International Airport, a bald chemotherapy patient and a pair of giggling tourists eye the stock on display. Reeking packets of mossy green buds—Girl Scout Cookies, KoolAid Kush, Power Cheese—sit alongside cabinets of chocolates and chilled drinks. In a warehouse behind the shop pointy-leaved plants bask in the artificial light of two-storey growing rooms. Sally Vander Veer, the president of Medicine Man, which runs this dispensary, reckons the inventory is worth about $4m.

America, and the world, are going to see a lot more such establishments. Since California’s voters legalised the sale of marijuana for medical use in 1996, 22 more states, plus the District of Columbia, have followed suit; in a year’s time the number is likely to be nearer 30. Sales to cannabis “patients” whose conditions range from the serious to the notional are also legal elsewhere in the Americas (Colombia is among the latest to license the drug) and in much of Europe. On February 10th Australia announced similar plans.

Now a growing number of jurisdictions are legalising the sale of cannabis for pure pleasure—or impure, if you prefer. In 2014 the American states of Colorado and Washington began sales of recreational weed; Oregon followed suit last October and Alaska will soon join them. They are all places where the drug is already popular (see chart 1). Jamaica has legalised ganja for broadly defined religious purposes. Spain allows users to grow and buy weed through small collectives. Uruguay expects to begin non-medicinal sales through pharmacies by August.

Canada’s government plans to legalise cannabis next year, making it the first G7 country to do so. But it may not be the largest pot economy for long; California is one of several states where ballot initiatives to legalise cannabis could well pass in America’s November elections. A majority of Americans are in favour of such changes (see chart 2).

Legalisers argue that regulated markets protect consumers, save the police money, raise revenues and put criminals out of business as well as extending freedom. Though it will be years before some of these claims can be tested, the initial results are encouraging: a big bite has been taken out of the mafia’s market, thousands of young people have been spared criminal records and hundreds of millions of dollars have been legitimately earned and taxed. There has so far been no explosion in consumption, nor of drug-related crime.

To get the most of these benefits, though, requires more than just legalisation. To live outside the law, Bob Dylan memorably if unconvincingly claimed, you must be honest; to live inside it you must be regulated. Ms Vander Veer points to a “two-inch thick” book of rules applicable to Medicine Man’s business.

Such rules should depend on which of legalisation’s benefits a jurisdiction wants to prioritise and what harms it wants to minimise. The first consideration is how much protection users need. As far as anyone has been able to establish (and some have tried very hard indeed) it is as good as impossible to die of a marijuana overdose. But the drug has downsides. Being stoned can lead to other calamities: in the past two years Colorado has seen three deaths associated with cannabis use (one fall, one suicide and one alleged murder, in which the defendant claims the pot made him do it). There may have been more. Colorado has seen an increase in the proportion of drivers involved in accidents who test positive for the drug, though there has been no corresponding rise in traffic fatalities.

The chronic harm done by the drug is still a matter for debate. Heavy cannabis use is associated with mental illness, but researchers struggle to establish the direction of causality; a tendency to mental illness may lead to drug use. It may also be the case that some are more susceptible to harm than others.

Jonathan Caulkins of Carnegie Mellon University has found that cannabis users are more likely than alcohol drinkers to say the drug has caused them problems at work or at home. It is an imperfect comparison because most cannabis users are, by definition, lawbreakers, and therefore perhaps more prone to such problems. Nonetheless it is clear that pot is, in Mr Caulkins’ words, a “performance-degrading drug”.

What’s more, some struggle to give it up: in America 14% of people who used pot in the past month meet the criteria by which doctors define dependence. As in the alcohol and tobacco markets, about 80% of consumption is accounted for by the heaviest-using 20% of users. Startlingly, Mr Caulkins calculates that in America more than half of all cannabis is consumed by people who are high for more than half their waking hours.

To complicate matters, the public-health effects of cannabis should not be looked at in isolation. If taking up weed made people less likely to consume cigarettes or alcohol it might offer net benefits. But if people treat cannabis and other drugs as complements—that is, if doing more pot makes them smoke more tobacco or guzzle more alcohol—an increase in use could be a big public-health problem.

No one yet knows which is more likely. A review of mostly American studies by the RAND Corporation, a think-tank, found mixed evidence on the relationship between cannabis and alcohol. Demand for tobacco seems to go up along with demand for cannabis, though the two are hard to separate because, in Europe at least, they are often smoked together. The data regarding other drugs are more limited. Proponents of the Dutch “coffee shop” system, which allows purchase and consumption in specific places, argue that legalisation keeps users away from dealers who may push them on to harder substances. And there is some evidence that cannabis functions as a substitute for prescription opioids, such as OxyContin, which kill 15,000 Americans each year. People used to worry that cigarettes were a “gateway” to cannabis, and that cannabis was in turn a gateway to hard drugs. It may be the reverse: cannabis could be a useful restraint on the abuse of opioids, but a dangerous pathway to tobacco.

More bong for your buck

Danger and harm are not in themselves a reason to make or keep things illegal. But the available evidence persuades many supporters of legalisation that cannabis consumption should still be discouraged. The simplest way to do so is to keep the drug expensive; children and heavy users, both good candidates for deterrence, are particularly likely to be cost sensitive. And keeping prices up through taxes has political appeal that goes beyond public health. Backers of California’s main legalisation measure make much of the annual $1 billion that could flow to state coffers.

Setting the right level for the tax, though, is challenging. Go too low and you encourage use. Aim too high and you lose one of the other benefits of legalisation: closing down a criminal black market.

Comparing Colorado and Washington illustrates the trade-off. Colorado has set its pot taxes fairly low, at 28% (including an existing sales tax). It has also taken a relaxed approach to licensing sellers; marijuana dispensaries outnumber Starbucks. Washington initially set its taxes higher, at an effective rate of 44%, and was much more conservative with licences for growers and vendors. That meant that when its legalisation effort got under way in 2014, the average retail price was about $25 per gram, compared with Colorado’s $15. The price of black-market weed (mostly an inferior product) in both states was around $10.

The effect on crime seems to have been as one would predict. Colorado’s authorities reckon licensed sales—about 90 tonnes a year—now meet 70% of total estimated demand, with much of the rest covered by a “grey” market of legally home-grown pot illegally sold. In Washington licensed sales accounted for only about 30% of the market in 2014, according to Roger Roffman of the University of Washington. Washington’s large, untaxed and rather wild-west “medical” marijuana market accounts for a lot of the rest. Still, most agree that Colorado’s lower prices have done more to make life hard for organised crime.

Uruguay also plans to set prices comparable to those that illegal dealers offer. “We intend to compete with the illicit market in price, quality and safety,” says Milton Romani, secretary-general of the National Drug Board. To avoid this competitively priced supply encouraging more use, the country will limit the amount that can be sold to any particular person over a month. In America, where such restrictions (along with the register of consumers needed to police them) would probably be rejected, it will be harder to stop prices for legal grass low enough to shut down the black market from also encouraging greater use. Indeed, since legalisation consumption in Colorado appears to have edged up a few percentage points among both adults and under-21s, who in theory shouldn’t be able to get hold of it at all; that said, a similar trend was apparent before legalisation, and the data are sparse.

If, starved of sales, the black market shrinks beyond a point of no return, taxes could later go up, restoring the deterrent. There is precedent for this. When the prohibition of alcohol ended in 1933, Joseph Choate of America’s Federal Alcohol Control Administration recommended “keeping the tax burden on legal alcoholic beverages comparatively low in the earlier post-prohibition period in order to permit the legal industry to offer more severe competition to its illegal competitor.” After three years, he estimated, with the mob “driven from business, the tax burden could be gradually increased.” And so it was (see chart 3).

Those taxes reflected the strength of what was for sale; taxing whiskey more than beer made sense as a deterrent to drunkenness. Here, so far, the regulation of cannabis lags behind. The levies on price or weight used by America’s legalising states are easy to administer, but could push consumers towards stronger strains. In the various lines sold by Medicine Man, for example, the concentration of tetrahydrocannabinol (THC), the chemical compound that gets you high, varies from 7% to over 20%. The prices, though, are mostly the same, and there is no difference in tax. Some like it weak, but on the whole, Ms Vander Veer says, the stronger varieties are what people ask for. If they cost no more, why not? The average potency on sale in Denver is now about 18%, roughly three times the strength of the smuggled Mexican weed that once dominated the market.

Barbara Brohl, the head of Colorado’s Department of Revenue, says THC-based taxation is something the state may try in the future. But the speed with which the regulatory apparatus was set up—sales began just over a year after the ballot initiative passed in November 2012—meant that they had to move fast. “We’re building the airplane while we’re in the air,” she says. Uruguay, clear that it wants to be “a regulated market, not a free market”, as Mr Romani puts it, plans a more direct way of discouraging the stronger stuff. Dispensaries will sell just three government-approved strains of cannabis, their potencies ranging from 5% to 14%.

Another issue for regulators is the increasing number of ways in which cannabis is consumed. The star performer of the legalised pot market is the “edibles” sector, which includes THC-laced chocolates, drinks, lollipops and gummy bears. There are also concentrated “tinctures” to be dropped onto the tongue and vaping products to be consumed through e-cigarettes. Foria, a California company, sells a THC-based personal lubricant (“For all my vagina knew, I was laying on one of San Diego’s fabulous beaches!” reads one testimonial).

The popularity of these products looks set to grow; users appreciate the discretion with which they can be consumed, producers like the ease with which their production can be automated (no hand-picking of buds required). But edibles, in particular, make it easy to take more than intended. A hit on a joint kicks in quickly; cakes or drinks can take an hour or two. Inexperienced users sometimes have a square of chocolate, feel nothing and wolf down the rest of the bar—only to spend the next 12 hours believing they are under attack by spiders from Mars.

The three cannabis-related deaths in Colorado all followed the consumption of edibles. Hospitals in the state also report seeing an increasing number of children who have eaten their parents’ grown-up gummy bears. In response the authorities have tightened their rules on packaging, demanding clearer labelling, childproof containers, and more obvious demarcation of portions.

A second concern about new ways of taking the drug is that they could attract new customers. Ms Vander Veer says that edibles offer a “good way to get comfortable with how THC makes you feel”; women, older people and first-timers are particularly keen on them. If you see cannabis as a harmless high, this is not a problem. If you want to keep usage low, it is.

The innovation seen to date is just a taste of what entrepreneurs might eventually dream up. On landing in Denver—which, uncoincidentally, is now the most popular spring-break destination for American students—you can call a limo from 420AirportPickup which will drive you to a dispensary and then let you smoke in the back while you cruise on to a cannabis-friendly hotel (some style themselves “bud ‘n’ breakfast”). You can take a marijuana cookery course, or sign up for joint-rolling lessons. Dispensaries offer coupons, loyalty points, happy hours and all the other tricks in the marketing book.

Legalisation has also paved the way for better branding. Snoop Dogg, a rap artist, has launched a range of smartly packaged products called “Leafs by Snoop”. The estate of Bob Marley has lent its name to a range of “heirloom marijuana strains” supposedly smoked by the man himself.

Roll up for the mystery tour

Branding means advertising, which may itself promote use. Many in America would like to follow Uruguay’s example and ban all cannabis advertising, but the constitution stands in their way. When Colorado banned advertising in places where more than 30% of the audience is likely to be under-age cannabis companies objected on the grounds of their right to free speech, though the suit was later dropped.

As well as moving into advertising, the industry is growing more professional in its lobbying. In legalisation initiatives the “Yes” side increasingly outspends the “No” side: in Alaska by four to one, in Oregon by more than 50 to one. Rich backers help—in California Sean Parker, an internet billionaire, has donated $1m to the cause. In some states, ballot initiatives have been heavily influenced by the very people who are hoping to sell the drugs once they are legalised. In November 2015 voters in Ohio soundly rejected a measure that would have granted a cannabis-cultivation oligopoly to the handful of firms that had backed it.

Worries about regulatory capture will increase along with the size of the businesses standing to gain. Big alcohol and tobacco firms currently deny any interest in the industry. But they said the same in the 1960s and 1970s, a time when Philip Morris and British American Tobacco, it has since been revealed, were indeed looking at the market. Brendan Kennedy, the chief executive of Privateer Holdings, a private-equity firm focused on the marijuana industry, says that several alcohol distributors have invested in American cannabis firms.

Even without such intervention big companies are likely to emerge. Sam Kamin, a law professor at Denver University who helped draft Colorado’s regulations, suspects that eventual federal legalisation, which would make interstate trade legal, could well see cannabis cultivation become something like the business of growing hops, virtually all of which come from Washington, Oregon and Idaho. Big farms supplying a national market would be much cheaper than the current local-warehouse model, driving local suppliers out of the market, or at least into a niche.

The industry has so far been helped by the fact that many on the left who might normally campaign against selling harmful substances to young people are vocal supporters of legalisation. That could change with the growth of a business lobby that, although understanding that an explosion in demand would trigger a backlash, may have little long-term interest in restraint. The prospect of such a lobby could also serve as an incentive for states to take the initiative on legalisation, rather than waiting for their citizens to demand it. Fine-tuning Colorado’s regime, Mr Kamin says, has been made harder by the fact that the ballot of 2012 enshrined legalisation in the state constitution. Other states “might want [their rules] to be defined instead by legislation, not citizens’ initiative,” suggests Ms Brohl, the Colorado tax chief.

Different places will legalise in different ways; some may never legalise at all; some will make mistakes they later think better of. But those that legalise early may prove to have a lasting influence well beyond their borders, establishing norms that last for a long while. It behoves them to think through what needs regulating, and what does not, with care. Over-regulation risks losing some of the main benefits of liberalisation. But as alcohol and tobacco show, tightening regimes at a later date can be very difficult indeed.

Source: http://www.economist.com/news/briefing/21692873 13 Feb. 2016

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects,Economic,Global Drug Legalisation Efforts,Political Sector :

Tragically, the last few months of music festivals repeatedly resembled scenes from a hospital emergency ward, witnessing this season’s highest number of drug related hospitalisations and the deaths of predominately young adults ranging from 19 to 25 years-old.
In the aftermath of these heart wrenching events, harm reduction advocates have taken to media on mass advocating for pill testing as the next risk minimisation strategy that could potentially save lives.
Often, supporters are quick to highlight that pill testing is “not a silver bullet”, just one measure among a plethora of strategies. But the metaphor is a false equivocation. Rather, pill testing is more like Russian Roulette.
Similar to Russian Roulette, taking psychotropic illicit drugs is a deadly, unpredictable high stakes ‘game’. It’s the reason they’re illegal. There is no ‘safe’ way to play.
But arguments and groups supporting pill testing construct this false perception, regardless of how strenuously advocates claim otherwise. Organisations such as STA-SAFE, Unharm, Harm Reduction Australia, the ‘Safer Summer’ campaign all exploit the context of harm and safety within an illicit drug taking culture.
To continue the metaphor of Russian Roulette, it’s rather like insisting on testing a ‘bullet’ for velocity or the gun for cleanliness and handing both back. It’s pointless. The bullet might not kill at first, but the odds increase exponentially after each attempt.

No Standard Dose Available and the Limitations of Pill Testing
In reality, no testing of the hundreds of new psychoactive substances flooding nations every year can make a dose safe.

As Drug Watch International succinctly puts it, “Most people have been conned into using the word ‘overdose’ regarding illicit drugs. No such thing. Why? Because it clearly implies there is a ‘safe’ dose which can be taken – and everyone knows that’s a lie. The same goes for the words, ‘use’ and ‘abuse’. Those terms can only be applied to prescribed pharmaceuticals because they have a prescribed safe dose. I have asked each jurisdiction in Australia if the legal amount of alcohol when driving, up to 0.49, is considered safe for driving. All said no – they would not state that.”
These substances remain prohibited because they are not manufactured to a pharmaceutical standard and are poisonous, unpredictable toxins that make it impossible to test which dose either in isolation or in a myriad of combinations proves fatal.
The limitations of pill testing4 have been discussed by Dr John Lewis (University of Technology Sydney) and prominent toxicologist Dr John Ramsey, emphasising that it is:
• Complex process
• Costly and time consuming
• Detects mainly major components of a sample that may not be the active substance
For example, even a relatively small amount of ingredients such as Carfentanil are lethal.
Speaking after Canberra’s pill trial in 2017, forensic toxicologist, Andrew Leibie, warned that pill testing trial is no “magic bullet” for preventing drug deaths but also expressed deep concern surrounding the freedom for scientific debate because public sector employees feared repercussions.

Leading harm reduction activist, Dr David Caldicott, in a 2015 interview admitted that the quality and type of pill testing would affect pill taking behaviour at festivals. When told that users potentially wouldn’t get their drugs back and the lengthy 45-minute process involved, “‘I think there’ll be a lot of people who will say forget it completely.’ His reasoning being that a lot of young people don’t have the money to spare a pill and it would slow down the momentum of the party.”

Could this be the motivation behind current trial of pill testing at Goovin’ the Moo where volunteering attendees where given the choice between testing the entire pill – effectively destroying it – or scraping the contents and handing back the remainder, despite the fact that the latter approach brings even less accuracy. This is another example of drug users, not evidence informing policy procedure.
The irony of course is that many of the advocates for pill testing would object to sugary drinks, foods and caffeinated energy drinks in school cafeterias on the basis these hinder the normal development of healthy children but do not object to the infinitely direr situation facing kids at music festivals.

Purity vs Contaminated – Another Misleading Contrast
The fallacious arguments surrounding safe dosage remain the same irrespective of whether the substance is tested as seemingly pure. Take MDMA that goes by various street names Molly and Ecstasy. It is the most popular recreational drug in Australia and was responsible for many of the deaths at music festivals.
In 1995, 15-year old, Anna Woods, died after several hours from consuming a single pill of pure MDMA at a Rave Party. Pill testing would not have changed this outcome. Anna’s case also highlights the idiosyncratic nature of drug taking in that while her three friends ingested the same tablets, Anna was the only one to have a reaction. Russian Roulette is again the most appropriate metaphor.
The Coroner’s report on Anna Wood’s death stated, “It is not unlikely that a tragedy such as this will occur again in N.S.W. In an effort to reduce the chance of that happening, I propose to recommend that the N.S.W. Health Department publishes a pamphlet, which will have the twofold effect of educating those who use the drug as to its dangers, and also educating the community as to the appropriate care of the individual who becomes ill following ingestion of the drug.”
Nearly twenty-five years later the fatalities involving MDMA keep mounting. In the only Australian study of 82 drug related deaths between 2001 to 2005, MDMA featured predominately. The fluctuating potency of this drug is further established as it is not only fifteen-year-old girls but grown men dying.

“The majority of decedents were male (83%), with a median age of 26 years. Deaths were predominantly due to drug toxicity (82%), with MDMA the sole drug causing death in 23% of cases, and combined drug toxicity in 59% of cases. The remaining deaths (18%) were primarily due to pathological events/disease or injury, with MDMA a significant contributing condition.”
The indiscriminate nature of MDMA was also witnessed with the latest fatalities at music festivals. For example, very different amounts of MDMA accounted for the five young people that died across New South Wales.
“In one case, a single MDMA pill had proved lethal while another young man who ingested six to nine pills over the course of the day had an MDMA purity of 77 per cent… (That is) a very high rate of purity,” Dr Dwyer said.”
Comparable stories are found all over the world including the UK case of Stephanie Jade Shevlin that is eerily similar to Anna Woods.
Drug dealers aware of the naïvely misleading narrative of pure and impure illicit drugs have been caught bringing pill testing kits to concerts in a bid to convince potential buyers of quality and hike up prices.

High Risk-Taking Culture

The prevailing culture at music festivals is one of blissful abandon and haste. It is a no longer fringe groups at the edges of society but the mainstream choice for generations of children and young adults fully embracing the legacy of, “tune in, turn on and drop out”.
Yet despite the prevailing culture, harm reductionists insist that pill testing will better inform partygoers of drug contents and provide the necessary platform for ‘further conversations about the drug dangers.’ (All of which of course can be achieved outside a venue.)
But this is conjecture and another attempt at experimental based policy.
As cited earlier, Dr Caldicott admitted, anything that stops the party momentum experience is likely rejected. This is because when dealing with high-risk behaviour removing too many risks takes away the thrill of reward.

In an age that has more educated men and women than ever before, it’s not the lack of information that is driving this level of experimentation but the growing indifference to it.
In the aftermath of the death of 25-year-old pharmacist, Sylvia Choi (2015), it was discovered that security staff at the Stereosonic festival were consuming and dealing drugs.
Further, the report often cited purporting to show a growing body of research for drug users wanting pill testing actually confirms that those with college degrees were less likely than those with high school qualifications to test their pills.
This seems to be a trend in Australia also with one judge fed up with groups of “well-off pill poppers” and “privileged” young professionals, including nurses and bankers – filling the court.
Another article describes the attitude of drug taking among festival goers (including University students) as not so much concerned about what is on offer but demand for cheap designer drugs.
The author notes, “A few deaths don’t deter experimentation, and if you’re going to experiment, you need to be sure you don’t die.”
But the determination for experimentation with different forms of self-destructive drugs is making staying alive increasingly less likely, as the levels of polydrug use is also on the rise.
According to Global Drug Survey, “Over 90% of people seeking Emergency Medical Treatment each year after MDMA have used other drugs (often cocaine or ketamine) and/or alcohol and more frequent use of MDMA is associated with the higher rates of combined MDMA use with other stimulant drugs and ketamine.”

Australia’s enquiry into MDMA supports this finding, “Nevertheless, the fact that half of the toxicology reports noted the detection of methamphetamine in the blood is consistent with the polydrug use patterns of living MDMA users.”

Pill Testing Overseas Failing to Stop Drug Demand and Supply

The push continues for Australia to adopt front of house or front-line pill testing at music festivals as in Europe and the UK. But not everyone is convinced of its resounding success.
Last year, UK’s largest festival organiser reversed its previous support for drug testing facilities. Managing director, Melvyn Benn, stating, “Front of house testing sounds perfect but has the ability to mislead I fear.”
Mr Benn details those fears, “Determining to a punter that a drug is in the ‘normal boundaries of what a drug should be’ takes no account of how many he or she will take, whether the person will mix it with other drugs or alcohol and nor does it give you any indicator of the receptiveness of a person’s body to that drug.”
In 2001, The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) produced its scientific report, On-Site Pill-Testing Interventions In The European Union.
Incomplete evaluation procedures have hindered the availability for empirical evidence on the effectiveness of pill testing. “The conclusions one can draw from that fact remain ambiguous.”
Perhaps the most disturbing feature of the report is the admission that decreasing black market activity isn’t within the scope of pill testing goals. “Overall, to alter black markets is ‘not a primary goal’ or ‘no goal at all’ for most pill-testing projects.” Within that same report drug users are classed as ‘consumers’ with an entitlement to know what their pills contain.
The report goes on to list the range of services offered alongside pill testing at venues. These include everything from: brain machines, internet consultations, needle exchange, presenting on-site results of pill-testings, chill-out zones, offering massage, giving out fruits, giving out free drinking water and giving out condoms.
And in another twist of just how far the common sense boundaries are stretched, for number of participating nations, tax payer funded pill testing is also offered at illegal rave venues.

Given the overwhelming lack of evidence that pill testing indeed saves lives, Australian toxicologist, Andrew Liebie’s claim is not easily dismissed, “the per capita death rate from new designer drugs was higher in Europe – where pill testing was available in some countries – than in Australia.”
The antipathy to drug taking was also witnessed by the Ambulance Commander at the latest pill testing trial, again in Canberra, Groovin’ the Moo.

No War on Drugs Just a Submission to Harm Reduction Promotion
The narrative for pill testing will at some stage mention the failed “war on drugs” and by association hard line but failing law enforcement measures either explicitly or implicitly such as in the statement below.
“Regardless of the desirability of treating it as a criminal issue rather than a health one, policing at festivals has limited impact on drug consumption, as research presented at the Global Cities After Dark conference last year suggests: 69.6 per cent of survey respondents said they would use drugs if police were present.”
But what this article completely fails to grasp is that police presence makes little impact because the law is rarely or, at best, laxly enforced and a climate of de facto decriminalisation has been the norm for decades. This was the situation with Portugal before finally decriminalising drugs for personal use in 2001.
Journalists for The Weekend Australian attempting to report events at a recent dance party stated sniffer dogs did nothing to stop the “rampart” stream of drugs. They described a scene of disarray; discarded condoms with traces of coffee grounds within toilets (believed to mask the smell of drugs), bodies strewn on the ground littered with drug paraphernalia, others were rushed to waiting ambulances, while one attendant told them “I got away with it” and another admitting popping two pills a night was “average”. Had they been allowed to stay longer maybe more party goers would be openly stating what many know, drugs supply and demand are at all-time highs irrespective of police presence.

Journalists instead were treated as criminal trespassers, threatened by security and ordered to leave under police escort.
The basis of Australia’s National Drug Strategy includes harm minimisation efforts as part of an overall strategy that also supports reductions in drug supply and demand.
The inadvertent admission that pill testing is not about curbing drug demand comes from another harm reduction stalwart, Alex Wodak, “It’s a supposition that this (pill testing) might increase drug use, but if it does increase drug use but decrease the number of deaths, surely that’s what we should be focusing on.”
In fact, Dr Wodak confirms that pill testing would incentivise drug dealers to provide a better product. “There was no commercial pressure on drug dealers to ensure their products were safe. But if we had testing and 10% of drug dealer A’s supply was getting rejected at the drug testing counter, then word would get around.”
A similar focus on consequences rather than causes is expressed by Dr David Caldicott, “I don’t give a s**t about the morality or philosophy of drug use. All I care about is people staying alive.”
In other words, take the pill, just don’t die…this time. What the long-term affects are to those drug users that survive hospitalisation, the impact on development, mental health, employment loss, families, the growing cost to taxpayers and the crushing weight on emergency services, hospitals and physicians let alone the constant appetite and entrenchment for more drugs will have to wait. Just don’t die.
The ongoing dilution of law enforcement is also seen by various experts all but demanding that police and sniffer dogs be removed entirely from music festivals. No doubt to be replaced with on-site massages, electrolyte drinks, brain machinery, chill out zones, fruit and more free condoms.
Prof Alison Ritter from the University of NSW and Fiona Measham from the University of Durham both agree that intensive policing combined with on-site dealing “could significantly increase drug related harm.” How intensive could police efforts be with such blatant on-site dealing was not explained.

The Unrelenting Push for Drug Legalisation
The real end game behind the dubious safety and harm messaging is drug legalisation. Pill testing, minus the caveat of being called a ‘trial’, would unlikely find full approval without a corresponding change in the law.
The limitations of pill testing and the legal ramifications in giving back a tested pill that proved lethal would become a public liability minefield.
This is clearly seen from the article in the Daily Telegraph, Pill Test Death Waiver Revealed, Jan 5, “The testing capabilities are so limited that revellers would be required to sign a death waiver, which includes a warning that tests cannot accurately determine drug purity levels or give any indication of safety.”
Later the article reports, “Mr Vumbaca said he had been given extensive legal advice to include the warnings on the waiver because of the limitations of testing information … we are not a laboratory and we have one piece of equipment … the test gives you an indication of purity, but you can’t tell the exact amount.”
The waiver would release everyone in testing from, “any liability for personal injury or death suffered … in any way from the services.”
Scattered within the pages of countless articles on pill testing released over the last few months, this admission of pill testing tied in within a broader agenda of drug legalisation is repeatedly made but easily missed among the hype.
Gary Barns from the Australian Lawyers Alliance said the latest deaths could be avoided or risk of death could be minimised with a “law change”.
Sydney Criminal Lawyers are more explicit, “And it seems clear that if adults were able to purchase quality controlled MDMA over the counter in plain packaging with the contents marked on the side, it would be far safer than buying from some backyard manufacturer with no oversight or guarantees.”
And disappointingly, even former AFP and DPP speaking on Four Corners state drug legalisation as a necessary public conversation.
It seems that these same advocates for policy and law change are willing to give a platform for the rights of those determined to self-destruct but not the rest of the law abiding community and their common good.

Pill testing – The Climate Change of Drugs
If comparing pill testing as a ‘silver bullet’ was an inaccurate metaphor, then the comparison to climate change shows the extent of not only erroneous but deliberate obfuscation. “This issue of pill-testing is climate change for drugs,” says Dr David Caldicott.
And yet the dark environment which produces the pills and wreaks so much unnecessary destruction to countless thousands of people all over the world is never fully understood or exposed to those that would blissfully take one small pill for a few hours of entertainment.
But talk of boycotting products that pollute the atmosphere, meat that is packaged from abused animals, clothing produced from exploited workers, or products genetically modified, most likely those same illicit pill takers would passionately relinquish and possibly even risk their personal safety to protest these injustices.
Yet, these are dwarfed by illicit drugs. The most barbaric network of human, economic and environmental exploitation.
Some of the social miseries are well known, including international crime syndicates and narco-terrorism. While others such as environmental damage due to deforestation, chemical waste and the recent drug toxicity detected in Adelaide waterways are often overlooked in an age of socially conscientious consumerism.
But the list of downward consequences is always local and personal, with illicit drugs linked to preventable death, disease and poverty. In cases of domestic violence, alcohol and drugs contributed to 49 per cent of women assaulted in the preceding 12 months.

Those who suffer the most are those who can least afford the consequences; the poor, young, vulnerable, indigenous and rural communities as revealed in the Australian Criminal Intelligence Commission report.
Faced with such overwhelming statistics pro-drug lobbyists use inevitability mantras such as, “they’re doing it anyway” to sway public opinion toward legalisation; but fail to apply the same arguments to other societal abuses such as paedophilia, obesity, gambling, domestic violence, alcohol or tobacco.
It is time to stop the dishonest rhetoric of harm reductionist activists and the deliberate intellectual disconnect that has greatly influenced the Australian government drug strategy and peak medical bodies toward policies emphasising reducing drug harms (injecting rooms, needle distribution, methadone and now pill testing) while minimising the need to reduce demand and supply.
Eleni Arapoglou
– Writer and Researcher, Drug Advisory Council of Australia (DACA)

Source: PillTestingDACA_PoliticianBrief05-02-19.pdf (drugfree.org.au) February 2019

Filed under: Alcohol,Australia,Cocaine,Drug use-various effects,Ecstasy,Global Drug Legalisation Efforts,Ketamine,Methamphetamine/GHB/Hallucinogens/Oxycodone,Political Sector,Youth :

Fullerton, California, police officer Jae Song conducts a field sobriety test on a driver suspected of driving while impaired by marijuana. A growing number of drugged drivers have been killed in crashes. Bill Alkofer/The Orange County Register/SCNG via AP

As legal marijuana spreads and the opioid epidemic rages on, the number of drugged drivers killed in car crashes is rising dramatically, according to a report released today.

Forty-four percent of fatally injured drivers tested for drugs had positive results in 2016, the Governors Highway Safety Association found, up more than 50 percent compared with a decade ago. More than half the drivers tested positive for marijuana, opioids or a combination of the two.

“These are big-deal drugs. They are used a lot,” said Jim Hedlund, an Ithaca, New York-based traffic safety consultant who conducted the highway safety group’s study. “People should not be driving while they’re impaired by anything and these two drugs can impair you.”

Nine states and Washington, D.C., allow marijuana to be sold for recreational and medical use, and 21 others allow it to be sold for medical use. Opioid addiction and overdoses have become a national crisis, with an estimated 115 deaths a day.

States are struggling to get a handle on drugged driving. Traffic safety experts say that while it’s easy for police to test drivers for alcohol impairment using a breathalyzer, it’s much harder to detect and screen them for drug impairment.

There is no nationally accepted method for testing drivers, and the number of drugs to test for is large. Different drugs also have different effects on drivers. And there is no definitive data linking drugged driving to crashes.

“With alcohol, we have 30 years of research looking at the relationship between how much alcohol is in a person’s blood and the odds they will cause a traffic crash,” said Jake Nelson, AAA’s traffic safety director. “For drugs, that relationship is not known.”

Another problem is that drivers often are using more than one drug at once. The new study found that about half of drivers who died and tested positive for drugs in 2016 were found to have two or more drugs in their system.

Alcohol is also part of the mix, the report found: About half the dead drivers who tested positive for alcohol also tested positive for drugs.

Drug Testing Varies

More than 37,000 people died in vehicle crashes in 2016, up 5.6 percent from the previous year, according to the National Transportation Highway Safety Administration.

Using fatality data from the federal agency, Hedlund, the governors’ highway safety group’s consultant, found that 54 percent of fatally injured drivers that year were tested for drugs and alcohol. Of those who had drugs in their system, 38 percent tested positive for marijuana, 16 percent for opioids and 4 percent for both. The remaining 42 percent tested positive for a variety of legal and illegal drugs, such as cocaine and Xanax.

That means more than 5,300 drivers who died in fatal crashes in 2016 tested positive for drugs, Hedlund said. Those numbers don’t include all drivers killed in crashes or those who drove impaired but didn’t have a crash.

Driver drug testing varies from state to state. States don’t all test for the same drugs or use the same testing methods.

“A lot of the tools we developed for alcohol don’t work for drugs,” said Russ Martin, government relations director for the highway safety group. “We don’t have as clear a method for every officer to conduct roadside tests.”

Police who stop drivers they think are impaired typically use standard sobriety tests, such as asking the person to walk heel to toe and stand on one leg. That works well for alcohol testing, as does breathing into a breathalyzer, which measures the blood alcohol level.

But these standard sobriety tests don’t work for drugs, which can only be detected by testing blood, urine or saliva. Even then, finding the presence of a drug doesn’t necessarily mean the person is impaired.

With marijuana, for example, metabolites can stay in the body for weeks, long after impairment has ended, making it difficult to determine when the person used the drug.

States have dealt with drugged driving in different ways. In every state it is illegal to drive under the influence of drugs, but some have created zero tolerance laws for some drugs, whereas others have set certain limits for marijuana or some other drugs.

That creates another challenge because policymakers are trying to make changes that aren’t necessarily based on research, said Richard Romer, AAA’s state relations manager.

“The presence of marijuana doesn’t necessarily mean impairment,” Romer said. “You could be releasing drivers who are dangerous and imprisoning people who are not impaired.”

State Statistics

In Colorado, the first state to legalize recreational marijuana, there were 51 fatalities in 2016 that involved drivers with THC blood levels above the state’s legal limit, according to the state department of transportation. THC is the main active ingredient in marijuana, and causes the euphoria associated with the drug.

An online survey in April by the department found that 69 percent of pot users said they had driven under the influence of marijuana at least once in the past year and 27 percent said they drove high almost daily. Many recreational users said they didn’t think it affected their ability to drive safely.

In Washington state, a 2016 report by the AAA Foundation for Traffic Safety found that fatal crashes of drivers who recently used marijuana doubled after the state legalized it.

The governors’ highway safety group is recommending that states offer advanced training to a majority of patrol officers about how to recognize drugged drivers at the roadside.

Officers in some states already are using a battery of roadside tests that focus on physiological symptoms, such as involuntary eye twitches, pulse rate and muscle tone, to determine whether a driver is impaired by drugs. And at the police station, some officers trained as drug examiners do a more extensive series of tests to identify the type of drug.

The safety group also wants states to launch a campaign to educate the public about how drugs can impair driving and work with doctors and pharmacists to make patients aware of the risks of driving while using prescription medications such as opioids.

And it is calling on states and the federal government to compile better data on drugged driving, including testing all drivers killed in crashes for drugs and alcohol.

“Not every driver in a fatal crash is tested. And plenty of drivers out there haven’t crashed and haven’t been tested,” Martin said. “We have good reason to believe there are more drug-impaired drivers out there than the data shows.”

Source: Drugged Driving Deaths Spike With Spread of Legal Marijuana, Opioid Abuse – Stateline May 2018

Filed under: Alcohol,Cannabis/Marijuana,Crime/Violence/Prison,Drug use-various effects,Drugs and Accidents,Global Drug Legalisation Efforts,Heroin/Methadone :

DRP0013

1.Aims Cannabis Skunk Sense (also known as CanSS Ltd) provides straight-forward facts and research-based advice on cannabis. We raise awareness of the continued and growing dangers to children, teenagers and their families of cannabis use.

2.We provide educational materials and information for community groups, schools, colleges and universities; and guidance to wide range of professions, Parliament and the general public – with a strong message of prevention not harm reduction.

3.The Inquiry document says: ‘Government’s stated intention in its 2017 drug strategy is to reduce all illicit and other harmful drug use…….’

4.Missing from this Inquiry document is the following 2017 Strategy statement: ‘preventing people – particularly young people – from becoming drug users in the first place’. Prevention should be first and foremost in any statement as well as in the minds of us all. FRANK was mentioned just once in this strategy; ‘develop our Talk to FRANK service so that it remains a trusted and credible source of information and advice for young people and concerned others’. This claim will be challenged in this report.

5.If prevention (pre-event) were to be successful, there would be little need for a policy of reducing harmful use. Unfortunately, for fifteen or sixteen years now, prevention has taken a back seat.

6.In 1995 Prime Minister John Major’s government produced ‘Tackling Drugs Together’ saying, ‘The new programme strengthens our efforts to reduce the demand for illegal drugs through prevention, education and treatment’.

7.Objectives included: ‘to discourage young people from taking drugs’ and to ensure that schools offer effective programmes of drug education, giving pupils the facts, warning them of risks, and helping them to develop the skills and attitudes to resist drug use – all good common sense.

8.On harm reduction, the government said, ‘The ultimate goal is to ensure people do not take drugs in the first place, but if they do, they should be helped to become and remain drug-free. Abstinence is the ultimate goal and harm reduction should be a means to that end, not an end in itself’.

9.In 1998 the Second National Plan for 2001-2, ‘Tackling Drugs to Build a Better Britain’ was published. Although prevention was still the aim, the phrase ‘informed choice’ appeared, the downhill slide from prevention had started.

10.The` Updated Strategy in 2002 contained the first high-profile mention of ‘Harm Minimisation (Reduction)’. David Blunkett in the Foreword said, ‘Prevention, education, harm minimisation, treatment and effective policing are our most powerful tools in dealing with drugs’.

Some bizarre statements appeared, e.g.: ‘To reduce the proportion of people under 25 reporting use of illegal drugs in the last month and previous year substantially’. Is infrequent use of drugs acceptable?

In October 2002 at a European Drugs Conference, Ashford, Kent, Bob Ainsworth, drugs spokesman for the Labour government, said that harm reduction was being moved to the centre of their strategy. Prevention was abandoned, ‘informed choice’ and ‘harm reduction’ ruled.

The official government website for information on drugs is FRANK set up in 2003. It continued with the harm reduction policy of the Labour Government.

From the beginning, FRANK was heavily criticised. The Centre for Social Justice (CSJ), founded by Iain Duncan-Smith MP in 2004, consistently criticised FRANK for being ill-informed, ineffective, inappropriate and shamefully inadequate, whilst citing a survey conducted by national treatment provider Addaction who found that only one in ten children would call the FRANK helpline to talk about drugs. Quite recently, when asked about sources where they had obtained helpful information about alcohol or smoking cigarettes, young people put FRANK at the bottom.

The CSJ recommended that FRANK be scrapped, and an effective replacement programme developed to inform young people about the dangers of drug and alcohol abuse based on prevention rather than harm reduction.

The IHRA (International Harm Reduction Alliance) gives the following definition of harm reduction:

Harm reduction refers to policies, programmes and practices that aim to minimise negative health, social and legal impacts associated with drug use, drug policies and drug laws. Harm reduction is grounded in justice and human rights – it focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that they stop using drugs as a precondition of support.

The use of Harm reduction instead of Prevention is tantamount to condoning drug use – a criminal activity. The legitimate place for harm reduction is with ‘known users’ on a one to one basis as part of a treatment programme to wean them off completely and attain abstinence in a safer manner than abrupt stoppage which can be very dangerous. One example of this is to inhale the fumes of heroin rather than injection, thus avoiding blood-borne diseases such as AIDS, hepatitis and septicaemia.

An opioid substitute drug for heroin addiction, methadone has the advantage of being taken orally and only once/day. As the dosage is reduced, abstinence will be attained more safely. However, methadone users are often ‘parked’ for months on this highly addictive drug without proper supervision or monitoring. In 2008 in Edinburgh, more addicts died of methadone than heroin.

Harm reduction is a green light. If children are encouraged to use drugs by being given tips on how to use them more safely, many will do it. The son of a friend told his mother. ‘It’s OK we go on to the FRANK website and find out how to take skunk safely by cutting our use and inhaling less deeply’. He is now psychotic!

Prevention works. Between 1997 and 1991 America saw drug use numbers plummet from 23 to 14 million, cocaine and cannabis use halved, daily cannabis use dropped by 75%.

In 2005, Jonathan Akwue of In-Volve writing in Drink and Drugs News, criticised the campaign for lacking authenticity; its ill-judged attempts at humour which try to engage with youth culture; and diluting the truth to accommodate more socially acceptable messages.

The conservatives regained power under David Cameron. FRANK did not change.

In 2005, Mr Iain Duncan Smith again criticised FRANK, saying “Drugs education programmes, such as Talk to FRANK, have failed on prevention and intervention, instead progressively focussing on harm reduction and risk minimisation, which can be counter-productive”

In 2011 it was announced FRANK would be re-launched and the team commissioned ‘A Summary of Health Harms of Drugs’ from The John Moore’s University Liverpool, a hotbed of harm reduction. A psychiatrist from The FRANK Team was involved. Their section on cannabis is totally inadequate, out of date, no recognition of deaths, brain shrinkage, violence, homicides, suicides, the huge increase of strength of THC etc. Professor Sir Robin Murray’s research on mental illness (2009) and the discovery that CBD is virtually absent from skunk are of vital importance.

Many worrying papers have been written since, especially about brain development, all of which are ignored. CanSS met with the FRANK team prior to their re-launch in 2011 where it was agreed that the cannabis section would, with their assistance, be re-written. All but two very small points were ignored, one about driving after taking alcohol with cannabis and the effect on exam results. The harm reduction advice about cannabis was removed at the request of CanSS.

Scientific evidence detailing FRANK’s inaccuracies was given to the Government by CanSS and other drug experts over the years – all of it ignored. Complaints and oral evidence were submitted to the HASC in April and September 2012 and the Education Select Committee in 2014. Government drugs spokesmen have also been contacted with concerns about FRANK.

As the official government source of information on drugs for the UK public, the FRANK site must be regularly updated and contain the many new accurate findings from current scientific research. The public is owed a duty of care and protection from the harm of drugs, especially cannabis, the most commonly used.

The following list contains some of the glaring omissions and vital details from the FRANK website:

Deaths from cancers except lung, road fatalities, heart attacks/strokes, violent crime, homicides, suicides. Tobacco doesn’t cause immediate deaths either.

Alcohol with cannabis can be fatal. An alcohol overdose can be avoided by vomiting but cannabis suppresses the vomiting reflex.

Cases of severe poisoning in the USA in toddlers are increasing, mostly due to ‘edibles’ left within reach. Accidental ingestion by children should be highlighted.

Hyperemesis (violent vomiting) is on the increase.

Abnormally high levels of dopamine in the brain cause psychosis (the first paper on this was written in 1845) and schizophrenia, especially in those with genetic vulnerabilities, causing violence, homicides and suicides. Skunk-induced schizophrenia costs the country around £2 billion/year to treat.

Young people should understand how THC damps down the activities of the whole brain by suppressing the chemical messages for several weeks. It is fat soluble and remains in the cells. Messages to the hippocampus (learning and memory) fail to reach its cells, some die, causing permanent brain damage. IQ points are lost. Few children using cannabis even occasionally will achieve their full potential.

Serotonin is depleted, causing depression and suicides. The huge increase in the strength of THC in cannabis due to the prevalence of skunk (anything from 16% to over 20%) and the almost total lack of CBD is ignored as is the gateway theory, medical cannabis, passive smoking and lower bone mineral density, bronchitis, emphysema and COPD.

They need to be taught that there is reduced ability to process information, self-criticise and think logically. Users lack attention and concentration, can’t find words, plan or achieve routines, have fixed opinions, whilst constantly feeling lonely and misunderstood. They should know of the risk of miscarriages and ectopic pregnancies.

Amazingly, the fact THC damages our DNA is virtually unknown among the public. In the 1990s, scientists found new cells being made in the adult body (white blood, sperm and foetal cells), suffered premature ‘apoptosis’ (programmed cell death) so were fewer in number. Impotence, infertility and suppressed immune systems were reported. This is important.

In 2016 an Australian paper discovered THC badly interferes with cell division i.e. where chromosomes replicate to form new cells. They fail to segregate properly causing numerous mutations as chromosomes shatter and randomly rejoin. Many cells die (about 50% of fertilized eggs (zygotes). Any affected developing foetus will suffer damage. Resultant foetal defects include gastroschisis (babies born with intestines outside the body), now rising in areas of legalisation, anencephaly (absence of brain parts) and shortened limbs (boys are about 4 inches shorter). Oncogenes (cancer-causing) can be switched on. Bladder, testicle and childhood cancers like neuroblastoma have all been reported. The DNA in mitochondria (energy producers in cells) can also be damaged.

Parliament controls the drug laws, so why are the police able to decide for themselves how to deal with cannabis possession?

Proof of the liberalisation of the law on cannabis possession appeared in the new Police Crime Harm Index in April 2016, where it appeared 2^nd bottom of the list of priorities. In the following November it fell to the bottom. Class ‘A’ drug possession was immediately above. Possession has clearly become a very low priority. In 2015, Durham Police decided they would no longer prosecute those smoking the drug and growing it ‘for their own use’. Instead, officers will issue a warning or a caution. Then Durham Chief Constable Mike Barton announced that his force will stop prosecuting all drug addicts from December 2017 and plans to use police money to give free heroin to addicts to inject themselves twice a day in a supervised ‘shooting gallery’. This surely constitutes dealing. The police can it seems, alter and ‘soften’ laws at will.

Several weeks ago, I happened to check the FRANK website. Quietly, stealthily and without fanfare, a new version had appeared – completely changed. Absent were the patronising videos, games and jokes. Left were A to Z of Drugs, News, Help and Advice (e.g. local harm reduction information) and Contact.

There is poor grammar, i.e. ‘are’ instead of ‘is’ and ‘effect’ where it should be ‘affect’. Mistakes like these do not enhance its credibility.

The drug information is still inadequate with scant essential detail, little explanation and still out of date. This is especially true of cannabis. THC can stay in the brain for many weeks – still sending out its damping-down signals.

What shocked me though were the following:

Our organisation recently received an email about a call to FRANK requesting advice. A friend, a user who also encouraged others to use as well, had lied in a court case where her drug use was a significant factor. He contacted FRANK about her disregard for the law for a substance that was illegal. The advisor raised his voice whilst stating the friend has the right to do what she wants in her own home and mocked him about calling the police. He was shocked and upset by the response.

Ecstasy – Physical health risks

Because the strength of ecstasy pills are so unpredictable, if you do decide to take ecstasy, you should start by taking half or even a quarter of the pill and then wait for the effects to kick in before taking anymore – you may find that this is enough.
If you’re taking MDMA, start by dabbing a small amount of powder only, then wait for the effects to kick in.
Users should sip no more than a pint of water or non-alcoholic drink every hour.

The ‘NEWS’ consisted of 8 pictures with text. In 2 of the 8 items, opportunity is taken to give more ecstasy harm reduction advice. One is titled, ‘Heading out this weekend with Mandy or Molly?’ This is blatant normalisation. The others aren’t ‘news’ items either, but more information about problems.

The section on each drug entitled, ‘Worried about drug x’ mostly consists of giving FRANK’s number. ‘If you are worried about your use, you can call FRANK on 0300 1236600 for friendly, confidential advice’. Any perceptions that FRANK is anything but a Harm Reduction advice site are dispelled completely.

Mentor International is a highly respected worldwide Prevention Charity. Government-funded Mentor UK is in charge of school drug-education with their programme, ADEPIS (Alcohol and Drug Education and Prevention Information Service). Mentor UK masquerades as a ‘Prevention’ charity but practices ‘Harm Reduction’ and has done so from its inception in 1998. A founding member, Lord Benjamin Mancroft, is currently prominent in the APPG: Drug Policy Reform, partly funded by legaliser George Soros’s Open Society Foundation.

Professor Harry Sumnall of John Moores University Liverpool, a trustee on Mentor UK’s board, signed a ‘Legalisation’ letter in The Telegraph 23^rd November 2016 along with the university, Professor David Nutt, The Beckley Foundation, Nick Clegg, Peter Lilley, Transform, Volte-face and other well-known legalisation advocates. Eric Carlin, former Mentor UK CEO (2000-2009), is now a member of Professor David Nutt’s Independent Scientific Committee on Drugs (ISCD). At a July 2008 conference in Vienna, he said “we are not about preventing drug use, we are about preventing harmful drug use”.

Examples of their activities:

The ‘Street Talk’ programme, funded by the Home Office, carried out by the charities Mentor UK and Addaction and completed in March 2012 was aimed to help vulnerable young people aged 10 – 19, to reduce or stop alcohol and drug misuse. Following the intervention, the majority of young people demonstrated a positive intention to change behaviour as follows: “I am confident that I know more about drugs and alcohol and can use them more safely in the future” – 70% agreed, 7% disagreed’.

Two CanSS members attended a Mentor UK meeting on 7^th January 2014 at Kent University, where Professor Alex Stevens, a sociology professor favouring the opening of a ‘coffee shop’ in Kent and supporting ‘grow your own’ was the main speaker. The audience consisted mainly of young primary school teachers. He became increasingly irritated as CanSS challenged his views, becoming incandescent when told knowledge of drug harms is the most important factor in drug education. The only mention of illegality (by CanSS) was met by mirth!

In a Mentor UK project ‘Safer at school’ (2013), the greatest number of requests from pupils, by 5 to 6 times, were: – effects of drugs, side-effects, what drugs do to your body and consequences. Clearly it had been ignored. Coggans 2003 said that, ‘the life skills elements used by Mentor UK may actually be less important than changing knowledge, attitudes and norms by high quality interactive learning’.

Paul Tuohy, the Director of Mentor UK in February 2013 emailed CanSS, ‘Harm reduction approaches are proven and should be part of the armoury for prevention……..there are many young people harming their life chances who are already using and need encouragement to stop, or where they won’t, to use more safely’.

In 2015 Mentor incorporated CAYT (Centre for Analysis of Youth Transitions) with their ‘The Climate Schools programmes’. Expected Outcomes: ‘To show that alcohol and drug prevention programmes, which are based on a harm minimisation approach and delivered through the internet, can offer a user-friendly, curriculum-based and commercially-attractive teaching method’.

In November 2016, Angelus and Mentor UK merged, ‘The Mentor-Angelus merger gives us the opportunity to reach a wider audience through the delivery of harm-prevention programs that informs young people of the harms associated with illicit and NPS drug-taking, to help support them in making conscientious healthy choices in the future’.

The under-developed brains in young people are quite incapable of making reasoned choices. Nor should they. Drug-taking is illegal.

Michael O’Toole (CEO 2014 –2018) said in an ACMD Briefing paper.

‘Harm reduction may be considered a form of selective prevention – reducing frequency of use or supporting a narrowing range of drugs used’. “It is possible to reduce adverse long-term health and social outcomes through prevention without necessarily abstaining from drugs”.

It is a puzzle that any organisation, including the Government, can condone drug-taking, an illegal activity, either by testing drugs or dishing out harm reduction advice, without being charged with ‘aiding and abetting’ a crime.

Mary Brett, Chair CanSS and Lucy Dawe,Administrator CanSS www.cannabisskunksense.co.uk

Source: http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/health-and-social-care-committee/drugs-policy/written/97965.html March 2019

Filed under: Addiction,Alcohol,Cannabis/Marijuana,Drug use-various effects,Ecstasy,Education,Legal Sector,Political Sector,Prevention and Intervention,Youth :

Britain snorts more of the drug than almost anywhere in Europe, more young people are taking it and deaths are rising. Why?

The moment Dan (not his real name) realised he had a problem with cocaine, he had been off work for a week, sick with flu. His phone buzzed. It was his cocaine dealer, calling to check he was OK. When Dan, one of his favoured customers, hadn’t been in touch to buy the cocaine he usually took several times a week, the dealer knew something was wrong.

“I don’t like thinking about that,” Dan says, shaking his head as we sit in a London pub. Now 36, Dan estimates he has spent £25,000 on cocaine. Lines in the pub on a Friday night after work. Lines on a Wednesday evening at a friend’s house while earnestly discussing 90s hip-hop. Lines at house parties, weddings, birthday parties and for no reason at all, other than that cocaine – the white powder that makes no one a better version of themselves, but that many of us continue to do anyway – is everywhere and freely available.

Britain is a cocaine-loving country, and its love for the drug is growing. The country snorts more cocaine than almost anywhere in Europe. “Cocaine use is going up,” says João Matias of the European Monitoring Centre for Drugs and Drug Addiction. In the UK in 2017-2018, 2.6% of people aged 16-59 took powdered cocaine (as opposed to crack cocaine, the more potent variant of the drug, which was taken by 0.1% of the population in the same period), up from 2.4% in 2013-2014, according to Home Office figures.

More young people are taking cocaine than ever before: 6% of 16- to 24-year-olds have tried it, despite the fact that, overall, fewer young people take drugs in general. It is also likely that Home Office figures, which often exclude students, prisoners and homeless people, underestimate cocaine use because those groups typically have above-average illegal drug use.

Most of this cocaine ends up in our sewage system, and researchers have been finding increasing levels in Britain’s water supply since 2012, Matias says. Levels are highest at weekends, indicating recreational use.

Cocaine used to be the sole preserve of affluent City workers and dissolute rock stars. They continue to favour the drug: data from the crime survey of England and Wales showed that powdered cocaine use increased from 2.2% in 2014/15 to 3.4% in 2017/18 in households earning £50,000 a year or more. (Use among those earning less than £10,000 a year fell during this period, although researchers believe the use of crack cocaine may be on the rise in poorer communities.) But powdered cocaine now appeals to those in more modest income brackets, too. “Coke is pretty classless now,” says Ian Hamilton, a senior lecturer in mental health at the University of York. “It’s not for financiers in the City of London any more. It’s more affordable, so that’s opened up the market to people who wouldn’t have tried it before.” And dealers are savvy marketers. Dan pulls out his phone to show me a “bargain bucket offer” he has received: five grams of cocaine for £210.

Users come from all backgrounds. In Hyndburn – the once-prosperous centre of England’s textile industry, which is now in decline – 17 young people died of cocaine overdoses in a nine-month period in 2017. In Newcastle, according to a Vice report, cocaine has become “an important factor in the city’s legitimate economy”, with bars offering privacy curtains for patrons who wish to snort lines off their phones.

According to the National Crime Agency, recent years have seen the Albanian mafia take control of the UK’s lucrative cocaine market with a brutally effective business model. By negotiating directly with the cartels in drug-producing Latin America, cutting out traditional international importers, the Albanian mafia have been able to deliver a purer, more affordable product to market: cocaine hasn’t been this cheap since 1990.

Ironically, anti-drug laws have also improved the quality of cocaine. The 2015 Serious Crime Act criminalised the import of cutting agents such as benzocaine. When it is harder to cut the product, purity increases. This, along with the fact that cocaine production has increased in Latin America, has created a perfect powder storm. Cocaine purity, which has been increasing since 2010, is at its highest level in a decade. What happens when a product becomes cheaper, more plentiful and better quality? More people try it.

As purity and availability increase, so, too, does the misery wreaked by cocaine. Hospital admissions for mental health disorders linked to cocaine have almost trebled in the past decade. Cocaine-related deaths have increased for the sixth year running, up to 432 deaths in England and Wales in 2017, compared with 112 in 2011. (It’s worth noting that these figures refer to powdered and crack cocaine, as official statistics do not differentiate between the two when establishing cause of death. Many of these deaths will involve users who have longstanding addictions to crack cocaine, as well as other co-dependencies.) Users leap from balconies, or fall from mountain paths while under the effects of the drug. Or their bodies give out on them: many deaths take place when users mix cocaine with alcohol, producing the toxic chemical cocaethylene.

“There are a number of risks when it comes to mixing any drugs together,” says the consultant addiction psychiatrist Dr Prun Bijral of the drug treatment service Change Grow Live. As “alcohol is a depressant and cocaine is a stimulant,” combining the two in large quantities can overstimulate the heart and nervous system, leading to, in extreme circumstances, heart attacks. Mixing the two also “impairs your ability to measure and make a judgment on risks”, Bijral adds, meaning that you are far more likely to get yourself into a dangerous situation while drinking and taking cocaine. And it is not just your heart you should be worried about: cocaine abuse can cause the soft inner cartilage of your nose to erode, and it has been linked to brain abnormalities in regular users.

Lucy White, a student at the University of the West of England, knew the dangers of messing with drugs: she saw 19-year-old Drake Morgan-Baines collapse and die in front of her, of MDMA (ecstasy) poisoning, while she was working in Motion nightclub in Bristol. “She was really disturbed by it,” her sister, Stacey Jordan, tells me. But just seven months later, White herself died of a lethal cocktail of cocaine and prescription drugs. “It was the drugs that killed her, but it was also the people she was with, and the peer pressure,” Jordan says. “I don’t think she realised how dangerous it was.”

Cocaine use creates subtler forms of misery, too. “I’m the most confident person for those few hours when I’m on it,” Dan says, “but afterwards I’m having horrendous, almost suicidal, thoughts.” Paranoia lasts for days after a bender. “It’s crushing. The depression outweighs the good times so much,” he says. “It’s the feeling of being a disappointment to my parents. What the fuck am I doing?”

Dan thinks Britons love cocaine because we work so hard (on average, we work the longest hours in Europe). “You can do coke tonight and go to work tomorrow and no one will know,” he says. “I may be a bit less productive, but only I know that.” Even though mixing alcohol and cocaine can prove deadly, many continue to do it. “Coke and alcohol go really well together,” Hamilton says. “You can drink for longer, and it makes you more confident.”

“After two drinks, I wouldn’t be able to relax unless I knew the coke was sorted,” Dan says. “That was my mentality.”

At a time of welfare cuts and ever-longer NHS mental health waiting lists, cocaine also seems to offer a quick fix for those struggling with stress or anxiety. “If you are a young person who is a bit anxious, lacking in confidence or not sure of your place in the grand scheme of things, coke sorts all that out for you,” Hamilton says. “If you can offer me a line now that makes me feel better, or the alternative is that I’m going to have to wait at least four weeks to see a counsellor, it’s an absolute no-brainer.” He pauses. “I’m not recommending it. But austerity has created a real bottleneck in people getting the support they need, and drugs are far more instant. They have no opening and closing hours.”

Recently, I was in the sort of pub you bring your parents to: an upmarket affair with chalkboard menus. I went to the bathroom and there, dusted across the toilet-roll holder like icing sugar on a Victoria sponge, was a fine but unmistakable layer of cocaine. For someone like Dan, who is trying to avoid taking the drug, “you have to be very careful. It’s everywhere.” Recently, he was eating dinner in a Greek restaurant when a nearby stranger offered him cocaine. Did he accept? He drops his voice. “I did, yeah.”

Cocaine’s resurgence is also linked to our changing night-time economy. The number of nightclubs in the UK halved between 2005 and 2015, and more than 25% of pubs have closed since 2001. As these places shutter, British people increasingly socialise behind closed doors. Unlike the club drug ecstasy, cocaine is best taken at home. Dan and his friends would often avoid bars to head back to someone’s flat, turn on some music and get a bag of cocaine in. “Bars are full of dickheads, so I’d say: ‘Let’s get out of here – I’m done.’ Only I wouldn’t be done: I’d stupidly stay up until 7am, having the same conversation.”

To many people, a line of cocaine with a glass of wine on Saturday night is an ordinary sort of thing – and they certainly don’t think of the devastation wreaked by drug cartels in cocaine-producing parts of the world. “It’s not seen as a hard drug,” says Hamilton. “It’s snorted, not injected, so you don’t have to cross that line.”

“The Chelsea flower show, the opera, churches, a Momentum fundraiser, Peppa Pig World …” The former Sun journalist Matt Quinton lists the places he and his colleagues found cocaine traces while working undercover for the newspaper. “Peppa Pig World was unexpected,” he says. The most shocking place Quinton found cocaine? A toilet that was only accessible to NHS staff. Because these exposés were popular with readers, and cheap to put together, Quinton or his colleagues would be sent out by editors to swab pretty much anywhere. As well as becoming extremely proficient at wiping down lavatories, Quinton learned one thing. “Coke is absolutely everywhere, especially if alcohol is being served,” he says. In the 18-month period Quinton only failed to find cocaine once: in the bathroom at a children’s festival. “That was because they had these toilets that were entirely plastic and clearly being blast-washed on a regular basis.” And, he adds, “they didn’t serve alcohol”.

Even Jordan’s friends don’t see a bit of coke as much of anything, really, despite the fact she lost her sister to the drug. It angers her. “You can’t get away from it if all your friends do it,” she says. “I’ve been at weddings and people are doing it in the toilet. I’m looking on in pure horror.” After witnessing someone snorting cocaine off their hand at a nightclub bar, she avoids going clubbing. “I start lecturing strangers because I get too angry.” She understands why people do it. “I don’t think people understand the butterfly effect that it has – unless something happens to you.”

Recent months have seen attempts to challenge the laissez-faire attitudes. Last July, London’s mayor, Sadiq Khan, linked escalating violence on the city’s streets to middle-class cocaine use. Days later, the Metropolitan police commissioner, Cressida Dick, denounced hypocritical middle-class users who profess to be politically aware. In October, the home secretary, Sajid Javid, told the Daily Mail that a government review would specifically look at the damage occasioned by middle-class drug users. Where did this sudden cross-party consensus on the evils of middle-class drug originate? One man: Simon Kempton.

In May last year, Kempton – who is the Police Federation’s lead on drugs – was chairing a panel discussion at its annual conference when a journalist asked for his views on prohibition. “I let my guard down a bit and said something honest, which is never a good thing,” Kempton smiles. He singled out middle-class drug users for fuelling street violence. A media storm ensued, but after Dick, Khan and Javid echoed his stance, Kempton felt vindicated. He hopes to transform middle-class users’ attitude to the drug. “If you think back to when I was a nipper, drink-driving was accepted ethically,” he says. “It took 20 or 30 years of better education to understand that drink-driving isn’t ethical. There’s similar work to be done.”

But does middle-class cocaine use really cause knife crime? “To my mind, the focus on middle-class cocaine users is a smokescreen for the failure to deal with the underlying causes of youth crime and violence,” says Prof Alex Stevens, an expert in criminal justice at the University of Kent, and the president of the International Society of the Study of Drug Policy. Since 2011, the coalition and Conservative governments have consistently attempted to link gangs and youth violence to drugs. But while street-level violence may be seen in the dealing of crack cocaine across so called county lines, powdered cocaine has a different supply chain. “Middle-class users don’t get their coke from young kids who are riding motorbikes out of council estates,” Stevens says. “There is violence in that supply chain too, but most of it happens in Latin America.”

If the evidence is shaky, why are politicians so keen to connect these dots? “It’s a strategy to keep in people’s minds the link between drugs and black youths,” says Stafford Scott, an anti-racism campaigner based in Tottenham, north London. It also allows them to shirk responsibility for dealing with the real causes of knife crime: “poverty, isolation and marginalisation”. Has Scott ever seen any evidence of cocaine dealing in the communities he works with? “You don’t see powdered cocaine in the ’hood,” he says.

Whether or not you agree that cocaine causes knife crime on our streets, one thing is for certain: cocaine causes damage. Maybe the damage takes place in a faraway country you prefer not to think about. Maybe it’s a subtler form of damage: to your relationships, finances, wellbeing or career.

Dan has pulled himself out of the depths of his cocaine addiction gingerly. Sometimes, he slides downhill. Avoiding social situations where he knows cocaine will be present helps, “because I’m weak”, he says. “If I have a drink, I know someone will have coke on them, and it’s so hard to say no.”

But it’s not easy to keep your distance. After we finish our interview, we step out of the pub into the frigid night air. We’re about to part ways when Dan notices a man outside, speaking loudly on the phone. He’s withdrawing a large sum of cash from an ATM and directing someone to his location. We look at each other, and Dan sighs.

The charity Change Grow Live (changegrowlive.org) offers further information on, and help with, the issues raised in this article

Source: The white stuff: why Britain can’t get enough cocaine | Drugs | The Guardian January 2019

Filed under: Alcohol,Cocaine,Crime/Violence/Prison,Drug use-various effects :

Abstract

Excessive alcohol use is extremely prevalent in the United States, particularly among trauma-exposed individuals. While several studies have examined genetic influences on alcohol use and related problems, this has not been studied in the context of trauma-exposed populations. We report results from a genome-wide association study of alcohol consumption and associated problems as measured by the alcohol use disorders identification test (AUDIT) in a trauma-exposed cohort. Results indicate a genome-wide significant association between total AUDIT score and rs1433375 [N = 1036, P = 2.61 × 10^-8 (dominant model), P = 7.76 × 10^-8 (additive model)], an intergenic single-nucleotide polymorphism located 323 kb upstream of the sodium channel and clathrin linker 1 (SCLT1) at 4q28. rs1433375 was also significant in a meta-analysis of two similar, but independent, cohorts (N = 1394, P = 0.0004), the Marine Resiliency Study and Systems Biology PTSD Biomarkers Consortium. Functional analysis indicated that rs1433375 was associated with SCLT1 gene expression and cortical-cerebellar functional connectivity measured via resting state functional magnetic resonance imaging. Together, findings suggest a role for sodium channel regulation and cerebellar functioning in alcohol use behavior. Identifying mechanisms underlying risk for problematic alcohol use in trauma-exposed populations is critical for future treatment and prevention efforts.

Keywords: AUDIT; alcohol consumption; alcohol use disorder; expression QTL; fMRI; genome-wide association study.

Source: Problematic alcohol use associates with sodium channel and clathrin linker 1 (SCLT1) in trauma-exposed populations – PubMed (nih.gov) September 2018

Filed under: Alcohol,Brain and Behaviour :

DRIVING WHILE HIGH is a growing problem in the U.S. Estimates show that a third of impaired driving incidents can be traced to marijuana, while many more involve a combination of multiple substances.

In Colorado, marijuana-related traffic deaths increased by 48 percent after the state legalized recreational use of the drug. In Washington State, 18.6% of all DUI cases in the state tested for drugs were positive for THC; from January through April, 2015, 33% were positive for THC. The number of fatally injured drivers positive for marijuana in the state more than doubled following marijuana legalization, reaching 17% in 2014.

Even as Colorado’s population has increased, fatal crashes in CO related to alcohol-impaired drivers have fallen during the era of recreational pot legalization, from 160 in 2011 to 143 in 2015 (crashes where Blood Alcohol Content, BAC, was greater than or equal to 0.08 percent), an 11 percent drop over four years. At the same time, traffic fatalities overall have risen, from 447 in 2011 to 608 in 2016, a 26 percent rise over five years, as drivers testing positive for marijuana use have risen sharply.

AAA has released guidelines on impaired driving that are important to remember. First, there is no science showing that drivers reliably become impaired after ingesting a specific amount of marijuana. This is very different from alcohol, and we could never count on a 0.08 BAC level equivalent for marijuana. Second, research has not been able to reliably measure impairment based on THC levels. THC blood levels fall so rapidly that such measured levels are vastly lower than when the impaired driving occurred due to the long delay in testing. But the effect on driving persists beyond the feeling of being high.

One groundbreaking study found that that chronic
marijuana use can impair a person’s ability to drive for up to three weeks after stopping marijuana use.

Other research has noted non-chronic users who
smoke one or two marijuana joints are likely to test
positive for marijuana at standard cut – off levels for only 2 – 3 days, with many testing negative 24
hours after smoking marijuana. After three to five
days, such users almost always test negative.

Furthermore, marijuana-impaired driving is likely an underreported problem, since many drivers high on marijuana are also using alcohol. Since there is an established standard for drunk driving, the criminal justice system often stops at a lab test showing greater than 0.08 BAC levels.

DRIVING WHILE HIGH is an unappreciated problem, compounded by a growing industry intent on protecting their brand and image. A recent Liberty Mutual survey found that a third of students said driving under the influence of marijuana is legal in states where it is recreational. More than 20% of teens reported it’s common among their friends. Parent perceptions were similar: 27% said it’s legal and 14% said it’s common among friends. A phttps://learnaboutsam.org/ublic education campaign on the dangers of driving while high is vital.

Source: Leaflet from SAM (Smart Approaches to Marijuana)

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects,Drugs and Accidents :

Abstract

Objectives To estimate the prevalence of fetal alcohol spectrum disorder (FASD) among young people in youth detention in Australia. Neurodevelopmental impairments due to FASD can predispose young people to engagement with the law. Canadian studies identified FASD in 11%–23% of young people in corrective services, but there are no data for Australia.

Design Multidisciplinary assessment of all young people aged 10–17 years 11 months and sentenced to detention in the only youth detention centre in Western Australia, from May 2015 to December 2016. FASD was diagnosed according to the Australian Guide to the Diagnosis of FASD.

Participants 99 young people completed a full assessment (88% of those consented; 60% of the 166 approached to participate); 93% were male and 74% were Aboriginal.

Findings 88 young people (89%) had at least one domain of severe neurodevelopmental impairment, and 36 were diagnosed with FASD, a prevalence of 36% (95% CI 27% to 46%).

Conclusions This study, in a representative sample of young people in detention in Western Australia, has documented a high prevalence of FASD and severe neurodevelopmental impairment, the majority of which had not been previously identified. These findings highlight the vulnerability of young people, particularly Aboriginal youth, within the justice system and their significant need for improved diagnosis to identify their strengths and difficulties, and to guide and improve their rehabilitation.

Source: https://bmjopen.bmj.com/content/8/2/e019605 February 2018

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth :

SCIENTISTS have captured graphic ultrasound images of the damage done to unborn babies as a result of women drinking during pregnancy. Just one glass of wine a week can make babies “jump” in the womb throughout a nine-month pregnancy. Experts believe this abnormal hyperactive behavior is the result of alcohol slowing or retarding the formation of the central nervous system. Doctors have warned for decades that women who consume large amounts of alcohol during pregnancy can affect their child’s mental development.

However, the new research suggests even moderate alcohol consumption makes a baby 3½ times more likely to suffer from abnormal spasms in the womb. The findings, by Peter Hepper, a professor at Belfast University’s fetal behavior research unit, appear to back the view that there is no safe level of alcohol consumption during pregnancy. Hepper’s findings have surprised child neurology experts. Between conception and 18 weeks, babies display a primitive “startle reflex” which causes babies to jump involuntarily in the womb at loud noises and other stimuli. However, once the nervous system is fully formed at 18 weeks, the reflex disappears in healthy babies and is replaced by a calmer “adult” reflex. Hepper found that the babies of mothers who drank — whether one unit a week or four — all continued to display a “startle reflex” throughout their pregnancy. The reflex in the babies of the non-drinking mothers tailed off at 18 weeks.

The professor also found that the babies of women who drank suffered more “startles” during the first 18 weeks. Hepper, who published his findings in the Journal of Physiology and Behaviour, concluded that even moderate consumption of alcohol had a serious effect on the formation of a baby’s central nervous system. He explained: “This indicates that the nerve pathways in the brain have been damaged.” Hepper concluded: “Our study shows that alcohol is having an effect on the baby even at low levels and that is quite disturbing. We don’t think there is a safe limit for alcohol consumption in pregnancy.” Hepper’s study appears to corroborate US research, conducted after birth, which has shown that drinking during pregnancy lowers a child’s IQ and increases hyperactivity. Some doctors believe the babies scanned by Hepper are showing the early signs of fetal alcohol syndrome (FAS) which is thought to cause a range of behavioral and neurological disorders in children.

The Fetal Alcohol Syndrome Trust estimates that between 6,000 to 12,000 babies are affected in the UK each year. Margaret Burrows, a clinical geneticist at Leicester royal infirmary, said: “The startle movement (in the womb) is clearly not normal and would seem to indicate the child has the traits of fidgeting which we see in attention deficit hyperactive disorder (ADHD). “We believe that a proportion of children who have ADHD may have developed it as a result of their mother’s drinking during pregnancy.” The next stage of Hepper’s study will monitor whether the babies go on to suffer mental and behavioral problems. Hepper presented the findings of his study of 40 pregnant women from the Royal Maternity hospital, Belfast, to the Royal Society of Medicine on Wednesday. None of the mothers was asked to drink but 20 admitted that they would continue to drink during their pregnancy. The other 20 drank no alcohol. Researchers questioned the 20 pregnant drinkers and found they consumed between one and four units of alcohol (four glasses of wine) a week. In the first half of the study all the women underwent three ultrasound scans during the first 18 weeks of their pregnancy. In the second half, the women had four more scans at 20, 25, 30 and 35 weeks. The scans lasted up to 45 minutes to try to capture hyperactivity.

Fetal Alcohol Spectrum Disorders (FASD), Fetal Alcohol Syndrome (FAS), Fetal Alcohol Effects (FAE), Partial Fetal Alcohol Syndrome (pFAS), Alcohol Related Neurodevelopmental Disorders (ARND), Static Encephalopathy Alcohol Exposed (SEAE) and Alcohol Related Birth Defects (ARBD) are all names for a spectrum of disorders caused when a pregnant woman consumes alcohol. FASD is 100% preventable. If you are pregnant or plan to become pregnant, don’t drink any beverage alcohol. There is no known safe level. To ignore the facts does not change the facts.

Source: Ultrasound Fetal Response To Alcohol Fetal Alcohol Syndrome – YouTube May 2008

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth :

Summary

Background

Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.

Methods

Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.

Findings

Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week.

Interpretation

Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.

Funding

Bill & Melinda Gates Foundation.

Source: Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 – The Lancet August 2018

Filed under: Alcohol,Health :

Abstract

Chronic alcohol abuse causes cognitive impairments associated with neurodegeneration and volume loss in the human hippocampus. Here, we hypothesize that alcohol reduces the number of granule cells in the human dentate gyrus and consequently contribute to the observed volume loss. Hippocampal samples were isolated from deceased donors with a history of chronic alcohol abuse and from controls with no alcohol overconsumption. From each case, a sample from the mid-portion of hippocampus was sectioned, immunostained for the neuronal nuclear marker NeuN, and counter stained with hematoxylin. Granule cell number and volume of granular cell layer in the dentate gyrus were estimated using stereology. We found a substantial reduction in granule cell number and also a significantly reduced volume of the granular cell layer of chronic alcohol abusers as compared to controls. In controls there was a slight age-related decline in the number of granule cells and volume of granular cell layer in line with previous studies. This was not observed among the alcoholics, possibly due to a larger impact of alcohol abuse than age on the degenerative changes in the dentate gyrus. Loss of neurons in the alcoholic group could either be explained by an increase of cell death or a reduced number of new cells added to the granular cell layer. However, there is no firm evidence for an increased neuronal death by chronic alcohol exposure, whereas a growing body of experimental data indicates that neurogenesis is impaired by alcohol. In a recent study, we reported that alcoholics show a reduced number of stem/progenitor cells and immature neurons in the dentate gyrus, hence that alcohol negatively affects hippocampal neurogenesis. The present results further suggest that such impairment of neurogenesis by chronic alcohol abuse also results in a net loss of granule cells in the dentate gyrus of hippocampus.

Keywords: Addiction; Alcohol abuse; Dentate gyrus; Granule cells; Hippocampus; Human; Neurogenesis; Neurons.

Source: Hippocampal granule cell loss in human chronic alcohol abusers – PubMed (nih.gov) December 2018

Filed under: Alcohol,Brain and Behaviour :

Abstract

The aim was to examine cross-sectional association between moderate alcohol consumption and total brain volume in a cohort of participants in early middle-age, unconfounded by age-related neuronal change. 353 participants aged 39 to 45 years reported on their alcohol consumption using the AUDIT-C measure. Participants with alcohol abuse were excluded. Brain MRI was analyzed using a fully automated method. Brain volumes were adjusted by intracranial volume expressed as adjusted total brain volume (aTBV). AUDIT-C mean of 3.92 (SD 2.04) indicated moderate consumption. In a linear regression model, alcohol consumption was associated with smaller aTBV (B = – 0.258, p < .001). When sex and current smoking status were added to the model, the association remained significant. Stratified by sex, the association was seen in both males (B = – 0.258, p = 0.003) and females (B = – 0.214, p = 0.011). Adjusted for current smoking, the association remained in males (B = – 0.268, p = 0.003), but not in females. When alcohol consumption increased, total brain volume decreased by 0.2% per one AUDIT-C unit already at 39-45 years of age. Moderate alcohol use is associated with neuronal changes in both males and females suggesting health risks that should not be overlooked.

Figure 1

Association between AUDIT-C and aTBV. Association between alcohol consumption (AUDIT-C as a continuous variable) and total brain volume adjusted for intracranial volume in males and females. Points in the plot have been jittered to improve visibility of single cases.

Source: Moderate alcohol use is associated with decreased brain volume in early middle age in both sexes – PubMed (nih.gov) August 2020

Filed under: Alcohol,Brain and Behaviour,Health :

Polysubstance use—when more than one drug is used or misused over a defined period of time—can occur from either the intentional use of opioids with other drugs or by accident, such as if street drugs are contaminated with synthetic opioids. In the first half of 2018, nearly 63% of opioid overdose deaths in the United States also involved cocaine, methamphetamine, or benzodiazepines, signaling the need to address polysubstance use as part of a comprehensive response to the opioid epidemic. Fentanyl, a highly potent synthetic opioid, has been identified as a driver of overdose deaths involving other opioids, benzodiazepines, alcohol, methamphetamine, and cocaine.

Two classes of drugs are frequently co-used with opioids: depressants and stimulants. Although there are medical uses for some drugs in these classes, they also all have high potential for misuse. Mixing opioids—which are depressants—with other depressants or stimulants, either intentionally or unknowingly, has contributed to the rising number of opioid overdose deaths, which have more than doubled since 2010. Efforts to reduce opioid overdose deaths should incorporate strategies to prevent, mitigate, and treat the use of multiple substances.

Depressants

Depressants act on the central nervous system to induce relaxation, reduce anxiety, and increase drowsiness. Opioid use concurrent with the use of another sedating drug compounds the respiratory depressant effect of each drug, creating a higher risk for overdose and fatal overdose than when either drug is used alone.

Benzodiazepines

Benzodiazepines are prescribed for medical use as sedatives but are commonly misused for nonmedical purposes and in combination with prescription and illicit opioids. In 2018, just over 9,000 U.S. deaths involved both opioids and benzodiazepines, more than twice the number of 2008 deaths due to such co-use. Moreover, in 2018, nearly half (47.2%) of benzodiazepine overdose deaths involved synthetic opioids (e.g., fentanyl). Fatal overdoses involving both prescription opioids and benzodiazepines nearly tripled from 2004 to 2011.

Alcohol

In 2017, 15% of opioid overdose deaths involved alcohol. From 2012 to 2014, more than 2 million people who misused prescription opioids were also binge drinkers of alcohol (defined as more than five drinks for a man or more than four drinks for a woman within a two-hour period); compared with nondrinkers, binge drinkers were associated with being twice as likely to misuse prescription opioids. Evidence indicates that about 23% of people with an opioid use disorder have a concurrent alcohol use disorder.

Stimulants

Stimulants increase arousal and activity in the brain. In 2017, opioids were involved in more than half of stimulant-involved overdose deaths—about 15,000 total. The co-use of stimulants with synthetic opioids such as fentanyl either intentionally or through drug contamination has increased the number of stimulant-involved overdose deaths. The opposing impacts of increased arousal from stimulants and sedation from opioids on the body can make the outcomes of co-use less predictable and raise the risk of overdose.

Methamphetamine

About 12% of opioid overdose deaths from January to June 2018 involved methamphetamine, an illicit drug. In 2017, opioids were involved in 50% of methamphetamine-involved deaths, and recent data suggests synthetic opioids are driving increases in methamphetamine-involved deaths. One study found that 65% of those seeking opioid treatment had reported a history of methamphetamine use, with more than three-quarters of them indicating that they had used methamphetamines and opioids mostly at the same time or on the same day.

Cocaine

Of the nearly 15,000 cocaine overdose deaths in 2018, nearly 11,000 also involved opioids; this number accounts for about 23% of the total opioid overdose deaths that year. In fact, since 2010 the number of deaths caused by a combination of opioids and cocaine has increased more than fivefold. People who primarily use cocaine but sometimes co-use opioids are at high risk for overdose because of the increasing presence and potency of fentanyl in the drug supply and a lower tolerance for opioids than someone who regularly uses them.

What should be done?

It is critical that state policies addressing the rise in polysubstance use and its link to increased risk of overdose span across prevention, harm reduction, and treatment strategies. To effectively accomplish this, states should:

Enact policies that increase provider use of prescription drug monitoring programs (PDMPs) to reduce the co-prescription of opioids and benzodiazepines. PDMPs, state-based electronic databases that contain information on controlled substance prescriptions, allow prescribers and pharmacists to monitor patients’ prescription drug use and can promote safer prescribing practices that help prevent overdoses. High rates of benzodiazepine prescribing are correlated with the drug’s involvement in opioid overdose deaths.
Expand naloxone distribution to reach people who use stimulants. Naloxone reverses the respiratory depression effects of opioids to safeguard against a fatal overdose and remains effective when people use opioids in combination with other drugs. Considering that opioids are frequently implicated in cocaine and methamphetamine overdose deaths, people who primarily use stimulants are recognized as an at-risk population for opioid overdose. Laws that allow for increased community distribution of naloxone can help safeguard against polysubstance use overdoses.
Amend drug paraphernalia laws to allow possession of fentanyl test strips. Fentanyl test strips can detect the presence of fentanyl in a person’s drug supply when dipped into a solution of a small amount of the drug in water. People who use drugs have indicated that if a test strip found fentanyl in their supply, they would take measures to prevent an overdose, such as injecting at a slower pace or using less of the drug at a time. Fentanyl test strips are mainly used by people who inject opioids but can also be helpful for those who use stimulants and fear fentanyl contamination by preventing unintentional co-use that could lead to a fatal overdose. Amending drug paraphernalia laws to allow the possession of drug-checking devices, including fentanyl test strips, would permit agencies and organizations to distribute test strips to people who use drugs and help to prevent fentanyl-related overdose deaths.
Prohibit the discharge of patients from publicly funded opioid use disorder (OUD) treatment programs for their continued substance use. Treatment programs often discharge patients from treatment involuntarily because of their continued illicit drug use (a practice commonly called administrative discharge). This practice poses a particular risk for patients being treated for OUD with methadone or buprenorphine who are at high risk for overdose if discharged without medication. Although co-use of other drugs, such as stimulants, with medications for OUD can interfere with treatment, it remains safer for patients to continue medication treatment because of their high risk for overdose from using illicit opioids. People with OUD who use benzodiazepines are particularly at higher risk for overdose when not on medication treatment. Federal guidelines recommend avoiding administrative discharge and instead suggest that treatment programs re-evaluate a patient’s needed level of care if the current treatment plan proves ineffective.

Conclusion

As the increase in opioid use evolves into an increase in polysubstance use, understanding how different substances interact may inform strategies that help prevent overdose. Though some individuals knowingly combine or co-use opioids with stimulants or other depressants, an additional and growing concern is the adulteration of other drug supplies with fentanyl. Strengthening policy efforts across the continuum of prevention, harm reduction, and treatment to address the risks of polysubstance use can slow the rates of drug overdose deaths in the United States.

Source: https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2020/10/opioid-overdose-crisis-compounded-by-polysubstance-use October 2020

Filed under: Alcohol,Cocaine,Drug use-various effects,Methamphetamine/GHB/Hallucinogens/Oxycodone,Political Sector,Prescription Drugs,Psychiatric drugs,Synthetics :

The proportion of inmates in jails with a moderate to severe stimulant use disorder—including addiction to methamphetamine—has surged in recent years, a study presented at the recent American Society of Addiction Medicine annual meeting suggests.

The study of inmates in two jails in rural North Carolina found over seven times more inmates with a substance use disorder met criteria for addiction to stimulants, including methamphetamine, in 2016 compared with 2008.

“These findings confirm anecdotal reports we were hearing from county sheriffs and correctional officers that they had noticed a considerable increase in meth-related crimes and meth lab seizures in rural areas,” said lead researcher Dr. Steven Proctor, Senior Research Professor and Associate Director of the Institutional Center for Scientific Research at Albizu University in Miami, Florida. “We don’t know whether a change in crime prevention strategy is driving law enforcement to prioritize meth-related crimes, leading to more arrests of people with stimulant use disorders, or whether increased use of meth is leading to an increase in meth-related crimes.”

Proctor said that although prevalence estimates of substance use disorders are provided annually for the non-institutionalized U.S. general population through nationally representative surveys, such methods are absent for correctional populations.

The study included data from 176 inmates in 2008 and 149 inmates in 2016. Proctor found alcohol was the most prevalent substance use disorder diagnosis in 2008, followed by cannabis and cocaine. Substance use disorders related to opioids and stimulants were relatively infrequent in 2008.

In sharp contrast, the substance use disorder category involving stimulants was the most prevalent diagnosis in 2016, followed by alcohol and opioids. The proportion of inmates with a moderate-severe opioid use disorder in 2016 was twice that of the prevalence of dependence in 2008.

The prevalence of cannabis use disorder remained relatively constant, but there was a dramatic drop in alcohol and cocaine use in 2008 and 2016.

Proctor noted these findings cannot be applied to the population at large. “It is difficult to track patterns of illicit meth use in the general population over the same period, because until 2015 the National Survey on Drug Use and Health only included questions about prescription stimulants, and didn’t ask about illicit meth use,” he said. “Further research is needed to determine whether these findings are applicable to non-correctional populations.”

Source: Featured News: Number of Inmates With Meth Addiction Jumps in Rural Jails – Partnership to End Addiction (drugfree.org) May 2018

Filed under: Alcohol,Cannabis/Marijuana,Crime/Violence/Prison,Methamphetamine/GHB/Hallucinogens/Oxycodone :

Proportion of young people who tried cigarettes as their first drug fell over the same period, US study says

The proportion of young people using marijuana as their first drug doubled in the 10 years from 2004, a US-based study has found.

The government study reveals that among people aged between 12 and 21, the proportion of those who tried cigarettes as their first drug fell from about 21% to just under 9% between 2004 and 2014. However, the proportion who turned first to marijuana almost doubled from 4.4% to 8%.

While some studies have suggested that, overall, use and abuse of marijuana has fallen among teenagers in the US, the latest research sought to look at trends in which drug, if any, young people turned to first.

“We have, particularly in the US, done prevention programmes that are really focused on alcohol and tobacco – and they are relatively easy arguments to make to young people,” said Dr Renee Johnson, a co-author of the study from Johns Hopkins Bloomberg School of Public Health.

But she said the “fear factor” is less likely to work for marijuana, noting that public programmes need instead to educate young people so they can make good decisions around drugs, and offer support to help them cope with difficulties in life and think about their life plans. “Once we teach young people about that, that will address the unhealthy marijuana use,” she said.

The study, published in the journal Prevention Science, is based on an analysis of data from more than 275,000 participants aged between 12 and 21 collected as part of the US national survey on drug use and health – an annual study that involves participants across all 50 states who are interviewed in person.

Among the findings, the team found that between 2004 and 2014, reported age at first use of each of the substances rose. What’s more, the proportion of young people reporting no drug use increased from 35.5% to just over 46%, while the proportion reporting cigarettes as their first substance fell. The proportion reporting alcohol as the first drug remained fairly constant at about 30%.Males were more likely than females to report using marijuana first. Ethnicity was also a factor, with almost 12% of American Indian and Alaskan native participants and over 9% of black participants reporting marijuana as their first drug – compared to under 5% of white participants and 2.5% of Asian participants.

Once age, sex and ethnicity were taken into account, the team found that those who smoked marijuana first were more likely to be current heavy marijuana users and have cannabis use disorder than those who used other substances first.

They were also as likely as those who used cigarettes first to have a nicotine dependancy if a smoker. “One concern about marijuana and tobacco use is [if] it increases tobacco use later in life,” said Johnson.

In addition, those who reported marijuana or alcohol as their first substance were more likely to report use of other drugs, such as heroin, than those who first used cigarettes or other tobacco products.

Prof Terrie Moffitt, a clinical psychologist at King’s College London who was not involved in the study, said the data was robust.

“The finding might arise because in the past decade, there have been major public campaigns warning of the dangers of tobacco and alcohol, whereas in contrast the media coverage of American states legalising cannabis creates the public impression that cannabis has no risks or dangers,” she said.

Sir Robin Murray, professor of psychiatric research at King’s College London, agreed, saying the findings are highly predictable. “It’s a pity that so many young people appear to be swopping one set of health risks with another,” he said.

The impact of cannabis on the brains of young people, mental health and life prospects has received much scrutiny. Moffitt noted the latest study shows it is young people who are already living in socially disadvantaged circumstances who tend to turn to marijuana as their first drug.

“If indeed it is not safe for teens, then cannabis use could compound the life challenges they already have to surmount to make their way in the world as adults,” she said.

Source: Surge in young Americans using marijuana as first drug | Science | The Guardian May 2018

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects,Nicotine,Youth :

Abstract

Background

Epigenetic modifications of a gene have been shown to play a role in maintaining a long‐lasting change in gene expression. We hypothesize that alcohol’s modulating effect on DNA methylation on certain genes in blood is evident in binge and heavy alcohol drinkers and is associated with alcohol motivation.

Methods

Methylation‐specific polymerase chain reaction (PCR) assays were used to measure changes in gene methylation of period 2 (PER2) and proopiomelanocortin (POMC) genes in peripheral blood samples collected from non-smoking moderate, non-binging, binge, and heavy social drinkers who participated in a 3‐day behavioral alcohol motivation experiment of imagery exposure to either stress, neutral, or alcohol‐related cues, 1 per day, presented on consecutive days in counterbalanced order. Following imagery exposure on each day, subjects were exposed to discrete alcoholic beer cues followed by an alcohol taste test (ATT) to assess behavioral motivation. Quantitative real‐time PCR was used to measure gene expression of PER2 and POMC gene levels in blood samples across samples.

Results

In the sample of moderate, binge, and heavy drinkers, we found increased methylation of the PER2 and POMC DNA, reduced expression of these genes in the blood samples of the binge and heavy drinkers relative to the moderate, non-binge drinkers. Increased PER2 and POMC DNA methylation was also significantly predictive of both increased levels of subjective alcohol craving immediately following imagery (p < 0.0001), and with presentation of the alcohol (2 beers) (p < 0.0001) prior to the ATT, as well as with alcohol amount consumed during the ATT (p < 0.003).

Conclusions

These data establish significant association between binge or heavy levels of alcohol drinking and elevated levels of methylation and reduced levels of expression of POMC and PER2 genes. Furthermore, elevated methylation of POMC and PER2 genes is associated with greater subjective and behavioral motivation for alcohol.

Source: https://doi.org/10.1111/acer.13932 31^st December 2018

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects,Health :

The authors of this ‘Before and After’ library (American Addiction Centers) have obviously spent a great deal of time in merging several still photographs which have produced a strikingly progressive presentation for each user, as time progresses.

Millions of Americans are trapped in a cycle of drug abuse and addiction: In 2013, over 24 million reported that they had abused illicit drugs or prescription medication in just the past month. More than 1.7 million were admitted to treatment programs for substance abuse in 2012. The pursuit of a drug habit can cost these people everything – their friends and family, their home and livelihood. And nowhere is that impact more evident than in the faces of addicts themselves.

Here, the catastrophic health effects of drug abuse are plain to see, ranging from skin scabs to decayed and missing teeth. While meth is often seen as one of the most visibly destructive drugs, leading to facial wasting and open sores,various other illicit drugs, and even prescription medications can cause equally severe symptoms when continuously abused. The use of opioids like OxyContin or heroin can cause flushing and a rash of red bumps all over the skin, while cocaine abuse can result in a significant drop in appetite and dangerous malnutrition and weight loss. Ecstasy may cause grinding of teeth, and smoking cannabis releases carcinogens and other chemicals that can diminish skin collagen and produce an appearance of premature aging. Even alcohol abuse can lead to wrinkles, redness, and loss of skin elasticity.

Beyond the direct effects of substance abuse, perhaps its most damaging result is addiction itself. The compulsion of addiction makes drug use the most important purpose in an addict’s life, leading them to pursue it at any cost and treat anything else as secondary. Self-neglect becomes normal – an accepted cost of continuing to use drugs. And the consequences of addiction can remain etched in their very skin for years.

Click here for an animated infographic

Disclaimer

The individuals in these before and after drug addiction photos were arrested on drug charges or related charges. There may be errors in arrest record reporting. All persons are considered innocent of these charges until proven guilty. These photos do not necessarily just show people after drugs and addiction; rather, they depict the physical deterioration of individuals who have been involved in repeated arrests, indicative of a life of crime and/or substance abuse.

Source: https://www.rehabs.com/explore/faces-of-addiction/

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ADDITIONAL INFORMATION ON PROGRESSIVE EFFECTS OF DRUG ABUSE

Thanks must go to the Daily Telegraph (London) for this second format.

This presents still photographs, in contrast with the animated presentation above.

https://www.telegraph.co.uk/news/health/pictures/8345461/From-Drugs-to-Mugs-Shocking-before-and-after-images-show-the-cost-of-drug-addiction.html?image=31255

Filed under: Addiction,Alcohol,Cannabis/Marijuana,Cocaine,Drug use-various effects,Ecstasy,Heroin/Methadone,Methamphetamine/GHB/Hallucinogens/Oxycodone :

Researchers have long known that there is a link between nicotine and alcohol consumption. But the nature of the connection—how long it lasts, which begets which—remains a mystery.

A new Tel Aviv University study finds that nicotine exposure during adolescence can predict increased alcohol intake in adulthood. This suggests that memories of smoking tobacco as a teenager alter the brain’s reaction to alcohol even after a prolonged nicotine withdrawal. The research indicates that these nicotine “memories” may even lead to a tendency toward heavier drinking later in life.

The research was led by Dr. Segev Barak and his research team at TAU’s School of Psychological Sciences and Sagol School of Neuroscience. It was published in Scientific Reports.

The influence of memory

“Previously, it was believed that the mere consumption of nicotine during adolescence could trigger the use of other drugs—cocaine, heroin and alcohol,” Dr. Barak said. “Our study shows that nicotine ‘memories’ from adolescence are the culprit, not the nicotine itself.”

The researchers found that nicotine “memories” caused long-lasting changes in the brain, long after the cessation of nicotine consumption. A brief exposure to the nicotine environment triggered a robust decrease in the expression of the growth factor GDNF in the brain’s pleasure center. “We have previously shown that GDNF serves as a brain regulator of alcohol consumption,” Dr. Barak said. “We assume that this drop in GDNF following the retrieval of nicotine memories leads to loss of control, thus boosting drinking.”

The researchers used rat models to test the link between nicotine and alcohol consumption. To study the effects on alcohol consumption, the researchers installed an experimental self-serve alcohol dispenser, operated by a lever press. When placed in this “bar,” rats were free to consume unlimited amounts of alcohol.

Group 1 received nicotine during adolescence in Chamber B, and then drank alcohol in adulthood in Chamber A—in other words, drinking alcohol in an environment different to that in which they used nicotine. Conversely, Group 2 received nicotine during adolescence in Chamber A, and then in adulthood drank alcohol in the same chamber (that is, in the nicotine-associated environment), triggering a reminder of the nicotine experience.

“The rats eagerly drink alcohol,” said Yossi Sadot-Sogrin, who contributed to the research. “During the daily one-hour sessions, most of them consumed the amount of alcohol equivalent to a glass or two of wine.”

But when the self-serve alcohol dispenser was installed in the same chamber in which rats received nicotine during their adolescence, the amount of alcohol consumed rose sharply.

“In the nicotine-associated environment, rats drank the amount of alcohol that corresponded to four glasses of wine, and even more,” said Koral Goltseker, who collaborated on the study.

The team is currently researching the specific changes to the brain caused by nicotine memories. “If we can prevent these brain changes, we hope we can prevent the long-term increase in alcohol consumption,” said Dr. Barak. “It will also teach us a lot about the brain mechanisms that lead to alcoholism.”

Source: https://medicalxpress.com/news/2017-11-consumption-nicotine-adolescence-alcohol-intake.html November 2017

Filed under: Alcohol,Brain and Behaviour,Nicotine :

Researchers from the University of Connecticut Health Center studied data from 1,165 young adults who took part in the Collaborative Study on the Genetics of Alcoholism. People in the alchol study were assessed at age 12 and then every two years over a span of the next 13 to 22 years.

Those who became dependent on both marijuana and alcohol were found to have lower levels of educational achievement, were less likely to be employed full time, less likely to be married, and had lower social and economic potential.

“This study found that chronic marijuana use in adolescence was negatively associated with achieving important developmental milestones in young adulthood. Awareness of marijuana’s potential deleterious effects will be important moving forward given the current move in the U.S. toward marijuana legalization for recreational / medicinal use,” says study author Elizabeth Harari, MD.

She presented her study at the annual meeting of the American Public Health Association being held in Atlanta, Georgia this week.

Read abstract here.

Email from National Families In Action http://www.nationalfamilies.org November 2017

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects,Education :

Researchers at the Centre for Addiction and Mental Health (CAMH) have identified 428 distinct disease conditions that co-occur in people with Fetal Alcohol Spectrum Disorders (FASD), in the most comprehensive review of its kind.

The results were published today in The Lancet.

“We’ve systematically identified numerous disease conditions co-occurring with FASD, which underscores the fact that it isn’t safe to drink any amount or type of alcohol at any stage of pregnancy, despite the conflicting messages the public may hear,” says Dr. Lana Popova, Senior Scientist in Social and Epidemiological Research at CAMH, and lead author on the paper. “Alcohol can affect any organ or system in the developing fetus.”

FASD is a broad term describing the range of disabilities that can occur in individuals as a result of alcohol exposure before birth. The severity and symptoms vary, based on how much and when alcohol was consumed, as well as other factors in the mother’s life such as stress levels, nutrition and environmental influences. The effects are also influenced by genetic factors and the body’s ability to break down alcohol, in both the mother and fetus.

Different Canadian surveys suggest that between six and 14 per cent of women drink during pregnancy.

The 428 co-occurring conditions were identified from 127 studies included in The Lancet review. These disease conditions, coded in the International Classification of Disease (ICD-10), affected nearly every system of the body, including the central nervous system (brain), vision, hearing, cardiac, circulation, digestion, and musculoskeletal and respiratory systems, among others.

While some of these disorders are known to be caused by alcohol exposure – such as developmental and cognitive problems, and certain facial anomalies – for others, the association with FASD does not necessarily represent a cause-and-effect link.

Problems range from communications disorders to hearing loss

However, many disorders occurred more often among those with FASD than the general population. Based on 33 studies representing 1,728 individuals with Fetal Alcohol Syndrome (FAS), the most severe form of FASD, the researchers were able to conduct a series of meta-analyses to establish the frequency with which 183 disease conditions occurred.

More than 90 per cent of those with FAS had co-occurring problems with conduct. About eight in 10 had communications disorders, related to either understanding or expressing language. Seven in 10 had developmental/cognitive disorders, and more than half had problems with attention and hyperactivity.

Because most studies were from the U.S., the frequency of certain co-occurring conditions was compared with the general U.S. population. Among people with FAS, the frequency of hearing loss was estimated to be up to 129 times higher than the general U.S. population, and blindness and low vision were 31 and 71 times higher, respectively.

“Some of these other co-occurring problems may lead people to seek professional help,” says Dr. Popova. “The issue is that the underlying cause of the problem, alcohol exposure before birth, may be overlooked by the clinician and not addressed.”

The benefits of screening and diagnosis

Improving the screening and diagnosis of FASD has numerous benefits. Earlier access to programs or resources may prevent or reduce secondary outcomes that can occur among those with FASD, such as problems with relationships, schooling, employment, mental health and addictions, or with the law.

“We can prevent these issues at many stages,” says Dr. Popova. “Eliminating alcohol consumption during pregnancy or reducing it among alcohol-dependent women is extremely important. Newborns should be screened for prenatal alcohol exposure, especially among populations at high risk. And alerting clinicians to these co-occurring conditions should trigger questions about prenatal alcohol exposure.”

“It is important that the public receive a consistent and clear message – if you want to have a healthy child, stay away from alcohol when you’re planning a pregnancy and throughout your whole pregnancy,” she says.

It’s estimated that FASD costs $1.8 billion annually in Canada, due largely to productivity losses, corrections and health care costs, among others.

In addition to this review, Dr. Popova has been part of an expert group of leading FASD researchers and clinicians working with the Ontario Ministry of Children and Youth Services on its new FASD strategy. Her team is also undertaking a study to determine how common FASD is in Canada, as well as in other countries in Eastern and Central Europe and Africa.

Provided by: Centre for Addiction and Mental Health

Source: https://m.medicalxpress.com/news/2016-01-conditions-co-occur-fetal-alcohol-spectrum.html January 2016

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Health :

PHE publications gateway number: 2016490 December 2016

Executive summary

Alcohol is a prominent commodity in the UK marketplace. It is widely used in numerous social situations. For many, alcohol is associated with positive aspects of life; however, there are currently over 10 million people drinking at levels which increase their risk of health harm. Among those aged 15 to 49 in England, alcohol is now the leading risk factor for ill-health, early mortality and disability and the fifth leading risk factor for ill health across all age groups. Since 1980, sales of alcohol in England and Wales have increased by 42%, from roughly 400 million litres in the early 1980s, with a peak at 567 million litres in 2008, and a subsequent decline.

This growth has been driven by increased consumption among women, a shift to higher strength products, and increasing affordability of alcohol, particularly through the 1980s and 1990s. Over this period, the way in which alcohol is sold and consumed also changed. In 2016 there were 210,000 license premises in England and Wales, a 4% increase on 2010. There has been a shift in drinking location such that most alcohol is now bought from shops and drunk at home.

Although consumption has declined in recent years, levels of abstinence have also increased. Consequently, it is unclear how much of the decline is actually related to drinkers consuming less alcohol and how much to an increasing proportion of the population not drinking at all. In recent years, many indicators of alcohol-related harm have increased.

There are now over 1 million hospital admissions relating to alcohol each year, half of which occur in the lowest three socioeconomic deciles. Alcohol-related mortality has also increased, particularly for liver disease which has seen a 400% increase since 1970, and this trend is in stark contrast to much of Western Europe. In England, the average age at death of those dying from an alcohol-specific cause is 54.3 years. The average age of death from all causes is 77.6 years.

More working years of life are lost in England as a result of alcohol-related deaths than from cancer of the lung, bronchus, trachea, colon, rectum, brain, pancreas, skin, ovary, kidney, stomach, bladder and prostate, combined.

Despite this burden of harm, some positive trends have emerged over this period, particularly indicators which relate to alcohol consumption among those aged less than 18 years, and there have been steady reductions in alcohol-related road traffic crashes. The public health burden of alcohol is wide ranging, relating to health, social or economic harms. These can be tangible, direct costs (including costs to the health, criminal justice and welfare systems), or indirect costs (including the costs of lost productivity due to absenteeism, unemployment, decreased output or lost working years due to premature pension or death).

Harms can also be intangible, and difficult to cost, including those assigned to pain and suffering, poor quality of life or the emotional The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies: An evidence review 7 distress caused by living with a heavy drinker. The spectrum of harm ranges from those that are relatively mild, such as drinkers loitering near residential streets, through to those that are severe, including death or lifelong disability. Many of these harms

impact upon other people, including relationship partners, children, relatives, friends, co-workers and strangers. In sum, the economic burden of alcohol is substantial, with estimates placing the annual cost to be between 1.3% and 2.7% of annual GDP.

Few studies report costs on the magnitude of harm to people other than the drinker, so the economic burden of alcohol consumption is generally underestimated. Crucially, the financial burden which alcohol-related harm places on society is not reflected in its market price, with taxpayers picking up a larger amount of the overall cost compared to the individual drinkers. This should provide impetus for governments to implement effective policies to reduce the public health impact of alcohol, not only because it is an intrinsically desirable societal goal, but because it is an important aspect of economic growth and competitiveness. Reflecting three key influencers of alcohol consumption – price (affordability), ease of purchase (availability) and the social norms around its consumption (acceptability) – an extensive array of policies have been developed with the primary aim of reducing the public health burden of alcohol. The present review evaluates the effectiveness and cost-effectiveness of each of these policy approaches.

Source: https://assets.publishing.service.gov.uk/government/uploads 2016

Filed under: Addiction (Papers),Alcohol,Social Affairs (Papers) :

Health visitors and other professionals should do more to deliver safe sleep messages to high-risk families to reduce sudden unexpected deaths in infancy (SUDI).

Researchers have recommended that children’s professionals help parents who use drugs and alcohol to develop safe sleep practices. University of Warwick study of 27 serious case reviews involving SUDI found that if parents followed UK safe sleep guidance many of those infant deaths could have been avoided.

In 19 of the 27 cases, parental drug or alcohol use was directly involved in the lead up to the infant’s death. In 12 of the 16 cases where parents were sleeping with their infants at the time of death, substance use was a factor.

In light of this, the researchers recommended that children’s professionals help parents who use drugs and alcohol to develop safe sleep practices.

“Health visitors and midwives should be encouraged to ask both parents about their use of alcohol and other substances, and help them develop safe sleep practices, including the avoidance of co-sleeping, which can then be used when parents are affected by substances,” the review concluded.

In three of the cases involving intoxicated parents, the mothers said they ignored the safe sleep advice they had been given because they thought “it couldn’t happen to me”. Long-standing neglect was another key feature in 15 of the cases examined. This finding echoes international research that suggests SUDI now predominately occurs among deprived families.

Dr Joanna Garstang, who led the review, said: “Eleven families’ siblings were reported as dirty, hungry, inadequately dressed or had severe dental caries, and seven families lived in homes described as squalid. “Four mothers lacked basic parenting skills, and one father was convicted for child neglect after leaving his young children home alone.”

Other risk factors identified by the review included parents’ unwillingness to engage with services, which occurred in 18 of the 27 serious case reviews.

“If parents are enabled to develop and understand safe sleep practices, they may be able to keep to these if there are unforeseen circumstances,” said the review paper. “Some families, however, are not willing to engage with services; and if there are concerns about parenting this has to be considered and managed as a safeguarding issue to ensure that vulnerable infants are protected.”

The researchers recommended that additional research into how best to deliver safe sleep messages to high-risk families is needed.

Jenny Ward, director of services at the Lullaby Trust, which promotes advice on preventing SUDI, said: “We welcome this study, which demonstrates the urgent need to ensure safer sleep advice reaches all parents and carers, particularly vulnerable families where extra support is often most needed. While reaching vulnerable parents can be challenging, the study shows that it could ultimately save babies’ lives.”

In 13 of the 27 cases parents had been given safe sleep advice prior to the death of their babies.

Every year there are around 300 to 400 deaths in England and Wales due to SUDI. SUDI is defined as the unexplained death of an infant when that had not been considered a reasonable possibility in the previous 48 hours. SUDI cases are often categorised as sudden infant death syndrome.

The University of Warwick’s review examined serious case reviews into deaths that occurred between 2011 and 2014. The full paper, Qualitative Analysis of Serious Case Reviews into Unexpected Infant Deaths, has been published in the Archives of Disease in Childhood journal.

In 2015 Public Health England recommended that all professionals who work with families are trained in how to prevent SUDI.

Source: https://www.cypnow.co.uk/cyp/news/2005572/health-visitors-must-ask-parents-about-alcohol-to-combat-sudden-infant-deaths 26th July 2018

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth :

Interviewed by Mark Gold, MD

FEATURED ADDICTION EXPERT:
Daniel M. Blumenthal, MD, MBA
Attending Physician, Division of Cardiology, Massachusetts General Hospital
Instructor of Medicine at Harvard Medical School
Associate Chief Medical Officer at Devoted Health

Do FDA-approved psychostimulants increase the risk of cardiovascular events?

There is no convincing evidence that FDA-approved psychostimulants (e.g. methylphenidate, dextroamphetamine, amphetamine salts, and atomoxatine) increase the risk for cardiovascular events among patients without pre-existing cardiovascular disease (CVD). However, among those with pre-existing heart disease, including arrhythmias, coronary artery disease, heart failure, or in patients for whom an increase in heart rate or blood pressure could be harmful, psychostimulants may increase the risk for cardiovascular events.

How does cocaine end up as the number two cause of drug deaths, just behind opioids? Excluding adulteration with opioids, how does cocaine kill you?
The effects of cocaine on the cardiovascular system can be grouped into acute and chronic processes. Cocaine use can cause one or more of several acute, life-threatening cardiovascular effects. The most common is myocardial ischemia or infarction (e.g. a heart attack). Cocaine can induce a heart attack through one of several mechanisms. First, cocaine causes arterial (including coronary artery) vasoconstriction, which can lead to coronary vasospasm. Second, cocaine activates platelets, which increases the risk of thrombosis (including coronary thrombosis). Third, cocaine use produces an adrenergic surge which induces tachycardia (high heart rate) and hypertension. High heart rate and hypertension both increase myocardial oxygen demand, which can cause supply-demand mismatch and precipitate myocardial ischemia or infarction. Fourth, vasospasm or stress associated with cocaine use can also precipitate coronary artery plaque rupture (the mechanism underlying most classic heart attacks).

Two thirds of heart attacks due to cocaine occur within three hours of cocaine use; the risk of a heart attack is 24-fold higher than normal in the first sixty minutes after using cocaine. Cocaine has several other potentially devastating acute effects, including stroke, aortic dissection (e.g. dissection of the major artery connecting the heart to the rest of the body), life threatening heart arrhythmias, and myocarditis which can also occur with chronic use. Chronic cocaine can result in accelerated atherogenesis (i.e. accelerated plaque buildup in the coronary arteries), hypertrophy of the left ventricle, dilated cardiomyopathy, aortic aneurysms, and coronary aneurysms.

Patients who are acutely intoxicated with cocaine and present with chest discomfort should be referred to an emergency room immediately for evaluation. They should undergo a chest-x-ray, an electrocardiogram, blood work to evaluate for evidence of a heart attack and non-myocardial muscle breakdown (e.g. rhabdomyolysis), and to assess kidney function, white and red blood cell counts, and liver function.

Cocaine intoxication is diagnosed if and when patients report recent cocaine use and through serum and urine toxicology screens (which should be performed immediately as well). If a clinician suspects that a patient is acutely intoxicated with cocaine, treatment should not be withheld while waiting for the results of the toxicology screen. Patients with acute cocaine intoxication and symptoms concerning for cerebrovascular or other cardiovascular sequelae of cocaine intoxication may also need additional imaging to assess for evidence of damage to the heart, aorta, or other blood vessels.

In terms of treatment, these patients should receive benzodiazepines to help mitigate the adrenergic surge. If chest pain due to myocardial ischemia is suspected, sublingual nitroglycerin should be administered. Ongoing ischemic symptoms, as well as hypertension and tachycardia (drivers of myocardial oxygen demand) should be treated with calcium channel blockers (i.e. diltiazem or verapamil). Beta blockers should ideally be avoided until there is no cocaine remaining in the patient’s system. If beta blockers must be used, we recommend using either labetalol or carvedilol, which are non-selective inhibitors of both alpha and beta receptors (note: other beta blockers that are selective for beta receptors are contraindicated due to a theoretical risk that selective beta blockade could lead to unopposed alpha-mediated arterial vasoconstriction, which could precipitate marked hypertension and even peripheral and splanchnic ischemia).

Alternative, and highly effective, agents for treatment of hypertension include IV nitroglycerin (which should also be used if the patient has chest pain) and IV nitroprusside. Phentolamine, an alpha blocker, can be used for refractory hypertension. Patients presenting with chest pain should also receive a full dose chewable aspirin (325 mg) and 80 mg of atorvastatin (if available). Patients with ECG changes consistent with myocardial ischemia or infarction and/or elevated blood levels of cardiac biomarkers should be managed identically to patients with non-cocaine induced myocardial ischemia and infarction.

Cocaine and methamphetamine addicts often have heart disease. Why? How is a diagnosis made?
Cardiac sequelae are the second most common cause of death (behind overdose) in patients who use methamphetamines (“meth”). Like cocaine use, use of methamphetamines can produce both acute and chronic cardiovascular disease. Acute intoxication with methamphetamines produces a hyperadrenergic state, not unlike having a pheochromocytoma. The hypertension and tachycardia that result can lead to myocardial ischemia and infarction, aortic dissection, malignant arrhythmias, Takotsubo’s (stressinduced) cardiomyopathy, and cardiac arrest.

Chronic methamphetamine use can lead to hypertrophic cardiomyopathy (due to persistent severe hypertension) or dilated cardiomyopathy (due to the drug’s toxic effects on myocardium), and the clinical syndrome of heart failure. In addition, chronic meth use can also cause pulmonary arterial hypertension (PAH). Meth-associated PAH is a devastating disease, with five year mortality rates above 50%.

Diagnosing and managing acute methamphetamine intoxication:

Patients who present with suspected acute methamphetamine intoxication should undergo a full physical exam, electrocardiogram, and basic lab work (including basic metabolic panel, blood counts, clotting times (prothrombin time and international normalized ratio), liver function tests, creatine phosphokinase (CPK), urinalysis, and urine and serum toxicology screens). Amphetamine intoxication or toxicity is ultimately diagnosed by confirming the presence of amphetamines in urine or serum. However, if patients present with signs and symptoms which raise concern for amphetamine intoxication—including hyperthermia, agitation, hypertension, and tachycardia—treatment should not be delayed while waiting for these test results to return.

If there is concern for myocardial ischemia or infarction (for example, if the patient complains of chest discomfort or shortness of breath or the ECG shows ischemic changes), then cardiac biomarkers should be checked as well (i.e. troponin I or T). Acute methamphetamine intoxication with secondary sequelae (i.e. agitation, hypertension, tachycardia) should be managed initially with sedatives (benzodiazepines and 2nd generation atypical antipsychotics).

Hyperthermia should be managed aggressively by controlling core body temperature with sedatives and, if necessary, with paralysis and intubation (but antipyretics should not be used).

Rhabdomyolysis is common, and a CPK level should always be checked in patients who are acutely intoxicated with meth. If the hypertension is refractory to treatment with an adequate trial of sedation, then nitrates and/or phentolamine should be used. Calcium channel blockers can also be used, and are effective agents for managing tachycardia that persists despite sedation. Beta-blockers should be avoided in the acute setting to avoid precipitating unopposed alpha-mediated vasoconstriction (via identical mechanisms to those described above).

If beta blockers are necessary for chronic management of a different disease process (e.g. cardiomyopathy or coronary artery disease), then labetalol or carvedilol are the preferred agents due to their partial alphaantagonism. Myocardial infarction in the setting of methamphetamine intoxication should be managed per evidence-based guidelines for the management of heart attacks, and as described above (for cocaine). The one exception is that, if heart rate control is needed, calcium channel blockers, not beta blockers, should be used. Interestingly, monoclonal antibodies against methamphetamine have been developed and are currently in clinical trials.

Chest pain in the setting of acute methamphetamine intoxication should raise concern not only for myocardial infarction, but also for acute aortic dissection. Methamphetamine abuse is the second most common cause of acute fatal aortic dissection in the US, after hypertension. Unlike chest discomfort due to myocardial ischemia, which often starts as mild or moderate discomfort and worsens progressively over minutes-hours, chest discomfort due to aortic dissection is typically extreme from the outset.

What does the patient PE and EKG look like if a patient has overdosed on opioids? What about when injected with Narcan and reversed? Does Methadone, when given as a MAT, have QT and other effects on the heart? What about Suboxone and the heart?
Opiate overdose can precipitate respiratory depression and coma. The pupils will be mioitic, or “pinpoint.” Patients commonly experience mild hypotension as well. The electrocardiogram classically shows sinus bradycardia with nonspecific changes. Approximately 20% of patients will have prolongation of the QT interval. Administration of an adequate dose of Narcan rapidly reverses the respiratory depression, miosis, and coma, and can also lead to improvements in blood pressure and an increase in heart rate.

However, Narcan is short acting and the reversal is temporary. Thus, patients must be monitored following Narcan administration to determine if they need subsequent doses, or even initiation of an IV naloxone drip. Methadone may also cause QT prolongation but is an uncommon cause of Torsades Des Pointes, the potentially fatal arrhythmia that can result from QT prolongation. Suboxone can also cause hypotension, including orthostatic hypotension, and should be used with caution in patients with established cardiovascular disease (e.g. coronary artery disease). However, I am unaware of any unique cardiovascular side effects associated with suboxone use.

Does smoking have effects on the heart?
Smoking is an extremely strong and independent risk factor for heart disease, stroke, and peripheral artery disease. Smoking increases the risk of these conditions in a dose dependent fashion, and no amount of smoking is safe. People who smoke less than five cigarettes per day are at increased risk for myocardial infarction relative to non-smokers. The incidence of myocardial infarction among men and women who have smoked at least twenty cigarettes per day for any period of time is three fold and six fold higher, respectively, than the incidence of myocardial infarction in never smokers.

More generally, smoking increases the risk of coronary artery disease, heart attack, arterial aneurysms, aortic dissection, blood clots, carotid artery stenosis, upper and lower extremity ischemic claudication, and death. Smoking’s deleterious cardiac, cerebrovascular, and peripheral vascular effects are the result of a variety of mechanisms that contribute to atherogenesis. Smoking is associated with insulin resistance and oxidization of low-density lipoprotein (LDL-c, or bad cholesterol). Oxidization of LDL-c makes it more proatherogenic. Smoking also activates the sympathetic nervous system which increases heart rate and blood pressure and leads to peripheral vasoconstriction.

Moreover, smoking increases inflammation, which activates platelets and creates a prothrombotic milieu. Furthermore, smoking damages blood vessel walls, rendering them less elastic and promoting premature arterial stiffening; in addition, smoking promotes endothelial dysfunction, which impairs the ability of coronary arteries to vasodilate. The risks of cardiovascular, cerebrovascular, and peripheral artery disease and associated events decrease significantly and relatively rapidly with smoking cessation.

What about cannabis addicts or chronic smokers and the cardiologist?
While we know relatively less about the effects of marijuana on the cardiovascular system, there is significant and growing interest in understanding how marijuana use impacts heart and blood vessel function. We do know that smoking marijuana leads to an acute, four- to five-fold increase in the risk of myocardial infarction in young men. This risk persists for approximately 60 minutes following inhalation. Daily cannabis use is associated with a 1.5%-3% annual increase in the risk of myocardial infarction. There is some evidence that the mechanism underlying this increased risk is a higher likelihood of experiencing coronary artery vasospasm (as opposed to accelerated atherogenesis).

The physiologic effects of marijuana may surprise some people. Marijuana intoxication typically leads to a slowing of the reflexes, and the appearance of a relaxed state. However, marijuana use actually stimulates the sympathetic nervous system, which leads to tachycardia, the release of systemic catecholamines, and increased myocardial oxygen demand. At the same time, marijuana use increases supine systolic and diastolic blood pressure, and increases the likelihood of experiencing orthostatic hypotension.

There is also some evidence that marijuana use activates platelets by modulating the endocannabinoid system. Longitudinal prospective studies of cannabis users have failed to reveal evidence that chronic cannabis use leads to significant alterations body mass index, blood pressure, total cholesterol, high density lipoprotein, triglycerides, or blood glucose levels. There is no consistent evidence that marijuana use increases cardiovascular mortality. We know relatively little about whether the mode of use (i.e. smoking vs. ingestion) modifies the effects of marijuana on the cardiovascular system.

Ketamine is being used off label for depression. What are the cardiovascular risks and concern when this is done?
This is an extremely interesting question. Ketamine is a sympathomimetic. Studies of the cardiovascular effects of Ketamine have found that the drug increases cardiac output by up to 50% in healthy subjects. However, among sicker patients, the drug’s effects appear to be more variable, with some patients experiencing augmented ventricular performance, and others demonstrating some impairment in left ventricular function due to Ketamine use (among coronary artery bypass graft patients, for example, induction of anesthesia with Ketamine has been shown to significantly reduce left ventricular stroke volume).

Ketamine does consistently produce tachycardia and this simple fact should lead us to be cautious about using it to treat depression in patients with obstructive coronary artery disease or congestive heart failure. The cardiovascular effects of Ketamine remain incompletely characterized, and the prospect of widespread use to treat chronic illnesses like depression heightens the need to more clearly elucidate how Ketamine effects the cardiovascular system.

Withdrawal from opioids is associated with hypertension and tachycardia. Is this a concern?
Yes—the hypertension and tachycardia which occur during opioid withdrawal can undoubtedly stress the cardiovascular system. Patients with a history of coronary artery disease (particularly those with a history of angina), patients with congestive heart failure, and those with aortic aneurysms should be monitored closely during the withdrawal period for new or worsening cardiovascular symptoms. In addition, patients’ home cardiovascular medication regimens, including beta blockers, antihypertensives, and anti-anginals (i.e. nitrates) should ideally be continued during the withdrawal period if possible in order to blunt the physiologic effects of opioid withdrawal.

Are any drug withdrawal syndromes a concern to a cardiologist?
In general, most withdrawal syndromes result in some degree of heightened sympathetic tone, which can produce hypertension and tachycardia. In patients with serious chronic cardiovascular illness, including coronary artery disease, congestive heart failure, valvular disease (i.e. aortic stenosis, mitral stenosis, or mitral regurgitation), or arrhythmias, including atrial fibrillation or paroxysmal supraventricular tachycardia, this sympathetic surge can precipitate symptoms or even acute decompensations. So, and this is a key point, it is the patient substrate which matters more than the specific withdrawal syndrome. Put another way, if the patient has significant cardiovascular comorbidities, any withdrawal syndrome may be dangerous.

In general, I worry most about alcohol withdrawal for a few reasons. First, alcoholics regularly live with multiple comorbidities, including cardiovascular comorbidities like atrial fibrillation and heart failure (which may be due to an alcoholic cardiomyopathy). I have seen alcohol withdrawal precipitate new or recurrent atrial fibrillation, and lead to acute heart failure decompensations in patients with underlying alcoholic cardiomyopathies.

Second, alcohol withdrawal is by far the most mortal withdrawal syndrome; seizures due to withdrawal, or delirium tremens, carry a significant risk of mortality in patients without underlying cardiovascular illness, and may be even more dangerous in patients who are suffering from concomitant cardiovascular disease. Third, many alcoholics are poorly nourished, and have significant electrolyte disturbances, including hypokalemia (which is a risk factor for ventricular arrhythmias).

The wasting of magnesium that occurs in alcoholics is particularly concerning, because potassium repletion is ineffective in the absence of adequate serum magnesium levels. Thus, when checking basic electrolytes in an alcoholic (e.g. sodium, potassium, bicarbonate, chloride, etc.), be sure to also check magnesium levels. And, if an alcoholic is hypokalemic and you don’t have a serum magnesium level, replete the magnesium before giving potassium (or alongside the potassium). A little extra magnesium won’t have any adverse consequences, but failing to replete magnesium could result in failure to correct the low potassium level, which could have serious consequences.

Which patients should an addiction rehab send to a cardiologist for evaluation?
This is a difficult question to answer with high specificity. First, any patient with new or concerning cardiovascular symptoms or confirmed cardiovascular disease, including 1) exertional chest discomfort; 2) documentation of a new or recurrent arrhythmia; 3) new exertional shortness of breath; and/or 4) new signs or symptoms of congestive heart failure, including exertional shortness of breath, new or progressive lower extremity edema, and/or paroxysmal nocturnal dyspnea or orthopnea, should be evaluated by a cardiologist. In addition, anyone with a syncopal event without a prodrome (i.e. sudden, unexplained, and unheralded syncope) or with a history of complex congenital heart disease should be referred to see a cardiologist.

Patients with chronic, stable cardiovascular comorbidities, including coronary artery disease (with or without angina), congestive heart failure, peripheral artery disease (with or without claudication), valvular disease (i.e. aortic stenosis or mitral regurgitation), and/or cerebrovascular disease do not necessarily need to be seen by a cardiologist while they are in Rehab, and provided they remain stable and are able to continue their long term outpatient treatment regimens for these conditions. However, a rehab should generally have a low threshold to engage a cardiologist in the management of any patient with complex, chronic cardiovascular disease.

What are the CVD effects of alcohol use, abuse, and addiction? Alcohol users have a variety of CV effects including noticing that their heart skips a beat or so…is this related to alcohol abusers or alcoholics heart blocks?
Modest alcohol consumption—two or fewer drinks per night for a man, and one drink per night for a woman— has been shown to be healthy, and may even reduce all-cause mortality and mortality due to cardiovascular disease. However, when consumed in greater quantities, alcohol is a cardiotoxin. People who abuse or are dependent on alcohol have a heightened risk of arrhythmias—including atrial fibrillation, atrial flutter, and ventricular arrhythmias (due to electrolyte abnormalities or an alcoholic cardiomyopathy)—and alcoholic cardiomyopathy.

Alcoholic cardiomyopathies can be profound; I have taken care of daily drinkers who present with severe, bi-ventricular dysfunction and left ventricular ejection fractions (LVEF) of 10%-15% (normal is 52- 70%). Importantly, alcoholic cardiomyopathy is usually not this fulminant. Many daily drinkers may suffer from very mild, and even subclinical, forms of this cardiomyopathy, and their LVEF may be normal.

However, in these patients the cardiotoxic effects of alcohol may still predispose to premature atrial and ventricular beats—which they may experience, and describe, as “skipped beats.” As noted above, alcoholic cardiomyopathy increases the risk of both atrial and ventricular arrhythmias, and prior work shows that the risk of ventricular tachycardia in alcoholic cardiomyopathy is comparable to that seen in patients with idiopathic dilated cardiomyopathies. The electrolyte abnormalities commonly found in alcoholics—most notably hypomagnesemia and hypokalemia— further compound the risk for these arrhythmias.

Fortunately, alcoholic cardiomyopathy is usually a reversible process; I have multiple patients whose LVEF has improved from this 10%-15% range (while drinking daily) to 50% or more (essentially normal) after one-two years of abstinence from alcohol and adherence with traditional heart failure therapies. Alcoholic cardiomyopathy may at times reach a point of irreversibility, of course, but, broadly speaking, it has a very favorable prognosis if long term abstinence can be achieved.

Alcoholic abuse/dependence is also associated with a modestly increased risk for myocardial infarction, particularly in patients with pre-existing cardiovascular disease.

Source:

https://www.rivermendhealth.com/resources/qa-daniel-blumenthal-abuse-cardiovascular-disease May 2018

Filed under: Alcohol,Cannabis/Marijuana,Cocaine,Health,Heroin/Methadone,Ketamine,Nicotine :

Interviewed by Mark Gold, MD

FEATURED ADDICTION EXPERT:
Frederick S. Southwick, MD
Professor of Internal Medicine and Former Chief of Infectious Diseases at the University of Florida
2010 Harvard University Advanced Leadership Fellow
Expert in Medicine, Infectious Disease and Medical Errors

We see patients who smoke cigarettes, drink and/or abuse drugs. How does this affect their immune status or ability to fight common infections? Any association between a drug dependency like cigarettes and/or marijuana, smoking and/or alcohol drinking?

Smoking is a major risk factor for developing pneumonia. Those who smoke 20 or more cigarettes a day have three times the risk of developing pneumonia. Cigarette smoke damages the tracheal lining of the lungs, alters the consistency of the fluid that coats this lining, and destroys the cilia that move bacteria and other foreign substances out of the lung. When the fluid coating the tubes of the lung becomes thicker as a consequence of the inflammatory reaction to smoke, cilia can no longer transport this fluid, and the foreign particles, including bacteria, usually trapped by this fluid can no longer be transported out of the lungs. Damage to the cilia also interferes with this important protective mechanism.

Alcohol and other sedating drugs interfere with the function of the epiglottis. This large flap of tissue covers the trachea to prevent saliva, food and liquids from entering the lungs. We have all accidently choked on water when our epiglottis malfunctions and water enters the lung. We quickly cough it out. When drugs lead to sedation our epiglottis is more likely to malfunction and food, saliva and bacteria from the mouth can more easily enter the lungs. Sedation also interferes with our cough reflex, and as a consequence, severe aspiration pneumonia can follow an overdose or an episode of heavy drinking.

Drug abuse often leads to malnutrition and some drugs, particularly alcohol, can depress the body’s ability to produce white blood cells. Malnutrition and the loss of these cells can depress the normal acute immune response to infection, and as a consequence, infections are often more severe and life threatening in alcoholics and patients who suffer drug abuse.

Do substance abusers or addicts have more mono, flu, pneumonia, TB or other Infectious Diseases (ID)?

The incidence of mononucleosis is not known to be higher. Influenza is more severe in addicts with depressed immune responses. Tuberculosis may have a higher incidence in addicts because their depressed immune function allows the organism to more readily spread in the lungs and throughout the body.

What are some IDs associated with intravenous drug users?

Another major risk for infection is the use of intravenous drugs. Too often the drugs being injected into the blood stream are contaminated with bacteria, particularly Staphylococcus aureus (found on the skin) and Pseudomonas (found in tap water). These bacteria can infect the heart valves leading to endocarditis, a very serious and potentially fatal infection. Once bacteria enter the blood stream they can also lodge in small vessels of the bones, particularly the vertebral bodies or back bones resulting in bone infection or osteomyelitis. This infection is associated with chronic pain, fever and loss of energy. Osteomyelitis is very difficult to treat and requires six weeks of high dose intravenous antibiotics. Despite prolonged therapy, this infection often relapses resulting in years of pain and suffering.

In addition to bacteria contaminating intravenous drug preparations, shared needles can transmit viruses – Hepatitis B, Hepatitis C, and HIV virus. Hepatitis B and Hepatitis C both can lead to severe liver inflammation that causes scaring of the liver called cirrhosis. Eventually the liver fails resulting in ascites (filling of the abdominal cavity with fluid), dilatation and bleeding of the esophageal veins (esophageal varices) resulting in gastrointestinal bleeding, and difficulty detoxifying substances in the blood resulting in the loss of alertness and eventually coma (called Hepatic encephalopathy).

HIV is another dreaded and all too common complication of IV drug use.

What would you evaluate all IV addicts for?

All IV addicts should be screened for Hepatitis B, Hepatitis C and HIV. They should also be screened for STDs.

What vaccinations would you suggest for patients with substance use disorders?

They should receive the influenza vaccine annually and the two pneumococcal vaccines. Also, if they are Hepatitis B antibody negative, they should receive the Hepatitis B vaccine.

Can you explain Hepatitis C. What is it? Who gets it? Why do so many addicts and abusers have it? What can you do to prevent it? Diagnose it? Treat it?

Hepatitis C is a virus that specifically infects the liver. This virus is transmitted by blood and blood products. Before the virus was recognized in the early 1990s, it contaminated our blood supply. Risk factors associated with an increased risk of Hepatitis C include:

persons receiving blood transfusions or transplanted organs before July of 1992
those who received clotting factors before 1987
anyone born to a mother with Hepatitis C virus
anyone who shared needles to inject drugs, or who had tattoos or body piercing with unsterile equipment

Addicts who use intravenous drugs and share needles are at very high risk, because the virus is transmitted by needles contaminated with virally infected blood. Individuals infected with Hep C have very high numbers of viral particles in their blood, and when they share a needle with an uninfected person, that person is at high risk of inadvertently injecting those viral particles intotheir own blood stream and infecting their liver. The best way to prevent the spread of Hep C is to avoid IV drug use.

Another alternative is to use a clean needle, and never share needles. In some areas of the country, needle exchange programs have been instituted to prevent the spread of Hep C, Hep B, and HIV. The diagnosis can be readily made with a blood test that measures antibodies directed against the virus. This is a very sensitive and specific test and anyone who falls into the above risk groups should undergo testing because we now have excellent antiviral therapy for this infection. Direct acting antiviral therapy offers high cure rates of over 95% in most cases. Treatment usually takes 8-12 weeks of a single pill once per day. In more complicated cases, treatment may be continued for 24 weeks. The cost of treatment is very high ($1,000/ pill) usually costing between $80,000-100,000 to achieve a cure.

Is there a new epidemic of STDs. Which? Who gets which? Why do so many addicts and abusers have it? What can you do to prevent it? Diagnose it? Treat it?

Drug abuse is associated with increased sexual activity and the more sexual partners one has the greater the risk of STDs. The incidence of syphilis in the U.S. has increased among women by 36% from 2015 to 2016 and 15% in men during this same period. Also, the incidence of newborn syphilis has increased by 28% as a consequence of transmission from mother to child.

The group with the highest incidence of this infection is men having sex with men (MSM), and about ½ of MSM who have syphilis also have HIV. The incidence of gonorrhea has also increased during this time period by 22%. This is a particularly worrisome development because strains of gonorrhea are increasingly becoming drug resistant meaning that we are at risk of running out of antibiotic treatments for this infection in the future. Condoms prevent the spread of these diseases; and should always be used given the high risk of STDs among drug abusers.

Public health workers try to identify contacts when a STD case is reported so that these contacts can be tested and treated to prevent the further spread of infection. All patients who have more than one sexual partner or who use illicit drugs should be screened for syphilis, gonorrhea, chlamydia, Hepatitis B and HIV, particularly sexually active women under 25, pregnant women, and men having sex with men.

Syphilis, Hepatitis B and HIV are detected primarily through blood tests. Gonorrhea and chlamydia are tested using vaginal and urethral (opening of the penis) swabs. These tests are all very sensitive and specific. Syphilis, gonorrhea and chlamydia are treated with antibiotics and can be cured. Hepatitis B, like Hepatitis C, can now be cured using antiviral agents, but at great expense. HIV requires lifelong treatment.

Can you explain HIV? AIDS? What is it? Who gets it? Why do so many addicts and abusers have it? What can you do to prevent it? Diagnose it? Treat it?

HIV stands for Human Immunodeficiency Virus and is caused by a retrovirus that is transmitted primarily through blood and through sexual contact as an STD. HIV is a lifelong infection that over time destroys immune cells and results in opportunistic infections (infections by organisms that rarely infect people with normal immune systems) including cryptococcal (fungal) meningitis, pneumocystis pneumonia, and toxoplasmosis brain infections.

When the immune system deteriorates to the point of allowing these infections to develop, HIV infection is said to have progressed to AIDS or Acquired Immune Deficiency Syndrome. Anti-retroviral medications can lower the viral counts and reverse this immunodeficiency; however, these medications cannot completely eradicate the infection, and they must be taken for life. If anti-retroviral medications are discontinued, the infection reactivates.

Can you explain what is HPV? Is it just a woman’s problem? Who gets it? Why do so many addicts and abusers have it? What can you do to prevent it? Diagnose it? Treat it?

Human papilloma virus (HPV) is a wart causing virus that is transmitted by close skin to skin contact and is most commonly transmitted by vaginal or anal sex. A high percentage of people become infected but our immune system often clears the virus; however, when the virus remains active it can cause genital warts that have a cauliflower like appearance. This virus can cause mouth and throat, penis, anal, vaginal and cervical cancer. The diagnosis of HPV is usually made based on examination. Cervical pap smears are recommended periodically for women to look for atypical precancerous cells. Treatment consists of removing the precancerous cells through surgical procedures. When cancer develops, chemotherapy and surgical resection are required.

There is no medical treatment for HPV. However, a very effective vaccine is now available that can prevent HPV induced cancer. The vaccine is recommended for all children at age 11-12 years and can be given up to age 21 for women and up to age 26 for men. This vaccine is strongly recommended for men who intend to have sex with men, transgenders, and adolescents who are immunocompromised, including patients with HIV.

For many years, we treated cigarette-related cancers rather than identifying smokers and helping people stop smoking. Is that still happening today with alcohol and drugs? With no drug testing or limited in Pediatrics and Medicine, how can asking the patient if they use or inject drugs identify and help treat the primary disease or users?

The newspapers and television news are now publicizing the worsening drug epidemic in our country. This epidemic has spread to people in every socioeconomic class. Given the many health risks of drug addiction, physicians and nurses have an obligation to ask questions about this potentially life-threatening behavior. Drug addiction is a disease, and to identify and treat this disease, medical caregivers are obligated to inquire about this important health issue. And those who suffer from drug addiction need not be ashamed. They should be open to help. The infectious disease risks of continuing addiction are real and potentially life threatening. Therapy for addiction is available and can be effective. Why wait until the damage has been done?

Source:

https://www.rivermendhealth.com/resources/qa-frederick-southwick-infections-and-addiction/ May 2018

Filed under: Addiction,Alcohol,Health,HIV/Injecting-Drug-Users,Nicotine :

Key Points

Question Are changes in population-level alcohol and tobacco consumption associated with changes in overall cancer mortality?

Findings In this population-based cohort study, temporal associations of alcohol and tobacco consumption with cancer mortality overall were found using Australian time series data (1935-2014). An estimated 1-L decrease in alcohol consumption per capita and a 1-kg decrease in tobacco consumption per capita were associated with a decline of 3.9% and 16%, respectively, in overall cancer mortality across a 20-year period.

Meaning Health policy interventions that can decrease population alcohol and tobacco consumption may lead to a reduction in cancer mortality over a 20-year period.

Abstract

Importance Understanding whether the population-level consumption of alcohol and tobacco is associated with cancer mortality is a crucial question for public health policy that has not been answered by previous studies.

Objective To examine temporal associations of alcohol and tobacco consumption with overall cancer mortality in the Australian population, looking across different sex and age groups.

Design, Setting, and Participants This population-based cohort study conducted a time series analysis (autoregressive integrated moving average models) using aggregate-level annual time series data from multiple sources. Data on alcohol consumption and tobacco consumption per capita between 1935 and 2014 among the Australian population aged 15 years and older were collected from the Australian Bureau of Statistics and Cancer Council Victoria. Analysis was conducted from June 1, 2017, to October 30, 2017.

Exposures Sex- and age-specific cancer mortality rates from 1968 to 2014 were collected from the Australian Institute Health and Welfare.

Main Outcomes and Measures Population-level cancer mortality in different sex and age groups in Australia, controlling for the effects of health expenditure.

Results Among the Australian total population aged 15 years and older in this study, 50.5% were women. Cancer death rates per 100 000 persons increased from 199 in 1968 to 214 in 1989 and then decreased steadily to 162 in 2014. Taking into account lagged effects, 1-L decreases in alcohol consumption per capita were associated with a decline of 3.9% in overall cancer mortality over a 20-year period, and 1-kg decreases in tobacco consumption per capita were associated with a 16% reduction. Alcohol consumption per capita was significantly associated with overall cancer mortality among men aged 50 to 69 years and women aged 50 years and older. Tobacco consumption per capita was found to be significantly associated with overall cancer mortality only among men aged 50 years and older.

Conclusions and Relevance In this study, alcohol consumption per capita was positively associated with overall cancer mortality among older men and women, and tobacco consumption per capita was positively associated with overall cancer mortality among older men over a 20-year period. This study provides evidence that a decrease in population-level drinking and tobacco smoking could lead to a reduction in cancer mortality.

Source: JAMA Network Open. 2018;1(3):e180713. doi:10.1001/jamanetworkopen.2018.0713

Filed under: Alcohol :

Researchers map out a cellular mechanism that offers a biological explanation for alcoholism, and could lead to treatments

Credit: Getty Images

You can lead a lab rat to sugar water, but you can’t make him drink—especially if there’s booze around.

New research published Thursday in Science may offer insights into why some humans who drink alcohol develop an addiction whereas most do not. After caffeine, alcohol is the most commonly consumed psychoactive substance in the world. For the majority of people the occasional happy hour beer or Bloody Mary brunch is where it stops. Yet we all know that others will drink compulsively, despite whatever consequence or darkness it brings.

The new research confirms earlier work showing this is true for rats; but it takes things a step further and supports a study design that could help scientists better understand addiction biology, and possibly develop more effective therapies for human addictive behaviors. Led by a team at Linköping University in Sweden, the researchers found that when given a choice between alcohol and a tastier, more biologically desirable sugar substitute, a subgroup of rats consistently preferred the alcohol. The authors further identified a specific brain region and molecular dysfunction most likely responsible for these addictive tendencies. They believe their findings and study design could be steps toward developing an effective pharmaceutical therapy for alcohol addiction, a kind of treatment that has eluded researchers for years.

A taste for sweetness is evolutionarily embedded in the mammalian brain; in the wild, sugar translates into fast calories and improved survival odds. For the new study, 32 rats were trained to sip a 20 percent alcohol solution for 10 weeks until it became habit. They were then presented with a daily choice between more alcohol or a solution of the noncaloric sweetener saccharine. (The artificial sweetener provides sugary-tasting enticement without the potential confounding variable of actual calories.) The majority of rats vastly preferred the faux sugar over the alcohol option.

But the fact that four rats—or 12.5 percent of the total—stuck with the alcohol was telling to senior author Markus Heilig, director of the Center for Social and Affective Neuroscience at Linköping, given the rate of alcohol misuse in humans is around 15 percent. So Heilig expanded the study. “There were four rats who went for alcohol despite the more natural reward of sweetness,” he says. “We built on that, and 600 animals later we found that a very stable proportion of the population chose alcohol.” What’s more, the “addicted” rats still chose alcohol even when it meant receiving an unpleasant foot shock.

To get a better sense of what was going on at a molecular level, Heilig and his colleagues analyzed which genes were expressed in the rodent subjects’ brains. The expression of one gene in particular—called GAT-3—was found to be greatly reduced in the brains of those who opted for alcohol rather than saccharine. GAT-3 codes for a protein that normally controls levels of a neurotransmitter called GABA, a common chemical in our brains and one known to be involved in alcohol dependence.

In collaboration with co-author and University of Texas at Austin research scientist Dayne Mayfield, Heilig’s team found that in brain samples from deceased humans who had suffered from alcohol addiction, GAT-3 levels were markedly lower in the amygdala—generally considered the brain’s emotional center. One might assume that any altered gene expression contributing to addictive behaviors would instead manifest in the brain’s reward circuitry—a network of centers involved in pleasurable responses to enticements like food, sex and gambling.

Yet the decrease in GAT-3 expression in both rats and humans was by far strongest in the amygdala. “Figuring out the reward circuitry has been a fantastic success story, but it’s probably of limited relevance to clinical addiction,” Heilig says. “The rewarding effect of drugs happens in everybody. It’s a completely different story in the minority of people who continue to take drugs despite adverse consequences.” He believes altered activity in the amygdala makes perfect sense, given that addiction—in both rats and humans—often brings with it negative emotions and anxiety.

Much previous addiction research has relied on models in which rodents learn to self-administer addictive substances, but without other options that could compete with drug use. It was French neuroscientist Serge Ahmed who recognized this as a major limitation to understanding addition biology given that, in reality, only a minority of humans develops addiction to a particular substance. By offering an alternative reward (that is, sweet water), his team showed only a minority of rats develop a harmful preference for drug use—a finding that has now been confirmed with several other commonly abused drugs.

Building on Ahmed’s concept, Heilig added the element of choice to his research. “You can’t determine the true reward of an addictive drug in isolation; it’s dependent on what other options are available—in our case a sugar substitute.” He says most models that have been used to study addiction, and to seek ways to treat it, were probably too limited in their design. “The availability of choice,” he adds, “is going to be fundamental to studying addiction and developing effective treatments for it.”

Paul Kenny, chair of neuroscience at Icahn School of Medicine at Mount Sinai, agrees. “In order to develop novel therapeutics for alcoholism it is critical to understand not just the actions of alcohol in the brain, but how those actions may differ between individuals who are vulnerable or resilient to the addictive properties of the drug,” he says. “This Herculean effort to impressively map out a cellular mechanism that likely contributes to alcohol dependence susceptibility will likely provide important new leads in the search for more effective therapeutics.” Kenny was not involved in the new research.

Heilig and his team believe they have already identified a promising addiction treatment based on their latest work, and have teamed up with a pharmaceutical company in hopes of soon testing the compound in humans. The drug suppresses the release of GABA and thus could restore levels of the neurotransmitter to normal in people with a dangerous taste for alcohol. With any luck, one of civilization’s oldest vices might soon loosen its grip.. Illumination.

Source: www.scientificamerican.com/article/scientists-pinpoint-brain-region-that-may-be-center-of-alcohol-addiction/ June 21^st 2018

Filed under: Addiction,Addiction (Papers),Alcohol,Brain and Behaviour :

Submitted by Andy Travis

Early onset of alcohol use is associated with a greater likelihood of developing alcohol abuse or dependence at a later age, according to data from the US National Survey on Drug Use and Health (NSDUH).

Those who first used alcohol at or before the age of 14 were nearly four times more likely to meet the criteria for past year alcohol abuse or dependence than those who started using alcohol between the ages of 18 and 20 (16.5% vs. 4.4%) and more than six times more likely than those who started using alcohol at or after age 21 (16.5% vs. 2.5%).

These findings illustrate the need for alcohol education and prevention efforts as early as middle school.

Percentage of Adults (Ages 21 or Older) Who Abused or Were Dependent on Alcohol in the Past Year, by Age of First Alcohol Use, 2009.

Similarly, adults who first started using marijuana at or before the age of 14 are most likely to have abused or been dependent on illicit drugs in the past year. Adults who first used marijuana at age 14 or younger were six times more likely to meet the criteria for past year illicit drug abuse or dependence than those who first used marijuana when they were 18 or older (12.6% vs. 2.1%) and almost twice as likely as those who started between the ages of 15 and 17 (12.6% vs. 6.6%).

Percentage of Adults (Ages 21 or Older) Who Abused or Were Dependent on Illicit Drugs in the Past Year, by Age of First Marijuana Use, 2009.

Links:
• Adults Who Initiate Alcohol Use Before Age 21 More Likely to Abuse or Become Dependent on Alcohol(link is external) – CESAR FAX, University of Maryland, USA.
• Early Marijuana Use Related to Later Illicit Drug Abuse and Dependence(link is external) – CESAR FAX, University of Maryland, USA.

Source:

http://preventionhub.org/en/prevention-update/adults-who-initiate-alcohol-and-marijuana-use-age-21-are-much-more-likely-abuse-or-become-d

22nd October 2010

Filed under: Alcohol,Cannabis/Marijuana,Prevention and Intervention,Youth :

Submitted by Andy Travis

This forthright editorial in the journal ‘Addiction’ joins over 500 public health leaders and 27 organisations in questioning the role of the global alcohol industry in making alcohol policy. Conflict with the tobacco industry is well documented, where vested interests have fought an aggressive rearguard action against efforts to reduce tobacco harm. Alcohol interests are now seen to be moving intensively into areas of policy making. Addiction’s editorial raises the strong suspicion that these moves are designed mainly to impede effective control and protect commercial interests. The WHO’s Global Strategy on the Harmful Use of Alcohol was endorsed unanimously in 2010, but in 2012 the alcohol producers issued their own strategy and claimed that the adoption of the WHO strategy, ‘…has legitimated industry’s ongoing efforts and has opened the door to the inclusion of producers as equal stakeholders’. Leading health professionals responded with dismay, arguing that the producer’s actions are weak, mostly lacking an appropriate evidence base and unlikely to reduce harm. Dr Chan, Director General of WHO, recently commented on the role of big business.

As the new publication makes clear, it is not just Big Tobacco anymore. Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation, and protect themselves by using the same tactics. Research has documented these tactics well. They include front groups, lobbies, promises of self-regulation, lawsuits, and industry-funded research that confuses the evidence and keeps the public in doubt. Tactics also include gifts, grants, and contributions to worthy causes that cast these industries as respectable corporate citizens in the eyes of politicians and the public.

Concern has also been expressed over ‘aggressive marketing strategies’ in areas of the world with minimum alcohol and tobacco policies in place, such as many countries with emerging economies in Asia, Africa and Latin America (see Prevention Hub link below). The ‘Addiction’ editorial highlights the marketing of alcohol to young people and promotion of products such as alcopops.

Links:

Who is responsible for the public’s health? The role of the alcohol industry in the WHO global strategy to reduce the harmful use of alcohol(link is external) – Addiction
Statement of Concern: The international public health community responds to the global alcohol producers’ attempts to implement the WHO Global Strategy on the Harmful Use of Alcohol(link is external) – Global Alcohol Policy Alliance
WHO Director-General addresses health promotion conference(link is external) – World Health Organisation
Children in developing nations targeted by Big Tobacco – Prevention Hub

Source:

http://preventionhub.org/en/prevention-update/international-outcry-grows-over-alcohol-industry-role-policy-making

30th October 2013

Filed under: Alcohol,Economic :

Submitted by Andy Travis

Much research on normative misconceptions among university students has been published in North America, but much less has surfaced in Europe. This cross-sectional study is based on 12 classes of second-year French college students in sociology, medicine, nursing or foreign language. Rather than focus on one substance the students were asked to estimate the proportion of tobacco, cannabis, alcohol use and heavy episodic drinking among their peers and to report their own use.

Researchers found that that substance use patterns and perceptions of the norms differ significantly across academic disciplines and that substance users are more likely to misjudge real peer use prevalence.

They conclude that social norms of substance use are an important factor among students personal use. Overestimating these norms is associated with increased levels of use. In addition to other strategies, the researchers recommend that prevention programs should consider changing use perception when it is overestimated.

“These results show that there are grounds for university level prevention campaigns based on local survey results.”

read more…

Source:

http://preventionhub.org/en/prevention-update/french-students-found-overestimate-their-peers-consumption-cannabis-tobacco-and-alcohol-pre

Filed under: Alcohol,Cannabis/Marijuana,Nicotine,Prevention and Intervention :

Submitted by Livia Edegger

Earlier this month Germany celebrated the results of the 2014 drug report which revealed a rapid decline in smoking, drinking and marijuana use among youth over the past ten years. Smoking among German teens aged 12 – 17 has halved in ten years (11.7%). Smoking rates have also dropped among 18 – 25 year olds, not as significantly though. Drinking rates have fallen from 17.9% in 2001 to 13.6% in 2012 among 12 – 17 year olds. In terms of gender differences, teenage boys are twice more likely to consume alcohol than their female counterparts. Little has changed among 18 – 25 year olds, the group that accounts for the highest alcohol consumption rate. Drinking in that age group was reported at 38.4% in 2012 which means it only dropped by a little over 1%. Cannabis ranks first among illicit drugs used with 5.6% of 12 – 17 year old teenagers using it compared to 9.2% in 2001. After years of steady consumption rates, cannabis use among 18 – 25 year olds is on the rise again and at 15.8% resembles figures of 2001.

Source:

http://preventionhub.org/en/prevention-update/germany-releases-drug-report

23rd July 2014

Filed under: Addiction,Alcohol,Cannabis/Marijuana,Nicotine,Youth :

Submitted by Livia Edegger

The findings of a report released by the Health and Social Care Information Centre (HSCIC) reveal a promising downward trend regarding drug use among secondary school students in England. Tobacco, alcohol and drug use among students have been cut in half in the past ten years. Smoking rates have dropped from 9% to 3% and alcohol rates have dropped from 25% to 9%. Illicit drug use has fallen by 50% between 2003 and 2013. The growing concern that e-cigarettes might fuel the uptake of smoking in teenagers was not supported by the report.

Links:

Smoking, Drinking and Drug Use Among Young People in England – 2013(link is external) – Health and Social Care Information Centre

Source:

http://preventionhub.org/en/prevention-update/drug-use-plunges-50-among-secondary-school-students-england

29th July 2014

Filed under: Alcohol,Nicotine,Youth :

Submitted by Livia Edegger

The most popular alcohol brands among US youth are the ones most often featured in advertisements in teenage magazines, according to a new study. Their ads are found to be five to nine times more likely to appear in those magazines. Leading researcher Craig Ross of Virtual Media Resources warns parents of the effects of alcohol ads on young adults, “Parents should take note that scientific evidence is growing that exposure to alcohol advertising promotes drinking initiation, and is likely to increase the frequency of consumption for kids already drinking”. Along with a group of researchers he called for developing standards that would limit alcohol advertising to magazines with less than 15% of young people among its readership.

Links:

Underage drinkers’ favourite alcohol brands are heavily advertised in magazines

http://www.drugfree.org/join-together/underage-drinkers-favorite-alcohol…

Source:

http://preventionhub.org/en/prevention-update/us-teens-targeted-alcohol-advertising-magazines

16th July 2014

Filed under: Alcohol,Youth :

Submitted by Livia Edegger on – 15:38

A group of researchers has developed a test to predict fourteen year old teenagers’ future drinking behaviour. The test takes a wide variety of factors that might influence young adults’ susceptibility to binge drinking into consideration such as family background, personality traits, availability of alcohol as well as brain-related variables. “There is no one really big thing. It’s a bunch of little things adding up to give you this prediction,” says Dr Robert Whelan from the University College Dublin. As of today, the test is far from practical as it lacks accuracy and relies on expensive brain scans. A more simplified and cost-effective version of the test could help identify at-risk adolescents for interventions in the future. Hugh Perry, chairman of the Medical Research Council Neurosciences and Mental Health Board, said further research could “lead to breakthroughs in this field and provide compelling evidence to inform public health policy and lay the groundwork for the design of interventions”.

Links:

Scientists develop test for teen binge-drinking risk(link is external)– BBC News

Source:

http://preventionhub.org/en/prevention-update/researchers-create-tool-predict-teens%E2%80%99-drinking-behaviour

9th July 2014

Filed under: Alcohol,Brain and Behaviour,Youth :

Submitted by joanna

This month the Australian Drug Foundation published the latest issue of their Prevention Research journal which features alcohol and drug prevention programmes in communities across Australia. The issue provides guidelines for organisations, individuals, practitioners and others developing and running prevention programmes and activities in community settings. The issue highlights the importance of comprehensive community programmes involving families, schools and other community entities and offers guidelines to community-based organisations and groups working in the field of drug prevention.

Links:

Preventing alcohol and drug problems in your community(link is external)– Australian Drug Foundation

Source:

http://preventionhub.org/en/prevention-update/guide-implementing-community-drug-prevention-programmes

3rd July 2014

Filed under: Alcohol,Prevention and Intervention :

Submitted by Livia Edegger

A recent study examines the extent to which peers and parents can influence an adolescent’s attitude towards drinking by comparing teenage drinkers with non-drinkers. The group of teenagers that viewed drinking as a fun activity were not restricted by their parents in their drinking and found it difficult to handle peer pressure. In contrast, the adolescents that did not drink were given stringent rules regarding drinking by their parents and did not feel the need to drink to fit in.

Links:

A qualitative exploration of attitudes towards alcohol, and the role of parents and peers of two alcohol-attitude-based segments of the adolescent population(link is external)– Substance Abuse Treatment, Prevention, and Policy

Source:

http://preventionhub.org/prevention-update/importance-parents-and-peers-young-people%E2%80%99s-attitude-towards-drinking

12th June 2014

Filed under: Alcohol,Youth :

Submitted by Livia Edegger

While the dangers of frequent binge drinking have been widely studied, the potentially harmful effects of a single alcohol binge have not yet been explored in detail. According to a new study, even a single binge can be harmful. Excessive drinking can lead to the release of toxins in the blood that can cause fever, inflammation or tissue damage. Research into how a single episode of binge drinking can affect the drinker’s health is still in its early stage and needs to develop further to determine its harms.

Links:

Acute binge drinking increases Serum Endotoxin and bacterial DNA levels in healthy individuals

Source:

http://preventionhub.org/prevention-update/single-alcohol-binge-may-be-harmful

3rd June 2014

Filed under: Alcohol,Health :

Submitted by Livia Edegger

A new study found that movies that present alcohol in a positive light can encourage drinking among young adults. As characters are often seen as role models their drinking habits can have an impact on teenagers’ views on drinking. Since young viewers tend to be more involved in movies and are mostly unaware of the hidden advertising messages, alcohol marketing in movies might actually be more effective than ads. ‘Participants were more transported into and had a more positive attitude toward movie clips with alcohol portrayals compared to the same movie clips with no alcohol portrayals’, says researcher Renske Koordeman. Research on the effects of alcohol marketing in films is of relevance as most movies include some kind of reference to alcohol brands or drinking and watching movies is among the top pastimes among adolescents.

Links:

New research: How movies may make you drink more(link is external)– European Centre for Monitoring Alcohol Marketing

Source:

http://preventionhub.org/en/prevention-update/how-movies-may-affect-young-viewers%E2%80%99-attitude-towards-drinking

3rd June 2014

Filed under: Alcohol,Youth :

Submitted by Livia Edegger

This study, carried out in several Dutch schools, was administered to adolescents and parents simultaneously as well as separately. While simultaneous interventions held off the onset of regular drinking, separate interventions did not have an impact on teenage drinking. Combined prevention, targeting adolescents and their parents, was found to be the most effective among adolescents with low self-control and lenient parents. The study highlights the importance of addressing self-control among adolescents and parenting styles as part of comprehensive prevention programmes.

Links:

Differential impact of a Dutch alcohol prevention programme targeting adolescents and parents separately and simultaneously: low self-control and lenient parenting at baseline predict effectiveness(link is external)

Source:

http://preventionhub.org/prevention-update/dutch-prevention-programme-yields-promising-results

28th May 2014

Filed under: Alcohol,Prevention and Intervention,Youth :

Submitted by Andy Travis

This study found that youth with more substance users in their networks reported greater alcohol, cigarette, and marijuana consumption regardless of whether these network members provided tangible or emotional support. The homeless setting was more significant in consumption than meeting network members in other contexts. Numbers of adults and school attendees in networks reduced consumption.

Links:
• One in three parents do not talk to their children about the risks associated with drinking alcohol(link is external) Full statement ,with further links.
• Alcohol. It’s no joke. | Why Let Drink Decide(link is external) The video campaign.

Source:

http://preventionhub.org/en/prevention-update/survey-uk-parents-suggests-parents-more-concerned-about-risks-drugs-alcohol-government-anno

11th January 2011

Filed under: Alcohol,Cannabis/Marijuana,Nicotine,Youth :

Click on the images to enlarge the detail.

Source:

https://www.intervenenow.com/breaking-the-stigma-of-recovery/

Filed under: Alcohol,Cannabis/Marijuana,Nicotine,Prescription Drugs,Treatment and Addiction :

It’s a question often raised in today’s heated discussion about the efficacy of drug policy in America: Do regulations outlawing certain drugs actually work?

Let’s go to the data. Here’s what the Nation’s largest, longest-running, and most comprehensive source on the state of drug use in America shows:

As you can see, the use of legal drugs like alcohol and tobacco far outpaces the use of illegal drugs. It is clear, then, that laws discouraging drug use do have an effect in keeping rates relatively low compared to rates for other drugs that are legal and therefore more available. Even beyond this one-year snapshot, we know that significant progress has been made in the long term. Since 1979, there has been a roughly 30 percent decline in the overall use of illicit drugs in America.

So our challenge is not that we’re powerless against the problem of substance use in America. The challenge is that rates of drug use – a behavior that harms too many of our fellow citizens — are still too high. That’s why the President’s National Drug Control Strategy supports innovative and proven programs that aim to reduce drug use and its consequences through a combination of public health and public safety interventions.

It boils down to simple arithmetic: The more Americans use drugs, the higher the health, safety, productivity, and criminal justice costs we all have to bear. And if sensible drug laws (in combination with a wide array of prevention, treatment, and other health interventions, of course) help keep those numbers down, then the answer is yes, they are working.

Source: www.whitehouse.gov 2013 ONDCP

Filed under: Alcohol,Global Drug Legalisation Efforts,Nicotine,USA :

A pair of new studies has revealed that marijuana use could lead to abuse of other drugs and alcohol. Experts said that these risks need to be considered not only by doctors and patients but by policy makers as well particularly in states where marijuana is legalized for recreational or medical use.

For the first study, which was published in the journal Drug and Alcohol Dependence, the results showed that adults who smoke marijuana have five times increased odds of developing alcohol use disorder (AUD) compared with their counterparts who do not smoke.

By looking at the data of more than 27,000 adults, researchers found that the participants who did not have AUD but reported using cannabis during the first survey were 5.4 times more likely to have an AUD three years later. The participants who already battle with an alcohol use disorder and were using marijuana were also found to aggravate their dependence on alcohol.

“Among adults with no history of AUD, cannabis use at Wave 1 was associated with increased incidence of an AUD three years later relative to no cannabis use,” study researcher Renee Goodwin, from Columbia University, and colleagues wrote. “Among adults with a history of AUD, cannabis use at Wave 1 was associated with increased likelihood of AUD persistence three years later relative to no cannabis use.”

The second study, which was published in JAMA Psychiatry and involved more than 34,000 subjects, revealed that participants who used cannabis during the first survey were about six times as likely to suffer from substance use disorder after three years.

Researchers also found an increased risk for drug use disorders and nicotine dependence among pot smokers. Although the study authors said that their findings do not establish a cause and effect relationship between pot use and substance abuse, they noted that there may be an overlap in brain circuitry that influence drug use and dependence.

“Our study indicates that cannabis use is associated with increased prevalence and incidence of substance use disorders,” Carlos Blanco, from the National Institute on Drug Abuse, and colleagues wrote. “These adverse psychiatric outcomes should be taken under careful consideration in clinical care and policy planning.”

Source: http://www.techtimes.com/articles/135554/20160222 22^nd Feb 2016

Filed under: Addiction,Alcohol,Australia,Cannabis/Marijuana :

A Systematic Review and Meta-analysis

Key Points

Question What is the prevalence of foetal alcohol spectrum disorder among children and youth in the general population?

Findings In this meta-analysis of 24 unique studies and 1416 unique children and youth with foetal alcohol spectrum disorder, approximately 8 of 1000 in the general population had foetal alcohol spectrum disorder, and 1 of every 13 pregnant women who consumed alcohol during pregnancy delivered a child with foetal alcohol spectrum disorder. The prevalence of foetal alcohol spectrum disorder was found to be notably higher among special populations.

Meaning The prevalence of foetal alcohol spectrum disorder among children and youth in the general population exceeds 1% in 76 countries, which underscores the need for universal prevention initiatives targeting maternal alcohol consumption, screening protocols, and improved access to diagnostic services, especially in special populations.

Abstract

Importance Prevalence estimates are essential to effectively prioritize, plan, and deliver health care to high-needs populations such as children and youth with fetal alcohol spectrum disorder (FASD). However, most countries do not have population-level prevalence data for FASD.

Objective To obtain prevalence estimates of FASD among children and youth in the general population by country, by World Health Organization (WHO) region, and globally.

Data Sources MEDLINE, MEDLINE in process, EMBASE, Education Resource Information Center, Cumulative Index to Nursing and Allied Health Literature, Web of Science, PsychINFO, and Scopus were systematically searched for studies published from November 1, 1973, through June 30, 2015, without geographic or language restrictions.

Study Selection Original quantitative studies that reported the prevalence of FASD among children and youth in the general population, used active case ascertainment or clinic-based methods, and specified the diagnostic guideline or case definition used were included.

Data Extraction and Synthesis Individual study characteristics and prevalence of FASD were extracted. Country-specific random-effects meta-analyses were conducted. For countries with 1 or no empirical study on the prevalence of FASD, this indicator was estimated based on the proportion of women who consumed alcohol during pregnancy per 1 case of FASD. Finally, WHO regional and global mean prevalence of FASD weighted by the number of live births in each country was estimated.

Main Outcomes and Measures Prevalence of FASD.

Results A total of 24 unique studies including 1416 unique children and youth diagnosed with FASD (age range, 0-16.4 years) were retained for data extraction. The global prevalence of FASD among children and youth in the general population was estimated to be 7.7 per 1000 population (95% CI, 4.9-11.7 per 1000 population).

The WHO European Region had the highest prevalence (19.8 per 1000 population; 95% CI, 14.1-28.0 per 1000 population), and the WHO Eastern Mediterranean Region had the lowest (0.1 per 1000 population; 95% CI, 0.1-0.5 per 1000 population).

Of 187 countries, South Africa was estimated to have the highest prevalence of FASD at 111.1 per 1000 population (95% CI, 71.1-158.4 per 1000 population), followed by Croatia at 53.3 per 1000 population (95% CI, 30.9-81.2 per 1000 population) and Ireland at 47.5 per 1000 population (95% CI, 28.0-73.6 per 1000 population).

Conclusions and Relevance

Globally, FASD is a prevalent alcohol-related developmental disability that is largely preventable. The findings highlight the need to establish a universal public health message about the potential harm of prenatal alcohol exposure and a routine screening protocol. Brief interventions should be provided, where appropriate.

Source: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2649225

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Health :

Fetal alcohol spectrum disorder (FASD) is a common condition that affects a substantial number of children, adolescents, and adults. Individuals can manifest FASD in a variety of ways, with many co-morbidities. They can present with birth defects, learning difficulties, intellectual disability, academic struggles, behavioral and psychiatric issues (e.g. attention-deficit/hyperactivity disorder, conduct disorder, depression, and drug and alcohol addiction), and difficulties with the law, with a risk for incarceration, unemployment, poverty, and dependency. Fetal alcohol spectrum disorder is important because it can potentially be prevented, and early recognition and diagnosis can lead to earlier interventions and supports that are associated with improved outcomes. Prevention is important because FASD is associated with a high cost to affected individuals, families, systems of care, and communities.

Source: http://jamanetwork.com/journals/jamapediatrics/article-abstract/2649222

See also:

Taylor & Francis. “Fathers drinking: Also responsible for fetal disorders?.” ScienceDaily, www.sciencedaily.com/releases/2014/02/140214075405.htm.

Am J Stem Cells 2016;5(1):11-18 www.AJSC.us /ISSN:2160-4150/AJSC0030217 Review Article Influence of paternal preconception exposures on their offspring: through epigenetics to phenotype

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth,Health :

Medical Illness Model:

Near the end of the Second World War researchers and leaders in the recovery community jointly formulated the problem of uncontrolled drinking into what is now known as the Disease Model of alcoholism. This model postulates that, like medical illnesses, alcoholism–more specifically alcohol dependence, or addiction—can be diagnosed, its course observed, and its physical causes understood.

Further, scientific trials can be undertaken to identify the best treatments for those who suffer from it. The diagnosis of Alcohol Dependence, in this model, rested on four symptoms: 1) a tolerance to alcohol in which a person needs to drink ever greater amounts to reach a desired effect, 2) withdrawal symptoms, such as “the shakes” and others, on stopping use, 3) the Loss of Control phenomenon in which affected persons lose the ability to control how much they drink at a sitting and thereby can no longer predict how much they will drink from one episode to the next, and 4) social or physical impairment resulting from combinations of the first three symptom categories1.

This model pictures a condition from which many alcohol dependent people emerge every year, and into which many others return. View as a disease, alcoholism takes on the characteristics of a remitting-relapsing illness with primary symptoms that direct us to brain functioning. And, because ethyl alcohol is a very small molecule with easy access to most parts of the body, moderate to heavy alcohol use often injures other organs, such as the liver and heart among others.

Uncontrolled, or dependent, alcohol use also affects the social network setting of family as well as work activities, friendships, and legal involvement. Last, however, the Disease model brings with it the possibilities of treatment and of hope. At this date, effective medicinal agents against alcoholism are very few. But hope, that necessary ingredient for recovery, waxes strong in the illness model. In the words of the alcoholic patient quoted in the Part 2, “It is much easier to think of myself as an ill person working to become well, rather than a bad person trying to become good.”

Genetic Models:

From the Disease model has come another, that of genetic influence. The observation that alcoholism often runs in families for many years meant that family cultures or mores determined who would become alcoholic and who would not. While it is clear that cultural and family life influences are very powerful, more recent studies have noted that an underlying genetic disposition may be at play in some genealogical lines2. If so, the evidence suggests a confluence of many gene effects rather than the dominant/recessive results of inheritance in Mendelian models of genetic death, as for example, in Huntington’s Disease.

Instead, the gene effects seem to have more to do with the vulnerability towards alcoholism. One form appears in those who have a genetically-based insensitivity to alcohol—an “inborn tolerance,” and develop alcohol dependence at much higher rates than alcohol sensitive comparison groups. Another form may require a combination of

gene influences and environment conditions to come together to result in alcohol-plus-multiple drug dependence, sometimes referred to as Type 2 or Type B alcoholics.

Unexpectedly, the news of gene involvement was greeted with enthusiasm among some quarters of the actively drinking alcoholic public: “Since alcoholism is genetic, we can’t escape our genes and may as well keep drinking.” As with older models however, the element of choice remains present in the sober periods between drinking episodes. As some of the other models suggest, healing from alcoholism remains an individual process.

Psychological Adaptation Models in Illness and Recovery:

Further modern research asks that we look at individuals and their abilities to adapt to the stresses of life. Careful observation has established that individual humans have the ability to adapt creatively to the painful thoughts and feelings of living and to do so in ways that connect us together rather than drive us apart3. This model of Mature human psychological adaptation, however, emphasizes that the brain function at its healthy best. Heavy, continuous use of alcohol carries often subtle, if severe, effects on the brain that are as yet poorly understood.

But we know they exist because of their effects in driving down the ability to adapt, from psychological Maturity to much more rigid Primitive mechanisms of coping, such as when an alcoholic “denies” that an obvious problem exists at all. This kind of Denial can occur in the actively drinking alcoholic who understands that resolving his or her ambivalence toward drinking is too painful to contemplate; therefore, a failure to perceive the problem seems preferable than facing it.

So it is that the Adaptation model views the First of the Twelve Steps as addressing primitive Denial in coming to recognize that the individual’s alcoholism exists. Progressing along the continuum of the Steps leads finally to the Twelfth: helping others who have the same problem. In the Psychological Adaptation model, this exemplifies the Mature mechanism of Altruism: selflessly helping others. The occurrence of brain healing as abstinence continues—along with the progression towards psychological maturity, whether viewed in the Psychological Adaptation or the Twelve Step models—suggests that brain recovery process are at work. We can only recognize their existence at this point, and need to understand their biology if we are to improve treatments in the Disease model.

Many Models, More Questions:

With this overview of the different model formulations of the problem of alcoholism and what to do about it, we are now ready to look as specific questions from a scientific point of view. As this series unfolds, we will have recourse to use all of the models mentioned—now adding the crucial ingredient of evidence, systematically gathered. In future Updates, the discussion will focus on specific problems and what we can learn about them.

Source: https://www.ncadd.org/blogs/research-update/models-of-alcoholism-medical-physiological-causes 14th Jan. 2014

Filed under: Addiction,Addiction (Papers),Alcohol,Brain and Behaviour :

Residential treatment has received a lot of criticism and scepticism over the last several years, especially for opioid use disorders. (Some of it is deserved. Too many providers are hustlers and others provide little more than detox with inadequate follow-up. Of course, many of the same criticisms have been directed at medication-assisted treatment. But, that’s not what this post is about.)

At any rate, the Recovery Research Institute recently posted about a study looking at completion rates for outpatient and residential treatment. The study looked at A LOT of treatment admissions, 318,924. Residential completion rates appear to have surprised a lot of people:

Results: Residential programs reported a 65% completion rate compared to 52% for outpatient settings. After controlling for other confounding factors, clients in residential treatment were nearly three times as likely as clients in outpatient treatment to complete treatment.

But, what really surprised some readers was this:

Compared to clients with a primary alcohol use disorder:
Clients with marijuana use disorder were only 74% as likely to complete residential treatment.
Clients with an opioid use disorder were 1.29x MORE likely to complete residential treatment.

So opioid users were much more likely to beneﬁt from residential treatment compared to alcohol users. . . .

We speculate that for opioid abusers, the increased structure and cloistering of residential treatment provide some protection from the environmental and social triggers for relapse or that otherwise lead to the termination of treatment that outpatient treatment settings do not afford. Indeed, environmental risk characteristics in drug abusers’ residential neighbourhoods, such as the presence of liquor stores and indicators of concentrated disadvantage at the neighbourhood level, have been found to be associated with treatment non-continuity and relapse.

Such environmental triggers may play a particularly substantial role for those addicted to opioids compared to those seeking treatment for marijuana abuse. Since opioid users have the lowest raw completion rates in general, this ﬁnding that residential treatment makes a greater positive difference for opioid users than it does for any of the other substances represents an important result that merits further investigation. Given the current epidemic of opioid-related overdoses in the U.S., our results suggest that greater use of residential treatment should be explored for opioid users in particular.

For the differences between residential and outpatient, they say the following:

In general, residential treatment completion rates are usually higher compared to outpatient settings, but what is particularly noteworthy is that even after controlling for various client characteristics and state level variations, the likelihood of treatment completion for residential programs was still nearly three times as great as for outpatient settings. Given the more highly structured nature and intensity of services of residential programs compared to outpatient treatment, it is understandable that residential treatment completion rates would be higher. It requires far less effort to end treatment prematurely in outpatient settings com-pared to residential treatment.

Given the strong association between treatment completion and positive post-treatment outcomes such as long term abstinence, the large magnitude of difference between outpatient and residential treatment represents a potentially important consideration for the choice of treatment setting for clients.

Source: https://addictionandrecoverynews.wordpress.com/2017/07/13/opioid-users-complete-residential-at-higher-rates

Filed under: Addiction,Alcohol,Health,Heroin/Methadone,Treatment and Addiction :

Drinking alcohol during pregnancy could harm not just a woman’s unborn child, but her grandchildren and beyond.

Researchers in the US have found brain abnormalities linked to foetal alcohol spectrum disorder (FASD), at least in mice, can be passed down through the generations.

“Traditionally, prenatal ethanol exposure from maternal consumption of alcohol was thought to solely impact directly exposed offspring, the embryo or foetus in the womb,” says Kelly Huffman from the University of California.

“However, we now have evidence that the effects of prenatal alcohol exposure could persist transgenerationally and negatively impact the next-generations of offspring who were never exposed to alcohol.”

In the experiment, Prof Huffman’s team found the children of mice with FASD also had reduced body weight and brain size, and were more likely to show signs of anxiety and depression. The defects were present in further generations.

“By demonstrating the strong transgenerational effects of prenatal ethanol exposure in a mouse model of FASD, we suggest that FASD may be a heritable condition in humans,” says Prof Huffman.

Babies born with FASD often have intellectual and physical disabilities, behavioural problems and distinct facial features. It is irreversible. A study in 2015 found almost third of Kiwi women continue to drink alcohol during their first trimester, and 11 percent right up until birth. · Concerns over number of women drinking while pregnant

The Ministry of Health says there is no known safe level of drinking, and recommends women abstain from alcohol from the time they decide to have a baby, through conception and the entire pregnancy.

The discovery that FASD affects children who were never exposed to alcohol is a clue to future potential therapies and perhaps even prevention, the researchers say.

The research was published in journal Cerebral Cortex.

Source: http://www.newshub.co.nz/home/health/2017/07/drinking-alcohol-while-pregnant-harms-kids-for-generations-study.html

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,New Zealand :

One in 5 adolescents at risk of tobacco dependency, harmful alcohol consumption and illicit drug use

Researchers from the University of Bristol have found regular and occasional cannabis use as a teen is associated with a greater risk of other illicit drug taking in early adulthood. The study by Bristol’s Population Health Science Institute, published online in the Journal of Epidemiology & Community Health, also found cannabis use was associated with harmful drinking and smoking.

Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), the researchers looked at levels of cannabis use during adolescence to determine whether these might predict other problematic substance misuse in early adulthood — by the age of 21.

The researchers looked at data about cannabis use among 5,315 teens between the ages of 13 and 18. At five time points approximately one year apart cannabis use was categorised as none; occasional (typically less than once a week); or frequent (typically once a week or more).

When the teens reached the age of 21, they were asked to say whether and how much they smoked and drank, and whether they had taken other illicit drugs during the previous three months. Some 462 reported recent illicit drug use: 176 (38%) had used cocaine; 278 (60%) had used ‘speed’ (amphetamines); 136 (30%) had used inhalants; 72 (16%) had used sedatives; 105 (23%) had used hallucinogens; and 25 (6%) had used opioids.

The study’s lead author, Dr Michelle Taylor from the School of Social and Community Medicine said:

“We tend to see clusters of different forms of substance misuse in adolescents and young people, and it has been argued that cannabis acts as a gateway to other drug use. However, historically the evidence has been inconsistent.

“I think the most important findings from this study are that one in five adolescents follow a pattern of occasional or regular cannabis use and that those individuals are more likely to be tobacco dependant, have harmful levels of alcohol consumption or use other illicit drugs in early adulthood.”

In all, complete data were available for 1571 people. Male sex, mother’s substance misuse and the child’s smoking, drinking, and behavioural problems before the age of 13 were all strongly associated with cannabis use during adolescence. Other potentially influential factors were also considered: housing tenure; mum’s education and number of children she had; her drinking and drug use; behavioural problems when the child was 11 and whether s/he had started smoking and/or drinking before the age of 13.

After taking account of other influential factors, those who used cannabis in their teens were at greater risk of problematic substance misuse by the age of 21 than those who didn’t.

Teens who regularly used cannabis were 37 times more likely to be nicotine dependent and three times more likely to have a harmful drinking pattern than non-users by the time they were 21. And they were 26 times more likely to use other illicit drugs.

Both those who used cannabis occasionally early in adolescence and those who starting using it much later during the teenage years had a heightened risk of nicotine dependence, harmful drinking, and other illicit drug use. And the more cannabis they used the greater was the likelihood of nicotine dependence by the age of 21.

This study used observational methods and therefore presents evidence for correlation but not does not determine clear cause and effect — whether the results observed are because cannabis use actually causes the use of other illicit drugs. Furthermore, it does not identify what the underlying mechanisms for this might be. Nevertheless, clear categories of use emerged.

Dr Taylor concludes:

“We have added further evidence that suggests adolescent cannabis use does predict later problematic substance use in early adulthood. From our study, we cannot say why this might be, and it is important that future research focuses on this question, as this will enable us to identify groups of individuals that might as risk and develop policy to advise people of the harms.

“Our study does not support or refute arguments for altering the legal status of cannabis use — especially since two of the outcomes are legal in the UK. This study and others do, however, lend support to public health strategies and interventions that aim to reduce cannabis exposure in young people.”

Journal Reference:

1. Michelle Taylor, Simon M Collin, Marcus R Munafò, John MacLeod, Matthew Hickman, Jon Heron. Patterns of cannabis use during adolescence and their association with harmful substance use behaviour: findings from a UK birth cohort. Journal of Epidemiology and Community Health, 2017; jech-2016-208503 DOI: 10.1136/jech-2016-208503

Source: www.sciencedaily.com/releases/2017/06/170607222448<.htm>. 7 June 2017.

Filed under: Addiction,Addiction (Papers),Alcohol,Cannabis/Marijuana,Youth :

Prenatal exposure to smoke and alcohol may increase the risk of children developing conduct problems in adolescence, researchers said.

Conduct disorder (CD) is a mental disorder where children demonstrate aggressive behaviour that causes or threatens harm to other people or animals such as bullying or intimidating others, often initiating physical fights, or being physically cruel to animals.

The findings, led by researchers from the King’s College London, showed that exposure to smoke and alcohol, especially during foetal development, may lead to some epigenetic changes — chemical modifications of DNA that turns our genes on or off — particularly in genes related to addiction and aggression, leading to conduct problems in children.

One of the genes which showed the most significant epigenetic changes is MGLL — known to play a role in reward, addiction and pain perception. Previous research have revealed that conduct problems are often accompanied by substance abuse and there is also evidence indicating that some people who engage in antisocial lifestyles show higher pain tolerance. The researchers also found smaller differences in a number of genes previously associated with aggression and antisocial behaviour.

“There is good evidence that exposure to maternal smoking and alcohol is associated with developmental problems in children, yet we don’t know how increased risk for conduct problems occurs”.

These results suggest that epigenetic changes taking place in the womb are a good place to start,” said Edward Barker from King’s College London. The results highlight the neonatal period as a potentially important window of biological vulnerability, as well as pinpointing novel genes for future investigation.

For the study, published in the journal Development and Psychopathology, the team measured the influence of environmental factors previously linked to an early onset of conduct problems, including maternal diet, smoking, alcohol use and exposure to stressful life events. They found epigenetic changes in seven sites across the DNA of those who went on to develop early-onset of conduct problems. Some of these epigenetic differences were associated with prenatal exposures, such as smoking and alcohol use during pregnancy.

Source: http://www.thehealthsite.com/news/prenatal-exposure-to-smoke-alcohol-may-increase-behaviour-problems-in-kids-ag0617/ Published: June 13, 2017

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth,Nicotine :

In this guest blog, Kate Fleming, Senior Lecturer, Public Health Institute, Liverpool John Moores University, and Raja Mukherjee, Consultant Psychiatrist, Lead Clinician UK National FASD clinic, Surrey and Borders Partnership NHS Foundation Trust consider the context and future for Foetal Alcohol Spectrum Disorders in the UK.

A recent opinion piece in The Guardian entitled Nothing prepared me for pregnancy- apart from the never ending hangover of my 20s took a, presumably, humorous take on the tiredness, vomiting, dehydration, and secrecy that so many women live through in early pregnancy, likening this to days spent hungover after excessive drinking in the author’s early 20s.

In an article that was entirely about alcohol and pregnancy there was reassuringly no mention of the author consuming alcohol during pregnancy, indeed quite the reverse “I don’t actually want booze in my body”. But neither was there explicit reference to the harms that alcohol can cause in pregnancy.

The harms caused by consuming alcohol in pregnancy

Foetal Alcohol Spectrum Disorders (FASD) is an umbrella term that encompasses the broad range of conditions that are related to maternal alcohol consumption. The most severe end of the spectrum is Foetal Alcohol Syndrome (FAS) associated with distinct facial characteristics, growth restriction and permanent brain damage. However, the spectrum includes conditions displaying mental, behavioural and physical effects on a child which can be difficult to diagnose. Confusingly, these conditions also go under several other names including Neuro-developmental Disorder associated with Prenatal Alcohol Exposure (ND-PAE) the preferred term by the American Psychiatric Association’s fifth version of its Diagnostic and Statistical Manual (APA DSM-V), alcohol-related birth defects, alcohol-related neuro-developmental disorder, and partial foetal alcohol syndrome.

How common is FASD? A recent study which brought together information from over 300 studies estimates the prevalence of drinking in pregnancy to be close to 10%, and around 1 in 4 women in Europe drinking during pregnancy. Their estimates of FAS (the most severe end of the spectrum) were 14.6 per 10000 people worldwide or 37.4 per 10000 people in Europe, corresponding to 1 child in every 67 women who drank being born with FAS.

Given the figure for alcohol consumption in pregnancy is even higher in the UK, with some studies suggesting up to 75% of women drink at some point in their pregnancy, conservatively in the UK we might expect a prevalence of FASD of at least 1%. We also know that it is highly unlikely that anything close to this number of individuals have formally had a diagnosis. This lack of knowledge of the prevalence in the UK is hampering efforts to ensure the required multi-sector support for those affected by FASD and their families.

Current policy

For some time a significant focus of alcohol in pregnancy research was to try and identify a safe threshold of consumption, without demonstrable success. No evidence of harm at low levels does not however equate to evidence of no harm and as such in 2016 the Chief Medical Officer revised guidance on alcohol consumption in pregnancy to recommend that women should avoid alcohol when trying to conceive or when pregnant. Though this clarity of guidelines has been well received by the overwhelming majority of health professionals there are barriers to its implementation with few professionals “very prepared to deal with the subject”. In addition, knowledge of the guideline amongst the general public has yet to be evaluated.

As part of the 2011 public health responsibility deal a commitment to 80% of products having labels which include warnings about drinking when pregnant forms part of the alcohol pledges. A study in 2014 showed that 90% of all labels did indeed include this information. However, it has also been shown that this form of education is amongst the least effective in terms of alcohol interventions, and the pledge is no longer in effect.

Pregnancy is recognised as a good time for the initiation of behaviour change yet in the context of alcohol consumption it is arguably too late. An estimated half of all pregnancies are unplanned and there remains therefore a window of early pregnancy before a woman is likely to have had contact with a health professional and before the guidelines can be explained during which unintentional damage to her unborn baby could occur. The same argument can be used when considering the suggestion of banning the sale of alcohol to pregnant women – visible identification of pregnancy tends only to be possible at the very latest stages.

How then to address consumption of alcohol during pregnancy?

Consumption of alcohol is doubtless shaped by the culture and context of the society in which one is living. Highest levels of alcohol consumption in pregnancy are, unsurprisingly, seen in countries where the population consumption of alcohol is also highest. Current UK policy that is directed to reducing population consumption of alcohol will likely have a knock-on effect of reducing alcohol consumption in pregnancy.

Many women will however be familiar with the barrage of questions that they encounter when not drinking on a night out. From the not-so-subtle “Not drinking, eh… Wonder why that is? <nudge, nudge, wink, wink>” to the more overt “Are you pregnant?”. The road to conception and pregnancy is littered with enough stumbling blocks and pressures that the additional unintentional announcement of either fact of conception or intention to conceive is an unnecessary cause of potential further anxiety. Until society accepts that not drinking is an acceptable choice, without any need for clarification or explanation, then pregnant women or those hoping to conceive who are adhering to guidelines will continue to identify themselves, perhaps before they want to.

What next?

The UK’s All Party Parliamentary Group for FASD had its inaugural meeting in June 2015. This group calls for an increased awareness of FASD particularly regarding looked

after children and individuals within the criminal justice system, sectors where the prevalence of FASD is particularly high. Concerted efforts need to be made to identify children with FASD to ensure that the appropriate support pathways are in place. Alongside this, efforts to ensure the best mechanisms for education of the dangers of alcohol consumption in pregnancy need to be increased, including training for midwives, and other health professionals who may be able to offer brief intervention and advice to women both before and after conception.

The views expressed by the authors are theirs alone and do not represent the views of Liverpool John Moores University, the UK National FASD clinic at Surrey and Borders Partnership NHS Foundation Trust. NOFAS run a national FASD helpline on on 020 8458 5951 as do the FASD Trust on 01608 811 599.

Source: http://www.alcoholpolicy.net/2017/05/drinking-in-pregnancy-where-next-for-fasd-in-the-uk.html

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs (Papers),Health :

Abstract

Childhood maltreatment increases the risk of subsequent depression, anxiety and alcohol abuse, but the rate of resilient victims is unknown. Here, we investigated the rate of victims that do not suffer from clinical levels of these problems after severe maltreatment in a population-based sample of 10980 adult participants.

Compared to men, women reported more severe emotional and sexual abuse, as well as more severe emotional neglect. For both genders, severe emotional abuse (OR = 3.80 [2.22, 6.52]); severe physical abuse (OR = 3.97 [1.72, 9.16]); severe emotional neglect (OR = 3.36 [1.73, 6.54]); and severe physical neglect (OR = 11.90 [2.66, 53.22]) were associated with depression and anxiety while only severe physical abuse (OR = 3.40 [1.28, 9.03]) was associated with alcohol abuse.

Looking at men and women separately, severe emotional abuse (OR = 6.05 [1.62, 22.60] in men; OR = 3.74 [2.06, 6.81] in women) and severe physical abuse (OR = 6.05 [1.62, 22.60] in men; OR = 3.03 [0.99, 9.33] in women) were associated with clinical levels of depression and anxiety. In addition, in women, severe sexual abuse (OR = 2.40 [1.10, 5.21]), emotional neglect (OR = 4.78 [2.40, 9.56]), and severe physical neglect (OR = 9.86 [1.99, 48.93]) were associated with clinical levels of depression and anxiety.

Severe emotional abuse in men (OR = 3.86 [0.96, 15.48]) and severe physical abuse in women (OR = 5.18 [1.48, 18.12]) were associated with alcohol abuse. Concerning resilience, the majority of severely maltreated participants did not report clinically significant levels of depression or anxiety (72%), or alcohol abuse (93%) in adulthood. Although the majority of severely abused or neglected individuals did not show clinical levels of depression, anxiety or alcohol use, severe childhood maltreatment increased the risk for showing clinical levels of psychopathology in adulthood.

Introduction

Severe child maltreatment is conventionally defined within child protection practice as severe physical, emotional, sexual abuse and/or severe physical and emotional neglect by adults [1]. Severity can be defined on the basis of the type of maltreatment, its frequency, if the child was subjected to multiple forms of maltreatment, if a weapon had been used, if the maltreatment resulted in an injury, and if the abuse was considered severe by the victim. For sexual abuse, even a single experience is often considered to be severe [1].

Childhood maltreatment and its psychosocial consequences

There are annually over one million victims of childhood maltreatment in the USA alone and childhood maltreatment has a large public health impact [2]. Several studies show that childhood physical, emotional, and sexual abuse are all related to an increased risk of depression and anxiety disorders in adulthood [3–9]. Other studies have found that the severity of abuse and neglect is associated with increased depression and anxiety symptoms in adulthood [10–12]. This means that as a general rule, the more severe the abuse and neglect, the more likely the abused individuals are to show symptoms of depression and anxiety.

There is also a robust relationship between childhood maltreatment and later alcohol abuse [13–16]. For example, Young-Wolff et al. [17] found that men who had experienced childhood maltreatment were 1.7 times more likely to suffer from alcohol abuse in adulthood than men who did not report experiences of childhood maltreatment. Similar findings have been made when investigating the consequences of abuse and neglect in women (e.g., [18]). Findings from a study by Schwandt et al. [19] suggested that the severity of emotional and physical abuse plays a prominent role in the development of alcohol abuse. In line with these results suggesting a role of the severity of childhood abuse on later substance misuse, Hyman et al. [20] found that the severity of abuse was predictive of cocaine use after having been discharged from an inpatient treatment for cocaine addiction. This was true for women but not for men. Kendler et al. [21] showed that women who had experienced child sexual abuse reported higher incidences of alcohol abuse. Twin studies have also shown that childhood sexual abuse increases the risk of alcohol abuse and addiction later in life [21–24]. To summarize, there is a strong, robust relationship between childhood maltreatment and mental disorders in adulthood. These associations include associations between childhood experiences of physical abuse, emotional abuse, and neglect, respectively, and mental disorders such as depression and anxiety disorders, and alcohol abuse [25–26]. Moreover, multi-type maltreatment in childhood is associated with greater impairment in adulthood, and this association also includes a range of psychological and behavioral problems, such as depression, anxiety, and alcohol abuse [27].

However, not all victims of childhood maltreatment develop symptoms of substance abuse or psychopathology in adulthood. Meta-analyses suggest that many (but not all) children who have experienced abuse succeed in overcoming some of the possible negative outcomes [28]. For example, Klika and Herrenkohl [28] found that some individuals who have experiences of abuse in childhood do not suffer long-term negative sequelae. Collishaw et al. [29] reported that despite serious experiences of childhood sexual or physical abuse, some individuals did not develop psychiatric problems during adulthood. Moreover, Hamilton et al. [30] reported that emotional neglect did not significantly predict increases in depressive or anxiety symptoms later in life. It has been estimated that 12–22% of maltreated individuals are functioning well despite experiencing childhood maltreatment [31].

The current study

Several studies have focused on only experiencing one type of maltreatment (e.g., sexual abuse) or one type of outcome (e.g., depression). Moreover, most previous studies have relied on either convenience samples or samples from health care services, and especially samples of the latter kind might bias the results and show less resilience than is actually the case.

In the present study, we used a large, population-based sample of Finnish men and women. The types of maltreatment included emotional, physical, and sexual abuse as well as emotional and physical neglect. Thus, the aims of the present study were to:

1. Investigate gender differences in severe experiences of different types of childhood abuse;

2. Compare if and how individuals reporting severe experiences of different types of childhood abuse differ from individuals who did not report experiencing childhood abuse, in terms of presence of clinically significant symptoms of depression and anxiety in adulthood; and

3. Compare if and how individuals reporting severe experiences of different types of childhood abuse differ from individuals who did not report experiencing childhood abuse in terms of presence of alcohol abuse symptoms in adulthood.

Results

Descriptive results

The proportion of participants with severe experiences of emotional abuse was 0.6% (n = 64). The corresponding proportion for severe experiences of physical abuse was 0.2% (n = 26) while the proportions for severe experiences of sexual abuse was 0.4% (n = 43). For severe experiences of emotional neglect, the proportion was 0.4% (n = 44) and for severe experiences of physical neglect 0.1% (n = 7). With regard to gender differences in the different types of severe experiences of abuse, Table 2 shows that there were statistically significant differences between men and women in the proportion of individuals with severe experiences of emotional abuse, sexual abuse and emotional neglect. All of these were more prevalent in women. There were no statistical differences between men and women in terms of having severe experiences of physical abuse and physical neglect.

We then investigated whether the proportion of individuals having clinical levels of depression and anxiety was higher in individuals with severe experiences of abuse and neglect compared to individuals with less severe (or no) experiences of abuse and neglect. Table 3 shows that, for both genders, severe experiences of emotional and physical abuse and emotional and physical neglect increased the likelihood of suffering from clinical depression or anxiety compared to less severe experiences of the said forms of childhood maltreatment.

In men, severe abuse experiences were significantly associated with increases in the prevalence of clinical depression or anxiety when it came to experiences of severe emotional and physical abuse and physical neglect. No association was observed for severe sexual abuse and severe emotional neglect. For women, severe experiences of all childhood maltreatment types increased the likelihood of suffering from clinical depression or anxiety compared to other lower experiences of maltreatment.

Next, we explored the proportions of both men and women who were resilient to severe experiences of childhood maltreatment with regards to not suffering from clinical levels of depression or anxiety in adulthood. Depending on the abuse type, 55.6% to 100% of men with experiences of severe abuse did not show clinically significant levels of depression or anxiety. For women, 50% to 80.5% did not show clinically significant levels of depression or anxiety.

Discussion

The present study investigated five types of maltreatment: emotional, physical and sexual abuse, and physical and emotional neglect; and their relationships to depression, anxiety and alcohol abuse. The study used a population-based sample of 10980 participants and used validated measures of experiences of childhood maltreatment, current depression and anxiety, and current alcohol abuse.

More particularly, our aim was to investigate gender differences in victims of severe childhood maltreatment, as well as to compare if and how individuals reporting severe experiences of different types of childhood abuse differ from individuals without such severe experiences in terms of presence of clinically significant symptoms of depression, anxiety and alcohol abuse in adulthood.

The present study found that women reported more childhood experiences of severe emotional, sexual abuse and emotional neglect than men. Our findings are inconsistent with the results of those of previous studies indicating that men reported more childhood experiences of abuse than women [3, 38]. However, our results are consistent with findings suggesting that women are more sensitive than men to the effects of experiences abuse in childhood [29].

Compared to another Finnish population based sample, the frequencies of severe abuse were relatively low in our sample. This could be due to samples being obtained at different times, as abuse in Finland has been decreasing [39], or that in the present study the complete CTQ was used: in the study by Albrecht’s et al. [33], only one item per factor was used. The decrease in measurement reliability that follows from removing 80% of the original items might have inflated the estimates in Albrecht’s study [33].

More specifically, our results revealed that, in men, severe experiences of emotional and physical abuse as well as physical neglect were significantly associated with increases in the prevalence of depression and anxiety symptoms. For women, there was an association between all types of severe childhood maltreatment (emotional, physical and sexual abuse, and physical and emotional neglect) with depression and anxiety symptoms in adulthood.

These results were consistent with previous literature indicating that physical abuse and/or emotional abuse are related to depression and anxiety disorders [4–5, 40–41]. These findings also corroborate findings from meta-analyses and extend previous reports of severe experiences of abuse or neglect being associated with greater risk of developing depressive and anxiety disorders in adulthood [26].

When we examined each type of maltreatment for associations with alcohol abuse, the results showed that severe emotional abuse was associated with alcohol abuse in men. For women, severe physical abuse emerged as a predictor for problematic alcohol use. This is consistent with research suggesting that childhood experiences of emotional and physical abuse were found to be the primary predictor of alcohol abuse [19, 42].

It is intriguing, however, that there appears to be a gender difference in response to abuse type, with men having a considerably more severe response to emotional abuse in terms of propensity to develop alcoholism later in life. For example, an explanation for why women appear to suffer greater consequences in terms of abusing alcohol later in life could be that boys are more likely to engage in rough-and-tumble play and play fights [43], and are thus desensitized to physical abuse to a higher extent than women. It is also, however, possible that measurement invariance could explain the perceived gender differences.

Our current findings suggest that, fortunately, more than half of the participants who have severe experiences of abuse and neglect in childhood seem to succeed in overcoming some of the possible consequences with regards to depression and anxiety symptoms and alcohol abuse in adulthood. While the present study did not investigate mediators of resilience, many studies have considered successful psychosocial adjustment as a mediator of psychological resilience following adverse events [44–45]. It should also be mentioned that some individuals likely have heritable factors that have been shown to protect against adverse effects of maltreatment, by means of gene–environment interaction (i.e., the concept that individuals respond differently to environmental stressors depending on their genotype) [46].

Limitations of the research

Despite the strengths of the present study, it is also characterized by some limitations worth mentioning. First, memories are usually influenced by later experiences, and since the questionnaire was about events that happened during childhood, the obtained information might be somewhat biased. Second, we did not consider the possible overlap between experiences of maltreatment types. Because experiencing one type of abuse or form of neglect is associated with experiencing also another type of abuse or form of neglect [10, 47], it is possible that also severe forms of abuse and neglect are correlated across types or maltreatment. This could, for example, mean that several of the individuals with clinical cases of depression and anxiety or alcohol abuse, not only had experienced one form of severe abuse, but several. Should this be the case, the additive effect of multiple types of abuse could influence the results.

In the present study, it is possible that the true prevalence of anxiety, depressive symptoms or alcohol abuse has been underestimated, as we have only one cross-sectional assessment of the above mentioned indicators (i.e., some individuals may have experienced clinically significant symptoms before study participation, or may experience symptoms in the future, but did not do so at the time of assessment). A longitudinal assessment of adulthood symptoms would thus arguable have been more appropriate than a single, cross-sectional measure.

Also, some of our results and group comparisons were based on very few individuals. This might both influence the estimated prevalence of depression and anxiety or problematic alcohol use and undermines the statistical power to detect differences. Finally, we only included three known consequences of experiencing childhood maltreatment: Depression and anxiety and problematic alcohol use. It is possible that individuals showing resilience on these possible consequences of maltreatment are not resilient with respect to other negative outcomes, such as social functioning or health-risk behavior.

Conclusions

To our knowledge, this is the first study that has looked at the effects of severe experiences of abuse in childhood on depression and anxiety symptoms and alcohol abuse in adulthood in a relatively large sample.

We found that a majority of individuals with severe experiences of childhood maltreatment did not meet the criteria for clinical of levels depression and anxiety or clinical significant levels of alcohol abuse. Although this is a positive message, it is important to remember that experiences of child maltreatment increase the risk of psychosocial problems in adulthood and several of the victims of severe maltreatment included in our study may have had increased, but non-clinical significant levels of depression, anxiety, and alcohol abuse.

Source: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0177252

Filed under: Alcohol,Effects of Drugs (Papers),Social Affairs (Papers) :

Summary:

Long-term heavy use of alcohol in adolescence alters cortical excitability and functional connectivity in the brain, according to a new study. These alterations were observed in physically and mentally healthy but heavy-drinking adolescents, who nevertheless did not fulfil the diagnostic criteria for a substance abuse disorder.

Long-term heavy use of alcohol in adolescence alters cortical excitability and functional connectivity in the brain, according to a new study from the University of Eastern Finland and Kuopio University Hospital. These alterations were observed in physically and mentally healthy but heavy-drinking adolescents, who nevertheless did not fulfil the diagnostic criteria for a substance abuse disorder. The findings were published in Addiction Biology.

Constituting part of the Adolescents and Alcohol Study, the study analysed the effects of heavy adolescent drinking on the electrical activity and excitability of the cortex. The study did a follow-up on 27 adolescents who had been heavy drinkers throughout their adolescence, as well as on 25 age-matched, gender-matched and education-matched controls with little or no alcohol use. The participants were 13 to 18 years old at the onset of the study.

At the age of 23-28, the participants’ brain activity was analysed using transcranial magnetic stimulation (TMS) combined with simultaneous electroencephalogram (EEG) recording. In TMS, magnetic pulses are directed at the head to activate cortical neuronal cells. These magnetic pulses pass the skull and other tissues, and they are safe and pain-free for the person undergoing TMS. The method allows for an analysis of how different regions of the cortex respond to electrical stimulation and what the functional connectivities between the different regions are. Indirectly, the method also makes it possible to analyse chemical transmission, i.e. mediator function. The effects of long-term alcohol use haven’t been studied among adolescents this way before.

The cortical response to the TMS pulse was stronger among alcohol users. They demonstrated greater overall electrical activity in the cortex as well as greater activity associated with the gamma-aminobutyric acid, GABA, neurotransmission system. There were also differences between the groups in how this activity spread into the different regions of the brain. Earlier research has shown that long-term, alcoholism-level use of alcohol alters the function of the GABA neurotransmission system. GABA is the most important neurotransmitter inhibiting brain and central nervous system function, and GABA is known to play a role in anxiety, depression and the pathogenesis of several neurological disorders.

The study found that alcohol use caused significant alterations in both electrical and chemical neurotransmission among the study participants, although none of them fulfilled the diagnostic criteria of a substance abuse disorder. Moreover, in an earlier study completed at the University of Eastern Finland, also within the Adolescents and Alcohol Study, cortical thinning was observable in young people who had been heavy drinkers throughout their adolescence. For young people whose brain is still developing, heavy alcohol use is especially detrimental. The findings of the study warrant the question of whether the diagnostic criteria for substance abuse disorders should be tighter for adolescents, and whether they should be more easily referred to treatment. The use of alcohol may be more detrimental to a developing brain than previously

thought, although it takes time for alcohol-related adverse effects to manifest in a person’s life

Source: https://www.sciencedaily.com/releases/2016/12/161208085850.htm? February_2017)

Filed under: Addiction (Papers),Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth :

January 12th, 2017

A new study finds ignition interlocks, devices that prevent a person from starting a car if their blood alcohol level is too high, prevents deadly accidents.

Ignition interlocks are associated with a 7 percent decrease in the rate of fatal crashes involving at least one drunk driver, researchers report in the American Journal of Preventive Medicine. Cars with the device will not start if the driver’s blood alcohol level exceeds a preset limit, HealthDay reports.

While all states have some type of ignition interlock law, only half require everyone convicted of a DUI to use the device, the researchers noted. Some states require them only for repeat offenders, or for those caught driving with very high blood alcohol levels.

Source: http://www.drugfree.org/news-service/ignition-interlocks-prevent-deadly-drunk-driving-accidents/

Filed under: Alcohol,Drugs and Accidents :

A new study by researchers at the University of Rochester sheds light on how parents and caregivers of children with foetal alcohol spectrum disorders (FASD) can best help their kids achieve to the best of their abilities, and at the same time, maintain peace at home and at school.

Children with FASD often have problems with executive functioning, including deficiencies in impulse control and task planning, information processing, emotion regulation, and social and adaptive skills. Young people with FASD are at high risk for school disruptions and getting into trouble with the law.

The study involved 31 parents and caregivers of children with FASD ages four through eight. The research team looked at data taken from standardized questionnaires and qualitative interviews that focused on parenting practices.

The findings reveal that parents of children with FASD who attribute their child’s misbehavior to their underlying disabilities — rather than to wilful disobedience — are more likely to use pre-emptive strategies designed to help prevent undesirable behaviors.

Given the brain damage associated with FASD, pre-emptive strategies are typically more effective than incentive-based strategies, such as the use of consequences or punishment for misbehavior. The study shows that educating families and caregivers about the disorder is critical.

“Children with FASD often have significant behavior problems due to neurological damage,” said Dr. Christie Petrenko, a research psychologist at the University’s Mt. Hope Family Center. She adds that parents who use pre-emptive strategies “change the environment in a way that fits their child’s needs better. They give one-step instructions rather than three-steps because their child has working memory issues.”

“They may buy clothes with soft seams if their child has sensory issues, or post stop signs to cue the child to not open the door. All of these preventive strategies help reduce the demands of the environment on the child,” said Petrenko.

The findings also reveal that parenting practices correlate with levels of caregiver confidence and frustration. Families of children with FASD are frequently judged and blamed for their children’s misbehavior. However, parents who are successful in preventing unwanted behaviors have greater confidence in their parenting skills and lower levels of frustration with their children than parents who respond to unwanted behaviors with consequences after the fact.

Petrenko and her team at Mt. Hope Family Center are continuing to test new parenting strategies and interventions in order to identify which practices are most effective.

Source: http://psychcentral.com/news/2016/11/20/best-parenting-strategies-for-kids-with-fetal-alcohol-syndrome/112788.html

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Parents :

Repeated binge drinking during adolescence can affect brain functions in future generations, potentially putting offspring at risk for such conditions as depression, anxiety, and metabolic disorders, a Loyola University Chicago Stritch School of Medicine study has found.

“Adolescent binge drinking not only is dangerous to the brain development of teenagers, but also may impact the brains of their children,” said senior author Toni R. Pak, PhD, an associate professor in the Department of Cell and Molecular Physiology of Loyola University Chicago Stritch School of Medicine.

The study by Dr. Pak, first author Anna Dorothea Asimes, a PhD student in Dr. Pak’s lab, and colleagues was presented Nov. 14, 2016 at Neuroscience 2016, the annual meeting of the Society for Neuroscience

The study, which was based on an animal model, found that adolescent binge drinking altered the on-off switches of multiple genes in the brains of offspring. When genes are turned on, they instruct cells to make proteins, which ultimately control physical and behavioral traits. The study found that in offspring, genes that normally are turned on were turned off, and vice versa.

Teenage binge drinking is a major health concern in the United States, with 21 percent of teenagers reporting they have done it during the past 30 days. Among drinkers under age 21, more than 90 percent of the alcohol is consumed during binge drinking episodes. Binge drinking is defined as raising the blood alcohol concentration to 0.08 percent, the legal driving limit, within two hours (generally about five drinks for a male and four drinks for a female).

In the study, one group of adolescent male and female rats was exposed to alcohol in amounts comparable to six binge drinking episodes. The rats mated after becoming sober and the females remained sober during their pregnancies. (Thus, any effects on offspring could not be attributed to fetal alcohol syndrome.) The alcohol-exposed rats were compared to a control group of rats that were not exposed to alcohol.

In the offspring of alcohol-exposed rats, researchers examined genes in the hypothalamus, a region of the brain involved in many functions, including reproduction, response to stress, sleep cycles and food intake. Researchers looked for molecular changes to DNA that would reverse the on-off switches in individual genes. They found 159 such changes in the offspring of binge-drinking mothers, 93 gene changes in the offspring of binge-drinking fathers and 244 gene changes in the offspring of mothers and fathers who both were exposed to binge drinking.

The study is the first to show a molecular pathway that teenage binge drinking by either parent can cause changes in the neurological health of subsequent generations. While findings from an animal model do not necessarily translate to humans, there are significant similarities between the study’s animal model and humans, including their metabolism of alcohol, the function of the hypothalamus, and the pattern and amount of binge drinking, Pak said.

The study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism. It is titled “Binge alcohol consumption during puberty causes altered DNA methylation in the brain of alcohol-naive offspring.”

Source: Loyola University Health System Article ID: 664605 http://www.newswise.com/articles/view/664605/?sc=dwtn 10th Nov. 2016

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth,Health :

To many people, a glass of wine with dinner or a nightcap before bed is enjoyable. But a recent study conducted by UC San Francisco shows that even moderate alcohol drinking may change the structure of the heart and increase risk of heart chamber damage.

The finding is published in Journal of the American Heart Association. Previous research has shown that moderate alcohol drinking may be a risk factor for abnormal heart rhythm (atrial fibrillation), but the mechanism by which alcohol may lead to atrial fibrillation is unknown.

Abnormal heart rhythm is a risk factor for stroke. The irregular pumping of blood can lead to blood clots, which may travel to the brain and cause stroke. In the study, researchers looked at damage to the left heart chamber (atrium) of the heart as a possible pathway between alcohol and abnormal heart rhythm.

They evaluated data from more than 5,000 adults collected over several years in the Framingham Heart Study, including heart tests, medical history and self-reported alcohol intake. Most of the participants were white and in their 40s to 60s, reported on average just over one drink per day.

The overall rate of abnormal heart rhythm in the group was 8.4 cases per 1,000 people per year – meaning over a 10-year period, 8 out of 100 people were likely to develop abnormal heart rhythm.

The result also showed that every additional drink per day was associated with a 5% increase in the yearly risk.

Every additional drink per day also was associated with a statistically significant 0.16 mm enlargement of the left heart chamber, which highlighted a possible site of physical damage caused by drinking.

Researchers suggest that the new finding shed light on the complex relationship between alcohol and heart health. Patients who drink moderately are more likely to have abnormal heart rhythm but less likely to have heart attacks and congestive heart failure.

Alcohol’s abilities to protect and harm the heart likely operate through different mechanisms and vary from person to person. Future work will try to figure out these mechanisms and inform therapies for heart conditions. Ultimately, the findings will enable physicians to give personalized advice to patients.

Source: McManus DD, et al. (2016). Alcohol Consumption, Left Atrial Diameter, and Atrial Fibrillation.Journal of the American Heart Association, published online. DOI:10.1161/JAHA.116.004060. 20thOct 2016

Filed under: Alcohol,Health :

This November, several states will vote on whether to legalize marijuana for recreational use, and the proponents of legalization have seized on a seemingly clever argument: marijuana is safer than alcohol. The Campaign to Regulate Marijuana Like Alcohol, an effort of the Marijuana Policy Project (or MPP), has taken this argument across the country. Their latest strategy is labelled Marijuana vs. Alcohol. It is a very misleading, even dangerous, message, based on bad social science and sophistic public deception. Citing out-of-date studies that go back ten years and more, even using that well-known scientific journal, Wikipedia, the MPP never references current research on the harms of today’s high potency and edible marijuana, studies that come out monthly if not more frequently. Indeed, their Marijuana vs. Alcohol page concludes with a 1988 statement about the negligible harms of marijuana—but that is a marijuana that simply does not exist anymore, neither in mode nor potency. Today’s marijuana is at least five times more potent, and sold in much different form. And the science of marijuana and its effects on the brain have come some distance since 1988 as well.

So out-of-date is the science and knowledge of marijuana from thirty years ago, it would be malpractice in any other field to suggest that kind of information about a drug having any contemporary relevance at all. One almost wonders if the MPP thinks public health professors still instruct their students on how to use microfiche to perform their research as they prepare to write their papers on 5k memory typewriters.

It is simply misleading in a public health campaign to cite dated research while at the same time ignore a larger body of current evidence that points in the opposite direction of a desired outcome. At great potential peril to our public health, political science (in the hands of the marijuana industry) is far outrunning medical science. But the danger is clear: with the further promotion, marketing, and use of an increasingly known dangerous substance, public health and safety will pay the price.

Consider three basic problems with the industry’s latest campaign:

I. Comparisons of relative dangers of various drugs are simply impossible and can often lead to paradoxical conclusions. It is impossible to compare a glass of chardonnay and its effects on various adults of various weights and tolerance levels with the inhalation or consumption of a high-potency marijuana joint or edible. Is the joint from the 5 percent THC level or the 25 percent level? How about a 30 mg—or stronger—gummy bear? A glass of wine with dinner processes through the body in about an hour and has little remaining effect. A marijuana brownie or candy can take up to 90 minutes to even begin to take effect.

Consider a consumer of a glass of wine who ate a full meal and waited an hour or more before driving and a consumer of a marijuana edible taking the wheel of a plane, train, automobile, or anything else. The wine drinker would likely be sober, the marijuana consumer would just be getting high, and, given the dose, possibly very high at that.

True, marijuana consumption rarely causes death, but its use is not benign. Last year, an ASU professor took a standard dose of edible marijuana, just two marijuana coffee beans. The effect? “Episodes of convulsive twitching and jerking and passing out” before the paramedics were called. Such episodes are rare for alcohol, but they are increasingly happening with marijuana.

Beyond acute effects, the chronic impact of marijuana is also damaging. Approximately twice the percentage of regular marijuana users will experience Marijuana Use Disorder than will alcohol users experience Alcohol Use Disorder—both disorders categorized by the Diagnostic Statistics Manual (DSM).[1] Marijuana is also the number one substance of abuse for teens admitted to treatment, far higher than the percentage who present with alcohol problems. In fact, the most recent data out of Colorado shows 20 percent of teens admitted for treatment have marijuana listed as their primary substance of abuse compared to less than one percent for alcohol.

Still, the Campaign persists in its deceptions—as if they have not even read their own literature. One online marketing tool it recently deployed was the “Consume Responsibly” campaign. Delve into that site and you will find this warning: “[Smoked marijuana] varies from person to person, you should wait at least three to four hours before driving a vehicle.” And: “Edible marijuana products and some other infused products remain in your system several hours longer, so you should not operate a vehicle for the rest of the day after consuming them.” Who has ever been told that they should not operate a vehicle for four hours, much less for the rest of the day, if they had a glass of wine or beer? Safer than alcohol? This is not even true according to the MPP’s own advice.

Beyond unscientific dose and effect comparisons, there is a growing list of problems where marijuana use does, indeed, appear to be more harmful than alcohol. According to Carnegie Mellon’s Jonathan Caulkins: “Marijuana is significantly more likely to interfere with life functioning” than alcohol and “it is moderately more likely to create challenges of self-control and to be associated with social and mental health problems.” Additionally, a recent study out of UC Davis revealed that marijuana dependence was more strongly linked to financial difficulties than alcohol dependence and had the same impacts on downward mobility, antisocial behavior in the workplace, and relationship conflict as alcohol.

II. The marijuana industry pushes and promotes the use of a smoked or vaped substance, but never compares marijuana to tobacco. Indeed, the two substances have much more in common than marijuana and alcohol, especially with regard to the products themselves and the method of consumption (though we are also seeing increasing sales of child-attractive marijuana candies). But why is the comparison never made? The answer lies in the clear impossibility.

Consider: Almost every claim about marijuana’s harms in relation to alcohol has to do with the deaths associated with alcohol. But, hundreds of thousands more people die from tobacco than alcohol. Based on their measures of mortality, which is safer: alcohol or tobacco? Can one safely drink and drive? No. Can one smoke as many cigarettes as one wants while driving? Of course. So, what’s the more dangerous substance? Mortality does not answer that question.

Alcohol consumption can create acute problems, while tobacco consumption can create chronic problems. And those chronic problems particularly affect organs like the lungs, throat, and heart. But what of the chronic impact on the brain? That’s the marijuana risk, and, seemingly, society is being told that brains are less important than lungs. Nobody can seriously believe that, which is why these comparisons simply fail scrutiny.

This illustrates but one of the problems in comparing dangerous substances. As Professor Caulkins recently wrote:

The real trouble is not that marijuana is more or less dangerous than alcohol; the problem is that they are altogether different….The country is not considering whether to switch the legal statuses of alcohol and marijuana. Unfortunately, our society does not get to choose either to have alcohol’s dangers or to have marijuana’s dangers. Rather, it gets to have alcohol’s dangers…and also marijuana’s dangers. Further, marijuana problems are associated with alcohol problems. New research out of Columbia University reveals that marijuana users are five times more likely to have an alcohol abuse disorder. Society doesn’t just switch alcohol for marijuana—too often, one ends up with use of both, compounding both problems.

The larger point for voters to understand: The marijuana legalization movement is not trying to ban or end alcohol sales or consumption; rather, it wants to add marijuana to the dangerous substances already available, including alcohol. This is not about marijuana or alcohol, after all. It’s about marijuana and alcohol. We can see this effect in states like Colorado, with headlines such as “Alcohol sales get higher after weed legalization.” And, according to the most recent federal data [2], alcohol use by teens, as well as adults, has increased in Colorado since 2012 (the year of legalization). If alcohol is the problem for the MPP, in their model state–Colorado–alcohol consumption has increased with marijuana legalization. Legalizing marijuana will, in the end, only make alcohol problems worse. III. The legalization movement regularly cites to one study in the Journal of Scientific Reports to “prove” that marijuana is safer than alcohol. But this study leads to odd conclusions in what the authors, themselves, call a “novel risk assessment methodology.” For instance, the researchers find that every drug, from cocaine to meth to MDMA to LSD, is found to be safer than alcohol. (See this graph). By the MPP standard, we should thereby make these substances legal as well. But, seeing such data in its full light, we all know this would be nonsensical.

Further, the authors specifically write that they only looked at acute effects and did not analyze “chronic toxicity,” and cannot judge marijuana and “long term effects.” Indeed, they specifically write in their study the toxicity of marijuana“may therefore be underestimated” given the limitations of their examination. Yet legalizers ignore these statements. Always. It simply does not fit their narrative. What long-term effects are we talking about? To cite the New England Journal of Medicine: “addiction, altered brain development, poor educational outcomes, cognitive impairment,” and “increased risk of chronic psychosis disorders.” Now think about what it will mean to make a drug with those adverse effects more available, and for recreational use.

Finally, the very authors of the much-cited Journal of Scientific Reports study specifically warn their research should be “treated carefully particularly in regard to dissemination to lay people….especially considering the differences of risks between individuals and the whole population.” But this is precisely what commercialization is about—not individual adult use but making a dangerous drug more available to “the whole population.”

Given what we know in states like Colorado, we clearly see that legalization creates more availability which translates into more use, affecting whole populations—Colorado college-age use, for example, is now 62 percent higher than the national average. [See FN2, below]. And the science is coming in, regularly. Indeed, the same journal the MPP points to in its two-year old “novel” study, just this year published another study and found:

Neurocognitive function of daily or near daily cannabis users can be substantially impaired from repeated cannabis use, during and beyond the initial phase of intoxication. As a consequence, frequent cannabis use and intoxication can be expected to interfere with neurocognitive performance in many daily environments such as school, work or traffic.

That is why these comparisons of safety and harm are—in the end—absurd and dangerous. In asking what is safer, the true answer is “neither.” And for a variety of reasons. But where one option is impossible to eliminate (as in alcohol), society should not add to the threat that exists: One doesn’t say because a playground is near train tracks you should also put a highway there. You fence off the playground.

That, however, is not the choice the MPP has given us. They are not sponsoring legislation to reduce the harms of alcohol, they are, instead, saying that with all the harms of alcohol, we should now add marijuana. But looking at all the problems society now has with substance abuse, the task of the serious is to reduce the problems with what already exists, not advance additional dangers.

If the MPP and its Campaigns to Regulate Marijuana Like Alcohol are serious about working on substance abuse problems, we invite them to join those of us who have labored in these fields for years. One thing we do know: adding to the problems with faulty arguments, sloppy reasoning, and questionable science, will not reduce the problems they point to. It will increase them. And that, beyond faulty argument and sloppy reasoning, is public policy malfeasance. [1] See http://archpsyc.jamanetwork.com/article.aspx?articleid=2464591 compared to http://archpsyc.jamanetwork.com/article.aspx?articleid=2300494

Source: http://amgreatness.com/2016/09/25/lie-travels-comparing-alcohol-marijuana/ Sept 25th 2016

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects,Global Drug Legalisation Efforts,Health,USA :

People with light-colored eyes may have a higher risk of alcoholism than people with dark-brown eyes, new research suggests.

In the study, researchers looked at 1,263 Americans of European ancestry, including 992 people who were diagnosed with alcohol dependence and 271 people who were not diagnosed with alcohol dependence. They found that the rate of alcohol dependence was 54 percent higher among people with light-colored eyes — including blue, green, gray and light-brown eyes — than among those with dark-brown eyes.

“This suggests an intriguing possibility — that eye color can be useful in the clinic for alcohol dependence diagnosis,” study co-author Arvis Sulovari, a graduate student in cellular, molecular and biological science at the University of Vermont, said in a statement. The prevalence of alcoholism was the highest in people with blue eyes — their rate was about 80 percent higher than that of people with other eye colors, according to the study.

Moreover, the connection between eye color and an increased risk of alcoholism was confirmed by the results of a genetic analysis, which showed a significant link between the genetic components responsible for eye color and those that studies have linked with a person’s risk of alcohol dependence, the researchers said. [7 Ways Alcohol Affects Your Health]

However, the researchers still don’t know the exact reasons that could underlie the link, and more research is needed to examine it, study co-author Dawei Li, an assistant professor of microbiology and molecular genetics at the University of Vermont, said in a statement. Previous research on people of European ancestry has shown that those with light-colored eyes may consume more alcohol on average than dark-eyed individuals, the researchers said. Other studies also have demonstrated a link between eye color and people’s risk of psychiatric illness, addiction and behavioral problems, according to the study. For example, studies have established a link between light eye color and an increased risk of seasonal affective disorder (SAD), which often co-occurs with alcohol dependence, the researchers said. A possible explanation for the link between light eye color and SAD is that light-eyed people may be more sensitive to variations in light levels, which has been associated with abnormal changes in the production of the sleep-regulating hormone melatonin and, consequently, with SAD, the researchers said.

However, the new study has shortcomings, said Gil Atzmon, an associate professor of medicine and genetics at Albert Einstein College of Medicine in New York, who was not involved in the study.

For example, although the researchers took into account participants’ gender and age, to see whether those factors may have played a role in people’s risk of alcohol dependence, they did not examine other factors that also may have affected the participants’ risk of alcoholism, such as their income level or their mental health status, Atzmon said. The researchers did not look at whether any of the people in the study had depression, a condition that may be associated with excessive drinking, he said.

The new study was published in the July issue of the American Journal of Medical Genetics: Neuropsychiatric Genetics Part B.

Source: http://www.livescience.com/51495-eye-color-alcoholism.html 15th July 2015

Filed under: Alcohol,Medical Studies :

At Californian methadone clinics, group education sessions led by a nurse and focused on the risks of aggravating hepatitis infection led to the same substantial reductions in drinking as one-to-one or group motivational interviewing conducted by highly trained counsellors, offering a cost-effective means to reduce alcohol-related risks.

Summary Many methadone-maintained patients drink excessively, a particular concern among those infected with hepatitis C for whom drinking may accelerate disease progression. Motivational interviewing is the most popular counselling approach found to reduce drinking, but so far no studies have tested it among patients treated for opioid dependence in methadone maintenance programmes.

The featured study aimed to start to fill this gap in the research and at the same time (given the dominance of group counselling in US treatment services) compare one-to-one motivational interviewing with the less familiar group version, and with a nurse-led group education programme focused on the relation between drinking and disease related to hepatitis C infection.

Each of the three approaches occupied three fortnightly one-hour sessions over the first six weeks after patients started methadone treatment. Interventions were guided by set protocols and delivered by staff trained in these approaches and supervised to help ensure they delivered them as intended. Patients were paid $5 for each session they attended.

Group and individual motivational sessions were generally conducted by different counsellors. Sessions explored the impact of drinking on health and risky behaviours and while focusing on life goals, worked through ambivalence about cutting drinking. Sessions were open, meaning that patients who had not completed three sessions in their original group could join a later one. Instead of a motivational approach, the nurse-led (assisted by a hepatitis-trained research assistant) hepatitis health promotion programme adopted an educational format. Sessions focused on the progression of hepatitis infection and culturally-sensitive strategies to prevent liver damage. Content included the dangers of drinking while infected with hepatitis, strategies for avoiding drinking and drug use, diet, the dangers of reinfection with hepatitis C if patients inject, other infection routes, consistently looking after one’s health, and seeking social support and building self-esteem.

After these sessions patients suitable for this started a course of hepatitis A and B vaccinations, concluding at the same time as a six-month follow-up interview.

Participants in the study were 256 adult drinkers starting methadone treatment at five Californian clinics who scored as moderate or heavy drinkers on a baseline questionnaire. They were randomly allocated to the three approaches to reducing drinking. Typically they were black or Latino men. On entering treatment about half had drunk at least 90 US standard drinks in the past month. On average 87% of the patients completed all three of the study’s counselling/education sessions and 91% completed the six-month follow-up.

Main findings

The main outcome tested by the study was the proportion of patients who cut their drinking by half from the month before they started treatment to the month before the six-month follow-up. On this yardstick, and on the yardstick of total abstinence, there were not only no statistically significant differences between patients allocated to the three interventions, but also no substantial differences. In each group about half the patients halved their drinking, ranging from 54% after group motivational sessions to 49% after hepatitis education and 47% after one-to-one motivational sessions, and from 20–23% had not drunk at all in the past month.

Once other variables had been taken in to account, across the three sets of patients the strongest predictor of which patients would halve their drinking was how much they drank before treatment; the more they drank, the more likely they were to halve it. Women were more likely to halve their drinking than men as were better educated patients and those who took at least one dose of vaccine, while less likely were those whose partners were also drug users or who had recently used cannabis.

The authors’ conclusions

The major finding of this study was that all three interventions were followed by roughly equally substantial reductions in drinking at the six-month follow-up. Delivered by trained therapists, group and one-to-one motivational interviewing sessions neither differed in effectiveness from each other nor from a nurse-led group hepatitis education programme focused on reducing drinking.

For services the implications are that the cost-saving group format can be used without detriment to effectiveness and that costs may also be saved by implementing programmes led by nurses rather than therapists, with the potential added benefit that such programmes can be integrated within more comprehensive health promotion. Research nurses also administered the vaccines, receipt of which was associated with drinking reductions, perhaps partly because of the extra time and attention required to explain the vaccine.

It should be acknowledged that any differences between the interventions may have been obscured by differences between the staff implementing them, and that patients had volunteered for a research study rather than being counselled during routine practice.

Source: Drug and Alcohol Dependence: 2010, 107(1), p. 23–30.Reported in Findings.org.uk

Filed under: Alcohol,Treatment,USA :

Some of the ways alcohol affects our health are well known, but others may surpriseyou. Here are six less-known effects that alcohol has on your body, according to gastroenterologist Ibrahim Hanouneh, MD:

Drinking gives your body work to do that keeps it from other processes. Once you take a drink, your body makes metabolizing it a priority — above processing anything else. Unlike proteins, carbohydrates and fats, your body doesn’t have a way to store alcohol, so it has to move to the front of the metabolizing line. This is why it affects your liver, as it’s your liver’s job to detoxify and remove alcohol from your blood.
Abusing alcohol causes bacteria to grow in your gut, which can eventually migrate through the intestinal wall and into the liver, leading to liver damage.
Too much is bad for your heart. It can cause the heart to become weak (cardiomyopathy) and have an irregular beat pattern (arrhythmias). It also puts people at higher risk for developing high blood pressure.
People can develop pancreatitis, or inflammation of the pancreas, from alcohol abuse.
Drinking too much puts you at risk for some cancers, such as cancer of the mouth, esophagus, throat, liver and breast.
It can affect your immune system. If you drink every day, or almost every day, you might notice that you catch colds, flu or other illnesses more frequently than people who don’t drink. This is because alcohol can weaken the immune system and make the body more susceptible to infections.

Your liver heads up alcohol breakdown process. When you drink, here’s what happens in your liver, where alcohol metabolism takes place.

Your liver detoxifies and removes alcohol from the blood through a process known as oxidation. Once the liver finishes the process, alcohol becomes water and carbon dioxide. If alcohol accumulates in the system, it can destroy cells and, eventually, organs. Oxidative metabolism prevents this.

But when you’ve ingested too much alcohol for your liver to process in a timely manner, the toxic substance begins to take its toll on your body, starting with your liver. “The oxidative metabolism of alcohol generates molecules that inhibit fat oxidation in the liver and, subsequently, can lead to a condition known as fatty liver,” says Dr. Hanouneh.

Fatty liver, early stage alcoholic liver disease, develops in about 90 percent of people who drink more than one and a half to two ounces of alcohol per day. So, if you drink that much or more on most days of the week, you probably have fatty liver. Continued alcohol use leads to liver fibrosis and, finally, cirrhosis.

The good news is that fatty liver is usually completely reversible in about four to six weeks if you completely abstain from drinking alcohol. Cirrhosis, on the other hand, is irreversible and likely to lead to liver failure despite abstinence from alcohol, according to Dr. Hanouneh. If you drink heavily, see your doctor immediately if you notice a yellow tinge to your skin, feel pain in the upper right portion of your abdomen or experience unexplained weight loss.

Healthy people can drink — a little

If you’re healthy, Dr. Hanouneh says you don’t have to avoid alcohol altogether, but you should not drink every day, or even most days of the week. And, when you drink, men should not drink more than two or three ounces and women should not consume over one or two ounces. If you have liver disease, or some other health issue, you should not drink alcohol at all.

This article was written by Digestive Health Team from Cleveland Clinic and was legally licensed through the NewsCred publisher network.

Source: http://www.msn.com/en-us/health 17^th March 2015

Filed under: Alcohol,Drug use-various effects,Health :

Beverages Target Youth

Alcohol Justice reported this week that an updated version of the alcopop Buzzballz is once again targeting youth. Buzzballz, with its bright colors and candy-like flavors packs a punch. The beverage has a 60-proof, or 30 percent alcohol by volume. That’s an additional 10-15 percent more alcohol than the original product that debuted several years ago.

The product is sold in a 750ml container of pre-mixed cocktails and a shot glass attached to the bottle.

The original flavored, colored, spirits-in-a-ball was created by a former high school teacher, who got the idea for a beverage that would be non-breakable and safe while sitting by the pool. According to the creator, Buzzballz is all meant to be fun, and not meant to be a harmful beverage.

Health advocates say the product is anything but harmless, and, in fact, appeals to youth. Flavors include Lemon Squeeze, Chocolate Caramel Cake, Red Hot Cinnamon Shot, Jalapeño Lime and Licorice Bomb.

To learn more about the dangers of alcopops and other flavored alcoholic beverages, see Alcohol Justice’s recent report.

Source: http://www.cadca.org/resources/re-branded-buzzballz 28^th Jan.2016

Filed under: Alcohol,USA,Youth :

A new study, published in Archives of Sexual Behavior by researchers affiliated with New York University’s Center for Drug Use and HIV Research (CDUHR), compared self-reported sexual experiences related to use of alcohol and marijuana. Since marijuana has increased in popularity in the U.S., the researchers examined if and how marijuana use may influence risk for unsafe sexual behavior.

“With marijuana becoming more accepted in the U.S. along with more liberal state-level policies,” notes Joseph J. Palamar, PhD, MPH, an affiliate of CDUHR and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC), “it is important to examine users’ sexual experiences and sexual risk behavior associated with use to inform prevention and harm reduction.”

In this study, the researchers interviewed 24 adults (12 males and 12 females, all self-identified as heterosexual and HIV-negative) who recently used marijuana before sex. Compared to marijuana, alcohol use was more commonly associated with social outgoingness and use often facilitated connections with potential sexual partners; however, alcohol was more likely than marijuana to lead to atypical partner choice or post-sex regret.

Alcohol was commonly used as a social lubricant to meet sexual partners, and this was related, in part, to alcohol being readily available in social gatherings.

“Interestingly, some users reported that the illegality of marijuana actually facilitated sexual interactions,” notes Dr. Palamar. “Since smoking marijuana recreationally is illegal in most states and smoking it tends to produce a strong odor, it usually has to be used in a private setting. Some individuals utilize such private or intimate situations to facilitate sexual encounters.”

While users often described favorable sexual effects of each drug, both alcohol and marijuana were reportedly associated with a variety of negative sexual effects including sexual dysfunction. For example, marijuana use was linked to vaginal dryness and alcohol was commonly described as increasing the likelihood of impotence among males.

The researchers noted that the sexual effects tended to be similar across males and females, and both alcohol and marijuana were generally associated with loss of inhibitions. Both drugs appear to be potentially associated with increased feelings of self-attractiveness, but possibly more so for alcohol, and participants reported feelings of increased sociability and boldness while consuming alcohol.

While some participants reported that marijuana use made them more selective in choosing a partner, many participants— both male and female—felt that their “standards” for choosing a partner were lowered while under the influence of alcohol.

“It wasn’t surprising that alcohol use reportedly led to less post-sex satisfaction than marijuana,” said Dr. Palamar. “Participants reported feelings of regret more frequently after sex on alcohol, but compared to alcohol they generally didn’t report poor judgment after using marijuana.”

When smoking marijuana, participants tended to reported increased feelings of anxiety or a sense of wariness in unfamiliar situations that they did not generally seem to experience after using alcohol. Therefore, these drugs appear to have different effects with regard to socialization that may precede a sexual encounter.

“Sexual encounters on marijuana tended to be with someone the individual knew,” comments Dr. Palamar. “Sex on alcohol was often with a stranger so the situation before sex may be much more important than the drug used.” Marijuana and alcohol are associated with unique sexual effects, with alcohol use reportedly leading to riskier sexual behavior. Both drugs appear to potentially increase risk for unsafe sex.

“Research is needed continue to study sexual effects of recreational drugs to inform prevention to ensure that users and potential users of these drugs are aware of sexual effects associated with use,” emphasizes Dr. Palamar. “Our results can inform prevention and harm reduction education especially with regard to marijuana, since people who smoke marijuana generally don’t receive any harm reduction information at all. They’re pretty much just told not to use it.”

More information: Joseph J. Palamar et al. A Qualitative Investigation Comparing Psychosocial and Physical Sexual Experiences Related to Alcohol and Marijuana Use among Adults, Archives of Sexual Behavior (2016). DOI: 10.1007/s10508-016-0782-

Source: http://medicalxpress.com/news/2016-08-drunk-stonedcomparing-sexual-alcohol-marijuana.html 4th Aug.2016

Filed under: Alcohol,Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects,Social Affairs :

Powdered alcohol was approved by a government agency on Tuesday, The Washington Post reports. The product, called “Palcohol,” could arrive in stores this summer. Last year the Alcohol and Tobacco Tax and Trade Bureau (TTB) approved labels for powdered alcohol. It then said the approval had been a mistake.

Lipsmark, the company that makes Palcohol, plans to sell four powdered products: cosmopolitan, margarita, a vodka and a rum, the article notes. The product will be sold in foil pouches that can be used as a glass. A person pours in five ounces of water, zips up the bag and shakes it until the powder dissolves.

Several states, including Louisiana, South Carolina and Vermont, have banned the use/sale of powdered alcohol, and a number of other states are considering similar legislation.

U.S. Senator Charles Schumer of New York introduced a bill last year to ban powdered alcohol. Last May Schumer urged the Food and Drug Administration (FDA) to prevent federal approval of powdered alcohol. He said it could become “the Kool-Aid of teen binge drinking.” Schumer noted the product can be mixed with water, sprinkled on food or snorted. He asked the FDA to investigate the potential harmful effects of the product.

In a statement released last May, Mothers Against Drunk Driving (MADD) said it agreed with Schumer. “This product is the latest in a long list of specialty alcohol fads,” MADD said. “As with anything ‘new,’ this product may be attractive to youth. … In the case of Palcohol, we share Senator Schumer’s view that the U.S. Food and Drug Administration should carefully review this product as it would seem to have the potential to increase underage drinking.” The FDA approved powdered alcohol last summer, the article notes.

Source: www.drugfree.org 12^th March 2015

Filed under: Alcohol,Legal Sector,USA :

Funded by a five-year, $7 million federal grant, the University of Illinois at Chicago College of Medicine will create a new center, the first of its kind, to study the effect of long-term alcohol exposure on genes.

The National Institute on Alcohol Abuse and Alcoholism, one of the National Institutes of Health, awarded the funding to establish a Center for Alcohol Research in Epigenetics (CARE). Subhash Pandey, UIC professor of psychiatry, will direct the center.

“Epigenetics” refers to chemical changes to DNA, RNA, or specific proteins, that change the activity of genes without changing the genes themselves. Epigenetic changes can occur in response to environmental or even social factors, such as alcohol and stress — and these changes have been linked to changes in behavior and disease. Epigenetics plays a role in the development and persistence of neurological changes associated with alcoholism, says Pandey, who is director of neuroscience alcoholism research at UIC and research career scientist at the Jesse Brown VA Medical Center.

The CARE researchers will investigate how alcohol-related epigenetic changes influence gene expression and “synaptic remodelling” — the networking of nerve cells to each other. They will also look closely at how these changes correlate with behavior, such as anxiety and depression, and whether epigenetics may play a role in the withdrawal symptoms that make abstinence difficult.

“This award will allow the College of Medicine to build on Professor Pandey’s exemplary research on chronic alcohol use and alcoholism in addition to bolstering our leadership in understanding the causes of alcoholism as well as finding new ways to treat this devastating disease,” said Dr. Dimitri Azar, dean of the University of Illinois College of Medicine.

In a recent study using an animal model, Pandey and colleagues at UIC found that epigenetic changes resulting from exposure to alcohol during adolescence were associated with abnormal brain development and anxiety and alcohol preference in adulthood. In earlier work, the researchers were able to show that reshaping of the DNA scaffolding that supports and controls the expression of genes in the brain may play a major role in alcohol withdrawal symptoms, particularly anxiety.

Several brain regions play a crucial role in regulating both the positive and negative emotional states associated with alcohol addiction. Pandey said the center will look at the circuitry involved in reward and pleasure, depression, cognition, and anxiety. CARE researchers will study disease using preclinical animal models and post-mortem examination of human brain. Investigators will also do neuroimaging of patients diagnosed with alcohol abuse and dependence and search for “biomarkers” of alcoholism — measurable indicators in blood that correlate with alcohol addiction.

There are two causes of dependence on alcohol, said Pandey — people may drink to get pleasure, or to self-medicate to relieve depression or anxiety. But alcohol addiction may itself cause depression and anxiety, feeding into a cycle.

“Ultimately, we hope these studies may lead to the identification of molecular cellular targets and gene networks which can be used to develop new pharmacotherapies to treat or prevent alcoholism,” Pandey said.

UIC’s CARE is the only NIH-funded alcohol research center in Illinois, said Dr. Anand Kumar, Lizzie Gilman Professor and head of psychiatry, and is “well positioned to perform state-of-the-art basic translational and clinical research in alcoholism.”

In addition to its research projects, CARE will provide resources for training and community outreach. Based in the UIC psychiatry department, it includes collaborators from biophysics and physiology, anaesthesiology, the Jesse Brown VA Medical Center, and the University of Illinois Urbana-Champaign campus.

Source: http://www.newswise.com/articles/view/632573/?sc=dwtn 13th April 2015

Filed under: Alcohol,Effects of Drugs :

Should heavy drinking in pregnancy be a crime? A recent test case in the UK was thrown out, but in the US hundreds of women have been imprisoned. We meet women and children affected by foetal alcohol syndrome

I’d had problems all my life and I didn’t know why,’ says Stella, who found out at 19 that she has foetal alcohol syndrome.

Stella was 19 when she discovered she has foetal alcohol syndrome. “I found out in a horrible way, to be honest,” she says. She had taken her boyfriend to meet her father for the first time. Stella and her father had only limited contact, but her boyfriend hoped that he might help to explain some of Stella’s erratic, unreliable behaviour, and asked him upfront, “What’s wrong with your daughter? Why is she the way she is?”

“That’s when he paused, and he breathed, and he said it,” Stella says, still distressed at the memory of the conversation. “I was shocked. I asked, ‘Why wasn’t I told about it?’ He said he didn’t want me to dwell on something like that.

“My heart felt like it was jumping out of my mouth,” the 25-year-old remembers. “It killed me inside. Why have I lived all my life without knowing about it? It was a really bad time.”

Stella and I arrange to meet at her friend’s flat, and she arrives two hours late, hugely apologetic that she forgot all about it. She tells me she has struggled with timekeeping all her life. Articulate and thoughtful, she gives no real indication of having the disorder, aside from occasionally trailing off and losing her train of thought, asking, “What was I just saying there?” But she describes how catastrophically her life has been affected by the legacy of her mother’s drinking.

Foetal alcohol spectrum disorder (FASD) is the umbrella term for a range of birth defects associated with drinking in pregnancy. At the extreme end of the spectrum is foetal alcohol syndrome (FAS), a very rare condition caused by heavy or frequent alcohol consumption during pregnancy. FAS can cause a range of physical and cognitive problems. Some babies are born with facial abnormalities – thin upper lips, a flatter area between the lip and the nose, smaller eyes. Babies with both FAS and FASD are often smaller than other babies, and typically remain small throughout their lives. Some children may have no physical signs of the condition, but a range of developmental disorders – attention deficit, hyperactivity, poor coordination, language problems and learning disabilities. There is no reliable research on how common it is in the UK; some doctors believe FAS may affect one child in 1,000, and FASD between three and four times more. Adolescents and adults with FASD are overrepresented in the criminal justice system.

Stella spent much of her childhood in care, until she was 11, when her aunt took her in. Her mother died before her father broke the news, so she was never able to ask her about the past. Instead, she went to her GP, who looked at her files. “She said, ‘Yes, you do have this. Your mum was a heavy alcoholic.’” The GP printed out a document that said Stella had been diagnosed in 1993, aged three.

She took to researching the condition online. “It described things that made sense,” Stella says. “All my life, things had been happening to me, and it was suddenly explained. I’m not good with organisation, bills, day-to-day things. I can’t read and write. I’m not good at maths. I’d had these problems and I didn’t know why.” She has never had a job and wonders if she would manage. “I want everything to be simple. If it isn’t, my head feels scattered. I can’t focus. I can’t concentrate.”

Women shouldn’t be prosecuted – they should be given alcohol rehabilitation

At the end of last year, a controversial British court case hinged on whether a woman should be considered to be committing a crime if she drinks heavily during pregnancy. The case looked at whether the council caring for a seven-year-old girl with FAS was entitled to extract compensation from the Criminal Injuries Compensation Authority on her behalf. Lawyers examined the legal rights of an unborn child and asked whether alcohol consumption by the mother constituted the crime of poisoning.

The court of appeal ruled in December that the mother, who inflicted lifelong damage on her child by consuming large quantities of alcohol while pregnant, had not committed a criminal offence, and that her daughter was not, therefore, entitled to compensation. To date, no woman has been prosecuted under English law for harm she caused to her child in utero, but hundreds of women in the US have been imprisoned for drinking or taking drugs during pregnancy. And the legal battle here is far from over; lawyers representing the seven-year-old (who remains anonymous), and around 80 other children affected by FASD, are considering whether to pursue the case in the supreme court.

We’re not talking here about the effects of drinking a couple of glasses of wine at a friend’s wedding. The test case involved a woman who drank, by her own account, half a bottle of vodka and several cans of strong lager daily. But there is a growing sense among politicians and doctors that drinking during pregnancy is an issue that is not taken seriously enough. In Westminster, politicians have been debating whether official guidance over drinking in pregnancy is sufficiently clear. The Royal College of Obstetricians & Gynaecologists recently hardened its advice, saying women should avoid alcohol altogether in the first three months of pregnancy. NHS Choices, the government’s health advisory website, states that the UK chief medical officers’ advice is that abstinence is best, but adds, “If they do choose to drink, to minimise the risk to the baby, we recommend they should not drink more than one or two units once or twice a week and should not get drunk.” The chief medical officer for England is currently reviewing these guidelines.

Lost in all these discussions, however, have been the voices of adults affected by the condition, and those of mothers who have given birth to, and brought up, children with FAS. Among them, there is little appetite for further stigmatising of mothers. But there is agreement that pregnant women need clearer guidance and help, and that affected children need much more support.

Stella thinks she can identify in herself the facial characteristics that sometimes go with the condition (although they are not discernible to others, or me; she looks lovely). But, she says, “It is more mental. I am not capable of doing things. I was hyperactive when I was young. I never listened. I got picked on a lot at primary school; there was a lot of spiteful behaviour. I went to a special needs secondary school – that was better – but I should have had more support as a teenager.”

Although she finds it painful to talk about her childhood, Stella is determined to raise awareness of the syndrome. Recently, she has spoken at conferences arranged by support group the National Organisation for Foetal Alcohol Syndrome (Nofas), which has helped find a charity that provides regular support sessions, allowing her to live independently: “They help with finances and forms, things I am not capable of doing.”

Stella feels ambivalent towards her mother. “I feel some sort of hate and some sort of love,” she says. “I want to be able to go back and ask her questions – questions that will never be answered, because she is dead.” She wishes she had known earlier what the cause of her difficulties was, but she is clear that moving towards prosecuting women is not the right answer. “What difference will it make? She hasn’t committed a crime – she has an issue with alcohol.”

No woman I have met ever wants to harm her baby. This is an illness, not a choice

Laura has two sons with FASD: ‘I need to make sure this doesn’t happen to other people.’ Photograph: Sophia Spring for the Guardian

Laura has two teenage sons who were diagnosed with FASD a few years ago. She was pregnant with them in the 1990s, when – as she remembers it – there was real ambiguity about the levels of safe alcohol consumption for pregnant women, and she doesn’t remember being confronted by her midwives. Her partner was violent, she was beaten during the first pregnancy, and had panic attacks. “I was a social drinker, but increasingly I was using alcohol to cope. I went to all my appointments, they were aware that I drank – I was drinking beer, mainly, Holsten Pils. The midwife knew I was a four-times-a-week drinker.”

Laura’s first pregnancy progressed without any problems, and she “gave birth to a beautiful child”. Over the next few years, her relationship with the child’s father deteriorated, she lost her job and her home, and began to drink more and more. By the time she was pregnant with her second son, she was an alcoholic. “I had to go into hospital early, and by that time I was drinking 24/7 – mainly beer, a few cans a day, not massive binges. But nobody mentioned the drink: not the doctors, not the midwives. They didn’t advise about the risk of FAS. I had no suspicion that my child could be affected.”

Her second son was born a few weeks prematurely. Neither child had any of the physical features of FAS, and both went to mainstream schools, but their behaviour was very challenging. Gradually, as her life became more stable and she stopped drinking, Laura began to be aware that both her sons had serious issues.

Her younger son had learning difficulties and was diagnosed with ADHD. She had taken him to a hospital appointment and was carrying his notes from one doctor to another, when she spotted a note on his file that said: “Possible FAS.”

“I was devastated,” Laura says. “I knew in my gut that’s what it was.” Both children were later given a formal diagnosis at Great Ormond Street hospital.

Laura is dynamic and energetic; she has a good job now, as she did when she was first pregnant. We meet in a cafe near Hampstead Heath in London, at teatime, and it soon becomes obvious from the discreet twitching of other customers’ heads that her calm, powerful account of this rarely discussed subject has them all engrossed.

She knows people will blame her for her actions, and is very conscious of her own responsibility for her sons’ difficulties, but she is adamant that mothers need support, not criminalisation. “There is sometimes a witch-hunt to go after the mothers, but I am living with my guilt every day. That’s a real life sentence.” She has coped by devoting herself to making sure her sons get all the support they need, and by volunteering to help other mothers who also drank during pregnancy, through the European Birth Mother Network.

“I need to make sure this doesn’t happen to other people,” Laura says. “Women shouldn’t be prosecuted – they should be given alcohol-rehabilitation services. No woman I have ever met ever wants to harm her baby. This is an illness, not a choice. But people need to be told if they do drink, what will happen. There aren’t enough clear guidelines. I think midwives are scared sometimes to confront women.”

Although Laura drank more during her second pregnancy, she thinks her older child has struggled more with the consequences of his condition. “My younger son got support earlier. For the older one, it was harder – we didn’t understand, so he was always being told, ‘You are awful – why do you behave like that?’ He had an organic brain injury; he couldn’t read people’s facial expressions, he had problems with social skills, he was overwhelmed by noise. We didn’t understand that.”

“There is a witch-hunt to go after the mothers, but I am living with my guilt every day. That’s a real life sentence”

Twenty years on from Laura’s pregnancy, the medical guidance is still confusing and contradictory. There are those, such as paediatrician and former children’s commissioner Sir Al Aynsley-Green, who argue for total abstinence. “Exposure to alcohol before birth is the most important preventable cause of brain damage in children, that could affect up to one in every 100 babies in England,” he says. “Its effects range from devastating physical and learning disabilities to subtle damage causing bad behaviour, violence and criminality.”

At the other end of the spectrum are groups such as the British Pregnancy Advisory Service, who point out that most women are already very sensible and warn against demonising their behaviour. According to BPAS, the main consequence of publishing excessively frightening advice is that women come to its clinics unnecessarily considering abortions, concerned about damage they might have inflicted on their foetus before they knew they were pregnant.

In the submission made by BPAS to the court case last year, it was pointed out that there are a wide variety of substances that may cause damage to an unborn baby, from food to plastics and household products. Lawyers in the case questioned whether demanding criminal injuries compensation for alcohol poisoning could mean by extension that “a pregnant mother who eats unpasteurised cheese or a soft-boiled egg, knowing that there is a risk of harm to the foetus might also find herself accused of a crime”.

At the frontline, Jo Austin, a midwife who works with vulnerable mothers in London, says it’s easier to get women to talk about heroin or crack addiction than it is to get them to confront their drinking during pregnancy. “We have lots of leaflets for women who take heroin and crack, who are quite a small minority of the women we see. But alcohol is more socially acceptable and it is legal. A large proportion of society drinks, at least socially. Our feeling is that it is a problem that women don’t admit to, perhaps because of stigma, guilt or fear of social services involvement.”

Austin says most of the pregnant women she sees are better informed about the risks of smoking during pregnancy. “There has been so much health promotion done on smoking, but the effects of alcohol are potentially much worse.”

Gail Priddey, CEO of Haringey Advisory Group on Alcohol, which supports families affected by alcohol, says she is currently writing an advice leaflet for midwives that attempts to navigate a line between being straightforward with the facts without “scaring pregnant women witless”. “It is such an emotive and difficult subject,” Priddey says. “You say, ‘Best not to drink when you’re pregnant,’ then someone says, ‘Well, actually, I’ve been drinking heavily. I didn’t realise.’ Where do you go from there? Do you say, ‘You may have done some damage’? It’s an area professionals don’t want to touch.”

The flipside of this is that children with FAS and FASD are not diagnosed early enough, and often do not receive the help they need. Raja Mukherjee, a neurodevelopmental psychiatrist and lead clinician at the national FASD clinic, says awareness of the condition has risen dramatically in the 12 years he has worked in the area, but diagnosis remains complicated. He believes doctors are often unwilling to label a child as suffering from FASD because it is “too stigmatising”. “It is easier to say, ‘You have ADHD,’” he says.

Yet Mukherjee is uncomfortable about the fight for criminal injuries compensation for children, because “criminalisation just pushes it underground. We struggle already with people who tell us, ‘I didn’t drink at all in pregnancy’ – yet they were an alcoholic before and an alcoholic afterwards.”

Neil Sugarman, the lawyer for the unidentified local authority in the north-west that took the legal action, said they were motivated by a quest to get adequate funding for the girl’s care. “This wasn’t about trying to get women prosecuted,” he says. “My job as a lawyer is to look at the interests of terribly badly impaired children. We have a state scheme that if you can show you are a victim of a crime, you are entitled to compensation.

“The Criminal Injuries Compensation Scheme has never required someone to be prosecuted – no one needs to be taken to court, charged, sentenced or convicted. All it requires is that a judge has to be satisfied that what happened can be recognised as a crime. It is very difficult for young people to get access to their therapeutic needs on the NHS – the occupational therapy and speech therapy they need is not always readily available. The true benefit of compensation would be to open up access to private treatment for these children and enhance their lives.”

I didn’t know the kids’ mother was an alcoholic. She loved them, but couldn’t cope. It didn’t put me off adopting them

Kay Collins adopted three children, two of whom have foetal alcohol spectrum disorder. Photograph: Sophia Spring for the Guardian

Kay Collins, 61, would also like to see more funding for children with FASD, but not if it means prosecuting their mothers. Ten years ago, she adopted three children, two of whom have the condition. She knew them before she adopted them, because they lived in a flat upstairs in the west London mansion block where they still live.

“We’d meet on the stairs and say hello, and I got to know them – they were lovely kids. I didn’t know their mother was an alcoholic. It was only as time went on, I realised. She was somebody who needed help, not someone to abuse or to judge.

“You saw that she loved the kids, but she couldn’t manage. She was in her 20s, the children’s father was there on and off. She never harmed the kids in any way. She loved them – she just didn’t know how to care for them.”

Eventually, the children were taken into care. Collins, who was working as a teaching assistant and had four, much older children of her own, decided to adopt them – a girl of 17 months and boys of four and five. She knew nothing about FASD until she was called by a paediatrician who was helping to prepare the adoption papers. She was told the two younger children might have learning disabilities and was asked how she would cope. “I said, ‘If I knew that now, I would be a genius. I can only know when I am dealing with it.’ It didn’t put me off. I knew that the children just needed a lot of love and attention.”

Now that she knows more about the condition, she can see some of the facial characteristics of FASD in pictures of the youngest as a baby. These have become less noticeable as she has grown up, but her cognitive problems have become more evident over time. “When they were about seven, it was clear things were not happening as with normal children. They both didn’t speak very well for a long time, they didn’t understand a lot of things. The younger one still doesn’t. Her brother understands better, but his behaviour is worse. If you try to correct him, he gets very angry.”

Collins is fighting for the youngest, now 12, to be given a place in a special needs school. “She has language difficulties. If things are not explained to her at a slower pace, she is not going to understand them. At the moment, I’m at loggerheads with the local authority and in a tribunal because they don’t think that’s necessary. They don’t want to pay for it. It’s down to cost.”

Collins thinks her 12-year-old daughter won’t take GCSEs and knows that, long-term, life will be complicated for her. “She will live independently, but she will need a lot of support – she is quite vulnerable because she thinks everyone is her friend.” But she doesn’t like the idea of fighting for compensation through the Criminal Injuries Compensation Scheme. “It would be nice to have the money; we could use it to get them educated in the right environment,” she says, but she is uncomfortable with the idea that this might be a step in the direction of criminalising troubled women. “Mothers who drink when pregnant need more support and understanding. No one sits down and just starts drinking. There has to be something that triggered it.”

Meanwhile, she just tries to help her children understand. “My daughter keeps asking, ‘Is there something wrong with me?’ I say, ‘Yes, you have foetal alcohol spectrum disorder.’” The middle child is angry about his mother’s role in his condition. “He says, ‘I hate my mum’, but I try to explain: ‘She couldn’t look after you. It doesn’t mean she didn’t love you. She was never a bad mum.’”

• Some names have been changed. To contact Nofas UK, call 020-8458 5951 or go to nofas-uk.org.

Source: http://gu.com/p/475mq April 2015 http://www.theguardian.com/society/2015/apr/04

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Legal Sector :

Underage youth who cite alcohol marketing and the influence of adults, movies or other media as the main reasons for choosing to consume a specific brand of alcohol are more likely to drink more and report adverse consequences from their drinking than youth who report other reasons for selecting a specific brand, new research suggests.

The findings, published in the May issue of the Journal of Adolescent Health, add to a growing body of research suggesting youth exposure to alcohol marketing affects their drinking behavior. The study was conducted by researchers from the Johns Hopkins Bloomberg School of Public Health’s Center on Alcohol Marketing and Youth and the Boston University School of Public Health.

The researchers conducted an Internet survey in 2012 of 1,031 people between the ages of 13 and 20 who reported having consumed alcohol in the previous 30 days. Of those, 541 reported having a choice of multiple alcohol brands the last time they drank and researchers wanted to know why they chose the brand they did. They classified the underage drinkers into five groups:

· Brand Ambassadors, who selected a brand because they identified with its marketed image (32.5 percent of respondents)
· Tasters, who selected a brand because they expected it to taste good (27.2 percent of respondents)
· Bargain Hunters, who selected a brand because it was inexpensive (18.5 percent of respondents)
· Copycats, who selected a brand because they’d seen adults drinking it, or seen it consumed in movies or other media (10.4 percent of respondents)
· Others (11.5 percent of respondents)

“Almost one in three underage drinkers reports choosing a brand of alcohol to drink based on branding and marketing,” says lead study author Craig Ross, PhD, president of Fiorente Media, Inc. and a consultant to the Johns Hopkins Bloomberg School of Public Health’s Center on Alcohol Marketing and Youth. “These findings suggest that alcohol advertisements, media portrayals of alcohol use, and celebrity endorsements play a significant role in alcohol brand selection among young people.”

Alcohol is the most commonly used drug among youth in the United States and is responsible on average for the deaths of 4,300 underage persons each year, researchers say. Approximately 33 percent of eighth graders and 70 percent of twelfth graders have consumed alcohol, and 13 percent of eighth graders and 40 percent of twelfth graders drank during the past month.

The researchers also examined whether different reasons for selecting a brand of alcohol were associated with riskier drinking behaviors. Brand Ambassadors and Copycats reported consuming the largest amount of alcohol and were most likely to report both heavy episodic drinking and negative alcohol-related health consequences, such as being injured while drinking or suffering an injury serious enough to require medical attention.

“The prevalence of heavy drinking among these two groups and the high rates of negative health consequences they report are of particular concern,” says study author David Jernigan, PhD, director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health. “Further research to explore methods of offsetting negative influences of alcohol marketing and promotion on our children’s health is sorely needed, as are more effective restrictions on advertising placement to reduce youth exposure to alcohol marketing and promotion.”

Alcohol advertising in the U.S. is primarily regulated by the industry itself. Several leading public health groups and officials, including the National Research Council, the Institute of Medicine and 24 state and territorial attorneys general, have called upon the alcohol industry to strengthen its standards to reduce youth exposure to alcohol advertising and marketing.

“Selection of Branded Alcohol Beverages by Underage Drinkers” was written by Craig S. Ross, PhD, MBA; Josh Ostroff; Timothy Naimi, MD, MPH; William DeJong, PhD; Michael Siegel, MD, MPH; and David H. Jernigan, PhD. This research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (R01AA020309-01).

Source: www.newswise.com 20^th April 2015 Journal of Adolescent Health, May 2015

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Social Affairs :

One in four deaths of young men aged from 15 to 39 in Ireland is due to alcohol and drink is a factor in half of all suicides, according to the Health Research Board.

Alcohol is also involved in more than one third of cases of deliberate self-harm, peaking around weekends and public holidays.

Those grim statistics are among the challenges for the medical professional nationwide and yesterday the first regional Alcohol Strategy to tackle the damage caused by alcohol in counties Cork and Kerry was launched at Cork County Hall.

“Our overarching principle in terms of strategy is to reduce the harm caused by alcohol in Cork and Kerry,” said David Lane, co-ordinator of Drug & Alcohol Services at HSE South.

While welcoming the new Public Health (Alcohol) Bill, Mr Lane said its slow progress through the legislature was frustrating. “We need this new legislation as a matter of urgency,” he said.

“In fact, the minimum unit pricing which is a central plank of the Bill should have been put in place years ago. In the meantime, more than one person every week in this country dies of alcohol poisoning. They just consume alcohol and no other drug and die from it. That is quite shocking.”

Among the HRB findings: n Alcohol consumption in Ireland almost trebled between 1960 (4.9 litres) and 2001 (14.3 litres); n Almost two thirds (63.9%) of males started drinking alcohol before the age of 18; n Four in five (80.3%) male drinkers consumed six or more standard drinks on occasion.

Those attending the launch of the strategy heard that liver disease rates are increasing rapidly in Ireland and the greatest level of increase is among 15- to 34-year-olds, who historically had the lowest rates of liver disease.

As well as that, 900 people are diagnosed with alcohol-related cancers with around 500 people dying from these diseases every year. Drink driving is also factor in one third of all deaths on Irish roads.

The bill aims to reduce alcohol consumption in Ireland to 9.1 litres per person per annum by 2020 and to reduce the harms associated with alcohol. It consists of 29 sections and includes five main provisions.

These are: Minimum unit pricing; health labelling of alcohol products; the regulation of advertising and sponsorship of alcohol products; structural separation of alcohol products in mixed trading outlets; and the regulation of the sale and supply of alcohol in certain circumstances.

However, Mr Lane lamented the absence in the proposed legislation of any attempt to tackle seriously the marketing of alcohol, particularly in its association with sporting events.

“We might be turning a corner,” said Mr Lane.

“The Public Health (Alcohol) Bill outlines some positive steps to tackle the issue for the first time in a meaningful way.

“It might be the first step in introducing minimum unit pricing which we, as an Alcohol Strategy Group for Cork and Kerry, will fully support. But Ireland needs to strengthen its resolve to tackle the availability and marketing of alcohol in a meaningful way too.

“Finally, we must include alcohol as part of our response to substance misuse and when our National Drugs Strategy runs out at the end of 2016 we must include alcohol in a new National Substance Misuse Strategy from the start of 2017.”

Source: http://www.irishexaminer.com/ireland/25-of-males-age-15-39-die-due-to-alcohol-404928.html

Filed under: Alcohol,Health :

Do manualized psychosocial interventions help reduce relapse among alcohol-dependent adults treated with naltrexone or placebo? A meta-analysis.

Agosti V., Nunes E.V., O’Shea D. et al.

Unable to obtain a copy by clicking title? Try asking the author for a reprint by adapting this prepared e-mail or by writing to Dr Agosti at agostiv@pi.cpmc.columbia.edu.

Supplementing the medication naltrexone with psychosocial relapse-prevention therapies has not helped prevent relapse among alcohol-dependent patients. However, these therapies have elevated outcomes among placebo patients to the level of those prescribed naltrexone.

SUMMARY Medications such as naltrexone and acamprosate are used in the treatment of alcohol dependence to combat frequent relapse to heavy drinking, but their impact has overall been modest, and many patients leave treatment early or do not take medication as intended. Researchers have tried to address these shortcomings by supplementing medication with psychosocial interventions. The featured review assessed whether these attempts have been successful by conducting a meta-analytic synthesis of results from studies which used psychosocial relapse-prevention interventions (typically cognitive-behavioural in approach) to support adult, alcohol-dependent patients who had achieved abstinence, and then randomly been allocated either to naltrexone or a placebo. Relapse was defined as a return to drinking at least 70g alcohol a day for men or 56g for women.

Key points

The review synthesised results from relevant studies to test whether supplementing the medication naltrexone with psychosocial relapse-prevention therapies helps prevent relapse among adult, alcohol-dependent patients.

It concluded this was not the case, though one finding suggested that psychosocial therapies can elevate outcomes for patients prescribed a placebo to the level of those prescribed naltrexone.

The implications of this and of other studies are that naltrexone can be a valuable supplement to medical counselling of dependent drinkers, especially when specialist therapies such as cognitive-behavioural therapy are refused or unavailable.

In some situations these therapies also work better when naltrexone is added. But if the core treatment is naltrexone, good quality medical care or counselling will on average be as effective as specialist structured psychosocial therapies.

Four of the 18 studies which met these criteria had also randomly allocated patients to cognitive-behavioural therapies versus a different approach – specifically either medical management or supportive psychotherapy. These direct tests of the impact of a cognitive-behavioural approach were analysed separately from the remaining 20 studies, in which all the patients were offered the same psychosocial therapies, either cognitive-behavioural or one typical of that type of service.

All 18 studies had recruited nearly 2,600 patients on average about 42 years old. Where this was known, three-quarters were men, 71% were employed, and about half were married.

Main findings

Within each of the four studies which had randomly allocated patients to these therapies, generally the proportions who relapsed when supported by cognitive-behavioural therapies were about the same as those who relapsed when supported in other ways. This was the case both among patients given naltrexone and those allocated to a placebo. When results from these studies were pooled, relapse rates among patients allocated to naltrexone or placebo were virtually the same regardless of the type of psychosocial support.

Among the remaining studies which each allocated all their patients to the same form of psychosocial support, results were available from seven in which this was a structured, manualised programme, usually cognitive-behavioural in nature. Across these studies, virtually the same proportion of patients (about half) relapsed whether prescribed naltrexone or placebo. In contrast, when support took a typical, less structured form such as counselling, fewer naltrexone patients relapsed (33%) than did patients prescribed a placebo (43%). This contrast was statistically significant, and was largely due to results from older studies published between 1992 and 1997. Another unexpected finding was that whether prescribed naltrexone or a placebo, fewer patients relapsed when the treatment was a typical approach than when it was a structured psychosocial therapy.

The authors’ conclusions

Results show that relative to other approaches, cognitive-behavioural therapy did not significantly decrease the likelihood of relapse to heavy drinking among patients prescribed naltrexone or among those prescribed a placebo, and did not augment the impacts of naltrexone relative to an inactive placebo. In the four studies which made direct comparisons, supportive psychotherapy and medical management interventions worked as well. Among the remaining studies, overall those which used a manualised programme such as cognitive-behavioural therapy actually recorded higher rates of relapse than studies which used a more typical, less structured approach.

These results should be viewed in the light of several major limitations. No adjustments could be made for important factors related to the chance of successful treatment such as severity of dependence, and relapse to heavy drinking was the only drinking outcome sufficiently commonly reported to be amalgamated across the studies. Also, the results derived from studies that required initial abstinence and excluded patients with major comorbid disorders, diminishing their applicability to routine practice.

Source: American Journal on Addictions: 2012, 21(6), p. 501–507. April 2015

COMMENTARY The weight of the evidence in respect of treating alcohol or drug dependence is that despite the prominence of cognitive-behavioural therapies, their theoretical pedigree, and an extensive research effort which has distilled them in to expert manuals (for example, 1 2), overall the advantage they confer over alternatives is minor, and especially so when added to a drug-based treatment. In respect of alcohol problems, an analysis has concluded that any variation in outcomes across different psychosocial therapies is likely to have been due to chance or to the allegiance of the researchers.

However, the large US COMBINE trial did find that supplementing inactive placebo pills with psychological therapy incorporating cognitive-behavioural elements raised outcomes to the level of patients prescribed naltrexone. A similar message emerged from another US study which found that as long as naltrexone was prescribed, primary care-style consultations were as effective as specialist cognitive-behavioural therapy in initiating and sustaining recovery from alcohol dependence. Without the medication, cognitive-behavioural therapy was the more effective option. A similar result emerged from the featured review’s analysis of studies which offered the same psychosocial support to all patients; when this was a structured therapy (generally cognitive-behavioural), it helped raise outcomes for placebo patients to the level of those prescribed naltrexone.

All these results suggest that structured therapies can elevate the outcomes of patients not prescribed an active medication to the level of those prescribed naltrexone – that either medication or structured therapy help relative no medication plus typical care. Combining the two does not augment the drug’s impacts – a surprise, since relapse-prevention therapies would be expected to have their own impacts and to give medication greater leverage by persuading more patients to complete treatment and take the pills as intended.

Even if adding structured cognitive-behavioural therapy to naltrexone does not help, the reverse may still be the case – that supplementing cognitive-behavioural therapy with naltrexone makes a more effective package. In several studies (described in these notes) this has indeed been the case. The findings are in line with guidance from the UK’s National Institute for Health and Clinical Excellence (NICE) that in addition to evidence-based psychological interventions, patients whose alcohol dependence is moderate or severe should also be able to access relapse prevention medication, including naltrexone.

Practice implications seem to be that naltrexone can be a valuable supplement to the medical counselling (by GPs or nurses) of dependent drinkers of the kind who might be treated in primary care, especially when specialist therapies such as cognitive-behavioural therapy are refused or unavailable. In some situations these therapies also work better when naltrexone is added. But if the core treatment is naltrexone, a good quality medical care approach or counselling will on average be as effective as specialist structured psychosocial therapies.

Last revised 17 April 2015. First uploaded 10 April 2015

Filed under: Addiction (Papers),Alcohol,Drug Specifics,Effects of Drugs,Intervention (including testing) (Papers) :

Using marijuana and alcohol together greatly increases the amount of THC, marijuana’s active ingredient, in the blood, a new study concludes. Using the two substances together raises THC levels much more than using marijuana by itself.

The researchers say using alcohol and marijuana together considerably increases the risk of car crashes, compared with using marijuana alone.

The study included 19 people who drank alcohol or a placebo in low doses 10 minutes before they inhaled vaporized marijuana in either a low or high dose, Time reports. When a person drank alcohol, their blood concentration of THC was much higher. The findings are published in Clinical Chemistry.

A  study published last year  found teenagers who use marijuana and alcohol together are more likely to engage in unsafe driving, compared with those who use one of those substances alone.

Teens who used alcohol alone were 40 percent more likely to admit they had gotten a traffic ticket and 24 percent more likely to admit involvement in a traffic crash, compared with teens who didn’t smoke marijuana or drink. Teens who smoked marijuana and drank were 90 percent more likely to get a ticket and 50 percent more likely to be in a car crash, compared with their peers who didn’t use either sub

Source: http://www.drugfree.org/join-together 28th May2015

Filed under: Alcohol,Cannabis/Marijuana,Drugs and Accidents,Effects of Drugs (Papers) :

Most of us who drink alcohol won’t die from liver disease – but it still kills more of us than diabetes and road deaths combined The recent report into life on the liver ward makes sobering reading. John has alcohol-induced dementia (Korsakoff’s syndrome) and doesn’t know where he is. Rita has cirrhosis of the liver and is homeless. Her life has spiralled downwards as a wine habit segued into damaging dependence. It’s easy to feel sorry for the Johns and Ritas, though most of us think it’ll never happen to us. But will it? Are we becoming a nation of drinkers and drunks? The UK death rate from liver disease has increased fourfold in the past 30 years as cheap alcohol has flooded our shores and our gullets. Alcohol-related emergencies resulted in over a quarter of a million admissions in 2013/14, most of whom were 45-64-year-olds, who see themselves as regular rather than binge drinkers. Jackie Ballard, the chief executive of Alcohol Concern, says “Alcohol is linked to over 60 medical conditions including cancer, diabetes and high blood pressure.” And the chief medical officer, Sally Davies is so concerned that she has published new and controversial guidelines on safe drinking. The good news is that the tide seems to be turning against alcohol use in the UK. The percentage of men drinking alcohol in a typical week fell from 72% in 2005 to 64% in 2012 (in women the fall was from 57% to 52%). Frequent drinking has also been reported to be in decline. Most of us who drink alcohol won’t die of liver disease, just as many smokers don’t die of lung cancer. It’s a question of weighing the risks against the benefit that alcohol gives us. It’s my drug of choice but I wouldn’t pretend that it’s harmless. The great British booze problem: how a few glasses a day has led to an epidemic for the NHS

How much alcohol is too much? Some can probably safely drink more than others; your size, genetics, lifestyle and state of your liver make a difference. But in general, less than 14 units, spread over at least three days a week should be OK. That’s just under a bottle-and-a-half of wine (ABV 13.5%), or an average of one 175ml glass per day. For beer drinkers, that’s less than five pints of higher strength beer (ABV 5.2%) a week.

The liver is a resilient and vital organ. With the kidneys, it acts as a waste-disposal system, filtering our blood of toxins. The liver plays a key role in digestion and also produces hormones, bile to digest fats and proteins for blood clotting. We have two kidneys, which is handy if one fails, but only one liver. Luckily, it can withstand a tremendous battering and still recover. We can survive on a liver that is only 30% operational; after that it gets critical.

Viruses, drugs, chemicals, toxins and some genetic conditions can take their toll on even the youngest and meatiest of livers. At first, these irritants cause inflammation, which is reversible. But long-standing damage causes cirrhosis, which is irreversible thickening (fibrosis) that stops the liver from functioning. We can’t live without a liver, so a transplant becomes the only option. Liver disease kills more of us than diabetes and road deaths combined and is the fifth-biggest killer now after heart attacks, cancer, strokes and lung diseases. It is the only major cause of death in the UK that is still increasing year on year. The hope is that as awareness rises and alcohol intake falls, the crowded NHS liver wards will become a thing of the past.

Source: http://www.theguardian.com/society/shortcuts/2016/jan/25

Filed under: Alcohol,Drug use-various effects,Health :

By Mark H. Moore; Mark H. Moore is professor of criminal justice at Harvard’s Kennedy School of Government.

CAMBRIDGE, Mass.— History has valuable lessons to teach policy makers but it reveals its lessons only grudgingly.

Close analyses of the facts and their relevance is required lest policy makers fall victim to the persuasive power of false analogies and are misled into imprudent judgments. Just such a danger is posed by those who casually invoke the ”lessons of Prohibition” to argue for the legalization of drugs.

What everyone ”knows” about Prohibition is that it was a failure. It did not eliminate drinking; it did create a black market. That in turn spawned criminal syndicates and random violence. Corruption and widespread disrespect for law were incubated and, most tellingly, Prohibition was repealed only 14 years after it was enshrined in the Constitution.

The lesson drawn by commentators is that it is fruitless to allow moralists to use criminal law to control intoxicating substances. Many now say it is equally unwise to rely on the law to solve the nation’s drug problem.

But the conventional view of Prohibition is not supported by the facts.

First, the regime created in 1919 by the 18th Amendment and the Volstead Act, which charged the Treasury Department with enforcement of the new restrictions, was far from all-embracing. The amendment prohibited the commercial manufacture and distribution of alcoholic beverages; it did not prohibit use, nor production for one’s own consumption. Moreover, the provisions did not take effect until a year after passage -plenty of time for people to stockpile supplies.

Second, alcohol consumption declined dramatically during Prohibition. Cirrhosis death rates for men were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to state mental hospitals for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928.

Arrests for public drunkenness and disorderly conduct declined 50 percent between 1916 and 1922. For the population as a whole, the best estimates are that consumption of alcohol declined by 30 percent to 50 percent.

Third, violent crime did not increase dramatically during Prohibition. Homicide rates rose dramatically from 1900 to 1910 but remained roughly constant during Prohibition’s 14 year rule. Organized crime may have become more visible and lurid during Prohibition, but it existed before and after.

Fourth, following the repeal of Prohibition, alcohol consumption increased. Today, alcohol is estimated to be the cause of more than 23,000 motor vehicle deaths and is implicated in more than half of the nation’s 20,000 homicides. In contrast, drugs have not yet been persuasively linked to highway fatalities and are believed to account for 10 percent to 20 percent of homicides.

Prohibition did not end alcohol use. What is remarkable, however, is that a relatively narrow political movement, relying on a relatively weak set of statutes, succeeded in reducing, by one-third, the consumption of a drug that had wide historical and popular sanction.

This is not to say that society was wrong to repeal Prohibition. A democratic society may decide that recreational drinking is worth the price in traffic fatalities and other consequences. But the common claim that laws backed by morally motivated political movements cannot reduce drug use is wrong.

Not only are the facts of Prohibition misunderstood, but the lessons are misapplied to the current situation.

The U.S. is in the early to middle stages of a potentially widespread cocaine epidemic. (in 2001) If the line is held now, we can prevent new users and increasing casualties. So this is exactly not the time to be considering a liberalization of our laws on cocaine. We need a firm stand by society against cocaine use to extend and reinforce the messages that are being learned through painful personal experience and testimony.

The real lesson of Prohibition is that the society can, indeed, make a dent in the consumption of drugs through laws. There is a price to be paid for such restrictions, of course. But for drugs such as heroin and cocaine, which are dangerous but currently largely unpopular, that price is small relative to the benefits.

Source: http://nyti.ms/U1QHdN Published October 16 1989

1. Prohibited the commercial manufacture, and distribution of alcoholic beverages

It DID NOT prohibit use, or production for one’s own consumption

2. Alcohol consumption declined dramatically during prohibition.

Cirrhosis death rates for men were 29.5 per 100,000 in 1911 and 10.7 inn 1929

Mental hospital admission for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928.

Arrests for public drunkenness and disorderly conducted declined 50% between 1916 and 1922

Consumption of alcohol declined by 30 to 50%

3. Violent crimes DID NOT increase dramatically during prohibition. Homicide rates rose dramatically from 1900 to 1910 but remained roughly constant during prohibition’s 14-year rule. Organized crime did become more visible during prohibition but it existed before and after.

4. Following the repeal of prohibition, alcohol consumption increased. Today alcohol is estimated to be the cause of 50% of traffic deaths and is implicated in more than half of the nation’s homicides.

Source: J.McDougal 2001 – re-printed Drug Watch International e-mails.

Filed under: Alcohol,Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector,USA :

BACKGROUND: The Gateway Drug Theory suggests that licit drugs, such as tobacco and alcohol, serve as a “gateway” toward the use of other, illicit drugs. However, there remains some discrepancy regarding which drug—alcohol, tobacco, or even marijuana—serves as the initial “gateway” drug subsequently leading to the use of illicit drugs such as cocaine and heroin. The purpose of this investigation was to determine which drug (alcohol, tobacco, or marijuana) was the actual “gateway” drug leading to additional substance use among a nationally representative sample of high school seniors.

METHODS: This investigation conducted a secondary analysis of the 2008 Monitoring the Future 12th-grade data. Initiation into alcohol, tobacco, and other drug use was analyzed using a Guttman scale. Coefficients of reliability and scalability were calculated to evaluate scale fit. Subsequent cross tabulations and chi-square test for independence were conducted to better understand the relationship between the identified gateway drug and other substances’ use.

RESULTS: Results from the Guttman scale indicated that alcohol represented the “gateway” drug, leading to the use of tobacco, marijuana, and other illicit substances. Moreover, students who used alcohol exhibited a significantly greater likelihood of using both licit and illicit drugs.

CONCLUSION: The findings from this investigation support that alcohol should receive primary attention in school-based substance abuse prevention programming, as the use of other substances could be impacted by delaying or preventing alcohol use. Therefore, it seems prudent for school and public health officials to focus prevention efforts, policies, and monies, on addressing adolescent alcohol use.

Source: “Alcohol as a Gateway Drug: A Study of US 12th Graders” that was published in the Journal of School Health in August 2012

Filed under: Alcohol,Drug use-various effects :

Summary: Cannabis plus alcohol is one of the most frequently detected drug combinations in car accidents, yet the interaction of these two compounds is still poorly understood. A study shows for the first time that the simultaneous use of alcohol and cannabis produces significantly higher blood concentrations of cannabis’s main psychoactive constituent, THC, as well as THC’s primary active metabolite than cannabis use alone.

Cannabis plus alcohol is one of the most frequently detected drug combinations in car accidents, yet the interaction of these two compounds is still poorly understood.

A study appearing online in Clinical Chemistry, the journal of AACC, shows for the first time that:

the simultaneous use of alcohol and cannabis produces significantly higher blood concentrations of cannabis’s main psychoactive constituent, Δ9-tetrahydrocannabinol (THC), as well as THC’s primary active metabolite, 11-hydroxy-THC (11-OH-THC), than cannabis use alone.

Currently, 23 states and the District of Columbia have legalized medical cannabis, and Colorado, Washington, Oregon, and Alaska have decriminalized recreational cannabis use.

As cannabis becomes more widely accessible, the verdict remains out on whether cannabis intoxication increases the risk of car accidents.

Experts agree, however, that the combination of cannabis and alcohol raises the chance of crashing more than either substance by itself.

In a study of 1,882 motor vehicle deaths, the U.S. Department of Transportation found an increased accident risk of 0.7 for cannabis use, 7.4 for alcohol use, and 8.4 for cannabis and alcohol use combined.

To shed light on the ways in which cannabis and alcohol interact to negatively impact driving, a group of researchers studied 19 adult participants who drank placebo or low-dose alcohol (with a target peak breath-alcohol concentration of approximately 0.065%) 10 minutes prior to inhaling 500 mg of placebo, low-dose (2.9% THC), or high-dose (6.7% THC) vaporized cannabis.

The researchers found that with no alcohol, the median maximum blood concentrations for low and high THC doses were 32.7 and 42.2 µg/L THC, respectively, and 2.8 and 5.0 µg/L 11-OH-THC.

With alcohol, the median maximum blood concentrations for low and high THC doses were 35.3 and 67.5 µg/L THC and 3.7 and 6.0 µg/L 11-OH-THC — which is significantly higher than without alcohol.

“The significantly higher blood THC and 11-OH-THC [median maximum concentration] values with alcohol possibly explain increased performance impairment observed from cannabis-alcohol combinations,” said lead study author Marilyn A. Huestis, PhD, of the National Institute on Drug Abuse, Baltimore, Maryland.

“Our results will help facilitate forensic interpretation and inform the debate on drugged driving legislation.”

Journal Reference:

1. Marilyn A. Huestis, PhD et al. Controlled Cannabis Vaporizer Administration: Blood and Plasma Cannabinoids with and without Alcohol. Clinical Chemistry, May 2015 DOI: 10.1373/clinchem.2015.238287

2. Source: www.sciencedaily.com/releases/2015/05/150527112728.htm

May 27, 2015 American Association for Clinical Chemistry (AACC).

Filed under: Alcohol,Cannabis/Marijuana :

If all new cars had devices that prevent drunk drivers from starting the engine, an estimated 85 percent of alcohol-related deaths could be prevented in the United States, a new study concludes.

The devices, called alcohol ignition interlocks, could prevent more than 59,000 crash fatalities and more than 1.25 million non-fatal injuries, according to the University of Michigan researchers. The findings appear in the American Journal of Public Health.

“Alcohol interlocks are used very effectively in all 50 states as a component of sentencing or as a condition for having a license reinstated after DUIs, but this only works for the drunk drivers caught by police and it doesn’t catch the people who choose to drive without a license to avoid having the interlock installed,” said lead author Dr. Patrick Carter.

He said most drunk drivers make about 80 trips under the influence of alcohol before they are stopped for a DUI. “If we decided that every new car should have an alcohol ignition interlock that’s seamless to use for the driver and doesn’t take any time or effort, we suddenly have a way to significantly reduce fatalities and injuries that doesn’t rely solely on police,” he told Reuters.

The study assumed it would take 15 years for older cars to be replaced with new vehicles that required interlock devices, which detect blood-alcohol levels. The devices prevent drivers above a certain threshold from starting the vehicle.

While all age groups would suffer fewer deaths and injuries if they used the interlock devices, the youngest drivers would benefit the most, the study found. Among drivers ages 21 to 29 years, 481,000 deaths and injuries could be prevented. Among drivers under 21, almost 195,000 deaths and injuries could be avoided.

“It is often difficult to penetrate these age groups with effective public health interventions and policies to prevent drinking and driving,” Carter said.

Source: http://www.drugfree.org/ 4th March 2015

Filed under: Alcohol,Drugs and Accidents :

Dutch study finds mathematics results suffer most from dope consumption – findings sure to fuel debate over steps towards legalisation If you want to do well in your exams, especially maths, don’t smoke dope.

This is the finding of a unique study that is likely to be fiercely debated by those in favour of and those against the liberalisation of cannabis laws.

Economists Olivier Marie of Maastricht University and Ulf Zölitz of IZA Bonn examined what happened in Maastricht in 2011 when the Dutch city allowed only Dutch, German and Belgian passport-holders access to the 13 coffee shops where cannabis was sold.

The temporary restrictions were introduced because of fears that nationals from other countries, chiefly France and Luxembourg, were visiting the city simply to smoke drugs, which would tarnish its genteel image.

After studying data on more than 54,000 course grades achieved by students from around the world who were enrolled at Maastricht University before and after the restrictions were introduced, the economists came to a striking conclusion.

In a paper recently presented at the Royal Economic Society conference in Manchester they revealed that those who could no longer legally buy cannabis did better in their studies. The restrictions, the economists conclude, constrained consumption for some users, whose cognitive functioning improved as a result.

“The effects we find are large, consistent and statistically very significant,” Marie told the Observer. “For example, we estimate that students who were no longer able to buy cannabis legally were 5% more likely to pass courses.

The grade improvement this represents is about the same as having a qualified teacher and, more relevantly, similar to decreases in grades observed from reaching legal drinking age in the US.”

For low performers, there was a larger effect on grades. They had a 7.6% better chance of passing their courses. Interestingly, Marie and Zölitz found the effects were even more pronounced when it came to particular disciplines.

“The policy effect is five times larger for courses requiring numerical/mathematical skills,” the pair write.This, they argue, is not that surprising. “In line with how THC consumption affects cognitive functioning, we find that performance gains are larger for courses that require more numerical/mathematical skills,” Marie said. THC – tetrahydrocannabinol – is the active ingredient in skunk cannabis, which some studies have linked with psychosis.

The ground breaking research comes at a significant moment. The clamour for liberalisation of cannabis laws is growing.

In Germany, Berlin is considering opening the country’s first legal cannabis shop. Uruguay plans to be the first nation in the world to fully legalise all aspects of the cannabis trade. In the US, more than 20 states now allow medical marijuana use, while recreational consumption has become legal in Alaska, Oregon, Washington and Colorado.

But, as Marie and Zölitz observe in their paper: “With scarce empirical evidence on its societal impact, these policies are mainly being implemented without governments knowing about their potential impact.

“We think this newfound effect on productivity from a change in legal access to cannabis is not negligible and should be, at least in the short run, politically relevant for any societal drug legalisation and prohibition decision-making,” Marie said. “In the bigger picture, our findings also indicate that soft drug consumption behaviour is affected by their legal accessibility, which has not been causally demonstrated before.”

The research is likely to be seized upon by anti-legalisation campaigners. But Marie was at pains to say the research should simply be used to raise awareness of an often overlooked aspect of drug use: its impact on the individual’s cognitive ability. “If marijuana is legalised like it is in many states in the US, we should at least inform consumers about the negative consequences of their drug choices.”

It will also feed into the debate about THC levels in cannabis, which are becoming ever stronger. Levels of THC in marijuana sold in Maastricht’s coffee shops are around double those in the US. “Considering the massive impact on cognitive performance high levels of THC have, I think it is reasonable to at least inform young users much more on consequences of consuming such products as compared with that of having a beer or pure vodka,” Marie said. History suggests that prohibition often results in the illicit drug or alcohol trade producing ever stronger products.

Campaigners for liberalisation argue that it could help bring THC levels down and allow users to know what they are buying. The authors concede that their findings could turn out to be different if they were to replicate their study in a country that did not have restrictions on cannabis use. Marie said his work had helped inform his discussions with his teenage son. “I have a 13-year old boy and I do extensively share this with him as a precautionary measure so that he can make the best informed choice if he is faced with the decision of whether to consume cannabis or not.”

http://www.theguardian.com/society/2015/apr/11/cannabis-smokers-risk-poorer-grades-dutch-study-legalisation

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Education,Education Sector,Europe,Social Affairs,USA,Youth :

Some good news, some not-so-good news about brain recovery from alcohol use disorders

According to a recent review article on recovery of behavior and brain function after abstinence from alcohol[1], individuals in recovery can rest assured that some brain functions fully recover; but others may require more work. In this article, authors looked at 22 separate studies of recovery after alcohol dependence, and drew some interesting conclusions.

First, the good news; studies show improvement or even complete recovery to the performance level of healthy participants who had never had an alcohol use disorder in many important areas, including short-term memory, long-term memory, verbal IQ, and verbal fluency. Even more promising, not only behavior, but the structure of the brain itself may recover; an increase in the volume of the hippocampus, a brain region involved in many memory functions, was associated with memory improvement.

Another study showed that after 6 months of abstinence, alcohol-dependent participants showed a reduction in a “contextual priming task” with alcohol cues; in day to day terms, this could mean that individuals in early recovery from alcohol dependence may be less likely to resume drinking when confronted with alcohol and alcohol-related cues in their natural environment because these alcohol-related triggers are eliciting less craving.- a good thing for someone seeking recovery!

Still other studies showed that sustained abstinence was associated with tissue gain in the brain; in other words, increases in the volumes of brain regions such as the insula and cingulate cortex, areas which are important in drug craving and decision-making, were seen in abstinent alcoholics. This increase is a good thing, because more tissue means more recovery from alcohol-induced damage. A greater volume of tissue in these areas may be related to a greater ability to make better decisions.

Now, the not-so-good news: these studies reported no improvement in visuospatial skills, divided attention (e.g. doing several tasks at once), semantic memory, sustained attention, impulsivity, emotional face recognition, or planning.  This means that even after abstinence from alcohol, people in recovery may still experience problems with these neurocognitive functions, which may be important for performing some jobs that require people to pay attention for long periods of time or remember long lists of requests. These functions may also be important for daily living (i.e. assessing emotions of a spouse, planning activities, etc.).

Importantly, there were many factors that influenced the degree of brain recovery; for example, the number of prior detoxifications. Those with less than two detoxifications showed greater recovery than those with more than two detoxifications.  A strong family history of alcohol use disorder was associated with less recovery. Finally, cigarette smoking may hinder recovery, as studies have shown that heavy smoking is associated with less recovery over time.

So what does all this mean? Recovery of brain function is certainly possible after abstinence, and will naturally occur in some domains, but complete recovery may be harder in other areas. Complete recovery of some kinds of behavior (e.g. sustained attention, or paying attention over long periods of time) may take more time and effort! New interventions, such as cognitive training or medication (e.g. modafinal, which improved neurocognitive function in patients with ADHD and schizophrenia, as well as in healthy groups), may be able to improve outcomes even more, but await further testing.

[1] Recovery of neurocognitive functions following sustained abstinence after substance dependence and implications for treatment

Source: Mieke H.J. Schulte et al., Clinical Psychology Review 34 (2014) 531–550 October 2014

Filed under: Addiction,Addiction (Papers),Alcohol,Brain and Behaviour,Health,Prevention and Intervention,Treatment and Addiction,USA :

Underage drinkers who consume supersized flavored alcoholic drinks – also known as alcopops – are more than six times as likely to report alcohol-related injuries as underage youth who consume other types of alcoholic beverages, according to a new study. The research, published in the Feb. 25 American Journal of Public Health, is the first to document the association between consumption of alcopops and risky drinking habits in teens.

Alcopops — alcoholic beverages blended with fruit juice, lemonade or other flavorings — appeal to underage drinkers because they taste more like sweet soda than other alcoholic drinks. These brews are typically 8 percent alcohol content by volume compared to less than 5 percent for beer.

Flavored alcoholic drinks come in malt-based beverages; spirits-based premixed, ready-to-drink cocktails; and supersized alcopops. Previous studies found that half of underage drinkers in the U.S. said they had consumed flavored alcohol beverages in the past 30 days.

“It is impossible to discuss harmful alcohol consumption among youth and not include supersized alcopops,” study co-author David Jernigan, PhD, director of the Center for Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health, said in a news release. “These low-priced and sweet-tasting beverages are associated with reports of dangerous consequences among youth.”

For their study, the researchers surveyed 1,031 underage youth ages 13 to 20 who had consumed at least one alcoholic drink during the past 30 days between December 2011 and May 2012. Using an online, self-reporting survey, respondents indicated which brands they had consumed in the past 30 days, and the typical number of drinks of each brand they had consumed on those days.

Survey results showed that heavy episodic drinking was reported by nearly 70 percent of the pre-mixed/ready-to-drink cocktail users. About 75 percent of supersized alcopop users and almost 80 percent of those who consumed more than one type of flavored alcoholic beverage engaged in the same drinking behaviors. Among the non-alcopop group, 45 percent reported heavy episodic drinking. Consumption of more than one type of alcopop was strongly associated with fighting and alcohol-related injuries.

In recent years, public health advocates have expressed concerns about the alcopops and their appeal to youth. Flavored alcoholic drinks, concluded the authors, “present an emerging public health problem among young people.”

“Public health practitioners and policy makers would be wise to consider what further steps could be taken to keep these beverages out of the hands of youth,” study author Alison Albers, PhD, an assistant professor at the Boston University School of Public Health, said in the news release.

Source: http://www.examiner.com/article/flavored-alcoholic-drinks 27^th Feb. 2015

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Global Drug Legalisation Efforts,USA :

The information comes from the Indiana Youth Institute’s annual Kids Count report.

The data is worrisome to area health professionals, like Dr. Ahmed Elmaadawi, who says marijuana is mentally addictive.

“Cannabis, in general, works in an area of the brain that’s responsible for judgment and well-being. We actually know if you use marijuana for a long period of time, it affects your judgment [and] self-esteem. And longtime use of cannabis can actually cause psychosis,” said Dr. Elmaadawi, a child and adolescent psychiatrist.

Dr. Elmaadawi is concerned mainly for teen use. He says there is proven research marijuana can be healing to cancer patients and others suffering from chronic pain, but use for teens is dangerous. He says those who try the drug before age 18 are 67% more likely to continue using. The number drops to 27% for adults who try it for the first time.

“The pleasurable response is there. They want to have more to get that same feeling from the first time they used marijuana,” said Dr. Elmaadawi.

While health professionals are standing strong in the dangers, there is an overwhelming support for legalization at the national level. According to a Pew Research Poll, millennials are setting aside partisan politics with 77% of Democrats between ages 18-34 and 63% of Republicans agreeing laws that prohibit pot are outdated.

But, not all young people agree, including one local teen who struggled with abuse at an early age. The teen, called “John” for the purpose of this story, went to rehab at age 16. He started using pot at 13. His legal trouble started when he was caught on camera stealing from parked cars with a friend. Both were high and had a history of theft.

“There was an adrenaline part that didn’t make me worry about it. The money part is what made me do it, but the thrill is what didn’t make me afraid of it,” said John.

After his first arrest, John went to the Juvenile Justice Center (JJC) for 10 days. After his release, he started using synthetic marijuana. His mom caught him sometime later, called his parole officer, and he was again arrested. This time, John went to JJC for a month and rehab for 6 months.

“I stopped mainly because it was hurting a lot of the relationships I had, and I wanted to do stuff for myself. I knew if I wanted to go as far as I wanted to, I was going to get backtracked all the time if I smoked weed,” said John.

An arrest record and rehab aren’t enough for everyone. The Indiana Youth Institute (IYI) says while overall substance abuse is declining in terms of alcohol and cigarettes, marijuana use is increasing in teens.

“A big key to being successful to keeping our kids away from any illicit substance is open communication with their parents and other caring adults in their lives,” said Bill Stanczykiewicz, the President and CEO at IYI.

Dr. Elmaadawi and Stanczykiewicz agree there are mixed messages about marijuana legalization and the longtime effects. They agree open communication and community resources are key in helping teens make tough choices. Dr. Elmaadawi says there needs to be more education in schools in addition to collaboration between the resources in the community. Stanczykiewicz says teens are most influenced in their personal decision making by people they know directly.

“Kids benefit when they hear consistent messages about right and wrong from all of the caring adults in their lives. There’s no 100% guarantee that kids are going to make good choices, but what we are trying to do is increase the odds,” said Stanczykiewicz.

To read the Kids Count Data, click here.

Source: www.wndu.com 9th March 2015

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Social Affairs,Treatment and Addiction,USA :

It started with a wine cooler, said Paige Cederna, describing that first sweet, easy-to-down drink she experienced as a “magic elixir.”

“I had no inhibitions with alcohol,” said Ms. Cederna, 24. “I could talk to guys and not worry about anyone judging me. I remember being really proud the day I learned to chug a beer. I couldn’t get that feeling fast enough.” But before long, to get over “that feeling,” she was taking Adderall to get through the days.

But it was now more than three years since she drank her last drop of alcohol and used a drug for nonmedical reasons. Her “sober date,” she told the group, many nodding their heads encouragingly, was July 8, 2011.

Ms. Cederna’s story of addiction and recovery, told in a clear, strong voice, was not being shared at a 12-step meeting or in a treatment center. Instead, it was presented on a cool autumn day, in a classroom on the campus of the University of Michigan in Ann Arbor, to a group of 30 undergraduate students in their teens and early 20s.

On the panel with Ms. Cederna were two other Michigan graduate students. Hannah Miller, 27, declared her “sober date” as Oct. 5, 2010, while Ariel Britt, 29, announced hers as Nov. 6, 2011. Like Ms. Cederna’s, Ms. Britt’s problems with drugs and alcohol started in her freshman year at Michigan, while Ms. Miller’s began in high school. All three are participants in a university initiative, now two years old, called the Collegiate Recovery Program.

Staying sober in college is no easy feat. “Pregaming,” as it is called on campus (drinking before social or sporting events), is rampant, and at Michigan it can start as early as 8 a.m. on a football Saturday. The parties take place on the porches and lawns of fraternities, the roofs and balconies of student houses, and clandestinely in dormitories — everywhere but inside the academic buildings.

For this reason — because the culture of college and drinking are so synonymous — in September 2012 the University of Michigan joined what are now 135 Collegiate Recovery communities on campuses all over the country. While they vary in size from small student-run organizations to large embedded university programs, the aim is the same: to help students stay sober while also thriving in college.

“It shouldn’t be that a young person has to choose to either be sober or go to college,” said Mary Jo Desprez, who started Michigan’s Collegiate Recovery Program as the director of Michigan’s Wolverine Wellness department. “These kids, who have the courage to see their problem early on, have the right to an education, too, but need support,” she said, calling it a “social justice, diversity issue.” Matthew Statman, the full-time clinical social worker who has run Michigan’s program since it began in 2012, added, “We want them to feel proud, not embarrassed, by their recovery.”

At the panel presentation, Ms. Britt, who temporarily dropped out of Michigan as an undergraduate, shared with the students her anxiety when she finally sobered up and decided to return to campus. “I had so many memories of throwing up in bushes here,” she said. “I wanted to have fun, but I also had no idea how to perform without partying.”

Ms. Cederna also remembers what it felt like to return to Michigan sober her senior year. Not only did she lose most of her friends (“Everyone I knew on campus drank,” she said), but she also dropped out of her sorority (“I was only in it to drink,” she said). “I ended up alone in the library a lot watching Netflix,” she said. Molly Payton, 24 (now a senior who once fell off an eight-foot ledge, drunk and high at a party), said, “I read all the Harry Potter books alone in my room my first months clean.”

Everything changed, however, when these students learned there were other students facing the same issues. Ms. Cederna first found Students for Recovery, a small student-run organization that, until the Collegiate Recovery Program began, was the only available support group on Michigan’s campus besides local 12-step meetings, most of which tend toward an older demographic.

“Through S.F.R., I ended up having five new friends,” she said of the organization, which still exists but is now run by the 25 to 30 Collegiate Recovery Program students; both groups meet every other week in the health center. The main difference between the two is that students in the Collegiate Recovery Program have to already be sober and sign a “commitment contract” that they will stay clean throughout college through a well-outlined plan of structure. Students for Recovery is aimed at those who are still seeking recovery, may be further into their recovery or want to support others in recovery.

When a young student incredulously asked the panel, “How do you possibly socialize in college without alcohol?” Ms. Britt, Collegiate Recovery Program’s social chairwoman, rattled off a list of its activities — sober tailgates, a pumpkin-carving night, volleyball games, dance parties, study groups, community service projects and even a film screening of “The Anonymous People” that attracted some 600 students. “But we also just hang out together a lot,” she said.

Indeed, looking around the organization’s lounge just before the holidays (a small, cordoned-off corner on the fourth floor of the health center, minimally decorated with ratty couches, a table and a small bookshelf stocking titles like “Wishful Drinking” and “Smashed”), it was hard to believe some of these young adults were once heroin addicts who had spent time in jail. On the contrary, they looked like model students, socializing over soft drinks and snacks as they celebrated one student who had earned back his suspended license.

“By far the biggest benefit to our students in the recovery program is the social component,” said Mr. Statman, who is hoping a current development campaign may provide more funding. (The program is currently supported by a mandatory student health tuition fee.) “Let’s just say, we all wish we could be Texas Tech,” he said.

The Collegiate Recovery Program was established at Texas Tech decades ago, and it is now one of the largest, with 120 recovery students enrolled (along with Rutgers University and Augsburg College in Minneapolis). Thanks to a $3 million endowment, the Texas Tech program now offers scholarships as well as substance-free trips abroad. The students there have access to an exclusive lounge outfitted with flat-screen TVs, a pool table and a Ping-Pong table, kitchen, study carrels and a seminar room. Entering freshmen in recovery even have their own dormitory.

“We found that simply putting them on the substance-free halls didn’t work,” said Kitty Harris, who, until recently, was the director for more than a decade of Texas Tech’s program (she remains on the faculty). “Most of the kids on substance-free floors are just there to make their parents happy.” (The Michigan students in the recovery program mostly live off campus for the same reason; they do not have their own housing.)

“Most students begin experimenting innocently in college with drugs and alcohol,” said Mr. Statman, who just celebrated his 13th year in recovery. “Then there are the ones who react differently. They are not immoral, pleasure-seeking hedonists, they are simply vulnerable, and for their whole life.”

Rates of substance-use disorders triple from 5.2 percent in adolescence to 17.3 percent in early adulthood, according to 2013 data from the Substance Abuse and Mental Health Services Administration. It thus makes this developmental stage critical to young people’s future.

It is at the drop-in Students for Recovery meetings where one often sees nervous new faces. At the beginning of one meeting at Michigan last semester, a young woman introduced herself as, “One day sober.” Shortly afterward, a young man spoke up, “I am five days sober.” Danny (who asked that his last name not be published), a graduating recovery program senior applying to medical schools, later explained an important tenet all of them know from their various 12-step programs. “The most important person in the room is the new person,” he said, adding that after the Students for Recovery meetings, members try to approach any new participants, directing them to the C.R.P. website and to Mr. Statman, who is always on call for worried students.

“In the same way a diabetic might not always get their sugar levels right, part of addiction is relapsing, and we really don’t want our students to see that as a failure if it happens,” said Mr. Statman, adding that it is often the other students in the program who tell him if they suspect a student is using again.

Jake Goldberg, 22, now a junior, arrived at Michigan three years ago as a freshman already in recovery. “I did really well the first five months,” he said. “I was sober. I was loud and proud on panels, but I had internal reservations. I had few friends and felt like I wanted to be more a part of the school.” He recalled that in the spring of his freshman year, he suddenly found himself trying heroin for the first time. “I should have died,” he said, remembering how he woke up 14 hours later, dazed and bruised.

After straightening up, Mr. Goldberg relapsed again his sophomore year when he thought he might be able to have just one drink. “That drink led to drugs and to more drinking,” he said, remembering how Mr. Statman and Ms. Desprez called him into their office one day. “They told me this is not going to end well,” he said. Now sober two years, Mr. Goldberg said: “I now live recovery with all the structure, but I also am in a prelaw fraternity. When they drink a beer, I drink a Red Bull.”

Ms. Miller echoed Mr. Goldberg’s feelings over coffee one day on the Michigan campus. “Most of us did not get sober just to go to meetings all the time,” she said. “We want to live life too.” She also said that socializing with nonrecovery students is still challenging. “I went to a small party recently where everyone was eating pot edibles and drinking top-shelf liquor,” she said. “I got a bit squirrely in my head and had to leave.”

But now students in the Collegiate Recovery Program have a new place in Ann Arbor they can frequent: Brillig Dry Bar, a pop-up, alcohol-free spot that serves up spiced pear sodas and cranberry sours and features live jazz. And in March, four of the students in the program are joining dozens of recovery students from other colleges on a six-day, five-night, “Clean Break” in Florida, arranged by Blue Community, an organization that hosts events and vacations for young adults in recovery. (The vacation package includes music, guest speakers, beach sports and daily transport to local 12-step meetings.)

“My hope is that we continue to get more students who need a safe zone to our social events,” said Ms. Britt, who is about to publicize a “sober skating night” in March at the university ice rink. “They would see you can have a lot of fun in college without drinking.

“And honestly, we really do have fun.”

source: http://mobile.nytimes.com/2015/03/01/style/not-the-usual-college-party-

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Education Sector,Treatment and Addiction,USA,Youth :

The largest recent US national survey of drink and drug problems shows that outside the addiction treatment clinic, remission is the norm and recovery common. After 14 years half the people at some time dependent on alcohol were in remission, a milestone reached for cannabis after six years, and for cocaine after just five.

SUMMARY Among the US general adult population, and for each of nicotine, alcohol, cannabis and cocaine (including crack), this study sought to estimate the time from onset of dependence to remission, the cumulative probability of remission in different racial/ethnic groups, and to identify factors related to the probability of remission.

It drew its data from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) conducted in 2000–2001, which focused on drinking disorders but also asked about other forms of drug use and psychological problems. The aim was to interview a representative sample of civilian, non-institutionalised adults aged 18 and over living in households and group residences such as college halls, boarding houses and non-transient hotels. About 8 in 10 of the sample responded to the survey yielding 43,093 respondents. The featured report investigated the subgroups who had some time in their lives been dependent on nicotine (of which there were 6937), alcohol (4781), cannabis (530) or cocaine (408).

Dependence was defined as meeting the dependence criteria of the applicable version of the American Psychiatric Association’s DSM manual, DSM-IV. ‘Lifetime’ dependence was diagnosed if the respondent reported having experienced at least three specific signs of this syndrome within the same 12-month period at some point in their life. The age this first happened for any particular substance was the onset year, while the remission year was based on the age when the respondent’s answers indicatedthey had last stopped meeting dependence criteria for the drug, and had continued to do so for at least a year until interviewed for the survey – essentially, the most recent (at least so far) lastinglysuccessful remission. It was on this basis that the study calculated remission rates for individual substances and related them to the time between the onset of dependence and remission.

Main findings

Proportion of dependent users in remission

Within a year of first becoming dependent, 3% each of smokers and drinkers were in remission and remained so until they were surveyed. For cannabis the figure was nearly 5% and for cocaine, nearly 9%. After ten years the proportions in remission had risen to 18% for nicotine, 37% for alcohol, 66% for cannabis and 76% for cocaine chart. It could be estimated that by the end of their lives 84% of formerly dependent smokers would be in remission, 91% for alcohol, 97% for cannabis and 99% for cocaine. About 26 years after first becoming dependent, half the people at some time dependent on nicotine were in remission, a milestone reached for alcohol after 14 years, for cannabis six years, and for cocaine five years.

Once other factors had been taken in to account, for each of the substances, men who had been dependent at some time were significantly less likely than women to be in remission, especially in respect of the two illegal drugs, cannabis and cocaine; for every 10 women only about six men were in remission from dependence on these drugs. Black Americans once dependent on nicotine or cocaine were less likely to be in remission than white Americans – for cocaine, half as likely. After four years, about 50% of whites had sustained remission from dependence on cocaine; African Americans took nine years to reach the same milestone.

About 80% of people at some time dependent on nicotine or alcohol and almost all those once dependent on cannabis or cocaine had also at some time met diagnostic criteria for another psychiatric disorder, including conduct (antisocial behaviour in early life) and personality disorders. Once other factors had been taken in to account, people who had met criteria for conduct disorder were much more likely than others to have overcome their dependence on cannabis. In contrast, a diagnosis of a personality disorder was associated with a lower probability of remission from cannabis (and also alcohol) dependence. Having once experienced mood and anxiety disorders was unrelated to remission from dependence on any of the four substances.

The authors’ conclusions

The general picture is that the vast majority of people in the USA once dependent on nicotine, alcohol, cannabis or cocaine stop being dependent at some point in their lives, and this happens after fewer years for cannabis or cocaine than for nicotine or alcohol. Black Americans stay dependent longer on nicotine and cocaine than white Americans, and probabilities of remission are associated with social and psychological characteristics and dependence on other substances. However, the fact that that many people once dependent were no longer at the time of the survey should be interpreted with caution given the irregular course of addictions punctuated by remissions and relapses; their remission may have been temporary. Possible explanations for these findings are considered below.

More than two thirds of remissions from cannabis and cocaine dependence occurred within the first decade after onset of dependence, but only a fifth for nicotine and a third for alcohol. These differences may be explained in part by how quickly adverse physical, psychological and social consequences become apparent. For instance, the risk of early cardiovascular problems is much higher among individuals dependent on cocaine than among those dependent on nicotine or alcohol. Behavioural disturbances resulting from cannabis or cocaine dependence and their illegal status impose stronger social pressures to remit. The pervasive availability of alcohol and nicotine also means pervasive environmental prompts to using the drugs. Particularly for nicotine, perceived immediate benefits including anxiety and stress reduction, improved cognitive performance, and weight control, may initially outweigh perceived potential harms from long-term use.

Consistent with previous studies, black Americans once dependent on cocaine were less likely to remit than their white counterparts. Psychosocial factors that commonly affect black populations, including discrimination and lower levels of social capital, have been recognised as barriers to remission and triggers to use or relapse; genetic factors may also contribute.

Men were less likely than women to remit from dependence, perhaps because substance use is more damaging (physically, mentally and socially) for women, heightening motivation to stop using. Feelings of guilt and concerns about substance use during pregnancy and child-rearing may also play a particular part in prompting remission among women.

Individuals who met criteria for a personality disorder were less likely to remit from alcohol or cannabis dependence. This may be because characteristics of these disorders such as being impulsive, intolerant to stress, anxious, and craving new experiences, also predispose to substance use, and these characteristics tend to persist.

Among the limitations of the study were that it omitted institutionalised individuals including prisoners. People whose substance use led to their early death would also have been missed, as may some with severe but non-fatal consequences. These omissions may have caused an overestimation of the probability of remission across the entire population. The study also had no information on the number and duration of remission episodes over an individual’s lifetime; it could only relate other factors to the latest of these remissions.

COMMENTARY The good news from this analysis is that, in the US context, rather than continued dependence, remission is the norm. Most people overcome or grow out of their dependence on the drugs analysed by the study – for cocaine and cannabis, after just five or six years, and for alcohol, after 14, and over their lives people continue to remit until nearly all are no longer dependent. But at least in respect of drinking, there are a set of multiply problematic drinkers who despite treatment, take many more years to stop being dependent. The findings on black versus white Americans suggest that remission rates depend on socioeconomic factors; sampled at another period in the USA’s economic cycles or in respect of drugs used predominantly by more or less advantaged sections of the population, remission rates too might differ, and look more or less like the chronic disease model.

The data presented in the featured article did not show whether the user ‘in remission’ had simply become dependent on another drug. Within the set of illegal drugs and medicines, this seemed uncommon, because the total remission rate was so high. But it seems more than possible that some who matured out of illegal drug use instead took up heavy drinking, in social and legal terms, a dependence easier to live with as an adult.

Remission rates looking forward

An acknowledged weakness of the featured report is that it asked respondents to recall changes which may have happened many years ago. However, the survey was repeated about three years later when 87% of the people who still qualified for the survey were re-interviewed. The follow-up offered an opportunity to see how many dependent at the time of the first survey had recovered three years later. These analyses seem only to have been done for drinking, for which they confirm that most people cease to be dependent though most too continue to experience drink-related problems and to sometimes drink heavily, and remain vulnerable to relapse. This average impression results from the pooling of dramatically different trajectories, from older multiply problematic alcoholics who usually do not remit despite treatment, to youngsters who generally quickly remit without formal help. Details below.

Among the re-interviewed sample were 1172 of the 1484 people who had been dependent on alcohol in the year before the first interview three years before. Nearly two thirds were longer dependent in the year before the follow-up interview. So complete was their recovery that a fifth of those previously dependent had in the past year experienced no indications of abuse or dependence; of these, three quarters were still drinking. About 11% not only had no symptoms, but were exclusively drinking within low-risk guidelines, evenly split between those drinking moderately and those not drinking at all.

But this broad-brush picture hid substantial variation in the fates of different types of dependent drinkers. At one extreme were the most severely affected drinkers with multiple psychological problems and on average about nine years of dependence behind them, two thirds of whom were still dependent at the second interview. At the other were young adults and older drinkers with few complicating psychological disorders and few years of dependent drinking. For most of these the dip in to dependence was a phase which (at least for time being) was over by the the second interview, when just under 30% were still dependent.

At least for the three years between the surveys, remission was very stable. Among the re-interviewed sample were 1772 of the 2109 who three years before had been in “full remission” from past dependence on alcohol, meaning that even though they may sometimes have drunk above low-risk guidelines, for the past 12 months they had reported no symptoms of alcohol abuse or dependence. Of these just 5% had slipped back to being dependent in the year before the second interview, though a third who had been drinking above low-risk guidelines had re-experienced some symptoms of alcohol abuse or dependence. Most stable in their recovery were the abstainers, of whom just 1 in 50 experienced such symptoms. The much greater stability of recovery in abstainers and low-risk drinkers was confirmed when other factors had been taken in to account, but was not apparent among the younger adults in the sample.

Treatment’s impact

Few dependent drug users recover through treatment and fewer still dependent on alcohol – in theNESARC survey on which the featured analysis was based, of those no longer dependent on alcohol,just 24% had at any time been in any kind of treatment for their drinking problems. Over two thirds of those who achieved more complete forms of recovery also did so without treatment.

While this shows that in the USA, treatment is generally not needed to recover from substance dependence, treatment may still make recovery more likely. In respect of dependence on alcohol, one analysis of data from the NESARC survey was consistent with formal treatment promoting recovery characterised by abstinence or low-risk drinking and no symptoms of abuse or dependence, but another and perhaps more reliable analysis found no such association.

Both however found that when treatment had been accompanied by attendance at 12-step mutual aid groups, recovery was more likely – especially abstinent recovery. These analyses could not however disentangle the possible effects of the motivation and conditions which drive someone to seek help, from the effect of actually receiving that help. Complicating the picture is the fact in this survey, the most severely affected and multiply comorbid drinkers with many years of dependence behind them were far more likely to seek treatment than less severely affected types of dependent drinkers. Despite seeking help, they were by a large margin the ones most likely to still be dependent when the survey was repeated three years later.

What about heroin and other opiates?

A notable omission from the illicit drugs included in the featured report was heroin and other opiates. Fortunately these were the subject of the greatest number of relevant studies in another review of follow-up studies of remission from dependence on amphetamine, cannabis, cocaine or opiate-type drugs. It included only studies of general populations or people who entered treatment in the normal way rather than enrolling in treatment trials.

Across the ten studies relevant to opiate-type drugs, every year on average between 22% and 9% of people were either abstinent or no longer dependent; the higher figure is the average of the proportions remitted among people who could be followed up, while the lower estimate includes cases who could not be followed and assumes they are still dependent. Generally the subjects were patients in treatment. Based mainly on patients in treatment, corresponding figures for cocaine were between 14% and 5%. The single study (from the USA) of a general population sample of cocaine-dependent people found that 39% had remitted four years after initially surveyed. For cannabis, the estimate was 17% per annum based on general population surveys and assuming people not followed up were still dependent.

In accordance with the featured article, such figures imply that within 10 years most dependent users of these drugs will no longer be dependent and may have entirely ceased use.

Racial differences reflect socioeconomic status

An analysis of data from the NESARC survey showed that taking alcohol and other drugs together, the longer dependence careers of black versus white Americans was associated with their having less social and socioeconomic resources, signified by fewer being married and fewer having completed their schooling. Once these were taken in to account, racial differences were no longer significant. The implication is that it is not race as such which makes the difference, but the position black people tend to occupy in US society. Given the same disadvantages, white Americans has dependence careers just as extended as black Americans.

Diagnostic system affects remission rate

Much in this analysis depends on the definitions used in the survey. Specifically, the probability of remission equates to the probability that someone will for at least the past 12 months have dropped below experiencing three or more dependence symptoms together in respect of the same drug. From the same survey, it is known for alcohol that many will still be consuming heavily, experiencing symptoms of dependence such as withdrawal and compulsive use, and suffering poor physical and mental health (1 2). They may be remitted from their dependence, but not according to most understandings, ‘recovered’.

Had the line been drawn elsewhere, the chances of remission might have been substantially lower – for example, as commonly in NESARC reports on drinking (1 2 3 4), if remission had been defined as non-problem moderate use or abstinence.

The latest version of the DSM manual (DSM-5) softens this binary system by diagnosing a substance use disorder when at least two symptoms are present in the same 12 months, and rating this as moderate if there were two or three, severe if four or more. ‘Abuse’ and ‘dependence’ are now subsumed within this continuum. The change seems likely to bring many more less severely affected people under the same substance use disorder umbrella as the three-symptom population investigated by the featured analysis. Their remission rates too may differ.

It is also theoretically possible that ‘remission’ may partly reflect the lack of noticeable change or struggle as with the years dependence becomes more deeply embedded and dominant in one’s life, and the change processes probed by some diagnostic questions cease to be live issues – not a sign of recovery, but of the lack such a prospect and the narrowing of life to substance use. For example, having plateaued in their use levels, long-term dependent users may no longer (or not for the past 12 months) have found themselves needing to take more of the drug to feel the desired effects, or taking more than they intended. Perhaps too in the past they had tried unsuccessfully to stop using, or had at least persistently wanted to, but now no longer tried or even wanted to. Ensuring a steady supply of drink or drugs they made no attempt to interrupt would minimise experience of withdrawal. They may also have no important interests and activities left to sacrifice to their dependence – all among the symptoms used to diagnose dependence.

Some findings from NESARC are consistent with this possibility. In the three years between the first interview and the re-interview, the alcohol dependence symptoms which fell away most often and most consistently across different types of drinkers were “taking alcohol often in larger amounts or over a longer period than was intended”, “a persistent desire or unsuccessful efforts to cut down or control use”, and withdrawal.

Similarly, young adult dependent drinkers tend not to endorse the dependence symptom relating to inability to stop drinking or cut back, presumably because they have yet to try.

Related analyses

This data from the featured report has been reanalysed to show that for each of these drugs, the probability that someone would have ceased being dependent remained the same no matter how long ago they had first become dependent. For the author this falsified theories which assume that the longer it lasts, the deeper dependence becomes embedded in neural circuits or lifestyles.

The survey on which the featured article was based and other US national surveys were among those included in a synthesisof hundreds of studies of remission and recovery from substance use problems. This too concluded that “Recovery is not an aberration achieved by a small and morally enlightened minority of addicted people. If there is a natural developmental momentum within the course of [these] problems, it is toward remission and recovery”.

Last revised 24 October 2013. First uploaded 19 October 2013

Source: Probability and predictors of remission from life-time nicotine, alcohol, cannabis or cocaine dependence: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

Lopez-Quintero C., Hasin D.S., Pérez de los Cobos J. et al.
Addiction: 2011, 106(3), p. 657–669.

Filed under: Alcohol,Cannabis/Marijuana,Cocaine,Effects of Drugs,Nicotine,Treatment and Addiction,USA :

A speaker at yesterday’s drugs conference has accused its organisers of being biased in favour of those who want to legalise all drugs.

Speaking at Homerton College yesterday, Neil McKeganey told those at the Home Affairs Select Committee’s drugs conference that too many of the selected speakers were those who wanted to push forward drug law reform. Mr McKeganey, of the centre for drug misuse research, asserted the conference programme was “overwhelmingly skewed” in favour of those who hope to see drugs legalised, particularly for medicinal purposes.

He said: “Their programme is so overwhelmingly skewed in favour of those in favourof drug law reform it has to be a fundamental compromise of that principle of the select committee.

“There’s no way with any justification whatsoever that the range of speakers overwhelmingly in favour of legalisation should stand as a contribution of the select committee’s discussion of drug misuse. The case for drug policy reform is based on the drug laws having failed. In actual fact drug policies in the UK have not failed.

“We have witnessed the most substantial reduction in the prevalence of illegal drug use since records began. The statistics here are very clear. It’s completely dishonest to present that situation as indicative of government failure.”

Mr McKeganey continued that it was “preposterous” to suggest that existing drug policies were doing more harm than illegal drugs themselves. He added: “It is said it is more effective to set up a regulated market. That is said by people who are not considering the evidence of the impact of a regulated market.

“How on earth do you propose to regulate an unregulated market? There will still be illegal suppliers of drugs – how do you propose to regulate those individuals?”

However opinion at the drugs conference remained divided, with several speakers giving whole-hearted support to drug law reform. The safety of drug users was one of the key reasons cited, with claims that regulating drug use would help prevent people from taking drugs which had been mixed with harmful cutting agents.

Health problems are also caused by cutting agents used to make the drug more profitable – including levamisole used to worm sheep – which can lower blood cell numbers and phenacetin which can cause kidney problems.

Imperial College London academic Prof David Nutt, who is also the chair and founder of the Independent Scientific Committee on Drugs, was one of those who spoke out in favour of drug law reform. Prof Nutt told the conference that almost everything which had been done in the past 30 years to tackle drugs had led to greater problems.

He said: “Prohibition of cannabis has driven us into much more dangerous drugs.

“It’s the same with MDMA. The prohibition of MDMA has led to the massive rise in deaths from PMA. The perverse consequences of the laws must be taken account of. You cannot think there is a simple solution.

“I am very sympathetic to the idea of recovery but the abstinence recovery programme will lead to more deaths. A policy which focuses simply on reducing use but does not take account of deaths is missing the key element of drugs policy.”

Sarah Graham, an addictions therapist and member of the advisory council on the misuse of drugs, also lent her support to the government regulating drugs. Ms Graham said she agreed with the argument that drug users should not be criminalised.

The support for drug law reform comes after the Advisory Council on the Misuse of Drugs in a report into the use of powdered cocaine in the UK and its impacts on society.

The report suggests powdered cocaine use remains most common among 20 to 29-year-olds.

Source: http://www.cambridge-news.co.uk/Cambridge-drugs-conference-accused-8216/story-26163142-detail/story.html#LvCZKJOoxrosfdYp.99

Filed under: Alcohol,Cannabis/Marijuana,Europe,Global Drug Legalisation Efforts,Legal Sector :

The main points are that it seems to target teens and college students and could easily be abused by underage persons. Powdered alcohol comes in packets and can be hidden from parents and  teachers, and sneaked into homes, schools, parties, bars, etc. The product may be abused by making it with less liquid (concentrating the alcohol), possibly snorting it. Underage drinking prevention is the main concern. Senator Flores is sponsoring senate bill 536 which would ban Palcohol/ powdered alcohol. Several other states have already banned it. AG Pam Bondi wants it banned.

The makers of powdered alcohol, Palcohol, say it will be available for sale soon, but several states are already moving to ban the product. So far, Alaska, Delaware, Louisiana, South Carolina and Vermont have banned Palcohol – even though it is not yet available – and Florida, New York, Virginia and several other states are also considering a ban. Florida Attorney General Pam Bondi publicly announced that prohibiting the product is one of her legislative priorities this year. Bondi said, “We want to flat-out ban it in our state.”

Palcohol is powdered alcohol, developed by Mark Phillips. Phillips said he wanted a “refreshing adult beverage” after engaging in activities such as biking or kayaking, where carrying large bottles of alcohol was not possible. He then spearheaded the creation of powdered alcohol. The product is available either in V powder, which is quadruple-distilled vodka, or R powder, which is premium Puerto Rican rum. Simply add water to the powder and you have an alcoholic beverage.

According to the Palcohol website, Palcohol will be sold in one ounce packages that contain the equivalent of one shot of alcohol each. Each bag is about 80 calories and is gluten-free. The website also notes that Palcohol is “for the legitimate and responsible enjoyment by lawful consumers.” The website explains it can be used by “outdoors enthusiasts such as campers, hikers and others who wanted to enjoy adult beverages responsibly without having the undue burden of carrying heavy bottles of liquid.” Or “adult travlers journeying to destinations far from home could conveniently and lawfully carry their favorite cocktail in powder format.”

Phillips is known in the wine community for producing and hosting the television show, “Enjoying Wine with Mark Phillips” and his book, “Swallow This: The Progressive Approach to Wine.” He also served as a wine expert to the Smithsonian.
However, Palcohol has faced difficulty almost from the beginning. Last April, the Alcohol and Tobacco Tax and Trade Bureau approved the product. However, 13 days later, it rescinded its approval and said it had issued the approval “in error.” The TTB announced, “Those label approvals were issued in error and have since been surrendered.”

As soon as the product hit the media headlines, criticism exploded over the possibility of minors gaining access to the product and users snorting the powdered alcohol. Palcohol dismisses these concerns and counters them on its web site. It notes that snorting the product is “painful” and “impractical…It takes approximately 60 minutes to snort the equivalent of one shot of vodka. Why would anyone do that when they can do a shot of liquid vodka in two seconds?”

The company also says it is not easier to “sneak into venues” and because it does not dissolve instantly, it can’t be used to spike a drink. Finally, the company says kids will not have easier access to powdered alcohol than to regular alcohol.
Unfortunately, however, early versions of the Palcohol web site did not help its cause. SB Nation reported that Palcohol’s website originally included the following wording:
Let’s talk about the elephant in the room….snorting Palcohol. Yes, you can snort it. And you’ll get drunk almost instantly because the alcohol will be absorbed so quickly in your nose. Good idea? No. It will mess you up. Use Palcohol responsibly.
Palcohol subsequently removed that wording and explained, “There was a page visible on this site where we were experimenting with some humorous and edgy verbiage about Palcohol. It was not meant to be our final presentation of Palcohol.”
Despite the controversy, the company says it will be available this Spring. It also is planning to introduce powdered cocktails, including Cosmopolitan, Mojito, and “Powderita,” which it says takes like a Margarita, and Lemon Drop.
However, so far, it is unclear where exactly you will be able to buy it.

Source: http://www.commdiginews.com/life/controversy-brews-over-powdered-alcohol-34291/ January 31, 2015

Filed under: Alcohol,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Health,Synthetics,USA :

In 1990s Britain a common reaction to allocating resources to treating cannabis users was, ‘Why bother? We have more than enough patients with problems with serious drugs like heroin.’ Calls for a treatment response were seen as pathologising what in many societies is both normal and in some ways desirable youth development: trying new experiences, challenging conventions, exposing the hypocrisy of alcohol-drinking adults. The typically calming use of the drug by adults was seen as preferable to the main alternative, alcohol and its associated violence and disorder.

Those views retain some validity for the vast majority of cannabis users, but this has become, and/or become seen more clearly as, a drug with a problem tail which justifies therapeutic intervention. As heroin use and treatment numbers fall way, cannabis treatment numbers are on the rise – not, according to Public Health England, because more people are using the drug, but perhaps because services relieved of some of the recent pressure of opiate user numbers are giving more priority to cannabis, because they are making themselves more amenable to cannabis users, and because stronger strains of the drug are creating more problems.

Cannabis accounts for half of all new drug treatment patients

Whatever the causes, across the UK figures submitted to the European drug misuse monitoring centre show that the proportion of patients starting treatment for drug problems who did so primarily due to their cannabis use rose steadily from 11% in 2003/04 to 27% in 2013, that year amounting to about 27,270 individuals. Among first ever treatment presentations, the increase was more pronounced, from 19% to 49%, meaning that by 2013 their cannabis use had became the main prompt for half the patients who sought treatment for the first time  chart right. Showing that more users was not the reason for more starting treatment, over about the same period, in England and Wales the proportion of 16–59-year-olds who in a survey said that had used cannabis in the past year fell from about 11% to about 7% in 2013/14, having hovered at 6–7% since 2009/10.

The treatment figures largely reflect trends in England, where in 2013/14 the number of patients starting treatment due primarily to their cannabis use had continued to rise to 11,821, 17% of all treatment starters, up from around 7,500 and 9% just seven years before. The greater ‘stickiness’ of opiate use meant that in the total treatment population – new and continuing – the proportionate trends were less steep, cannabis numbers rising from around 11,000 in 2005/06 to 17,229 in 2013/14, and in proportion from 6% to 9%. Among younger adults, cannabis dominates; in 2013/14, far more 18–24s started treatment for cannabis than for opiate use problems – 5,039 versus 3,142 – and they constituted 43% of all treatment starters.

Further down the age range, among under-18s in treatment in England, cannabis is even more dominant. In 2013/14, of the 19,126 young people who received help for alcohol or drug problems, 13,659 or 71% did so mainly in relation to cannabis, continuing the generally upward trend since 2005/06.

Though the crime reduction justification for treating adult heroin and crack users is not so clear among young cannabis users, still immediate impacts plus the longer term benefits of forestalling further problems has been calculated to more than justify the costs of treating under-18 patients, among whom cannabis is the major player.

Cannabis users rarely stay in long-term treatment

Relative to the main legal drugs, at least in the USA dependence on cannabis is more quickly overcome. A survey of the US general adult population found that within a year of first becoming dependent, 3% each of smokers and drinkers were in remission and remained so until they were surveyed. For cannabis the figure was nearly 5% and for cocaine, nearly 9%. After ten years the proportions in remission had risen to 18% for nicotine, 37% for alcohol, 66% for cannabis and 76% for cocaine  chart right. About 26 years after first becoming dependent, half the people at some time dependent on nicotine were in remission, a milestone reached for alcohol after 14 years, for cannabis six years, and for cocaine, five.

Unlike heroin users, regular users of cannabis have been seen as sufficiently amenable to intervention to warrant trying brief interventions along the lines established for risky but not dependent drinkers, and sufficiently numerous in some countries to make routine screening in general medical and other settings a worthwhile way of identifying problem users. When the World Health Organization trialled its ASSIST substance use screening and brief advice programme in Australia, India, the United States and Brazil, just over half the identified patients (all had to be at moderate risk of harm but probably not dependent) were primarily problem cannabis users. Among these, risk reduction in relation to this drug was significantly greater among patients allocated to a brief advice session than among those placed on a three-month waiting list for advice. In each country too, risk reduction was greater among intervention patients, except for the USA, where the order was reversed. Suggesting that severity of use was not a barrier to reacting well to brief intervention, only patients at the higher end of the moderate risk spectrum further reduced their cannabis use/risk scores following intervention. The ASSIST study was confined to adults, but young people in secondary schools in the USA whose problem substance use focused mainly on cannabis also reacted well to brief advice.

In some studies brief interventions have been found to work just as well as more intensive treatment, but when the patients are heavily dependent, and the most difficult cases are not filtered out by the research, longer and more individualised therapies can have the advantage. These studies on adults might not translate to adolescents, for whom approaches which address family, school and other factors in the child’s environment are considered most appropriate for what are often multiply troubled youngsters.

The relative persistence of opiate use problems and transitory nature of those primarily related to cannabis seemed reflected in an analysis of treatment entrants in England from 1 April 2005 to the end of 2013/14. At the end of this period just 7% of primary cannabis users were still in or back in treatment compared to the 30% overall figure and 36% for primary opiate users. The figure peaked at 43% for users of opiates and crack. Over half – 53% – of primary cannabis users had left treatment as planned, apparently having overcome their cannabis problems, compared to 27% of primary opiate users and just 20% with dual opiates and crack use problems. Another 40% of cannabis users had left treatment in an unplanned manner not having overcome their dependence, a slightly higher proportion than among opiate users. The figures tell a tale of relatively high level of success which enables cannabis users to leave treatment, though even in the absence of recorded success, few stay long-term.

However, the forms patients in England complete with their keyworkers while in treatment seem to tell a different story. Compared to how they started treatment, around six months later 45% of primary cannabis users were assessed as using just as often (including a few using more), compared to 29% of opiate users and 38% whose main problem drugs were both opiates and crack, suggesting more rapid and/or more complete remission for opiate users than for cannabis users. One interpretation is that the widespread use of substitute drugs like methadone more reliably reduced the illegal opiate use of opiate users and also helped retain them in treatment, while cannabis users tended quickly to leave treatment, having done well or not. However, these figures relate only to patients who completed the forms at their six-month review, which in practice could have happened anywhere from about one to six months after their assessment for treatment. What proportion of primary cannabis users were still in treatment at that point and available to complete the forms is not clear, but they may have been the patients whose problems were deep seated enough to require extended treatment.

These are some of the issues thrown up by a set of patients and a set of interventions rather different from those associated with the drugs treatment in the UK has normally focused on. If current trends continue, understanding the findings of these and other studies will become yet more important to British treatment services.

Source: www.findings.org.uk 03 March 2015

Filed under: Alcohol,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Effects of Drugs,Europe,Treatment and Addiction :

Christopher Lapish, Ph.D. (left) and Alexey Kuznetsov, Ph.D. of the School of Science at Indiana University-Purdue University study how alcohol hijacks the brain’s reward system. Credit: School of Science at IUPUIWith the support of a $545,000 three-year grant from the National Institute on Alcohol Abuse and Alcoholism, researchers from the School of Science at Indiana University-Purdue University Indianapolis are conducting research on how the brain’s reward system—the circuitry that helps regulate the body’s ability to feel pleasure—is hijacked by alcohol.

Scientists have only a rudimentary understanding of how alcohol affects neurons in the brain. It is known that, as any addictive drug, alcohol directly or indirectly acts on a specific population of brain cells, called dopamine neurons. Through this action, the neurotransmitter dopamine is released, which evokes feelings of pleasure. However, the biological mechanisms of how alcohol evokes dopamine release have not been determined; exploring this question is the major goal of the grant.

The synergistic approach of the IUPUI researchers—biomathematician Alexey Kuznetsov, Ph.D., associate professor of mathematical sciences, and neuroscientist Christopher Lapish, Ph.D., assistant professor of psychology—is novel as they marry the cutting-edge tools of mathematical modeling developed by Kuznetsov and the sophisticated experimental neuroscience experiments designed and conducted by Lapish to study the electrical properties that determine the release of the neurotransmitter dopamine in the brain. As a starting point, they are focusing on the brain’s initial exposure to alcohol.

Kuznetsov has developed unique mathematical models as he homes in on why and how much dopamine is released when alcohol is consumed. With the same goal, Lapish is employing sophisticated tools and methods to measure and analyze electrical signals of dopamine neurons in rats. This synergy forms a two-way street with data from the recordings of the electrical impulses of the rat brains affecting how the mathematical models are constructed and the predictions generated by the mathematical models informing the study of the animal brains.

IUPUI undergraduates and graduate students are assisting the investigators in their work.

“Our mathematical models go much further than simple logic,” Kuznetsov said. “What we are learning from experiments is critical. The direct connection of modeling and experiments enables us to test and refine our hypotheses.”

“As we begin our second year on this project we are gaining a better understanding of how the brain responds to alcohol,” Lapish said. “The cross talk between us drives this hypothesis-driven research. There are many unknowns to explore and interpret.”

The IUPUI researchers are also collaborating with French scientists. “We are working on the problem at different levels—we are modeling and studying the brains of live rodents—in vivo work—and they [the French researchers] are studying in vitro brain slices in the lab,” Kuznetsov added.

“Alcohol addiction is among America’s largest public health concerns yet we know far less about it than most other addictions. If we are going to successfully treat alcohol addiction we need to begin with the basics and understand how alcohol directly acts on dopamine neurons in both the alcoholic and normal brain,” Lapish said.

Provided by Indiana University-Purdue University Indianapolis School of Science

Source: http://phys.org/wire-news/187100819 6th March 2015

Filed under: Addiction,Alcohol,Brain and Behaviour,Health,USA :

A study published Wednesday found that consuming large flavored alcoholic beverages can increase risk for binge drinking and related alcohol injuries for underage drinkers. PHOTO BY EMILY ZABOSKI/DAILY FREE PRESS STAFF

Super-sized flavored alcoholic beverages can increase the risk of binge drinking and alcohol-related injuries for underage drinkers, researchers from Johns Hopkins University and Boston University found in a study, a Wednesday press release stated.

The study, published in the American Journal of Public Health on Feb. 25, found that underage drinkers who reported consuming malts, premixed cocktails and alcopops drank more on average and were more likely to experience “episodic heavy drinking,” the report stated. About 1,000 people ages 13 to 20 were surveyed online.

David Jernigan, an author of the study and director of the Center on Alcohol Marketing at Johns Hopkins, said heavier drinking occurs with these flavored beverages because of the serving sizes. Most of these beverages hold the equivalent of 4 to 5 beers in one container, he said.

“We particularly found the correlations between the largest size of these drinks and negative behaviors because one of these super-sized drinks is the equivalent of four to five beers,” he said. “Even though the can may have serving size though most don’t, teens are treating them as a single serving. Some people in the field call it a binge in a can.”

Study co-author Alison Albers, a professor in BU’s School of Public Health, said the study brings up important issues and will help determine future policies.

“These findings raise important concerns about the popularity and use of flavored alcoholic beverages among young people, particularly for the supersized varieties,” she said in the release. “Public health practitioners and policymakers would be wise to consider what further steps could be taken to keep these beverages out of the hands of youth.”

Jernigan said careful packaging should be implemented in the production of super-sized beverages.

“The re-sealable top is more of a joke,” he said. “These are being treated as a single serving, and the results suggest this may be a dangerous form of packaging.”

Katharine Mooney, director of Wellness and Prevention Services at BU, said the university takes steps to prevent the overconsumption of alcohol.

“We discourage against any kind of risky behavior, and these oversized sugar sweetened beverages definitely all into the category of risky,” she said. “[It’s] just like a punch bowl at a party.”

Mooney said because the drinks do not taste entirely like alcohol, it is difficult to determine how much alcohol is in them, which often leads to over drinking. Over drinking can affect students’ physical, social and academic wellbeing.

The Boston University Police Department has noted that the number of alcohol violations and transports for the spring 2015 semester has increased compared to numbers from the spring 2014 semester, The Daily Free Press reported Thursday.

Mooney said BU Student Health Services tries to do whatever possible to inform students about the dangers of binge drinking and learn how to drink in a less dangerous way.

“One of the things we work really hard to educate students about our standard drink portion. A standard beer has the same alcohol content as one shot,” she said. “A student needs to be particularly aware of what they are consuming when drinking these so that they don’t drink more than they intend to.”

Several students said they recognize how super-sized flavored drinks can be risky.

Brock Guzman, a freshman in the College of Engineering, said the drinks are popular because of their cheap prices, and because some items contain caffeine, young drinkers find them even more appealing.

“It’s appealing because you can get really drunk and you stay awake,” he said. “They have caffeine in them and don’t really taste like alcohol.”

Sergio Araujo, a junior in Metropolitan College, said he has seen a friend in a dangerous scenario after consuming Four Loko, a popular super-sized alcoholic beverage. Though Four Loko’s contents used to include caffeine, the company chose to remove caffeine from their product in 2010.

“One guy I know drank them a lot, and he left a party alone, then he got lost in a snowstorm and was too drunk to find his way home,” he said. “He almost had to sleep in the snow.”

Jaqui Manning, a freshman in the College of General Studies, said she has seen firsthand the consequences when others drink the types of alcoholic beverages described in the study, as well as the products that contain caffeine.

“I’ve heard a lot of people have had really bad experiences with them,” she said. “Especially drinking them really fast is really dangerous because not only is there alcohol, but there is so much sugar and caffeine that goes into it, and your body sometimes can’t handle it.”

Source: http://dailyfreepress.com/flavored-alcohol 6th March 2015

Filed under: Addiction,Alcohol,Environment,Health,USA,Youth :

A lot of times, a simple “no thanks” may be enough. But sometimes it’s not. It can get intense, especially if the people who want you to join in on a bad idea feel judged. If you’re all being “stupid” together, then they feel less self-conscious and don’t need to take all the responsibility.

But knowing they are just trying to save face doesn’t end the pressure, so here are a few tips that may come in handy.

1. Offer to be the designated driver. Get your friends home safely, and everyone will be glad you didn’t drink or take drugs.

2. If you’re on a sports team, you can say you are staying healthy to maximize your athletic performance—besides, no one would argue that a hangover would help you play your best.

3. “I have to [study for a big test / go to a concert / visit my grandmother / babysit / march in a parade, etc.]. I can’t do that after a night of drinking/drugs.”

4. Keep a bottled drink like a soda or iced tea with you to drink at parties. People will be less likely to pressure you to drink alcohol if you’re already drinking something. If they still offer you something, just say “I’m covered.”

5. Find something to do so that you look busy. Get up and dance. Offer to DJ.

6. When all else fails…blame your parents. They won’t mind! Explain that your parents are really strict, or that they will check up on you when you get home.

If your friends aren’t having it—then it’s a good time to find the door. Nobody wants to leave the party or their friends, but if your friends won’t let you party without drugs, then it’s not going to be fun for you.

Sometimes these situations totally surprise us. But sometimes we know that the party we are going to has alcohol or that people plan to do drugs at a concert. These are the times when asking yourself what you could do differently is key to not having to go through this weekend after weekend.

Source: www.teens.drugabuse.gov March 9th 2015

Filed under: Addiction,Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth,Health :

Teens Affected by Addiction is a project aimed at raising awareness about the impact of alcoholism on families – here, they share some personal stories.

Here, four people who grew up with an alcoholic parent share their stories. These stories have been collected by ‘Teens Affected by Addiction’, a Young Social Innovators project from Mount Mercy College in Cork, Ireland, with the aim of raising awareness about how addiction impacts children.

“I will never get my childhood back”

“My life as a child of an alcoholic parent was frightening and lonely. My dad was a chronic alcoholic. I had a different childhood to all my friends: no birthday parties, couldn’t invite friends over to the house, and Christmas was a nightmare.

There was no one I could talk to and no one could help me, I just had to put up with it.

When I was 17 I had no choice but to leave home. I had to live my own life. My mother was heartbroken but she knew I had to go.

When I was 18, I was able to get counselling which was a great help to me. I was able to understand that alcoholism was an illness. A few months after leaving home my dad turned his life around and stopped drinking.

I will never get my childhood back but I now have a great relationship with my father and my mother now has the life she deserves. I hope this story can give other children some hope and let them know that there is a light at the end of the tunnel.”

*******

“Missing you”

The following is a short poem a woman sent to us about her father’s alcoholism.

I don’t miss the sense of invisibility to you,

I don’t miss listening constantly for the front door,
I don’t miss watching your face to decipher your mood,
I don’t miss dodging your verbal assaults,
I don’t miss the sense of being so small,
I don’t miss the enormity of you and your drink,
I don’t miss the deep shame,
I don’t miss everyone covering up for you,
I don’t miss everyone knowing but me,
I don’t miss the smell of drink,
I don’t miss the fear of drink,
I don’t miss my friends knowing,
I don’t miss no-one caring about me,
I don’t miss fear,
I don’t miss loving you,
I don’t miss hating you,
I don’t miss you.

*******

“We had food in the house but it wasn’t for us – it was for the social worker to see.”

“My alcoholic parent was my mother. She always drank. She started when she was young. When she was a child her father abused her and her brothers. They were battered by their father constantly. They locked their doors every night to keep their father out. She was beaten badly and was always expected to act like a lady. She started drinking to forget the pain she had to go through. This doesn’t make what she did to her children any bit forgivable.

When I was a child my uncle and aunts tried to take me away from my home by taking me on day trips with my sister. Back then I thought my mother would heal. My sister and I used to beg my uncle and aunts to bring us home so we could mind our mother. We didn’t want to upset her by being away for too long. One of my uncles was like a father to me. His oldest daughter and I look like brother and sister. We are just as close too. They tried to help me and give me a better life but they couldn’t.

My mom had a lot of ‘boyfriends’. They never really stayed too long. A small few used to beat me. These men were constantly in our house so we never really questioned a strange man in our house. It was normal for us.

At 15 years old I would come home from school and meet up with my mother and grandmother in the pub. My mother would buy me beer and I would sit in the pub with my drunken mother and help her get home. My home was filthy. There used to be dogs running through the house constantly and the house was never cleaned. We had food but it wasn’t for us. The food was perfect but we were not allowed eat it as it was only for when the social workers called so it would look like she was feeding us. In reality we were starving.

I started hanging out with a very rough group where I lived. They were drinking constantly and doing drugs. Eventually, I got away from them and my mother. I ran from Ireland at 16 to the States to my father. My sister was so upset with me for leaving her with my mother back in Ireland.

Now I’m living in America with a beautiful wife and three amazing children. Sometimes what happened still affects me but I try to block it out and ignore it and carry on. I’m honestly not recommending running away. I am planning on coming back to Ireland soon to sort out a few things with my mother.

*******

“I’ve never not known Mum to have her cans by her chair and her vodka stashed away under the bed”

Well to begin with there’s a common misconception that men are generally the alcoholics in a family but when it’s the mother, the nucleus of the family is destroyed and everything falling apart becomes an inevitable fate. I come from a small family with it just being my mum, dad and my brother and I. We’ve been battling with my mother’s alcoholism for as long as I remember, I’ve never not know her to have her cans by her chair and her vodka stashed away under the bed. It wasn’t that I always saw it as the norm but when you don’t know any different it does tend to be a bit more difficult to imagine the situation differently. I’m actually very happy to see the back of 2014 as from December 2013 my whole family spiralled out of control and I spent more times in hospital than anywhere else. My parents split in December 2013 after 21 years married (I am 20 years old) my mum’s alcoholism was at its peak. Having been in and out of hospital for the past six years due to liver failure, she was on a path to destruction. In those months, mum had fallen whilst drunk and tried to hit my father with a golf club and broke her femur. She had several serious operations and she nearly died as her blood is extremely thin due to medication and alcoholism. Mum came out of hospital and continued to drink and began running around saying that she was fine and could walk. She fell hundreds of times and it became so bad she now can’t walk properly. I live with my grandmother, having left school at 17 as I suffered from depression and I went back to do my Leaving Cert and moved out of my home. Within months a series of events led to both my father and brother leaving and moving into an apartment and my mum was left wallowing in her drunken states ringing and abusing everybody (she still does this).I contacted the HSE in January 2014 with several emails sent to all organisations that support victims of alcoholism, I got a lot of reaction. I was furious that I spent years sitting in my mothers’ doctor’s surgery with my dad begging for ways out. They would always look at us helplessly and say “move out”. I felt embarrassed and as if there were no light at the end of the tunnel. My grandmother who I live with and who’s been a mother to me all my life has had a nervous breakdown and right now I spend my days working eight hour shifts as a photographer in a studio and then I go home to this mess.

My mum has been in hospital about eight times since February 2014 when a stomach ulcer burst and she was found in a pool of blood by my grandmother. I soon lost faith but I always tried to get help; my letter to the HSE got me six months with a councillor but I was so busy with my Leaving Cert and everything I just couldn’t find time to go.

Now I am still living with this situation but I try my very best to overcome it every day and I refuse any kind of medication such as an “anti depressant” as I believe it’s just a easy way for doctors to dose people up and make money. I wish to study politics and history and possibly then business in university in the future and I hope that one day I can actually help people.

These stories are shared by ‘Teens Affected by Addiction’, a Young Social Innovators project from Mount Mercy College in Cork. The students have recently received funding from the YSI Den to publish a book with the stories of adults who grew up with an addict in the home.

Please see www.teensaffectedbyaddiction.com or email:  affectedbyaddictionysi@gmail.com if you would like to share your story.

Follow Teens Affected by Addiction on Twitter: @affbyaddiction

Source: www.thejournal.ie March 2015

Filed under: Addiction,Alcohol,Drug use-various effects on foetus, babies, children and youth,Europe,Parents :

Excessive alcohol consumption is a leading cause of premature death in the U.S. and responsible for one in every 10 deaths. The statistics that describe the ways in which we drink ourselves to death are staggering. A study published in the journal Preventing Chronic Disease found that nearly 70% of deaths due to excessive drinking involved working-age adults. The study also found that about 5% of the deaths involved people younger than age 21. Moreover, excessive alcohol use shortened the lives of those who died by about 30 years. Yes, 30 years.

One strong factor that reinforces the popular culture surrounding drinking is the glamour of advertising. Researchers at the Johns Hopkins Bloomberg School of Public Health examined alcohol-advertising placements to determine whether the alcohol industry had kept its word to refrain from advertising targeting young people. This included television programs for which more than 30% of the viewing audience is likely to be younger than 21 years, the legal drinking age in every state.

The study found that alcohol related advertising increased by 71% in the last decade; this is largely attributed to exposure on cable television. That increase coincided with a reported upsurge of alcohol consumption by high school students. In conclusion, the study suggested that if the National Research Council/Institute of Medicine’s proposed threshold of 15% exposure to advertising was implemented, young viewers would see 54% fewer alcohol ads and society would see a correlating decrease in alcohol related deaths.

What about those “drink responsibly” admonitions on so many commercials? Federal regulations do not require responsibility statements in alcohol advertising. The alcohol industry’s voluntary codes for marketing and promotion emphasize responsibility, but they provide no definition for responsible drinking. So when you see the admonition to “drink responsibly” at the end of an alcohol-related television commercial, there is no idea given as to exactly what that may mean, particularly to someone under the legal drinking age.

David Jernigan, PhD, director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health said:

“The contradiction between appearing to promote responsible drinking and the actual use of ‘drink responsibly’ messages to reinforce product promotion suggests that these messages can be deceptive and misleading.”

Youth who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 years according to the Centers for Disease Control and Prevention.

Alcohol advertising influences many people across a wide range of demographics. Regardless of the warning labels on alcohol containers, community prevention programs and general public knowledge of the risks of excessive alcohol consumption, people continue to drink in health-damaging ways. Drinking in public, at sporting events, in parks, during celebrations, etc., is firmly embedded in society as acceptable behavior. At the same time, the large number of alcohol related deaths among all age groups is a concern, especially when this drinking behavior is generally developed while individuals are underage.

Alcohol use is a major public health problem that can lead to social, financial, and health related setbacks and premature death. Talk to health care professional if you or someone close to you is struggling with excessive alcohol consumption.

Source: www.psychcentral.com/science-addiction/2014/10

Filed under: Addiction,Alcohol,Drug use-various effects,Health,USA,Youth :

The polarized legalization debate leads to exaggerated claims and denials about pot’s potential harms. The truth lies in between.

Pretty much everyone who has spent time smoking marijuana knows at least one diehard stoner. The guy whose eyes are always red, the girl who doesn’t use the term “wake and bake” ironically, the person who just can’t seem to ever get it together. These heavy smokers might work at a low-level job or they may be unemployed—but everyone who knows them well knows that they are capable of much more, if only they had any ambition.

Is this really addiction? I believe that it is (and I don’t think that’s an argument against legalization). In fact, the reasons why marijuana is addictive elucidate the true nature of addiction itself. Addiction is a relationship between a person and a substance or activity; addictiveness is not a simple matter of a drug “hijacking the brain.” In fact, with all potentially addictive experiences, only a minority of those who try them get hooked—and people can even become addicted to apparently “nonaddictive” things, like carrots. Addiction depends on learning, context and psychology, not just neurotransmitters.

With two states having already legalized recreational marijuana use and several more considering doing so, understanding the nature of addiction is more important than ever. Partisans on both sides of the debate have made extreme claims here; some legalizers saying there’s no such thing as marijuana addiction, while some prohibitionists claim “cannabis as addictive as heroin.”

Our concepts of addiction, however, come primarily from cultural experience with alcohol, heroin and, later, cocaine. No one has ever argued that opioids like heroin don’t have the potential to cause addiction because the withdrawal symptoms—vomiting, shaking, pallor, sweating and diarrhea—are objectively measurable. Opioids cause physical dependence that is evident when they become unavailable. The same is true for alcohol, where withdrawal is even more severe and can sometimes even be deadly.

So early researchers focused on these measurable symptoms related to alcoholism and opioid addictions in defining addiction: Using a drug could lead to becoming tolerant to it, tolerance could lead to dose escalation, which could in turn lead to physical dependence, and then the addiction could be driven by the need to avoid the painful symptoms of withdrawal. It was simple and physical.

In this view, however, cocaine and marijuana were not “really” addictive. While people can experience withdrawal symptoms like irritability, depression, craving and sleep problems when quitting these drugs, these are much more subjective and therefore can be dismissed as “psychological” rather than physical. You might really want coke or pot, but you didn’t need it like a real junkie, the thinking went.

And since most of us like to believe that we have much more control over our minds than we do over physical symptoms, “psychological” addiction is seen as far less serious than the “physical” type. It’s the remnants of this kind of thinking that mainly underlie the idea that marijuana addiction doesn’t exist. Unfortunately, that view of addiction is stuck in the 1970s.

In the 1980s—ironically, not long after Scientific American caused a big controversy by arguing that snorted cocaine is no more addictive than eating potato chips—entrepreneurs began marketing a ready-made smokeable form of the drug. The birth of crack shattered the idea that “physical” dependence is more serious than psychological dependence because people with cocaine addictions don’t vomit or have diarrhea when they quit; while they may appear desperate, it’s not in the physically obvious way of heroin or alcohol withdrawal. And so, if you are going to argue that marijuana is not addictive because you don’t get sick when you quit, you also have to argue the same for crack.

In the 1970s view, cocaine and marijuana were not “really” addictive: You might really want coke or pot, but you didn’t need it like a real junkie, the thinking went.

Good luck with that one, I say. Clearly, crack-addicted people are every bit as compulsive as those with heroin problems—and their criminal involvement if they can’t afford the drug is at least equally likely, though not as common as has been claimed. Crack dealt a deathblow to the “psychological” vs. “physical” distinction—and if it hadn’t, neuroscience was creeping up to show that the psychological and the physical aren’t exactly distinct anyway.

In the ‘70s and ‘80s, researchers also began recognizing that simply detoxing heroin addicts—getting them through the two-week period of intense physical withdrawal symptoms—is not effective treatment. If heroin addiction was driven primarily by the need to avoid withdrawal, addicted people should be out of the woods after they complete cold turkey. But as those of us who have been through it know, that is far from the hardest part.

While kicking heroin isn’t fun, staying off it in the long run is the problem—those “mere” psychological cravings are what drive addiction. Physical dependence isn’t the main problem; it isn’t even necessary. Indeed, we now know that you can actually have physical dependence without any addiction at all: There are some blood pressure medications, for example, that can have deadly withdrawal symptoms if not tapered properly, but people on these meds don’t crave them even though they are quite dependent. Similarly, antidepressants like Paxil have physical withdrawal symptoms, but because they don’t produce a high, you don’t see people robbing drug stores to get them.

So what is addiction, then, if tolerance, withdrawal and physical dependence aren’t essential to it? All of these facts point to one definition that can sum up the problem: Addiction is compulsive use of a substance or engagement in a behavior despite negative consequences. (Put more in neuroscience, addiction is a learned distortion in the brain’s motivational systems that make us persist in pursuing things linked to evolutionary fitness like food and sex.) Anything that causes pleasure via these systems—and that’s basically anything that is possible to enjoy—can be addictive to some person at some time. And that includes marijuana (and, for that matter potato chips).

This doesn’t mean that marijuana addiction is necessarily as severe as cocaine, heroin or alcohol addiction—in fact, it typically isn’t. If given the choice, most families would vociferously prefer having a member addicted to marijuana rather than to cocaine, heroin or alcohol. The negative consequences associated with marijuana addiction tend to be subtler: lost promotions, for example, rather than lostjobs; worse relationships, not no relationships. And of course, no risk of overdose death.

Marijuana addiction may quietly make your life worse without ever getting bad enough to seem worth addressing; it may not destroy your life but it may make you miss opportunities.

But this is also what can make it insidious. Marijuana addiction may quietly make your life worse without ever getting bad enough to seem worth addressing; it may not destroy your life but it may make you miss opportunities. With any pattern of regular drug use, it’s important to continually track whether the risks outweigh the benefits, keeping in mind that addiction itself may distort this calculation. This is especially true with marijuana.

However, as with all other drugs, only a minority of marijuana users ever struggle with addiction. Research suggests that about 10% get hooked—and on average, marijuana addiction lasts six years. Even more than other addictions, marijuana addiction seems to be driven by self-medication of mental health problems—90% of people with marijuana addiction also have another addiction or mental illness, typically alcoholism or antisocial personality disorder.

This suggests that exposing more of the population to marijuana won’t necessarily increase the addicted population. First, people with antisocial personality disorder, by definition, tend not to be law abiding, so most have probably already tried it. Second, the percent of people with other pre-existing mental illness will not change because marijuana becomes legal—in fact, in the UK, when they reversed their prior liberalization of marijuana law because of fears related to increased schizophrenia, psychosis rates actually went up. (The link probably wasn’t causal, but it does suggest that legal crackdowns on cannabis don’t prevent related psychosis).

If some people with alcohol, cocaine or heroin addiction switch to marijuana instead, overall harm would be reduced. As I and others have been reporting at least since 2001, using marijuana as an “exit” drug is a real phenomenon, both in cocaine and opioid addiction.

When we consider the risks of various substances, we tend to do so in isolation—but that’s not how choices are made in the real world. Most people would rather their partners have no addictions—but again, some are clearly worse than others. Marijuana craving is rarely as severe as crack craving, as is obvious.

Still, like anything that can be pleasurable, marijuana can be addictive. This doesn’t mean all addictions are the same or that it is as addictive as the currently legal drugs alcohol and tobacco—the data shows it is less so.

Pretending it can’t do any harm at all, however—or that there aren’t people who are addicted to it—does no one any good. If we want better drug policy, as with other types of recovery, we need to avoid denial.

Maia Szalavitz is one of the nation’s leading neuroscience and addiction journalists, and a columnist at Substance.com. She has contributed to Time, the New York Times, Scientific American Mind, the Washington Post and many other publications. She has also published five books, including Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006), and is currently finishing her sixth, Unbroken Brain, which examines why seeing addiction as a developmental or learning disorder can help us better understand, prevent and treat it. Her last column for Substance.com was about why the oft-documented fact that most people age, or grow, out of substance misuse is not common knowledge.

Source: www.substance.com 15^th October 2014

Filed under: Addiction,Alcohol,Cannabis/Marijuana,Cocaine,Drug use-various effects,Effects of Drugs,Health,Heroin/Methadone,Social Affairs,USA :

Moderate alcohol intake of at least 5 units every week is linked to poorer sperm quality in otherwise healthy young men, suggests research. And the higher the weekly tally of units, the worse the sperm quality seems to be, the findings indicate, prompting the researchers to suggest that young men should be advised to steer clear of habitual drinking.

They base their findings on 1221 Danish men between the ages of 18 and 28, all of whom underwent a medical examination to assess their fitness for military service, which is compulsory in Denmark, between 2008 and 2012.

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As part of their assessment, the military recruits were asked how much alcohol they drank in the week before their medical exam (recent drinking); whether this was typical (habitual); and how often they binge drank, defined as more than 5 units in one sitting, and had been drunk in the preceding month.

They were also invited to provide a semen sample to check on the quality of their sperm, and a blood sample to check on their levels of reproductive hormones.

The average number of units drunk in the preceding week was 11. Almost two thirds (64%) had binge drunk, while around six out of 10 (59%) said they had been drunk more than twice, during the preceding month.

The analysis showed that after taking account of various influential factors, there was no strong link between sperm quality and either recent alcohol consumption or binge drinking in the preceding month. But drinking alcohol in the preceding week was linked to changes in reproductive hormone levels, with the effects increasingly more noticeable the higher the tally of units.

Testosterone levels rose, while sex hormone binding globulin (SHBG) fell; similar associations were also evident for the number of times an individual had been drunk or had binge drunk in the preceding month. Almost half (45%, 553) of the men said that the quantity of alcohol they drank in the preceding week was typical of their weekly consumption.

And in this group the higher the tally of weekly units, the lower was the sperm quality, in terms of total sperm count and the proportion of sperm that were of normal size and shape, after taking account of influential factors. The effects were evident from 5+ units a week upwards, but most apparent among those who drank 25 or more units every week. And total sperm counts were 33% lower, and the proportion of normal-looking sperm 51% lower, among those knocking back 40 units a week compared with those drinking 1-5. Habitual drinking was associated with changes in reproductive hormone levels, although not as strongly as recent drinking, while abstinence was also linked to poorer sperm quality.

This is an observational study, so no definitive conclusions can be drawn about cause and effect. And the researchers point out that the findings could be the result of reverse causation — whereby men with poor quality sperm have an unhealthier lifestyle and behaviours to start with. But animal studies suggest that alcohol may have a direct impact on sperm quality, they say.

“This is, to our knowledge, the first study among healthy young men with detailed information on alcohol intake, and given the fact that young men in the western world [drink a lot], this is of public health concern, and could be a contributing factor to the low sperm count reported among [them],” they suggest.

And they conclude: “It remains to be seen whether semen quality is restored if alcohol intake is reduced, but young men should be advised that high habitual alcohol intake may affect not only their general health, but also their reproductive health.”

Source:

BMJ-British Medical Journal. “Moderate weekly alcohol intake linked to poorer sperm quality in healthy young men”ScienceDaily,2October2014. <www.sciencedaily.com/releases/2014/10/141002221232.htm>.

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Europe :

An ITV documentary will take a look at the impact of drinking alcohol in pregnancy as one in 100 babies are born in Britain each year brain-damaged with Foetal Alcohol Spectrum Disorder (FASD).

These babies will go through life with a range of developmental, social and learning difficulties. A few will have tell-tale facial features which will make it easier to get a diagnosis and access support, but the majority will battle with an invisible disability.

What is FASD?

Foetal Alcohol Spectrum Disorder is a series of preventable birth defects caused entirely by a woman drinking alcohol at any time during her pregnancy, often even before she knows that she is pregnant.

The term ‘spectrum’ is used because each individual with FASD may have some or all of a spectrum of mental and physical challenges. In addition each individual with FASD may have these challenges to a degree or ‘spectrum’ from mild to very severe.

These defects of both the brain and the body exist only because of prenatal exposure to alcohol.

What are the guidelines?

The Government’s current guidelines advise that those who are pregnant or trying to get pregnant should avoid alcohol altogether – but then adds: “If women do choose to drink, to minimise the risk to the baby, we recommend they should not drink more than one to two units once or twice a week and they should not get drunk.”

The Royal College of Obstetricians and Gynaecologists had taken a similar view, although they referred to one or two units a week as a safe amount.

Spokesman Dr Pat O’Brien said: “If nobody drank any alcohol in pregnancy there would be no Foetal Alcohol Syndrome and no Foetal Alcohol Spectrum Disorder. But on the other hand if you look at all of the evidence there appears to be a safe level of alcohol intake in pregnancy.”

However earlier this month they updated their advice, recommending that pregnant women do not drink alcohol during the first three months of pregnancy. The advice does say that drinking small amounts of alcohol after this time does not appear to be harmful for the unborn baby, but that pregnant women should not drink more than one or two units, and then not more than once or twice a week.

Professor Sir Al Aynsley-Green, former Children’s Commissioner for England, said: “Exposure to alcohol before birth is the single most important preventable cause of incurable brain damage. And it’s an issue which affects all of us in society.”

Source: http://www.liverpoolecho.co.uk/ 3rd March 2015

Filed under: Alcohol,Drug use-various effects,Drug use-various effects on foetus, babies, children and youth,Environment,Europe,Health,Treatment and Addiction :

Nearly five young people are being admitted to hospital every day in NSW because of alcohol, exclusive data from NSW Health shows.

The figures show the huge toll alcohol is taking on children and young people in NSW, with a child aged between zero and four admitted to hospital almost every week because of injuries linked to their parents’ drinking.

In total, nearly 1800 children aged between zero and 19 were so injured by their own drinking or that of others they were admitted to hospital in the 2012-13 financial year.

Experts say the government needs to urgently crack down on alcohol sales to children by introducing undercover stings, while parents need to heed the message that providing alcohol to their kids is dangerous.

The director of the McCusker Centre for Action on Alcohol and Youth, Mike Daube, said the hospital admissions were just the tip of the iceberg.

“This is only injuries so severe they need hospitalisation, and even then it is five a day in NSW alone,” he said. “This comes in a week when research has shown more than half of kids say it’s easy to buy alcohol.

“How many more wake-up calls do we need … state governments need to crack down on this issue.”

In the 2012-13 financial year, the last for which information is available, 1565 teenagers aged 15 to 19 year were admitted to hospital because of problems linked to alcohol. The overwhelming majority were male.

The injuries could involve problems directly caused by alcohol consumption, or injuries linked to alcohol, NSW Health said. Last month a 19-year-old student, Carl Salomon, died after falling from a crane into water in Balmain after a night out drinking.

And the harm doesn’t stop with teenagers. More than 50 children aged between zero and four and 70 aged five to nine were treated in hospital because of injuries linked to alcohol. Even more would have suffered from problems linked to foetal alcohol syndrome, which occurs in a baby whose mother drinks heavily while pregnant, that are not included in the data.

The chief executive of the Foundation for Alcohol Research and Education, Michael Thorn, said cheap, two-for-one and similar alcohol deals encouraged young people to binge drink. “Kids are very price-sensitive,” he said. “And they don’t take it home if they haven’t drunk it all”.

This week the foundation released a report into alcohol’s impact on children and families that found up to a quarter of people could be experiencing harm from the drinking of family members.

“Being raised in a harmful environment is very deleterious to a child, it affects their education, their development, their wellbeing, and it certainly increases their likelihood of health problems later,” he said.

Jo Mitchell, the director of the centre for population health in NSW Health, said dangerous drinking did not just occur among young people. “This is a serious public health issue across all age groups,” she said. “Often people think there’s a specific problem for young people … whereas the data shows that across the board there are high levels of risky drinking among adults as well.”

A new NSW Health data snapshot shows the rate of alcohol hospitalisations in NSW increased by 35 per cent from 1998-99, with nearly 52,000 hospital cases linked to alcohol in 2012-13.

But she said there had been some good successes in recent years in decreasing drinking rates. The department was also focused on delaying the age at which young people drank, and raising awareness among parents about the dangers of alcohol supply.

One such program, called “Stop the Supply“, has been run by the Northern Beaches Community Drug Action Team.

Team chairwoman Susan Watson said many parents were not aware of the dangers of youth drinking.

“We know that alcohol causes damage to [a growing] brain, and we didn’t know that years ago … so it’s really about starting conversations with parents about that,” she said. “It can be really difficult for parents to make these decisions when there is all this pressure out there, not just from themselves but from other parents.”

Source: http://www.smh.com.au/nsw/children-admitted-to-hospital-because-of-alcohol 1^st March 2015

Filed under: Alcohol,Australia,Drug use-various effects on foetus, babies, children and youth,Education,Parents :

Seeking professional help for addiction is usually overwhelming. In this professional’s opinion, AA and NA (along with your primary care physician) are better starting points, but if you’re going to add a trained clinician, please consider starting with counseling and not therapy.

There’s an important difference between the two. Therapy is about the past and how it continues to affect us today. Counseling is about dealing with today forward. We’re putting the cart before the horse when we consider how and why everything went to hell. It’s infinitely better to concretely plan and be accountable for taking the steps to get out of hell.

You can deal with the past when your ass is no longer on fire.

Go see your doctor and make sure you’re medically safe. Go to a meeting and ask for help. See a counselor if you want additional support but interview them to ensure that they have a thorough understanding of how to treat addiction (your health insurance company will pay virtually any clinician with a masters degree whether they know what they’re doing or not).

How to Pick the Right One:

One of my biggest criticisms of counselors and therapists alike is that a lot of us talk pretty but don’t get down to the nitty gritty of what (specifically) folks need to do in order to change. When you meet with a counselor ask them what their experience is in treating addiction and to what extent they are willing to offer you specific steps toward recovery.

These are the basics that I recommend after a person’s medical well being is assured:

Keep it simple and be willing to make an honest effort. Are you willing to not drink today? Just for today, are you willing to do whatever it takes to not drink? Stop thinking about the rest of your life and focus on not drinking for the next 24 hours. I am totally, unapologetically biased in favor of 12 step programs and so I offer the adage:

Don’t think. Don’t drink. Go to meetings.

If that’s all we do, we’re well on our way.

People often ask me how to not drink. I annoy them by starting with common sense: Get the alcohol out of your home, office, garage, etc. Stay out of bars. Stay away from people you drink with. Do not go to the liquor store. Do not buy alcohol. Then we move on to what they’re really asking, which is what are they supposed to do instead of drinking:

Next step: embrace responsibility and accountability. If you’re doing treatment and a 12 step program you can have at least two folks assisting you with this – your counselor and a temporary sponsor. You don’t need to make huge commitments. You need someone to call and lean on (especially when you crave a drink), guidance for when you’re not sure what to do next, and you need a relapse prevention plan because:

There are few things more dangerous than a person in early recovery with too much time on their hands. AND because the worst possible time to make a plan is when we’re already scared/squirrelly/antsy. There’s a balance to be struck here: We can’t over commit ourselves to the point of going 100 mph but we have to structure our day to incorporate people and meaningful activities that do not include alcohol/drugs.

Personalize Your Plan/Get Specific:

I spoke recently with an active alcoholic who told me he can’t stop drinking screwdrivers (vodka and orange juice). I’m suggesting he brush his teeth once per hour because orange juice and toothpaste are one of the most disgusting combinations I can think of. Put it under the category of “whatever works.”

I note the habits and routines that are part of a person’s life – everything that gets associated with drinking or using. Example: You put on ESPN and crack open a beer. Ok, how about we temporarily ban Sports Center in order to reduce temptation. Instead, let’s change things up and consciously choose what to do instead. Example – put on loud music and drink huge quantities of water (vital in early recovery as your body seeks to right itself).

The same individual was able to share with me how their drinking has had a negative impact on their loved ones. I’m suggesting that conversations with the family are a great starting point. Generally this is poorly received. Folks get concerned about “burdening”, “imposing” or “getting their hopes up.” I ask if this was a concern when they were drinking/using? Whether we tried to hide it or not it’s almost always had some effect. Talk with them. Let them support you and be part of the solution if they’re willing.

Again we’ll deal with the past after the storm has past. Be clear about this and marshal all the support you can. Getting clean/sober is one of the most bad ass things a human being can do and the road to recovery is long and winding. First things first.

Source: recoveryrocks.bangordailynews.com 27^th Feb. 2015

Filed under: Alcohol,Treatment and Addiction :

Researchers led by Catherine Fortier at Harvard Medical School found that chronic alcohol misuse damaged white matter in areas of the brain that are important for self-control and recovery from alcoholism. The findings appeared in the December 2014 issue of Alcoholism: Clinical & Experimental Research.

Using high-resolution diffusion magnetic resonance brain scans, the researchers compared a group of 20 healthy light drinkers to a group of 31 individuals with a history of alcoholism. The recovering alcoholics drank heavily for an average of 25 years and had been sober for about five years.

Compared with the light drinkers, the abstinent alcoholics showed pronounced reductions in the structural integrity of frontal and superior white matter tracts. According to the authors, the results suggest altered connectivity in frontostriatal circuits—pathways associated with the amygdala, hippocampus, nucleus accumbens, regions that are involved in the brain’s reward system. These networks are essential for controlling impulsive behavior and stopping drinking.

The study also found that longer and heavier alcohol abuse was associated with greater damage. The findings pointed to possible recovery of white matter tissue in drinkers who became abstinent before they turned 50 years of age.

The authors recommend that future investigations should continue to explore white matter changes due to alcohol misuse, including measurements related to the severity of alcoholism and questions about tissue recovery with maintained abstinence.

Source: Adapted from the story published in the NIAAA Spectrum, February 2015, Volume 7, Issue 1 Fortier, C.B.; Leritz, E.C.; et al. Widespread effects of alcohol on white matter microstructure. Alcoholism: Clinical & Experimental Research. Nov. 18, 2014 [Epub ahead of print]. PMID: 25406797

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects,Health :

Previous research has suggested a link between intelligence and various health outcomes. New findings show a link between a lower IQ and greater and riskier drinking among young adult men.

The poor IQ-test results may also be linked to other disadvantages such as lower socio-economic standing.

Although several studies have shown an association between intelligence and various health-related outcomes, the research on cognitive abilities and alcohol-related problems has been inconsistent. A new study of the association between IQ-test results and drinking, measured as both total intake and pattern of use, has found that a lower IQ is clearly associated with greater and riskier drinking among young adult men, although their poor performance on the IQ-test may also be linked to other disadvantages.

“Previous results in this area have been inconsistent,” said Sara Sjölund, a doctoral student at the Karolinska Institutet in Stockholm, Sweden as well as corresponding author for the study. “In two studies where the CAGE questionnaire — a method of screening for alcoholism — was used, a higher cognitive ability was found to be associated with a higher risk for drinking problems. Conversely, less risk has been found when looking at outcomes such as, for example, International Classification of Diseases diagnoses of alcoholism, alcohol abuse, and dependence.”

“In this study of a general population, intelligence probably comes before the behavior, in this case, alcohol consumption and a pattern of drinking in late adolescence,” said Daniel Falkstedt, assistant professor in the department of public health sciences at Karolinska Institutet. “It could be the other way around for a minority of individuals, that is, when exposure to alcohol has led to cognitive impairment, but this is less likely to be found among young persons of course.”

Sjölund and her colleagues analyzed data collected from 49,321 Swedish males born during 1949 to 1951 and who were conscripted for Swedish military service from 1969 to 1971. IQ results were available from tests performed at conscription, and questionnaires also given at conscription provided data on total alcohol intake (consumed grams of alcohol/week) and pattern of drinking, as well as medical, childhood and adolescent conditions, and tobacco use. Adjustments were made for socio-economic position as a child, psychiatric symptoms and emotional stability, and the father’s alcohol habits.

“We found that lower results on IQ tests in Swedish adolescent men are associated with a higher consumption of alcohol, measured in both terms of total intake and binge drinking,” said Sjölund. “It may be that a higher IQ results in healthier lifestyle choices. Suggested explanations for the association between IQ and different health outcomes, could be childhood conditions, which could influence both IQ and health, or that a socio-economic position as an adult mediates the association.”

“By taking into account as little as four measured characteristics of the men, including their backgrounds,” added Falkstedt, “the authors seem to be able to explain a large part of the association between IQ and heavy drinking. I think this may be a main message of this large cohort study: poor performance on IQ tests tend to go along with other disadvantages, for instance, poorer social background and emotional problems, which may explain the association with risky alcohol consumption. In reality, other differences of importance are likely to exist among the men, which could further explain the IQ-alcohol association.”

Both Sjölund and Falkstedt noted that results may vary among cultures and countries.

“I think that large parts of the association between IQ and alcohol consumption may be indirect and mediated by experiences in everyday life and differences in social situations,” said Falkstedt. “It is not necessarily about making intelligent or unintelligent choices. For instance, in countries with weak social-safety nets and high alcohol consumption among low-wage workers and the unemployed, I assume the association could be stronger than in economically more-equal countries, perhaps also among the young.”

“I hope that our findings add to the general understanding of drinking behaviours and what factors that may influence them,” said Sjölund. “However, we must be very careful in making any attempt to generalize our results to women, since their level of consumption and patterns of drinking likely differ in comparison with men.”

“I think a higher intelligence may give some advantage in relation to lifestyle choices,” noted Falkstedt. “However, I think it is very important to remember that intelligence differences already existing in childhood and adolescence may put people at an advantage or disadvantage and may generate subsequent differences in experiences, and accumulation of such experiences over many years. Therefore, another important explanation of ‘bad choices’ among lower-IQ individuals may be feelings of inadequacy and frustration, I think. A number of studies have shown that a lower IQ in childhood or adolescence is associated with an increased risk of suicide over many years in adulthood.”

Source: Alcoholism: Clinical & Experimental Research. “A lower IQ has been linked to greater and riskier drinking among young adult men.” ScienceDaily. ScienceDaily, 20 February 2015. <www.sciencedaily.com/releases/2015/02/15022019

Filed under: Alcohol,Brain and Behaviour :

Heavy drinking during adolescence may lead to structural changes in the brain and memory deficits that persist into adulthood, according to an animal study published October 29 in The Journal of Neuroscience. The study found that, even as adults, rats given daily access to alcohol during adolescence had reduced levels of myelin — the fatty coating on nerve fibers that accelerates the transmission of electrical signals between neurons. These changes were observed in a brain region important in reasoning and decision-making. Animals that were the heaviest drinkers also performed worse on a memory test later in adulthood. The findings suggest that high doses of alcohol during adolescence may continue to affect the brain even after drinking stops. Further research is required to determine the applicability of these findings to humans.

According to the World Health Organization, a growing number of adolescents and young adults around the world engage in binge drinking, the consumption of four (five for men) or more drinks over approximately two hours. Previous research in humans has shown an association between heavy episodic (binge) drinking in adolescence, changes in myelin in several brain regions, and cognitive impairments in adulthood. However, it was unknown whether alcohol was behind these brain and behavioral differences or if predisposing factors could explain the findings.

In this study, Heather Richardson, PhD, her graduate student Wanette Vargas, BA, and colleagues at the University of Massachusetts, Amherst, compared myelin in the prefrontal cortex — an area of the brain that is vital to reasoning and decision-making — in young male rats given daily access to either sweetened alcohol or sweetened water for two weeks. Animals that drank alcohol as adolescents had reduced myelin levels in the prefrontal cortex compared with those that drank a similar amount of sweetened water. When the researchers examined the alcohol-exposed animals several months later, they found that the animals continued to display reduced myelin levels as adults.

“Our study provides novel data demonstrating that alcohol drinking early in adolescence causes lasting myelin deficits in the prefrontal cortex,” Richardson said. “These findings suggest that alcohol may negatively affect brain development in humans and have long-term consequences on areas of the brain that are important for controlling impulses and making decisions.”

The researchers also examined how adult animals that binged on alcohol as adolescents performed on a test to assess working memory, the ability to hold on to information for a short period. The more alcohol the rats consumed over the two-week period as adolescents, the worse they performed on the working memory task as adults.

“This study suggests that exposure to high doses of alcohol during adolescence could exert lingering, if not permanent, damage to selective brain fibers,” said Edith Sullivan, PhD, who studies the effects of alcohol on brain function at Stanford University and was not involved with this study. “This damage might underlie persistent compromise of cognitive functions involved in learning and render youth vulnerable for later development of alcohol use disorders.”

This research was funded by the National Institute on Alcohol Abuse and Alcoholism.

The Journal of Neuroscience is published by the Society for Neuroscience, an organization of nearly 40,000 basic scientists and clinicians who study the brain and nervous system. Richardson can be reached at hrichardson@cns.umass.edu. More information on alcohol and the teenage brain can be found on BrainFacts.org.

Source: http://www.eurekalert.org/ 28th October 2014

Filed under: Alcohol,Brain and Behaviour :

Singer’s poignant track pays tribute to the brother who went from David Beckham lookalike to death from alcoholism within 10 years.

Tom Maybury

Henry Maybury and (inset) his brother Tom

Henry Maybury looked up to his handsome big brother.

They loved to banter about football, with Tom teasing Henry about his love of Aston Villa. Last month, Tom would have been celebrating his 31st birthday with his family. If he hadn’t drunk himself to death. At the age of 29.

“To see my brother go from a David Beckham lookalike to someone who shook all the time and could barely recognise his relatives was completely heartbreaking,” says Henry.

But the 22-year-old is determined that some good should come out of the tragedy. He is campaigning to raise awareness of alcohol addiction, telling others about his brother.

He has written and released a song, Lost Days, to raise money for addiction charities. An accompanying video starts with the message: “Alcohol abuse kills about 2.5 million people each year worldwide. “I witnessed it take over someone I loved and then lost.”

It features a man drinking, and the effect it has on his family, who are begging him to stop. Then there’s the line: “It’s just too late, all we can do is pray.”

The video has proved an internet hit with more than a million views. Celebrities including Lorraine Kelly, John Challis, Adam Woodyatt and Abi Phillips have shown their support.

Henry, from Shrewsbury, explains: “When Tom passed away it was a rough couple of months for everyone. “I was sitting in my bedroom when I came across this song, Lost Days, that I’d written about Tom because I saw what alcohol was doing to him.

“I asked people to take part in the video and auditioned 200 of them on Skype. I did it on a tiny budget and recorded it at Chichester University, where I’ve just graduated in musical theatre. “I uploaded the video and it went viral. Within the first hour I had 200 shares on Facebook and in the first couple of weeks there were more than a million hits on YouTube.

“The most touching response was the people who contacted me to say ‘It really makes you think’.

“I would love the video to be used in schools. I remember being at school when we had people in to talk about subjects like this – but I’d just switch off.“I’d hope the video would get the message across better.

“I was asked to speak at a DrugFam conference at the Holiday Inn at Birmingham Airport, to help the families of those with drug and alcohol addiction. They said the video could save lives.”

Tom Maybury died on February 22, 2013 in Royal Shrewsbury Hospital from liver and kidney failure and alcohol poisoning. He was the eldest son of Neil and Sally and brother to Toby, Natasha and Henry.

“My brother had so much going for him. I just don’t want other people to follow in his footsteps,” says Henry. “I’m passionate about spreading the word that it could happen to anyone. “Tom went from being a normal teenager, having a few drinks on a Saturday night, to going to the pub every night and drinking a lot more than two pints.

“He started drinking heavily at the age of 19 but we noticed he had a real problem in his early twenties. You don’t pick up on it at first.

“We don’t know what triggered it, whether he had an addictive gene. He went to agricultural college and had a gardening business, but he lost his licence because of drink-driving and the work dried up. So he just stayed at home, drinking pretty much continuously. The first thought that went through his head when he woke up was to have a drink – cider and beer, mainly.

“But however much we tried to help, it’s impossible unless they want to be helped. He suffered from epilepsy and would sometimes be hospitalised after a bad fit. His epilepsy medicine would stop working because of the alcohol.

“The ambulance was called on a regular basis. Hospital would dry him out and he would say he wanted to quit, but then the draw was too much and he’d drink again.

“Alcohol is so readily available these days, and cheap. He was dependant on drink for a decade.” Tom was warned by medics that his liver would fail, but the warnings fell on deaf ears. “He was warned that his liver would pack up – and it did,” says Henry.

“It was just so diseased. He had yellow eyes, was shaking continuously and could barely recognise his family. He really suffered at the end. We knew he wasn’t going to get better. He was my big brother. I looked up to him and he always had my back. I want to make sure he’s not been forgotten.

“After I made the video, several people told me ‘Your brother would be so proud of you’. “It’s nerve-racking, telling your story to the world. I wasn’t expecting the support. I’ve always said I want to help people through my music. I have lots more songs in the pipeline, I want to release another video in January and an album called Timeline in 2015.”

Henry and his mother Sally have set up the Lost Days Charitable Aid Trust and a committee to decide where best to send the money raised by downloading the single from iTunes. It includes Professor John Kelly, the first professor for addiction at Harvard University, and Canon Mark Oakley from St Paul’s Cathedral. Henry has done all this despite having his own problems to deal with.

“Music has always been a massive part of my life, but I wanted to be a professional rugby player,” he remembers.

“I was playing 40 hours a week, for Ellesmere School, Shrewsbury Rugby Club and Shropshire. “Then, at the age of 15, I was struck down by arthritis and ended up in a wheelchair. “But I was determined to beat it and within a year I was back on the rugby field. It’s still a problem, one I manage with medication. “It can be painful and make it difficult to walk, but I won’t let it stop me. It has helped me, I think. The music industry is so tough but I am tough too after what I’ve been through.”

For more information and to donate, go to www.henrymaybury.com .

Source: http://www.birminghammail.co.uk/news/health 2^nd November 2014

Filed under: Alcohol,Social Affairs :

Children of mothers who drink as little as four units of alcohol in a day even once while pregnant are at greater risk of developing mental health problems and doing less well at school, new research claims. The study found that the 11-year-old offspring of women who consumed the equivalent of two medium-sized glasses of wine in one session during pregnancy are more likely to suffer from hyperactivity and inattention. The findings, from a British study of more than 4,000 children in the Bristol area, have reopened the debate about how much, if any, alcohol women should consume while carrying a child. The Department of Health advised pregnant women and those trying to conceive to remain abstinent. “If they do choose to drink, to minimise the risk to the baby, they should not drink more than one to two units of alcohol once or twice a week and should not get drunk,” said a DoH spokesman.

Academics found that 11-year-olds born in 1991-92 to mothers who had drunk that amount one or more times in pregnancy had “slightly higher” levels of hyperactivity and inattention, in the opinion of both their parents and their teachers, who each filled out questionnaires. Girls seemed to display such behaviour more often than boys, the study found. Among 7,000 children in the study, those affected by their mother’s prenatal drinking scored on average one point lower in key stage 2 exams taken in their last year at primary school, according to an analysis of results.

The lead author of the research, Professor Kapil Sayal of Nottingham University, said: “Women who are pregnant or who are planning to become pregnant should be aware of the possible risks associated with episodes of heavier drinking during pregnancy, even if this only occurs on an occasional basis.

“The consumption of four or more drinks in a day may increase the risk for hyperactivity and inattention problems and lower academic attainment even if daily average levels of alcohol consumption during pregnancy are low.” However, children of women who had one drink a day while pregnant did not have any higher risk of either problem, Sayal and colleagues found.

The findings are from ongoing, long-term research called the Avon Longitudinal Study of Parents and Children, which looked at and followed the health of children born to mothers in Avon in 1991-92. They are published on Thursday in the journal European Child and Adolescent Psychiatry. Belinda Phipps, chief executive of the parenting charity NCT, said better awareness of the risks meant far fewer mothers-to-be now drink more than they should compared to when the children in this study were born. Phipps said: “According to the latest Infant Feeding Survey in 2010, only 3% of pregnant women reported drinking more than two units of alcohol per week on average, compared to 24% drinking four or more units a day at least once while they were pregnant in 1990-1992.”

The director of the Institute of Alcohol Studies thinktank, Katherine Brown, said: “Exposure to alcohol can lead to foetal alcohol spectrum disorder, which manifests itself in a range of symptoms including hyperactivity, poor attention span and memory deficits, all of which can adversely impact on a child’s ability to learn and socialise. So it’s no surprise that this study found poor performance at school was linked to pre-natal drinking.”

However, FASD gets little attention in the UK and there is “huge under recording” of how common it is, with symptoms often not picked up until children are at school and sometimes misdiagnosed, Brown added. “Greater awareness is needed about the risks of drinking during pregnancy, with a clear message that no amount alcohol is safe. There also needs to be increased levels of support for those women who struggle to stop drinking due to dependency, and better diagnosis and treatment for babies with FASD,” she said.

Professor Dame Sally Davies, the chief medical officer for England and government’s chief scientific adviser, is currently reviewing guidelines on safe levels of drinking, including in pregnancy.

Source: www.theguardian.com 11th Sept. 2014

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth :

Emily Olfson, an MD/PhD student, led a research team that found that although a gene variant protects some teens from developing alcohol problems, its protective effects disappear when those adolescents spend time with other teens who drink.

Among more than 1,500 adolescents who had consumed at least one drink before age 18, researchers have found that although a gene variant prevents some young drinkers from developing alcohol problems, the gene’s protective effects can vanish in the presence of other teens who drink.

The study, by investigators at Washington University School of Medicine in St. Louis, is published online Sept. 23 in the journal Alcoholism: Clinical & Experimental Research.

Previous research has shown that a variant of a gene involved in metabolizing alcohol reduces the likelihood that a person will develop drinking problems. Acetaldehyde is a product of alcohol metabolism that can be toxic at high levels.

People who have the gene variant make more acetaldehyde when they drink, leading to unpleasant effects, such as headaches and vomiting. Consequently, those with the gene variant may be less eager to drink and, therefore, less likely to develop alcohol problems.

But in the new study, the researchers found that when adolescents with the gene variant spend time with friends who drink, they tend to join in the drinking, and the gene variant’s protective effects disappear.

“Young people with this protective variant in the alcohol dehydrogenase gene, ADH1B, had a lower risk of becoming intoxicated and developing early symptoms of alcohol use disorder,” said first author Emily Olfson, an MD/PhD student doing research in the Department of Psychiatry. “But when in a high-risk environment — that is, if they reported that ‘most or all’ of their best friends drank alcohol — the gene’s protective effect essentially disappeared.”

The participants are part of a national study called the Collaborative Study on the Genetics of Alcoholism (COGA), a nine-center effort that began in 1989. Researchers involved in the study gathered blood samples and conducted interviews with people from families affected by alcoholism and, for comparison, from families unaffected by alcohol problems.

In recent years, subjects ages 12 to 22 have been recruited into the study and followed to learn more about genetic and environmental factors that protect some people and put others at risk for alcohol problems. One of COGA’s principal investigators is Laura Jean Bierut, MD, the Alumni Endowed Professor of Psychiatry at Washington University.

By focusing on the development of alcohol problems, it may be possible to prevent them, Bierut said. The age at which adolescents begin drinking alcohol is a key influence on alcohol consumption later in life. A person’s age at the time he or she consumes that first drink can help predict the risk for problems down the road.

By the age of 17, most adolescents have consumed alcohol, and about 15 percent already meet the criteria for alcohol abuse,” Bierut said. “When we compare people who begin drinking at age 21 or older to those who begin drinking at age 14 or younger, we find that the risk for younger drinkers is nearly twice what we see in those who don’t start drinking until they’ve reached legal age.”

The adolescents with the protective gene variant were no more likely than others to wait until they were older to take their first drinks, but they were less likely to progress to problem drinking.

“When people with this gene variant drink, they feel bad, which limits the amount of alcohol they consume,” said Olfson.

Some medications used to treat alcoholism target the same pathway that the gene influences, making alcoholics and problem drinkers who take the drugs feel bad when they consume alcohol. In this study, the young people with the protective gene variant often did not drink to intoxication or develop alcohol problems — unless their friends were drinkers.

“There is an important interplay between genes and environment here,” Olfson said. “And this study demonstrates that a high-risk social environment can overwhelm the protective effects of a certain genetic variant.”

And since drinking patterns established in adolescence have an enormous influence on alcohol use and abuse throughout life, the investigators believe it is important for teens to reduce interactions with peers who drink alcohol.

“It is vital to reduce adolescent drinking, and although it clearly overrides the protective effect of the ADH1B gene, peer drinking is a modifiable environmental risk factor,” Bierut said. “If we look at something like smoking, we’ve done a good job over the last few decades of informing people that smoking is bad for your health. As a result, there has been a decrease in smoking initiation rates among adolescents. It’s important that we try to do the same things with alcohol.”

An ADH1B variant and peer drinking in progression to adolescent drinking milestones: evidence of a gene-by-environment interaction. Alcoholism: Clinical & Experimental Research, Early View.

Source: http://onlinelibrary.wiley.com/journal/10.1111(ISSN)1530-0277/earlyview.Published online Sept. 23, 2014. An ADH1B variant and peer drinking in progression to adolescent drinking milestones: evidence of a gene-by-environment interaction. Alcoholism: Clinical & Experimental Research, Early View.

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Health :

One in 10 cancers in men and one in 33 in women are caused by drinking

The projected number of new cases of alcohol-related cancers in the Republic of Ireland is expected to double by the year 2020 for women and to increase by 81% for men during the same period (Source)

Because alcohol consumption is higher among poorer people, their risk for alcohol-related cancers is also higher (Source)

The National Cancer Registry has noted the correlation between higher incidence of head and neck cancers and lung cancer among males in the Republic of Ireland living in socio- economically deprived areas and the corresponding higher rates of alcohol consumption and tobacco use in these areas (Source)

Alcohol is classified as a group 1 carcinogen and it is one of the most important causes of cancer in Ireland, being a risk factor in seven types of cancer
Cancers of the mouth, upper throat, larynx, oesophagus, liver, bowel and female breast have a causal relationship to alcohol consumption
The National Cancer Control Programme (NCCP) conducted research in 2012 to calculate Ireland’s overall cancer incidence and mortality attributable to alcohol consumption and found that approximately 5% of newly diagnosed cancers and cancer deaths are attributable to alcohol – that’s around 900 cases and 500 deaths each year
There is a risk relationship between the amount a woman drinks, and the likelihood of her developing the most common type of breast cancer. Drinking one standard alcoholic drink a day is associated with a 9% increase in the risk of developing breast cancer, while drinking 3-6 standard drinks a day increases the risk by 41%
It is estimated that up to 20% of breast cancer cases in the UK can be attributed to alcohol
Three people in Ireland die from oral and pharyngeal cancer (OPC) every week – which is more than skin melanoma or cervical cancer. Two major risk factors for OPC are tobacco and alcohol consumption
Ireland has the second highest cancer rate in the world. Regular alcohol consumption is listed by the World Health Organisation (WHO) and World Cancer Research Fund (WCRF) as one of the factors contributing to the high cancer rates
Alcohol and tobacco together are estimated to account for about three-quarters of oral cancer cases in Europe
The risk of bowel cancer increases by 8% for every two units of alcohol consumed a day
Cancer risk due to alcohol are the same, regardless of the type of alcohol consumed and even drinking within the recommended limits carries an increased risk
A recent study on the burden of alcohol consumption on the incidence of cancer in eight European countries reported that up to 10% of all cancers in men and 3% of women may be attributed to alcohol consumption (Source)

While moderate alcohol consumption has been linked to a decrease in risk for cardiovascular disease, the overall net effect of drinking in relation to cancer risk, even of moderate drinking, has been shown to be harmful (Source)

Follow this link for research and reports on alcohol and cancer

Source:http://alcoholireland.ie/facts/alcohol-and cancer/#sthash.JUf1wiYP.dpuf

Filed under: Alcohol,Europe,Health :

HOSPITALS across Bristol are under pressure from hundreds of admissions as a result of alcohol-poisoning – including more than 60 cases involving children.

The Department of Health figures released in the House of Commons show that there were 1,510 admissions in 2012-13 where alcohol poisoning was identified as the primary or secondary diagnosis.

While most cases involved adults, 62 admissions involved youngsters under the age of 18. Of those, 18 were aged between 11 and 16.

University Hospitals Bristol NHS Foundation Trust, which runs the city centre hospitals, had 970 people admitted with alcohol-poisoning, including 40 minors. North Bristol NHS Trust, in charge of Southmead and Frenchay during the time covered by the statistics, recorded 540 comparable admissions, of which 22 were children.

Figures for the same year showed there were 3,748 alcohol abuse-related admissions among children younger than 18 years old in England, of which 52 were under 11.

Labour MP Kerry McCarthy said it was regrettable that the Government scrapped plans to introduce a minimum pricing on alcohol.

The Bristol East MP said: “It’s worrying to see the number of people being admitted to hospital in Bristol due to alcohol poisoning, particularly young people under the age of 18 and even 16.”

Ms McCarthy said more needed to be done to educate young people about the dangers of drinking too much, as well as greater support for local services, which can help problem drinkers overcome their addiction.

A commitment to introduce a 45p minimum unit price for alcohol to deter youngsters and other drinkers from buying cheap alcohol was axed by the coalition in July last year, following lobbying by the drinks industry.

Earlier this year, the Government adopted a new approach, introducing a ban on the sale of alcohol below cost price (defined as the level of alcohol duty plus VAT), meaning that a can of average strength lager can now not be sold for less than 40p, while a standard bottle of vodka cannot be sold for less than £8.89.

The figures, which came in answer to a parliamentary question, show that there were also 21,401 admissions in 2012-13, where substance abuse was identified as the primary or secondary diagnosis, including 426 cases involving under-18s.

Maggie Telfer, chief executive of the Bristol Drugs Project, said the figures indicated that Bristol appeared to have a similar number of hospital admissions to other cities of a similar size.

Source: http://www.bristolpost.co.uk/Young-Bristol-drinkers-admitted-hospital-alcohol/story-22786043-detail/story.html#ixzz3B1QYWsC6 August 20, 2014

Filed under: Alcohol,Youth :

Australians have become accustomed to labels on cigarettes warning about the risk of smoking causing cancer and other diseases. And our research, published in the latest edition of BMC Public Health, shows similar labels could help consumers better understand the harms of drinking alcohol. Alcohol is estimated to cost the Australian economy A$36 billion a year in preventable death, illness, injury, and hospitalisation. There is growing evidence that alcohol increases the risk of certain types of cancer, diabetes and heart disease. The national alcohol guidelines recommend Australians limit their alcohol consumption to no more than two standard alcoholic drinks per day or drink no more than four drinks in a single sitting to reduce the risk of alcohol-related disease and injury.

But despite the risks, no warnings are given when alcohol is advertised, other than to suggest responsible drinking, often tacked on at the end of the ad.

Even worse, ads sponsored by Australia’s alcohol industry, such as DrinkWise’s ad showing young people how to drink “properly”, do little to inform. They serve only as a token demonstration of balancing the A$125 million-plus a year spent on indirect and direct advertising of alcohol.

There are few opportunities for the public to be made aware of the health risks of alcohol. Around 90% of men and 81% of women believe that they can drink alcohol every day without affecting their health.

Labelling cans and bottles with health warnings is one way of raising awareness of the risks of alcohol, and has been adopted in a range of countries including France and the United States.

The problem with these messages is that they tend to focus on the risks of drinking when pregnant and the dangers of drink driving. Even in these countries, few people would necessarily associate alcohol with an increased risk of a range of cancers, including breast cancer.

Unsurprisingly, little research has been done into the effectiveness of labelling of alcohol with cancer warnings. This is what motivated a team of researchers from Curtin, the University of Western Australia and the Cancer Council WA to investigate how the public would respond to cancer warnings and which messages would be the most effective in getting salient information across.

The online survey tracked the responses of 2,168 drinkers to 12 different health messages: 11 about cancer and a general health warning. The messages had been generated out of a previous round of focus sessions with a group of 48 drinkers.

The results showed that overall, responses to cancer statements were neutral or favourable. Younger, female and more educated participants were more likely to find the messages believable, convincing and personally relevant.

Heavy drinkers – defined as those who drink more than two drinks a day and more than four drinks in a single sitting – were also more likely to consider the messages personally relevant than those who drank less. This is particularly encouraging because this group is most at short-term and long-term risk from the harmful effects of alcohol.

People tended to believe messages about specific cancers and those that said alcohol can “increase the risk of cancer” more than general messages about cancer. A message such as “Alcohol increases your risk of bowel cancer” was more effective than the message “Alcohol causes one in 20 cancer deaths”.

The results of the survey showed there would not be a significant amount of negative reaction to the labelling of alcohol among the general public. This is important because legislation will be easier to pass if it’s unlikely to cause a public backlash.

The other important finding was that the messages about the risk of alcohol and cancer were believable, convincing and personally relevant. This suggests they could help inform consumers about the true risks involved in drinking, especially large amounts regularly.

It’s important for consumers to make informed decisions about whether and how much alcohol to drink. It’s time for Australia to join the growing list of nations mandating alcohol labelling. But we should do so with more targeted and relevant health warnings.

Source: uwa.edu.au 18th August 2014

Filed under: Alcohol,Drug use-various effects,Health,Prevention and Intervention :

An early onset of drinking is a risk factor for subsequent heavy drinking and negative outcomes among high school students, finds a new study.

Researchers asked 295 adolescent drinkers (163 females, 132 males) with an average age of 16 years to complete an anonymous survey about their substance use. These self-report questions assessed age at first intoxication – for example, “How old were you the first time you tried alcohol/got drunk?” They also took stock of the previous month’s consumption of alcohol, including an assessment of the frequency of engaging in binge drinking.

“Teenagers who have their first drink at an early age drink more heavily, on average, than those who start drinking later on,” said Meghan E. Morean, an assistant professor of psychology at the Oberlin College, Ohio and adjunct assistant professor of psychiatry at Yale School of Medicine. The findings also suggest that how quickly teenagers move from having their first drink to getting drunk for the first time is an important piece of the puzzle.

“In total, having your first drink at a young age and quickly moving to drinking to the point of getting drunk are associated with underage alcohol use and binge drinking, which we defined as five or more drinks on an occasion in this study,” Morean noted. We would expect a teenager who had his first drink at age 14, and who got drunk at 15, to be a heavier drinker than a teenager who had his first drink at age 14, and waited to get drunk until age 18, researchers emphasised.

“The key finding here is that both age of first use and delay from first use to first intoxication serve as risk factors for heavy drinking in adolescence,” said William R. Corbin, associate professor and director of clinical training in the department of psychology at Arizona State University

The study is scheduled to be published in the journal Alcoholism: Clinical and Experimental Research.

Source: www.business-standrd.com 20th Sept 2014

Filed under: Addiction,Addiction (Papers),Alcohol,Drug use-various effects on foetus, babies, children and youth,Education Sector (Papers),Prevention (Papers),Prevention and Intervention,Youth :

The United States is on the verge of having powdered alcohol – in packets like Kool-aid but with the punch of a rum or vodka cocktail – on sale across the country. After much confusion, Palcohol, which has seven flavours including Cosmopolitan and “Powderita” is on hold over problems with its labelling.

There is a lot we don’t know about this form of alcohol (although a version was patented as far back as 1964), but we know enough about how many young people might receive it and the troubles that are likely to come from putting this kind of product on the market. The makers of Palcohol have defended claims that their product could be used as a sneaky way of avoiding high drinks prices in venues and that the idea came as a neat way of avoiding carrying booze after a day of physical activities. In reality, it could be used in all sorts of ways.

What we do know is that powdered alcohol will probably be particularly appealing to young people, judging from their demonstrated preference for flavoured alcohol (take alcopops for example), and alcoholic jello. Many adults never imagined that alcoholic jello would take off among youth, but we know from recent research that these are not only popular, but also most popular among the kids who drink the most. Powdered alcohol is also easily concealable, which will make it more feasible for people who are underage to get hold of, travel with and consume, in both liquid and food form. Palcohol’s makers appear to have been caught off guard after the Alcohol Tobacco Tax and Trade Bureau (TTB) announced approval for the product. They hastily changed marketing for their product. Their website had suggested mixing it with guacamole (for “kamikaze guacamole”), salad or other foods as part of their plans to market the product while pointing out that this does not add flavor to the dish, just alcohol.

What’s an average mixed drink?

The producers of Palcohol suggest adding five ounces of liquid to make “one average mixed drink”. It isn’t too big a leap to suggest that drinkers will experiment with adding less liquid and using multiple packets to strengthen the effects – something you can’t do with a regular bottle of drink.

When it comes to alcohol consumption in its traditional liquid form there can be a narrow margin of safety before brain stem functions like breathing, heartbeat rhythm and the gagging reflex begin to shut down when large amounts are consumed over a short space of time, as the fallout from the Neknomination craze has shown. When drinking over a two-hour time period brain stem function may be impaired for average sized men and women respectively at approximately 13 and 10 standard drinkservings of alcohol. The National Institute on Alcohol Abuse and Alcoholism defines the threshold of low risk drinking as no more than four and three drinks in any one day and 14 and seven in any one week period for men and women respectively. The possibility of consuming multiple packets could be dangerous.

Alcohol poisoning is already on the rise: hospitalisations of 18 to 24-year-olds related to alcohol overdoses in the US increased by 67% between 1999 and 2008. The hospitalisation of 26 teens aged 14 to 18 after loading up with drink before a Whiz Khalifa concert in New York shows that alcohol is already too accessible without making it available in packets that are easy to slip into a coat, a classroom or a concert. And of course, what better way to maximise the high than to add Palcohol to beverage alcohol, for at least twice the effect?

Stealth intoxication

The manufacturers have said they only promote responsible drinking, including asking people to make sure they find out whether they can take the product into venues. But we know very little about this new vehicle of alcohol delivery: is it easily detectable when added to other drinks? Could it be used as another form of stealth intoxication in a manner similar to other drugs used to facilitate sexual assaults, for example? If the company suggest adding it to food but say it doesn’t affect taste, does this up the chances of some unsuspecting person consuming it? Experience in multiple countries with alcopops has shown this type of product and marketing attracts young people at earlier ages, putting them at higher risk for addiction and other negative consequences than those who wait until they are older to drink.

In the US, regulation falls between a number of entities but the Treasury Department’s Alcohol Tobacco Tax and Trade Bureau (TTB) has the most power to regulate alcohol and control decisions through labelling and alcohol taxes. It is the agency that recently gave and then within days and without public explanation withdrew labelling approval for Palcohol to go on the market. It is also possible that the Food and Drug Administration could prevent Palcohol from going to market based on claims that it could be considered a food product or food additive. Given that Palcohol has never before been consumed or sold to the US public at large, it is unlikely the FDA would have considered it to be generally regarded as safe, the FDA’s standard for food safety.

The new, the cool, the tongue-in-cheek all appeal to younger people. Alcoholic powder would likely attract a similarly youthful and risk-taking customer base as did alcoholic jello, and the result might just be more drinking, more addiction, injuries and other adverse consequences to the drinkers as well as the people around them.

Source: www.theconservation.com April 2014

Filed under: Alcohol,Youth :

Omega-3 fish oil might help protect against alcohol-related neurodamage and the risk of eventual dementia, according to a study. Many human studies have shown that long-term alcohol abuse causes brain damage and increases the risk of dementia. The new study found that in brain cells exposed to high levels of alcohol, a fish oil compound protected against inflammation and neuronal cell death.

Omega-3 fish oil might help protect against alcohol-related neurodamage and the risk of eventual dementia, according to a study published in the journal PLOS ONE.

Many human studies have shown that long-term alcohol abuse causes brain damage and increases the risk of dementia. The new study found that in brain cells exposed to high levels of alcohol, a fish oil compound protected against inflammation and neuronal cell death.

The study was conducted by Michael A. Collins, PhD, Edward J. Neafsey, PhD, and colleagues at Loyola University Chicago Stritch School of Medicine, and collaborators at the University of Kentucky and the National Institute of Alcohol Abuse and Alcoholism (NIAAA). Collins and colleagues exposed cultures of adult rat brain cells over several days to concentrations of alcohol equivalent to about four times the legal limit for driving — a concentration seen in chronic alcoholics. These brain cultures were compared with cultures exposed to the same high levels of alcohol, plus a compound found in fish oil called omega-3 docosahexaenoic acid (DHA).

Researchers found there was up to 90 percent less neuroinflammation and neuronal death in the brain cells exposed to alcohol plus DHA than in the cells exposed to alcohol alone. An earlier meta-analysis by Collins and Neafsey, which pooled the results of about 75 studies, found that moderate social drinking may have the opposite effect of reducing the risk of dementia and/or cognitive impairment during aging. (Moderate drinking is defined as a maximum of two drinks per day for men and 1 drink per day for women.)

It appears that limited amounts of alcohol might, in effect, tend to make brain cells more fit. Alcohol in moderate amounts stresses cells and thus toughens them up to cope with major stresses and insults down the road that could cause dementia. But too much alcohol overwhelms the cells, leading to neuroinflammation and cell death.

Further studies are needed to confirm whether fish oil protects against alcohol-related cognitive injury and dementia in adult rodent models. “Fish oil has the potential of helping preserve brain integrity in chronic alcohol abusers,” Collins said. “At the very least, it is unlikely that it would hurt them.”

But Collins added that the best way for an alcohol abuser to protect the brain is to cut back to low or moderate amounts or quit entirely. “We don’t want people to think it is okay to take a few fish oil capsules and then continue to go on abusing alcohol,” he said. PLOS ONE is an international, peer-reviewed, open-access online journal. Collins earlier reported findings at the 14th Congress of the European Society for Biomedical Research on Alcoholism in Warsaw.

Source: Neuroinflammation and Neurodegeneration in Adult Rat Brain from Binge Ethanol Exposure: Abrogation by Docosahexaenoic Acid. PLoS ONE, 2014; 9 (7): e101223 DOI:10.1371/journal.pone.0101223

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects,Health :

Researchers link a gene already tied to alcohol dependence with a neurotransmitter involved in anxiety and relaxation.

The neurofibromatosis type 1 (Nf1) gene, which has been previously linked to alcohol dependence, may exert its influence on alcohol intake through the regulation of gamma-aminobutyric acid (GABA), a neurotransmitter known to decrease anxiety and boost feelings of relaxation, according to a mouse study published this month (August 18) in Biological Psychiatry. The research, led by scientists at The Scripps Research Institute (TSRI), also links variations in the human Nf1 with the risk and severity of alcohol dependence.

“Despite a significant genetic contribution to alcohol dependence, few risk genes have been identified to date, and their mechanisms of action are generally poorly understood,” co-author Vez Repunte-Canonigo said in a press release.

The team decided to look for a connection with the neurotransmitter GABA as a result of previous work that has shown GABA release in the central amygdala, a brain area involved in decision making, stress, and addiction, is “critical in the transition from recreational drinking to alcohol dependence,” said co-author Melissa Herman. Examining mouse models of alcohol dependence, the team found that mice with functional Nf1 genes started to increase their alcohol intake after a single period of withdrawal, while those with one copy of the gene knocked out did not increase their ethanol consumption. Moreover, in heterozygous Nf1 mice, intake of alcohol did not result in higher GABA release in the central amygdala, which was observed in mice with two functional copies of the Nf1 gene.

The researchers also explored variation in human Nf1 using data from some 9,000 people and found the gene correlated alcohol-dependence risk and severity. “A better understanding of the molecular processes involved in the transition to alcohol dependence will foster novel strategies for prevention and therapy,” co-author Pietro Paolo Sanna said in the release.

Source: the-scientist.com August 27, 2014

Filed under: Addiction,Alcohol,Brain and Behaviour :

A new survey finds an estimated 17 percent of American high school students say they drink, smoke or use drugs during the school day. The National Center on Addiction and Substance Abuse (CASA) at Columbia University found 86 percent of teens say they know which of their peers are abusing substances at school, CNN reports.

The findings come from an annual telephone survey of about 1,000 students ages 12 to 17. According to the survey, 60 percent of high school students say drugs are available on school grounds, and 44 percent know a classmate who sells drugs at school. Marijuana is the most commonly sold drug at school. Prescription drugs, cocaine and Ecstasy are also available.

Social media plays a role in peer pressure to use drugs and alcohol, the study found. Three-quarters of students said they are encouraged to use marijuana or alcohol when they see images of their peers doing so. The survey found 45 percent said they have seen photos online of their classmates drinking, using drugs or passing out, up 5 percent since last year.

For the first time in the history of the survey, a majority of private school students—54 percent—said their school was “drug-infected.” In 2011, that figure was 36 percent.

Teens are more likely to use drugs or alcohol if they have been left alone overnight, and are less likely to do so if they regularly attend religious services, the survey found.

“The take away from this survey for parents is to talk to their children and get engaged in their children’s lives,” Emily Feinstein, project director of the teen survey, said in a news release. “They should ask their children what they’re seeing at school and online. It takes a teen to know what’s going on in the teen world, but it takes parents to help their children navigate that world.”

Source: www.partnership@drugfree.org. 5^th Sept. 2012

Filed under: Alcohol,Cannabis/Marijuana,Internet,Parents,USA,Youth :

An inquiry on Foetal Alcohol Spectrum Disorder (FASD) has been told men could be just as responsible for causing the condition as women.

A Northern Territory select committee inquiry into action to prevent FASD held public hearings in Alice Springs after visiting Katherine and Tennant Creek.

Criminal lawyer Russell Goldflam presented the People’s Alcohol Action Coalition’s submission and told the inquiry stopping men and women drinking alcohol is the only real solution to prevent damage to the foetus.

Outside the hearing he told reporters new research from South Korea shows an embryo can be affected at the time of conception by compromised semen from men who drink excessively.

“This is very early days. The research has only been done on animals at this stage and it was only published a few months ago,” he said.

What is FASD?

Foetal Alcohol Spectrum Disorder is an umbrella term given to a range of conditions caused by alcohol exposure during pregnancy. There is no agreed way of screening, diagnosing or even defining the condition.

Signs and symptoms of FASD:

• Low birth weight
• Small head circumference
• Failure to thrive
• Feeding problems
• Sensitivity to noise, touch and/or light
• Developmental delay.

In an older child:

• Learning difficulties
• Developmental delays
• Attention deficit/hyperactivity/ADHD
• Memory problems
• Difficulties with social relationships
• Impulsiveness
• Inappropriate behaviour
• Poor understanding of consequences
• Major organ damage.

Source: NT Centre for Disease Control, April 2014

“But it may well be that in some cases FASD is nothing to do with the drinking of the mother but may be from the drinking of the father who helped conceive that child.”

He said the research could have profound implications on policy responses to FASD.

“Instead of focussing on ‘irresponsible women who drink’ we need to cast our net more broadly and develop policies in the population overall, including men,” he said.

Push for a floor price on alcohol

The group has lobbied for years for the Northern Territory Government to introduce a floor price to control alcohol sales.

It has also urged the NT not to impose policies that criminalise the behaviour of women who drink when they’re pregnant.

“We’re now beginning to realise the enormity of the problem of children not even being born with a real chance in life because they’re afflicted with this inherited condition which stunts their growth, stunts their development as individuals, stunts their potential,” Mr Goldflam said.

“It may turn out that there are so many people in this category that it stunts our community as a whole.”

The Public Health Association’s Dr Rosalie Schultz told the inquiry by the time most women realise they are pregnant the baby is already affected by FASD.

She said this meant efforts to reduce the prevalence of the disorder needed to apply to the entire population, not just women who drink when they are pregnant.

Source: abc.net.au 1^st Aug.2014

Filed under: Alcohol,Australia,Drug use-various effects on foetus, babies, children and youth,Health :

Lawmakers have expressed concern over a new form of alcohol that could hit the market as early as the fall. In early April, the Alcohol and Tobacco Tax and Trade Bureau (TTB) approved labels for seven varieties of Palcohol, a brand of dehydrated alcohol, ranging from straight vodka to a powdered margarita. Derided as “the Kool-Aid of teen binge drinking,” lawmakers and other concerned parties say Palcohol poses a particular risk for youth who may be attracted to this easily portable, easily hidden form of alcohol.

Dehydrated or powdered alcohol is not a new product. Patents have been held for various formulas since 1970, but never came to market due to either a lackluster market or difficulty with government regulation. However, the labelling approval of Palcohol, which the TTB has since revoked, drew attention to the many dangers inherent in dehydrated alcohol, many of which seemed to be not only acknowledged, but advertised by Palcohol creator Mark Phillips.The original Palcohol website, written in language Phillips describes as “edgy,” encouraged users to sneak the product into banned venues, sprinkle it onto food, and even discussed snorting the product. From the original website: “Let’s talk about the elephant in the room….snorting Palcohol. Yes, you can snort it. And you’ll get drunk almost instantly because the alcohol will be absorbed so quickly in your nose. Good idea? No. It will mess you up. Use Palcohol responsibly.”This flippant approach of the manufacturer only highlighted growing concerns with the product, particularly: youth access, spiking food or beverages, and snorting or inhaling the product. The Palcohol site has now been modified to remove the offending remarks and provide more information on how the product will be difficult to abuse.

The modified FAQ section on snorting now reads: “Can I snort it? We have seen comments about goofballs wanting to snort it. Don’t do it! You wouldn’t want to anyway. It would take you approximately 60 minutes of painful snorting to get the equivalent of one shot of vodka up your nose. Why would you do that when drinking a shot of liquid vodka takes about two seconds?”

While Phillips has modified his marketing approach and resubmitted Palcohol for TTB review, concerned lawmakers, such as Senator Chuck Schumer (D-N.Y.) are calling for the product to be banned before it enters the market.

“It’s absurd. It’s scary,” Schumer told WCBS Radio and other news outlets recently. “I’m calling on the Food and Drug Administration to immediately step in, investigate Palcohol based on its obvious health risks and prohibit this ludicrous product from going to market.”

Schumer was a driving force behind the ban of Four Loko and other dangerous caffeinated alcohol products, the last alcoholic fad abused by teens and young adults.

CADCA agrees with Sen. Schumer.

“Palcohol is a ridiculous product and really just an attempt to appeal to young people. CADCA believes that there’s nothing good that can come out of powdered alcohol and we support efforts to restrict it.  It’s important to remain vigilant about new and emerging novelty products like these and that’s why it’s critical that we have community coalitions across the country that are alerting us to these products and trends before they wreak havoc on our communities,” said Gen. Arthur T. Dean, CADCA Chairman and CEO.

While Palcohol is being resubmitted to the TTB for further review, some states are working to ban the product before it enters the national market. While Mark Phillips notes that Palcohol would federally be processed and sold in the same venues as traditional alcohol, in Vermont, state Senator Kevin Mullin is concerned that current state laws only address liquid alcohol, making the powdered form difficult to regulate, and more accessible to youth.

“You can’t buy a bottle of gin at the liquor store if you’re 16. But there’s nothing that I can see in Vermont statute that would prohibit you from buying powdered alcohol, if it was available,” he told Vermont’s NPR affiliate.

In Minnesota, state Representative Joe Atkins has introduced a bill to enact a statewide ban as quickly as possible, noting “with how quickly this is moving, we shouldn’t wait until next session to deal with this issue. We need to move quickly to protect public health.”

Alcohol Justice, an alcohol industry watchdog group, agrees that immediate action is necessary to prevent powered alcohol from ever reaching the market. The group has asked concerned parties to write letters to federal officials through their online tool, calling for the ban of powdered alcohol before it ever is available to teens or young adults.

Source: CADCA May 07, 2014

Filed under: Alcohol,Economic,Effects of Drugs,Global Drug Legalisation Efforts,Legal Sector,USA :

Excessive alcohol use is usually associated with damage to the liver. While that is a common side effect, researchers are now warning that heavy drinking can also take a toll on the lungs.

Alcohol can break down the immune system in the lungs, making them more vulnerable to infection, and the damage it causes. It’s why alcoholics are at increased risk of developing pneumonia and life-threatening acute respiratory distress syndrome (ARDS), for which there is no treatment.

Researchers at Thomas Jefferson University say they have discovered that one of the keys to immune system failure in the lung is a build-up of fat. It’s significant, they say, because it not only explains why alcohol is linked to lung disease but offers the possibility of a new treatment.

Alcoholic fatty lung

“We call it the alcoholic fatty lung,” said lead researcher Ross Summer, M.D. “The fat accumulation in the lungs mimics the process that causes fat to build up and destroy the liver of alcoholics.”

When you over-consume alcohol your liver cells begin to produce fat – most likely a defense against the toxic effects of alcohol. Over time that fat accumulates to the point that heavy drinkers develop so called “fatty liver disease.”

The fat build-up at first impairs liver function but can also cause scarring that eventually leads to liver failure. So, what does this have to do with the lungs?

The lungs also contain cells that produce fat. These cells expel a fatty secretion onto the inner lining of the lung to keep the airways properly lubricated during breathing. Summer and his teams speculated that these cells might act the same way liver cells do after extended alcohol exposure.

The study

Laboratory rats were enlisted for experiments and the researchers noted the lung cells increased production of triglycerides by 100% and free fatty acids by 300%. The researchers also noticed that immune cells in the lungs were less effective against infection.

From this, the researchers conclude that lipid lowering drugs might be an effective tool for doctors treating alcohol-related pneumonia. They think it might also head off development of ARDS.

Increased scrutiny

Alcohol only recently has received new scrutiny as a serious health threat. The Centers for Disease Control and Prevention (CDC) says there are approximately 88,000 deaths in the U.S. each year that can be attributed to excessive alcohol use, making it the third leading lifestyle cause of death in the nation.

“Excessive alcohol use is responsible for 2.5 million years of potential life lost (YPLL) annually, or an average of about 30 years of potential life lost for each death,” the CDC said in a report.

In 2006, there were more than 1.2 million emergency room visits and 2.7 million physician office visits due to excessive drinking, the agency said. The economic costs of excessive alcohol consumption in 2006 were estimated at $223.5 billion.

Then there is the whole category of deaths and injuries due to accidents caused by excessive alcohol consumption. And there is some evidence that the current statistics understate the problem.

In March researchers writing in the Journal of Studies on Alcohol and Drugs suggested a lot of highway deaths – and other accidents in which alcohol was a factor – might not make it into the alcohol-related statistics.

Between 1999 and 2009, more than 450,000 Americans were killed in a traffic crashes. The researchers maintain that in cases where alcohol was involved, death certificates very often failed to list alcohol as a cause of death.

Defining problem drinking

What constitutes excessive drinking? Heavy drinking is defined as 8 or more drinks per week for women and 15 or more drinks for men.

But don’t think only drinking on Saturday night – but polishing off 12 beers – will qualify you as a moderate drinker. Binge drinking, according to the CDC, is the worst kind.

Binge drinking is defined as 4 or more drinks on a single occasion for women and 5 drinks for men.

Source: www.consumeraffairs.com 7^th July 2014

Filed under: Addiction,Alcohol,Health :

More mothers are now drinking heavily in pregnancy, leading to birth defects The number of diagnosed cases of foetal alcohol syndrome in those born to women who drink during pregnancy has tripled since records of the debilitating condition were first kept 16 years ago.

In 2012-2013 there were 252 diagnoses of the syndrome, which can leave victims severely mentally and physically impaired, compared with 89 in 1997-98. Cases are up 37% since 2009-2010.

Experts say the figures, for England only, suggest an improved ability to diagnose the condition but also a continued failure to deal with alcohol abuse. It is feared that those so far diagnosed are the tip of the iceberg. There is often no physical sign of the condition, but victims are left with learning difficulties and an inability to connect emotionally with their peers. Without diagnosis, they are often not helped during their time at school and become isolated as adults.

Susan Fleisher, chief executive of the National Organisation for Foetal Alcohol Syndrome, whose adopted daughter suffers from the condition, said: “The World Health Organisation says that one in 100 people has foetal alcohol spectrum disorder, which is the umbrella term used to describe the conditions that occur in people who have been diagnosed with some, but not all, of the symptoms of foetal alcohol syndrome. But there have been studies in Italy and the US that say that between 2% and 5% of the population is affected by this.

“And, remember, Britain is the number one binge-drinking country in Europe. The chances are we are closer to 5%, although we can’t say that for sure because it is under-diagnosed and difficult to diagnose. Only 20% have the physical signs of this condition such as small, wide-set eye openings, flattened filtrum, thin upper lip, lower ears, different creases in the hands and there can be skeletal damage. Those are the physical things, but if you don’t see them, then perhaps you don’t ask the question.”

Alcohol kills brain cells in developing foetuses by reducing their oxygen and nutrient intake. More than half of women drink more than the recommended daily amounts, and a quarter of those drink more than twice the recommended amounts. In 2002 some 200,000 women were admitted to NHS hospitals because of alcohol abuse. By 2010 the figure was 437,000. Luciana Berger, the shadow public health minister, said the government should do more to highlight the consequences of heavy drinking and, in particular, during pregnancy. The Department of Health advises that alcohol is to be avoided in pregnancy, while the independent National Institute for Health and Clinical Excellence advises women to avoid alcohol in the first three months of pregnancy because of the risk of a miscarriage.

In 2007 Lord Mitchell introduced an alcohol labelling bill into the House of Lords. The bill was passed, but it failed to gain a sponsor in the Commons. The bill sought to make it mandatory for all containers of alcoholic products to have a government warning telling purchasers: “Drinking alcoholic beverages during pregnancy, even in small quantities, can have serious consequences for the health of the baby.”

In the United States and Canada all containers have similar wording and all pubs, bars and clubs are obliged to display a warning statement.

Berger, who uncovered the new figures, said: “The government must ensure that expectant mums have the information they need to make informed choices during their pregnancy. Instead, ministers have relied too heavily on the drinks industry to do it for them.

“Government must stop putting the interests of business before the health of mums and babies and take a bolder approach.”

Source: theguardian.com 21st June 2014

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,USA :

A charity has called for action to tackle the “growing and serious” problem of excessive drinking in older age after official figures revealed the number of alcohol-related deaths among people aged 75 and over has increased to their highest level since records began in 1991.

The rise in alcohol-related deaths in the UK among the elderly in 2012, up 18% for men and 12% for women, came despite an overall drop in the number of such deaths across all age groups to 8,367, down 361 on the previous year, Office for National Statistics (ONS) data shows.

The death rates per 100,000 also reached their highest level since records began, at 28.5 for men and 13.5 for women – illustrating that the rise is not just a result of an aging population. Caroline Abrahams, charity director at Age UK said excessive drinking was often linked with issues such as bereavement, loneliness and isolation.

“Whilst the spotlight on excessive drinking generally falls on younger people, the most significant increases in alcohol related harm are actually in older age groups, with people aged 65 and over also reporting the highest rates of drinking on five or more days a week,” she said. “The numbers of alcohol-related hospital admissions, illnesses and mental health disorders among older people are also sadly on the rise. “It’s time that excessive drinking in older age is recognised as a growing and serious problem and that appropriate and effective preventative and treatment services are made available.”

There were 580 alcohol-related deaths among men aged 75 and over in 2012 and 385 among women aged 75 and over. When the data series began in 1991 there were 18.1 deaths per 100,000 men aged 75 and over (equivalent to 257 in absolute terms) and 10.5 deaths per 100,000 women aged 75 and over (equivalent to 271 deaths). The only other group which saw a rise in deaths in 2012 over the previous year was women aged between 55-74, with a 3% increase to 1,318 deaths in 2012 and a rise in the rate per 100,000 from 19.5 to 19.8.

The overall number of alcohol-related deaths per 100,000, adjusted for age, fell to 11.8 in 2012, its lowest level since 2000, when it stood at 11.2. But the ONS said Scotland was the only country in the UK in which male and female death rates were significantly lower in 2012 than 2002.

Eric Appleby, chief executive of Alcohol Concern said: “We are facing historically high levels of health harms caused by alcohol misuse, with over a million alcohol-related hospital admissions each year and we’re one of the few European countries where liver disease is on the increase.”

Alcoholic liver disease was responsible for 63% (4,425) of alcohol-related deaths in 2012. The fourth highest alcohol-related cause of death was accidental alcohol poisoning (396 deaths), including 14 deaths of people in their 20s. The ONS said: “There has been speculation that the influence of social media drinking games may drive these figures up in the future particularly among younger people.”

Professor Kevin Fenton, director of health and wellbeing at Public Health England, said it was working in partnership with the NHS, other agencies and local authorities to tackle

harmful use of alcohol. “Key priorities are implementing measures which make drinking at lower risk levels the easier choice; early identification and advice targeted at those who are most at risk; and the right treatment and support for people who are dependent on alcohol,” he said.

Source: http://www.theguardian.com/society/2014/feb/19/alcohol-deaths-elderly-rise-ons

Filed under: Alcohol,Health,Social Affairs :

Universal Internet-based prevention for alcohol and cannabis use reduces truancy, psychological distress and moral disengagement: A cluster randomised controlled trial.

Abstract

AIMS:

A universal Internet-based preventive intervention has been shown to reduce alcohol and cannabis use. The aim of this study was to examine if this program could also reduce risk-factors associated with substance use in adolescents.

METHOD:

A cluster randomised controlled trial was conducted in Sydney, Australia in 2007-2008 to assess the effectiveness of the Internet-based Climate Schools: Alcohol and Cannabis course. The evidence-based course, aimed at reducing alcohol and cannabis use, consists of two sets of six lessons delivered approximately six months apart. A total of 764 students (mean 13.1years) from 10 secondary schools were randomly allocated to receive the preventive intervention (n=397, five schools), or their usual health classes (n=367, five schools) over the year. Participants were assessed at baseline, immediately post, and six and twelve months following the intervention on their levels of truancy, psychological distress and moral disengagement.

RESULTS:

Compared to the control group, students in the intervention group showed significant reductions in truancy, psychological distress and moral disengagement up to twelve months following completion of the intervention.

CONCLUSIONS:

These intervention effects indicate that Internet-based preventive interventions designed to prevent alcohol and cannabis use can concurrently reduce risk-factors associated with substance use in adolescents.

Source: Prev Med. 2014 May 10;65C:109-115. doi: 10.1016/j.ypmed.2014.05.003. [Epub ahead of print]

Filed under: Alcohol,Cannabis/Marijuana,Education,Internet,Prevention and Intervention :

Abstract

OBJECTIVES:

The online universal Climate Schools intervention has been found to be effective in reducing the use of alcohol and cannabis among Australian adolescents. The aim of the current study was to examine the feasibility of implementing this prevention programme in the UK.

DESIGN:

A pilot study examining the feasibility of the Climate Schools programme in the UK was conducted with teachers and students from Year 9 classes at two secondary schools in southeast London. Teachers were asked to implement the evidence-based Climate Schools programme over the school year with their students. The intervention consisted of two modules (each with six lessons) delivered approximately 6 months apart. Following completion of the intervention, students and teachers were asked to evaluate the programme.

RESULTS:

11 teachers and 222 students from two secondary schools evaluated the programme. Overall, the evaluations were extremely positive. Specifically, 85% of students said the information on alcohol and cannabis and how to stay safe was easy to understand, 84% said it was easy to learn and 80% said the online cartoon-based format was an enjoyable way to learn health theory topics. All teachers said the students were able to recall the information taught, 82% said the computer component was easy to implement and all teachers said the teacher’s manual was easy to use to prepare class activities. Importantly, 82% of teachers said it was likely that they would use the programme in the future and recommend it to others.

CONCLUSIONS:

The Internet-based universal Climate Schools prevention programme to be both feasible and acceptable to students and teachers in the UK. A full evaluation trial of the intervention is now required to examine its effectiveness in reducing alcohol and cannabis use among adolescents in the UK before implementation in the UK school system.

Source: PMID: 24840248 BMJ Open. 2014 May 19;4(5):e004750. doi: 10.1136/bmjopen-2013-004750.

Filed under: Alcohol,Australia,Cannabis/Marijuana,Education,Prevention and Intervention :

Dr. Robert DuPont, President, Institute for Behavior and Health | March 28, 2014

In a recent National Public Radio interview, Dr. Lance Dodes, co-author of a new book that attacks the efficacy of Alcoholics Anonymous (AA) and the many 12-step groups it has inspired, declared that AA — which he repeatedly misidentified as a “treatment” — probably has “the worst success rate in all of medicine,” and is “harmful” to those who do not do well within its program.

He told NPR that AA’s success rate was “between 5 and 10 percent,” and that AA harms people because “everyone believes that AA is the right treatment. AA is never wrong … If you fail in AA, it’s you that’s failed,” he said.

Moreover, Dodes criticized AA and Narcotics Anonymous’ (NA) “tally” system, which recognizes incremental periods of continued sobriety by awarding chips. “The dark side is, if you have a beer after six months of sobriety, you’re back to zero in AA,” Dodes said. “That makes no sense. It’s unscientific. It’s simply crazy. If you have only a beer in six months, you’re doing beautifully.”

I couldn’t disagree more. His message is not only inaccurate and distorted, but also dangerous. No one should be discouraged from participating in these fellowships. They save lives every day.

When people ask me the percentage of success of AA and NA, the 12-step fellowships, I say it is 100 percent — for those who follow the programs as they’re intended to be followed. This means not just going to an occasional meeting, but to many meetings every week, having a sponsor — who is similar to a sober companion — “working” each of the 12 steps in depth, specifically as they apply to the recovering addict, and making recovery the No. 1 priority. This group of related fellowships is a modern miracle. There are many reasons to be proud of America, but none is more personally important to me — or more unique — than the founding of Alcoholics Anonymous in 1935 in Akron, Ohio.

AA is not “treatment,” and it cannot be meaningfully compared to any treatment. When can anyone find a treatment program located in virtually every part of the world? A treatment program where someone calls you daily? A treatment program where you can call someone at 3 a.m.? And a “treatment” that not only is free to the suffering addict and alcoholic, but that requires no insurance, government funding or a license, and is not subject to any regulation?

No one makes money from it. Rich folks cannot even give money to it, because it needs none, other than the few dollars for administrative costs that its members donate during the meetings themselves. No one writes books about it. The groups actually seek no publicity; in fact, publicity goes against its principles. The word “anonymous” is part of its name for a reason; members respect the anonymity of those who participate, as well as their personal stories.

Moreover, unlike what Dodes apparently believes, no one judges you if you relapse. No one makes you feel as if you’ve failed. Rather, you receive unconditional support. I know of no other programs like these. They are not treatment, nor are they religion. The only requirement is a desire to stop drinking and using drugs.

But to say, as Dodes seems to be suggesting, that AA merely is a supportive social organization completely misses what this miracle is: AA and NA are well-established, sophisticated and effective paths to “recovery,” a term adopted by these fellowships to make clear that AA does not offer to help members get back to their “premorbid” state, but rather to reach an entirely new and better state of living. Its members are not “reformed,” which has a negative connotation, but “recovering,” which is — and must be — a lifelong process.

Those in recovery serve as an inspiration, not only to drug addicts and alcoholics, but to everyone they encounter — a striking and remarkable contrast to the response they would receive if they were still using alcohol and drugs.

The bright line drawn by AA and NA — the sobriety date that marks the last time a recovering addict used alcohol or other drugs — is essential. It differs radically from the academic and professional standard for drug and alcohol addiction , which tolerates slips and relapses. The bright line of the sobriety date is a matter of importance and of huge pride for fellowship members — it is a core marker of identity in the fellowships, and a fundamental defining part of the disease of addiction. One of the true joys of this fellowship is attending a group celebration that commemorates a recovering addict’s “clean time” anniversary.

The all too common academic, professional views on addiction, well represented by Dodes, run counter to the AA and NA goal of sobriety. Many professionals and academics see continued alcohol and drug use as OK but “problem-generating use” as not quite as acceptable. They encourage controlled, responsible alcohol and drug use. They encourage cutting down, but not stopping. They view drug and alcohol use by addicts as a lifestyle alternative that, like sexual orientation, should not be “stigmatized.”

That is a reckless view. An addict who has one beer after six months of sobriety is not doing “beautifully.” Instead, he or she is courting catastrophe, and likely to easily fall back into active addiction. An addict cannot just have one beer, or one cigarette, or one pill. True lifelong recovery does not happen that way, and anyone who believes that it does is heading for a major relapse.

There are endless examples of skeptics like Dodes who seek alternatives to AA, or approaches that attack AA. I suggest to my patients who reject AA that they find one of these alternatives, and see what they think of it. They tell me that such programs are hard to find. I ask them, “Why do you think that is the case? Doesn’t that tell you something?” When they go to these alternative meetings and hear little beyond AA-bashing, I ask them, “How will this help keep you sober?”

AA and NA do not replace treatment; they enhance it. I see this daily in my own practice. Some addicts do get well without AA or NA, but far more of them fail. I encourage my patients to join the fellowships, and I rejoice with them when they do, confident that they have a better chance at lifelong recovery.

When patients tell me they have attended AA or NA meetings but they haven’t helped, it doesn’t take long to discover that their attendance was brief. I urge them to find a sponsor and speak to their sponsor daily. I tell them to work the steps with a life-or-death intensity, and to do what is known as “90/90” — attend 90 meetings in 90 days. Those who follow these suggestions almost always end up with a new outlook on life and the potential for long-term sobriety. [Most Alcoholics in ‘Serious Denial’ About Treatment ]

Clinicians like me all have come to believe that these fellowships are a blessing — not just for our patients, but for all of us.

The wisdom of the 12-step fellowships does not come simply from Bill Wilson or Bob Smith, AA’s founders. It is wisdom distilled from the experiences of millions of suffering addicts and alcoholics. That source makes it utterly different from the academic studies of addiction. With the 12 steps, what works sticks, and what doesn’t disappears. The leaders don’t abandon the latter; the entire community does.

The 12-step approach is ever-changing and growing. It also is endlessly diverse, fitting in with every culture and subculture in the world. It is adaptable and sensitive to vast diversity. It is unlicensed and uncensored. Anyone can start an AA or NA meeting anywhere he or she chooses. Those groups that meet real needs of real people will thrive and grow.

To be sure, attacking AA probably sells books. Sadly, Dodes’ view of the 12-step fellowships, while misguided and ill-informed, is held by many otherwise sensible and well-informed individuals. I never have understood their skepticism. Think about it. Why have these programs endured so long and become so widespread?

The answer: It works if you work it.

Source: www. livescience.com 28^th March 2014

Filed under: Addiction,Alcohol,Treatment and Addiction :

BINGE drinking and smoking marijuana in adolescence can cause irreversible brain damage, a new study has found.

Chronic abuse for just a year and a half damages white matter and leads to worsened neuro-cognitive abilities into adulthood, researchers say. Drink and drug abuse is also associated with poorer neural structure, function and metabolism, and can change the structure of the brain and lead to diminished self-control, it is claimed.

“Research has shown differences in the brains of teens who use alcohol and marijuana as compared to teens who do not use these drugs or report only very infrequent, minimal use,” said Joanna Jacobus, of the University of California, San Diego, and lead author for the study.

“Alcohol and marijuana may have a negative impact by altering important cellular communication in the brain, preventing development of new healthy cells, and/or causing inflammation, which can adversely impact healthy brain development in many ways.

White matter, the areas of the brain which contain the “information highway”, allows for quick and efficient communication between brain regions. If these are damaged, it can mean slower processing and poorer performance in memory, attention and decision-making.

A teenager’s brain is still developing, and brain connections which inhibit risky behaviour are still forming, meaning some youths are likely to think of the immediate effects rather than the consequences.

Co-author Professor Duncan Clark said. “Maturation of the brain during adolescence is thought to be the foundation for self-control. The developing adolescent brain, compared to the fully developed adult brain, is also probably more vulnerable to alcohol neurotoxicity.

“Adolescents are vulnerable to loss of control and, when this loss of control involves substance use, excessive or risky substance use can have adverse consequences.”

For the study, published in a special online issue of Alcoholism: Clinical & Experimental Research, the researchers followed 92 adolescents – 63 males, 29 females – aged between 16 and 20 who were divided into two groups: 41 with extensive alcohol and marijuana use histories and 51 with consistently minimal, if any, substance use. They all underwent extensive brain scans.

Poorer white matter tissue health was found in teens who engage in heavy alcohol and marijuana use and that health declined over the period of the study.

Prof Clark said: “We are concerned that even subtle deficits in brain microstructure may lead to diminished self-control.” Ms Jacobus added: “Our findings underscore that early initiation of alcohol and marijuana use can have negative implications on the brain.

“We hope this information can be communicated to teens to help them understand why drinking during adolescence is discouraged. In the future, biomarkers such as tissue health may help identify teens that are particularly vulnerable for engaging in riskier behaviours such as drinking.”

Source: www.Scotsman.com 15.12.12

Filed under: Alcohol,Cannabis/Marijuana,Health :

What are the facts?

The International Agency on Research on Cancer Monographs has declared alcohol carcinogenic. It is the ethanol within alcohol that is carcinogenic and it is impossible to differentiate between different risks associated with different alcohol.

According to some studies, 10% total cancer in men and 3% total cancer in women could be attributable to alcohol consumption

Why alcohol causes cancer?

There are a number of biological mechanisms that may explain alcohol’s contribution to cancer development.

– Ethanol may cause cancer through the formation of acetaldehyde, its most toxic metabolite.

– Acetaldeyhde has mutagenic and carciongenic properties, and bonds with DNA to increase the risk of DNA mutations and impaired cell replication.

– Ethanol may also cause direct tissue damage by irritating the epithelium and increasing the absorption of carcinogens through its effects as a solvent.

– In addition, alcohol can increase the level of hormones such as oestrogen, therby increasing breast cancer risk, and increase the risk of liver cancer by causing cirrhosis of the liver, increased oxidative stress, altered methylation and reduced levels of retinoic acid.

Lifestyle factors such as smoking, poor oral hygiene, and certain nutrient deficiencies (folate, vitamin B6, methyl donors) or excesses (vitamin A/ Beta carotene), owing to poor diet or self- medication, may also increase the risk for alcohol-associated tumours.

Research Findings

Heavy ethanol intake is associated with an increased risk of prostate cancer (PCa) among low-risk men with at least one prior negative prostate biopsy, investigators reported here at the annual Genitourinary Cancers Symposium. It also is associated with an elevated risk for high-grade PCa. Renal& Urology News

Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study

In western Europe, an important proportion of cases of cancer can be attributable to alcohol consumption, especially consumption higher than the recommended upper limits. Among men and women 10% and 3% of the incidence of total cancer was attributable to former and current alcohol consumption in the selected European countries: British Medical Journal

Source: www.alcoholandcancer.eu June2012

Filed under: Alcohol,Health :

More than 3 million people died from using alcohol in 2012, for reasons ranging from cancer to violence, the World Health Organisation said on Monday, as it called on governments to do more to limit the damage.

“More needs to be done to protect populations from the negative health consequences of alcohol consumption,” said Oleg Chestnov, a WHO expert on chronic disease and mental health.

He added there was “no room for complacency”, warning that drinking too much kills more men than women, raises people’s risk of developing more than 200 diseases, and killed 3.3 million people in 2012.

On average, according to the WHO report, every person in the world aged 15 years or older drinks 6.2 liters of pure alcohol per year. But less than half the population – 38.3 percent – drinks, so those who do drink on average 17 liters of pure alcohol a year.

“We found that worldwide about 16 percent of drinkers engage in heavy episodic drinking – often referred to as ‘binge-drinking’ – which is the most harmful to health,” said Shekhar Saxena, director for mental health and substance abuse at the WHO. Poorer people are generally more affected by the social and health consequences of alcohol, he said: “They often lack quality health care and are less protected by functional family or community networks.”

The global status report on alcohol and health covered 194 countries and looked at alcohol consumption, its impact on public health and policy responses. It found that some countries are already strengthening measures to protect people from harmful drinking. Those include increasing taxes on alcohol, limiting its availability by raising age limits and regulating marketing.

More countries should take similar action, WHO said. More also needed to be done to raise awareness of the damage alcohol can do to people’s health and screen for those who may need earlier intervention to cut down or stop. Globally, Europe consumes the most alcohol per person. Some of its countries having particularly high rates of harmful drinking. A study published earlier this year found that a quarter of all Russian men die before they reach their mid-fifties, largely from drinking to excess. Some men in that study reported drinking three or more bottles of vodka a week.

The WHO said global trend analyses showed that drinking has been stable over the last five years in Europe, Africa and the Americas. But it is growing in South-East Asia and the Western Pacific.

Source: http://www.reuters.com/article/2014/05/12/us-health-alcohol-idUSKBN0DS0QS20140512

Filed under: Alcohol,Drug use-various effects,Health,Prevention and Intervention :

Molecular analysis of brain tissue from alcoholics revealed numerous differences from normal controls, potentially providing a key link connecting the brain to behavior in chronic alcoholism. Light microscopy of the prefrontal cortex in alcoholics identified altered neuronal cell organization, and subsequent studies revealed profound reductions in the levels of various cytoskeletal proteins

This Is Your Brain on Alcohol for Years

Brain autopsies in 20 alcoholic individuals versus 20 matched controls revealed a spectrum of differences in protein types and concentrations that may “provide a molecular basis for some of the neuronal and behavioral abnormalities attributed to alcoholics,” according to a British-Spanish research group. Led by Amaia Erdozain, PhD, and Wayne Carter, PhD, of the University of Nottingham in England, the researchers examined the prefrontal cortex (Brodmann area 9) in exquisite detail, using gel electrophoresis, two types of mass spectrometry, and other assays to identify and quantify proteins present in the postmortem tissue.

Key findings in the alcoholic specimens compared with controls included:

* Thinner cytoskeletons around cell nuclei in cortical and subcortical neurons

* Disrupted subcortical neuron patterning

* “Dramatic” reductions in spectrin-beta II and in alpha- and beta-tubulins

* Greater alpha-tubulin acetylation

* Reduced proteasome activity

Not only might these molecular changes reflect or cause the clinical effects of chronic alcoholism, they may also contribute to the overall brain atrophy seen in the condition, the researchers suggested in their report, appearing online in PLoS ONE.

Limitations to the study included less-than-perfect assays for some proteins and variations among the alcoholic subjects in age, duration of alcoholism, and cumulative alcohol intake; these subjects may not be representative of alcoholics in the general population.

Source: www.medpagetoday.com 4th April 2014

Filed under: Alcohol,Brain and Behaviour :

Bereavement, loneliness and isolation said to be contributing to excessive drinking among older people.

“It’s time that excessive drinking in older age is recognised as a growing and serious problem and that appropriate and effective preventative and treatment services are made available.”

There were 580 alcohol-related deaths among men aged 75 and over in 2012 and 385 among women aged 75 and over.

When the data series began in 1991 there were 18.1 deaths per 100,000 men aged 75 and over (equivalent to 257 in absolute terms) and 10.5 deaths per 100,000 women aged 75 and over (equivalent to 271 deaths). The only other group which saw a rise in deaths in 2012 over the previous year was women aged between 55-74, with a 3% increase to 1,318 deaths in 2012 and a rise in the rate per 100,000 from 19.5 to 19.8.

Professor Kevin Fenton, director of health and wellbeing at Public Health England, said it was working in partnership with the NHS, other agencies and local authorities to tackle harmful use of alcohol. “Key priorities are implementing measures which make drinking at lower risk levels the easier choice; early identification and advice targeted at those who are most at risk; and the right treatment and support for people who are dependent on alcohol,” he said.

Source: http://www.theguardian.com/society/2014/feb/19/alcohol-deaths-elderly-rise-ons

Filed under: Alcohol,Drug use-various effects,Health :

What are the facts?
The International Agency on Research on Cancer Monographs has declared alcohol carcinogenic. It is the ethanol within alcohol that is carcinogenic and it is impossible to differentiate between different risks associated with different alcohol. According to some studies, 10% total cancer in men and 3% total cancer in women could be attributable to alcohol consumption.
Why alcohol causes cancer?
There are a number of biological mechanisms that may explain alcohol’s contribution to cancer development.
– Ethanol may cause cancer through the formation of acetaldehyde, its most toxic metabolite.
– Acetaldeyhde has mutagenic and carciongenic properties, and bonds with DNA to increase the risk of DNA mutations and impaired cell replication.
– Ethanol may also cause direct tissue damage by irritating the epithelium and increasing the absorption of carcinogens through its effects as a solvent.
– In addition, alcohol can increase the level of hormones such as oestrogen, therby increasing breast cancer risk, and increase the risk of liver cancer by causing cirrhosis of the liver, increased oxidative stress, altered methylation and reduced levels of retinoic acid.
Lifestyle factors such as smoking, poor oral hygiene, and certain nutrient deficiencies (folate, vitamin B6, methyl donors) or excesses (vitamin A/ Beta carotene), owing to poor diet or self- medication, may also increase the risk for alcohol-associated tumours.

Research Findings
Prostate Cancer Linked to Heavy Alcohol Intake

Filed under: Alcohol,Drug use-various effects :

Canada’s drinking-age laws have a significant effect on youth mortality, a study demonstrates. The study’s author writes that when compared to Canadian males slightly younger than the minimum legal drinking age, young men who are just older than the drinking age have significant and abrupt increases in mortality, especially from injuries and motor vehicle accidents.

A recent study by a University of Northern British Columbia-based scientist associated with the UBC Faculty of Medicine and UNBC’s Northern Medical Program demonstrates that Canada’s drinking-age laws have a significant effect on youth mortality.

The study was published in the international journal Drug and Alcohol Dependence. In it, Dr. Russell Callaghan writes that when compared to Canadian males slightly younger than the minimum legal drinking age, young men who are just older than the drinking age have significant and abrupt increases in mortality, especially from injuries and motor vehicle accidents.

“This evidence demonstrates that drinking-age legislation has a significant effect on reducing mortality among youth, especially young males,” says Dr. Callaghan.

Currently, the minimum legal drinking age is 18 years of age in Alberta, Manitoba, and Québec, and 19 years in the rest of the country. Using national Canadian death data from 1980 to 2009, researchers examined the causes of deaths of individuals who died between 16 and 22 years of age. They found that immediately following the minimum legal drinking age, male deaths due to injuries rose sharply by 10 to 16 per cent, and male deaths due to motor vehicle accidents increased suddenly by 13 to 15 per cent.

Increases in mortality appeared immediately following the legislated drinking age for 18-year-old females, but these jumps were relatively small.

According to the research, increasing the drinking age to 19 years of age in Alberta, Manitoba, and Québec would prevent seven deaths of 18-year-old men each year. Raising the drinking age to 21 years across the country would prevent 32 annual deaths of male youth 18 to 20 years of age.

“Many provinces, including British Columbia, are undertaking alcohol-policy reforms,” adds Dr. Callaghan. “Our research shows that there are substantial social harms associated with youth drinking. These adverse consequences need to be carefully considered when we develop new provincial alcohol policies. I hope these results will help inform the public and policy makers in Canada about the serious costs associated with hazardous drinking among young people.”

Source: . Impacts of drinking-age laws on mortality in Canada, 1980–2009. Drug and Alcohol Dependence, March 18, 2014

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Health :

Washington, DC (March 21, 2014) – Binge drinking for college students has proven to be a huge problem at many universities. The risk of DUI or even death makes it a public health concern that students and administrators need to face. A recent study by researchers at the University at Buffalo, State University of New York, found that college students exposed to the risk messages of alcohol-related cancer had lower intent to engage in binge drinking.

Cindy Yixin Chen and Z. Janet Yang of the University at Buffalo, State University of New York will present their study at the 64th Annual Conference of the International Communication Association in Seattle, WA. Chen and Yang conducted an online survey in which an experiment was embedded among a sample of college students. The survey examined if risk perception of alcohol-attributable cancer could decrease intention for binge drinking among college students.

Participants were exposed to a brief risk message presenting alcohol-attributable cancer incidence in textual, tabular, or graphic format. The experiment explored if risk messages regarding alcohol-attributable cancer in different formats (text, table, graph) have different influences on risk perception. The experiment also tested if such influences are contingent on different levels of numerical skills of college students.

Chen and Yang found that when risk of alcohol-related cancer was presented in visual tables and graphs, this increased participants’ risk perception and in turn, their reluctance to engage in binge-drinking behavior. Previous studies have examined college students’ perceptions of risk from experiencing alcohol-related problems such as having a hangover, feeling nauseated or vomiting, experiencing blackouts, drunk driving, and unplanned sex. Chen and Yang’s study is the first to examine what formats of messages regarding alcohol-attributable cancer are best to curtail this behavior.

“Binge-drinking among college students has been recognized as one of the most serious public health concerns for over a decade. The current alcohol-prevention campaigns generally focus on consequences of binge-drinking, such as DUI, unintended injuries, death, or a series of health and psychological problems. These negative consequences are well-known, and students hear these repeatedly, which may incur message fatigue,” said Chen. “The risk messages we designed focused on the cancer incidence rates attributable to drinking. This is an innovative approach in message design, as not many college students know the association between drinking and cancer.”

Source: www.sciencecodex.com 26th March 2014

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Education,Health :

HSE launches report on extent of harm caused by alcohol

One in four Irish people have experienced problems because of someone else’s drinking, according to a new report on the extent of harm caused in society by alcohol.

Alcohol’s Harm to Others in Ireland was published by the HSE today. It examined alcohol harm to people other than the drinker in three Irish settings – the general population, the workplace and children and families.

The report confirmed there is very significant harm associated with alcohol, extending far beyond that experienced by the person drinking, in each of these settings. Women are more likely to experience family problems while men are more likely to report assaults due to other people’s drinking habits.

At work, one in ten people reported having to work extra hours or had experienced accidents or close calls due to a co-worker’s problematic drinking. Men and workers in the youngest age group were the most likely to experience the negative consequences due to co-workers who were heavy drinkers.

The overall rate of reported harms in the Irish workforce was double that in comparison to the Australian findings for each of the measures used.

One in ten parents or guardians reported that children experienced at least one negative consequence as a result of someone else’s drinking in the past year. These included verbal abuse, being left in unsafe situations, witnessing serious violence in the home and physical abuse.

Parents who themselves were regular risky drinkers were more likely to report that children experienced at least one of these harms due to others drinking, after controlling for demographics.

Dr. Stephanie O’Keeffe, National Director for Health and Wellbeing with the HSE said the report had been commissioned in response to a growing recognition of alcohol related harm.

“Significant public health and safety concerns are raised by the harm caused to other individuals and to wider society – where we see that a quarter of the population has experienced harm due to another’s drinking,” she said.

Source: www.irishtimes.com 26th March 2014

Filed under: Alcohol,Crime/Violence/Prison :

Parents who believe that following the Continental way of introducing their children to alcohol early as a way of promoting responsible drinking could actually risk them developing alcoholism in later life, a new study has claimed.

Researchers at Yale University said that the younger people have their first drink, the more likely they are to suffer alcohol-related problems in sixth form and at university, and be more prone to drug abuse, liver damage and problematic brain development.

The report belies the belief of many parents who think that giving their children watered-down wine from an early age, or allow them to drink in their mid-teens whilst being supervised, will teach them the dangers of drinking and encourage them to behave more responsibly with alcohol when they grow up.

Meghan Morean, a postdoctoral fellow in the department of psychiatry at Yale University School of Medicine and corresponding author for the study, said: “Beginning to use alcohol at an earlier age was associated with heavier drinking and the experience of more negative consequences during senior year of college.

“Many studies have found relationships between an early AFD (age at first drink) and a range of negative alcohol-related outcomes later in life, including the development of alcohol use disorders, legal problems like drink-driving, and health problems like cirrhosis of the liver.

“There is also evidence that beginning to drink at an early age is associated with more immediate problems, such as compromised brain development and liver damage during adolescence, risky sexual behaviours, poor performance in school, and use of other substances like marijuana and cocaine.”

The research involved 1,160 first year college students who had data compiled about their drinking habits from the previous four years. Teenagers had their first drink, on average, aged 14. Those who had started getting drunk at 15 were far more likely to develop problems than those who waited until they were 17, even if they had had their first drink at 15, she said.

However, she said that while having your first drink at a young age is associated with many negative consequences, it is not clear that it directly causes heavy drinking or other negative outcomes.

In 2009, the Chief Medical Officer warned that children under 15 should not drink alcohol and warned that as many as a third of 11-15 year olds on a typical weekend drank.

A year later, the charity Alcohol Concern reported that youngsters drinking was a “significant problem” for the UK and that it accounted for 5% of young people’s deaths. In response, the Alcohol Health Alliance UK said that parents should realise they are role models and that “their behaviour in relation to alcohol has more impact than what they tell their children”.

Aric Sigman, who advises the NHS on children and drinking, and has written a book about the issue, Alcohol Nation, said that parents were too happy to ignore the addictive qualities of alcohol as they would drugs, and said that even small amounts of alcohol at a young age can cause addiction.

He said: “Britain has been living under a misconception about not becoming addictive to what is a highly addictive substance. “Parents have this idea that you can somehow override the addictive qualities simply because alcohol is something adults enjoy and like to share.

“Those who drink between the ages of 14 and 16 are four times more likely to become alcoholics or experience problems. “Aside from any moral argument, this is a purely a physiological one. Children are very different physiologically to adults in terms of damage to cells and tissue. We know this in relation to skin cancer, cervical cancer, other addictive substances; alcohol is no different. “Parental disapproval is brilliant for child sobriety. There is a myth that banning your children will turn them into drinkers later. It won’t, and parents should not be conned into discussing their fears.”

Jeremy Todd, Chief Executive of the charity Family Lives, said: “A balance has to be made between whether parents feel comfortable about introducing alcohol to their children in safe environment such as the home, or whether they trust that their children will only drink alcohol once they have reached the legal age.

Ultimately parents know their children and will need to make a judgement call about when and if to introduce their child to alcohol. Equipping parents with the tools to ensure they can talk effectively with their children is the best way of preventing children excessively experimenting and can prevent later problems in teenage and adult life.”

The findings of the Yale research are due to be published in the journal Alcoholism: Clinical & Experimental Research.

Source: TheTelegraph.co.uk 25th August 2012

Filed under: Alcohol,Health,Parents :

Alcohol-related deaths among Welshmen have risen by 15% in the last decade, figures have shown, A report published yesterday by the Office for National Statistics (ONS) found that between 2002 and 2012, the death rate for men in Wales rose by 15%, while the comparable figure for England was a 2% rise.

By contrast, Scotland saw a 37% fall with Northern Ireland saw figures dropping by 8%.

The report said the harmful effects of drinking have caused more than 5,000 deaths every year in Wales and England for the past decade. And it warns that the harmful effects of alcohol accounts for 2.5 million deaths worldwide each year.

“Excessive alcohol consumption is a major cause of preventable premature death, accounting for 1.4% of all deaths registered in England and Wales in 2012,” the study said.

Of the UK’s four nations, only Scotland had both male and female alcohol-related death rates that were significantly higher in 2012 than they were in 2002. Meanwhile, overall death rates were highest among men aged 60 to 64.

The figures published by the ONS showed, that in Wales, 311 men and 193 women died due to alcohol-related reasons in 2012 – an increase of 9.8% on the 459 who died in 2011. The number of deaths in 2012 is the highest since 2008, when 541 people died, and the second highest since at least 1991.

In Wales and England, accidental alcohol poisoning was the fourth highest alcohol-related cause of death in 2012 (accounting for 396 deaths), with over a third of cases among people in their 40s. There were 14 deaths from accidental alcohol poisoning among people in their 20s.

Eric Appleby, chief executive of Alcohol Concern, said: “We are facing historically high levels of health harms caused by alcohol misuse, with over a million alcohol-related hospital admissions each year. “To tackle this, we’re urging the Government to take tougher action including introducing minimum unit pricing.”

A Welsh Government spokesman said: “Each of these deaths is a tragedy for the individuals, their families and friends and society as a whole. These statistics are of course disappointing, and highlight the scale of the challenge we face to change public behaviours in relation to alcohol consumption. Over-consumption of alcohol can be addressed with a strategic approach to changing behaviours.

“Welsh Ministers have been pressing for the devolution of alcohol licensing powers for a number of years. We want to limit advertising of alcohol products and see the introduction of a minimum unit price for alcohol.”

Source: www.walesonline.co 20th Feb 2014

Filed under: Alcohol,Drug use-various effects,Health :

Alcohol Concern Cymru says its report highlights the ‘serious public health challenge’ of alcohol-related brain damage .Alcohol Concern Cymru says alcohol -related brain damage can be treated effectively

A new report outlining the “serious public health challenge” of alcohol-related brain damage has been labelled as a “wake-up call” by campaigners. Alcohol Concern Cymru’s ‘All in the Mind’ paper, published today, says alcohol -related brain damage (ARBD) is poorly understood by the public and many healthcare professionals which is leading to under-diagnosis and lack of treatment. It says there is still “ignorance” and “stereotypes” around the subject, with many seeing its associated conditions, such as Wernicke-Korsakoff’s Syndrome which leads to confusion, memory loss, and difficulty reasoning and understanding, being confined to particular groups of society.

The charity says that the ARBD can be treated effectively, but warns that many health professionals do not know what to look for. The report said: “The long term effects of alcohol on the brain can be both psychological (mental health problems) and physiological (damage to brain tissue). People who drink heavily are particularly vulnerable to developing mental health problems, and alcohol has a role in a number of conditions, including anxiety and depression, psychotic disorders and suicide.

“Over a long period of time, however, heavy drinkers may also develop various types of physical brain damage. These are due in part to the toxic effects of alcohol itself, but long term alcohol misuse can also lead to vitamin deficiencies that exacerbate the damage.

“Although less common than some other alcohol-related conditions, ARBD nevertheless represents a serious public health challenge and remains very much overlooked and misunderstood. This paper seeks to clear up much of the ignorance around ARBD and to place it firmly in the context of our drinking society, rather than stereotyping it as an extreme affliction of a distinct group of easily identifiable ‘problem drinkers’. It also makes the case that, unlike some other forms of mental impairment, ARBD is not a progressive condition – it does not inevitably worsen, and can be successfully treated. It makes the case for ensuring that appropriate treatment is provided promptly to all who can benefit from it.”

Alcohol Concern Cymru director, Andrew Misell, said he hoped the report would be seen as a “wake-up call”. He said: “Most of us know that alcohol can damage our liver, but the fact that it could undermine our long-term brain function is much less well known. And when alcohol-

related brain damage is on the radar, the focus is often on older street drinkers.

“But staff on the front line have been seeing younger people, and other people who don’t fit the stereotype of a homeless dependent drinker, coming in with ARBD.

“Once again, our willingness to see alcohol problems as someone else’s problem, confined to an extreme group of obvious drinkers, is keeping us from seeing the elephant on our doorstep. We hope this paper will be a wake-up call for all of us who drink.

“It’s been excellent to see the stigma around Alzheimer’s Disease gradually disappearing. Unfortunately, the same cannot be said for ARBD. But the prognosis for people with ARBD can be very good – up to three quarters can make some sort of recovery. That has to spur us on to take concerted action to support people to overcome this condition. One very simple and relatively cheap treatment that doesn’t seem to be used a much as it could be is injections of Vitamin B1, also known as thiamine.”

The report raised concerns about the level of drinking in younger people but said research found the highest prevalence of ARBD between the ages of 50 and 60, and follows concerns about the rise in older people abusing alcohol. Recent figures for substance misuse showed the proportion of over 50s in Wales being referred to alcohol treatment centres has increased in the past year from 23.8% of all referrals in July-September 2012 to 25.2% in the same period for 2013.

Today’s report calls for better training for health and social care professionals on how to recognise ARBD and for the Welsh Government to draw up a care pathway for the diagnosis and treatment of the associated conditions.

A Welsh Government spokesman said: “The Substance Misuse Delivery Plan 2013-15 sets out the actions that the Welsh Government is taking to tackle alcohol related brain damage and the recommendations from Alcohol Concern’s report are welcomed and will be considered in conjunction with these actions.”

Source: www.walesonline.co.uk Mar 18, 2014 06:00

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects :

On the basis of three innovative US programmes for offenders or doctors with substance use problems, this analysis concludes that many seriously dependent individuals stop using if non-use is enforced through intensive monitoring and swift, certain but not necessarily severe consequences.

Summary Typical US substance use treatment amounts to a few weeks of outpatient counselling. Given that these disorders are characterised by lifelong risk of relapse, it is not surprising that many treatments yield suboptimal outcomes for many patients. Interventions that work:

• last months or years rather than weeks; • carefully monitor use of alcohol or other drugs of abuse; • impose swift, certain, and meaningful consequences for use and non-use of substances.

This article profiles three innovative care management programmes with these characteristics: physician health programmes, and two therapeutic jurisprudence programmes – South Dakota’s 24/7 Sobriety Project and HOPE probation. These actively and intensively manage the environments in which people with substance use disorders make decisions to use or not to use.

Physician health programmes

Physician health programmes offer drug- and alcohol-using physicians the opportunity, motivation, and support to achieve long-term recovery, using all three strategies in the new paradigm: monitoring, treatment, and 12-step programmes. In return, physicians sign contracts, typically for five years, to adhere to the programme, including completing treatment and submitting to frequent random drug testing to ensure abstinence. Each working day physicians phone or log-in to find out if they must report for testing. All are expected to be active in 12-step or similar community support programmes. Substance use or any other evidence of non-compliance typically results in immediate removal from medical practice to arrange extended treatment followed by more intensive monitoring. A chart review study of a single episode of physician health programme care involving 904 physicians showed that only 0.5% of tests on this high risk, substance abusing population were positive for alcohol or other drugs of abuse.

Hawaii Opportunity Probation with Enforcement

The Hawaii Opportunity Probation with Enforcement (HOPE) programme manages convicted offenders, most of whom are identified as likely to violate community supervision requirements. Their most common drug problem is smoked crystal methamphetamine. A judge tells offenders about the rules, including that they are subject to intensive random testing similar to that used by physician health programmes. Violations of probation, including any drug or alcohol use, missed drug tests, or missed appointments, are met with certain, swift but brief imprisonment.

When asked at the start of the programme, only a few HOPE probationers choose treatment to help them meet the abstinence requirement. The remainder are simply monitored unless they violate probation; most are then referred to treatment. About 85% complete the programme (which can last up to six years) without treatment.

In a 12-month period, 61% of HOPE offenders had no positive drug tests and fewer than 5% had four or more. A study compared probationers randomly assigned to HOPE or to standard probation. After a year, HOPE probationers were 55% less likely to be arrested for a new crime, 72% less likely to use drugs, 61% less likely to miss supervisory appointments, 53% less likely to have their probation revoked, and were sentenced to 48% fewer days of prison.

South Dakota’s 24/7 Sobriety project South Dakota’s 24/7 Sobriety programme serves drink-driving offenders, nearly half of whom have three or more drink-driving convictions. Participants must undergo twice-daily alcohol breath tests at a local police station or wear continuous transdermal alcohol monitoring bracelets and are also subject to regular drug urinalyses or must wear drug detection patches. Positive tests result in immediate brief imprisonment and missed appointments in immediate issuance of arrest warrants. Results are impressive: over 90% of all types of tests are negative, for alcohol breath tests, virtually all. Post-programme recidivism among twice-daily tested offenders is considerably lower than among comparison offenders.

Conclusions

A distinctive feature of these three interventions is the strong leverage used to sanction substance use and to reward abstinence: in physician health programmes, removal from practice and ultimately the loss of medical license versus continuing to practice in a prestigious and well paid profession; in HOPE and 24/7 Sobriety, immediate brief imprisonment versus freedom.

Mandatory abstinence in this new paradigm contrasts sharply with programmes which mandate treatment but do not impose meaningful consequences for substance use. The two offender programmes contrast with common approaches where consequences for non-compliance, including substance use, are delayed, uncertain, and, when applied often after many violations, draconian. This new way of managing substance use patients challenges the view that relapse is an essential feature of their disorder, shifts the focus away from finding new biological treatments, and shows that the key to long-term success lies in sustained changes in the environment in which decisions to use and not use are made. If this passively or actively rewards substance use, use is likely to continue, but the drinking and drug use of many – not all – seriously dependent individuals stops if the environment not only prohibits use, but enforces this with intensive monitoring and swift, certain but not necessarily severe consequences.

Source: Findings.org.uk March 2014

Filed under: Alcohol,Treatment and Addiction :

Although choosing to do something because the perceived benefit outweighs the financial cost is something people do daily, little is known about what happens in the brain when a person makes these kinds of decisions. Studying how these cost-benefit decisions are made when choosing to consume alcohol, University of Georgia associate professor of psychology James MacKillop identified distinct profiles of brain activity that are present when making these decisions.

“We were interested in understanding how the brain makes decisions about drinking alcohol. Particularly, we wanted to clarify how the brain weighs the pros and cons of drinking,” said MacKillop, who directs the Experimental and Clinical Psychopharmacology Laboratory in the UGA Franklin College of Arts and Sciences.

The study combined functional magnetic resonance imaging and a bar laboratory alcohol procedure to see how the cost of alcohol affected people’s preferences. The study group included 24 men, age 21-31, who were heavy drinkers. Participants were given a $15 bar tab and then were asked to make decisions in the fMRI scanner about how many drinks they would choose at varying prices, from very low to very high. Their choices translated into real drinks, at most eight that they received in the bar immediately after the scan. Any money not spent on drinks was theirs to keep.

The study applied a neuro-economic approach, which integrates concepts and methods from psychology, economics and cognitive neuroscience to understand how the brain makes decisions. In this study, participants’ cost-benefit decisions were categorized into those in which drinking was perceived to have all benefit and no cost, to have both benefits and costs, and to have all costs and no benefits. In doing so, MacKillop could dissect the neural mechanisms responsible for different types of cost-benefit decision-making.

“We tried to span several levels of analysis, to think about clinical questions, like why do people choose to drink or not drink alcohol, and then unpack those choices into the underlying units of the brain that are involved,” he said.

When participants decided to drink in general, activation was seen in several areas of the cerebral cortex, such as the prefrontal and parietal cortices. However, when the decision to drink was affected by the cost of alcohol, activation involved frontostriatal regions, which are important for the interplay between deliberation and reward value, suggesting suppression resulting from greater cognitive load. This is the first study of its kind to examine cost-benefit decision-making for alcohol and was the first to apply a framework from economics, called demand curve analysis, to understanding cost-benefit decision making.

“The brain activity was most differentially active during the suppressed consumption choices, suggesting that participants were experiencing the most conflict,” MacKillop said. “We had speculated during the design of the study that the choices not to drink at all might require the most cognitive effort, but that didn’t seem to be the case. Once people decided that the cost of drinking was too high, they didn’t appear to experience a great deal of conflict in terms of the associated brain activity.”

These conflicted decisions appeared to be represented by activity in the anterior insula, which has been linked in previous addiction studies to the motivational circuitry of the brain. Not only encoding how much people crave or value drugs, this portion of the brain is believed to be responsible for processing interceptive experiences, a person’s visceral physiological responses.

“It was interesting that the insula was sensitive to escalating alcohol costs especially when the costs of drinking outweighed the benefits,” MacKillop said. “That means this could be the region of the brain at the intersection of how our rational and irrational systems work with one another. In general, we saw the choices associated with differential brain activity were those choices in the middle, where people were making choices that reflect the ambivalence between cost and benefits. Where we saw that tension, we saw the most brain activity.”

While MacKillop acknowledges the impact this research could have on neuromarketing — or understanding how the brain makes decisions about what to buy — he is more interested in how this research can help people with alcohol addictions.

“These findings reveal the distinct neural signatures associated with different kinds of consumption preferences. Now that we have established a way of studying these choices, we can apply this approach to better understanding substance use disorders and improving treatment,” he said, adding that comparing fMRI scans from alcoholics with those of people with normal drinking habits could potentially tease out brain patterns that show what is different between healthy and unhealthy drinkers. “In the past, we have found that behavioral indices of alcohol value predict poor treatment prognosis, but this would permit us to understand the neural basis for negative outcomes.”

Source: Neuropsychopharmacology, 2014; DOI: 10.1038/npp.2014.47 March 2014

The Neuroeconomics of Alcohol Demand: An Initial Investigation of the Neural Correlates of Alcohol Cost-Benefit Decision Making in Heavy Drinking Men.

Filed under: Alcohol,Brain and Behaviour :

Doctors have long recognized a link between alcoholism and anxiety disorders such as post-traumatic stress disorder (PTSD). Those who drink heavily are at increased risk for traumatic events like car accidents and domestic violence, but that only partially explains the connection. New research using mice reveals heavy alcohol use actually rewires brain circuitry, making it harder for alcoholics to recover psychologically following a traumatic experience.

“There’s a whole spectrum to how people react to a traumatic event,” said study author Thomas Kash, PhD, assistant professor of pharmacology at the University of North Carolina School of Medicine. “It’s the recovery that we’re looking at – the ability to say ‘this is not dangerous anymore.’ Basically, our research shows that chronic exposure to alcohol can cause a deficit with regard to how our cognitive brain centers control our emotional brain centers.”

The study, which was published online on Sept. 2, 2012 by the journal Nature Neuroscience, was conducted by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and UNC’s Bowles Center for Alcohol Studies.

“A history of heavy alcohol abuse could impair a critical mechanism for recovering from a trauma, and in doing so put people at greater risk for PTSD,” said NIAAA scientist Andrew Holmes, PhD, the study’s senior author. “The next step will be to test whether our preclinical findings translate to patients currently suffering from comorbid PTSD and alcohol abuse. If it does, then this could lead to new thinking about how we can better treat these serious medical conditions.”

Over the course of a month, the researchers gave one group of mice doses of alcohol equivalent to double the legal driving limit in humans. A second group of mice was given

no alcohol. The team then used mild electric shocks to train all the mice to fear the sound of a brief tone.

When the tone was repeatedly played without the accompanying electric shock, the mice with no alcohol exposure gradually stopped fearing it. The mice with chronic alcohol exposure, on the other hand, froze in place each time the tone was played, even long after the electric shocks had stopped.

The pattern is similar to what is seen in patients with PTSD, who have trouble overcoming fear even when they are no longer in a dangerous situation.

The researchers traced the effect to differences in the neural circuitry of the alcohol-exposed mice. Comparing the brains of the mice, researchers noticed nerve cells in the prefrontal cortex of the alcohol-exposed mice actually had a different shape than those of the other mice. In addition, the activity of a key receptor, NMDA, was suppressed in the mice given heavy doses of alcohol.

Holmes said the findings are valuable because they pinpoint exactly where alcohol causes damage that leads to problems overcoming fear. “We’re not only seeing that alcohol has detrimental effects on a clinically important emotional process, but we’re able to offer some insight into how alcohol might do so by disrupting the functioning of some very specific brain circuits,” said Holmes.

Understanding the relationship between alcohol and anxiety at the molecular level could offer new possibilities for developing drugs to help patients with anxiety disorders who also have a history of heavy alcohol use. “This study is exciting because it gives us a specific molecule to look at in a specific brain region, thus opening the door to discovering new methods to treat these disorders,” said Kash.

Source: www.newrelevant.com 2012

Filed under: Alcohol,Brain and Behaviour,Health :

An examination of drinking motives as mediators. Goldstein AL, Flett GL, Wekerle C. Author information

Abstract

Although the relationship between child maltreatment and alcohol use and drinking problems is well established, the mechanisms involved in this relationship remain largely unknown and research has focused primarily on women. Using the Modified Drinking Motives Questionnaire-Revised (M-DMQ-R; Grant, Stewart, O’Connor, Blackwell & Conrod, 2007), drinking motives were examined as mediators in the relationship between childhood maltreatment and alcohol consumption and consequences among male and female college student drinkers (N = 218, 60.6% women). Participants completed questionnaires assessing child maltreatment, drinking motives, alcohol consumption and alcohol consequences. Enhancement motives in particular mediated the relationship between childhood abuse and alcohol consequences for men, whereas coping-depression motives mediated this relationship for women. Implications of these findings for alcohol interventions and future research are discussed, along with limitations of the present study.

Source: Addict Behav. 2010 Jun;35(6):636-9. doi: 10.1016/j.addbeh.2010.02.002. Epub 2010 Feb 10.

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects on foetus, babies, children and youth :

Abstract

Background

Exposure to tobacco and alcohol imagery in films is strongly associated with uptake and consumption of both tobacco and alcohol in young people. In an analysis of popular UK films over the 20 years from 1989 to 2008, we have previously documented substantial tobacco and alcohol content in films marketed to children and young people. In view of increasing awareness of the potential harm of this exposure, this study was undertaken to assess whether these exposures continue to be prevalent in more recent films, by analysing the most popular films in the years 2009—11.

Methods

Occurrence of tobacco (tobacco use, implied use, tobacco paraphernalia, and tobacco brand appearances) and alcohol (alcohol use, inferred alcohol use, other alcohol reference, and alcohol brand appearances) imagery was measured by 5-min interval coding in the 15 most commercially successful films in the UK in each year from 2009 to 2011. Each 5-min period of film was coded as positive for each category of tobacco or alcohol imagery, or both, if at least one such incident occurred during the 5-min period.

Findings

All of the 45 most popular films for 2009—11 were rated by UK film classifiers as suitable for youth audiences (those aged younger than 18 years). Any tobacco was present in a third of all films (15 of 45), whereas any alcohol was present in more than four-fifths (37 of 45 [82%]). Tobacco use occurred in 11 films, and alcohol use occurred in 26. Tobacco branding was infrequent, but two brands, Marlboro and K & J, were clearly identifiable. Alcohol branding was far more frequent, occurring in 22% (ten of 45) of films, with the most frequently occurring brands being Jagermeister, Singha, and Budweiser. When combined with earlier findings using the same methods in films from 1989 to 2008, tobacco was present in 65% (225 of 345) of films, and alcohol in 86% (295 of 345) of films. Tobacco content in each of the coded categories decreased between 1989 and 2010, but increased again in 2011, largely as a result of two films: The King’s Speech and Sherlock Homes: a Game of Shadows. Alcohol content fluctuated over the 23 years, without any significant decline overall (p>0·05). Overall, the most commonly represented tobacco brands were Marlboro, Silk Cut, and Embassy, and the most common alcohol brands were Budweiser, Miller, and Coors.

Interpretation

Although conventional tobacco promotion is heavily restricted in the UK, tobacco imagery continues to be evident in films classified for and popular with youth audiences. The amount of tobacco content in films has decreased over the years but increased again in 2011. Alcohol advertising and promotion remains largely self-regulated in the UK, and there has been no appreciable reduction in any alcohol depictions in youth classified films. UK film regulators are aware of the effects of film content on youth audiences, but in practice do not seem to consider either tobacco or alcohol imagery in the age classification process of films suitable for young people.

Funding

This research was done as part of the research undertaken by AL as part of a research fellowship funded by the UK Centre for Tobacco Control Studies, which is a UKCRC Centre of Public Health Research Excellence. Funding was from the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Medical Research Council, and the Department of Health.

Source: The Lancet, Volume 382, Issue , Page S66, 29 November 2013

Filed under: Alcohol,Nicotine,Prevention and Intervention :

Saturday 28 September 2013 – 12am PST

Drugged driving has been a safety issue of increasing public concern in the United States and many other countries but its role in motor vehicle crashes had not been adequately examined. In a new study conducted at Columbia University’s Mailman School of Public Health, researchers assessed the association of driver drug use, as well as the combination of drugs and alcohol, with the risk of fatal crash. They found that drug use is associated with a significantly increased risk of fatal crash involvement, particularly when used in combination with alcohol. The study provides critical data for understanding the joint effect of alcohol and drugs on driving safety.

Data for the study came from two national information systems sources sponsored by the National Highway Traffic Safety Administration: the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers and the Fatality Analysis Reporting System (FARS), a repository of investigation data for all crashes that resulted in at least one fatality within 30 days of the crash and that occurred on a public road. This second data source also contains detailed information about the crash circumstances as well as individuals and vehicles involved in the crash. This is the first study to use both data sources to quantify relative risks of fatal crash involvement associated with different drugs.

Results of the Mailman School study led by Guohua Li, MD, DrPH, professor of Epidemiology and director of the Center for Injury Epidemiology and Prevention, show that 31.9% of the drivers involved in fatal car crashes (cases) and 13.7% of the drivers interviewed at the roadside survey (controls) tested positive for at least one non-alcohol drug. Overall, drivers testing positive for drugs were three times as likely as those testing negative to be involved in a fatal crash. Among the drugs studied, depressants conferred the highest risk, followed by stimulants, narcotics, and marijuana.

Elevated blood alcohol levels were found in 57.0% of the cases and 8.8% of the controls; and the risk of fatal crash involvement increased exponentially as these levels rose. About one-fifth (20.5%) of the cases tested positive for alcohol and one or more drugs, compared with 2.2% of the controls. Relative to drivers who tested positive for neither alcohol nor drugs, the odds of fatal crash involvement increased by more than 13 times for those who were alcohol-positive but drug-negative, more than two-fold for those who were alcohol-negative but drug-positive, and 23 times for those who were positive for both alcohol and drugs.

While heightened risk of fatal crash involvement associated with driver drug use was comparable across demographic groups and geographic regions, Dr. Li cautions that findings need to be carefully interpreted. First, a positive test indicates that the driver had used the drug detected but does not necessarily mean that the driver was impaired by the drug at the time of crash or survey. Secondly, variations in individual tolerance and pharmacological characteristics of different drugs make it difficult to determine drug impairment. Also, there is no uniformly accepted definition of impairment for different drugs.

“The possible interaction of drugs in combination with alcohol on driving safety has long been a concern,” said Dr. Li, who is also professor of Anesthesiology at Columbia. “While alcohol-impaired driving remains the greatest threat to traffic safety, these findings about drugged driving are particularly salient in light of the increases in the availability of prescription stimulants and opioids over the past decade.”

Source: http://preview.medicalnewstoday.com/releases/266654#rate Sept. 2013

Filed under: Alcohol,Drug use-various effects,Drugs and Accidents :

US students already burdened by these emotions reacted to shame or guilt-inducing anti-drink ads by intending to and actually drinking more, the opposite of what was intended. This intriguing series of studies may reinforce the feeling that the ways anti-substance use ads can backfire are so various, the safest option is not to try them.

Summary This series of US studies using university students as subjects explored how people already experiencing or prone to shame or guilt respond to anti-alcohol adverts which induce the same unpleasant emotion. Unlike other aversive emotions, shame and guilt involve a conscious and negative perception of oneself as being seen to violate social norms and one’s ideal self (shame), or having unacceptably caused harm to others (guilt). Especially if already feeling bad about oneself in these ways, people may guard against and resist information (eg. ‘That won’t happen to me’) which would otherwise aggravate these uncomfortable feelings. The result could be to negate and even reverse the intended impacts of adverts which arouse these emotions. A case in point might be ads warning that the consequences of one’s over-drinking may be witnessed by friends and family (shame-inducing) or cause them serious inconvenience or harm (guilt-inducing).

To investigate this theory, in a pilot study an ad from a public service responsible-drinking campaign was modified to convey either shame or guilt due to the impact on “those you love” of a drink-laced “Best night of my life” illustrations.

By random allocation, one or other ad or none were shown to 75 students, who then rated the degree to which they were feeling guilt or shame. As expected, the shame-inducing ad did lead to the greatest feelings of shame, while the guilt-inducing ad led to the greatest feelings of guilt.

Having established that the ads aroused the intended emotions, the researchers then investigated this effect’s impact on how students responded to the ads, in particular their intended or actual drinking.

Study 1 randomly allocated 478 students to describe in writing an episode during which they had experienced either extreme shame or extreme guilt, or to simply describe their typical day. Again ratings indicated that the intended emotions had been aroused. Then the students were asked to evaluate either the shame-inducing anti-drinking ad or the guilt-inducing version. After a break they then completed a survey of the “habits of college students” which included the question, “Compared to last year, how often do you plan to binge drink this year?” A similar question asked their views about the intentions of the average student.

Students primed by the first task to feel shame, and then shown an advert inducing the same emotion, planned to binge significantly more often than the other students, including shame-primed students shown a guilt-inducing ad. The pattern was the same for the guilt variants of the preceding task and the ad. In contrast when, the individual was no longer themselves ‘threatened’ by the question, the combination of shame-inducing task and ad led them to make the lowest estimate of how often other students would binge-drink.

In other words, it was not the ads’ induction of negative emotions as such which generated a counterproductive impact on drinking intentions, but the ‘piling on’ of the same unpleasant emotion previously aroused, and then only when the viewer’s own drinking was at issue. The process of defending themselves from yet further shame (or further guilt) seemed to lead the students to reject the ad’s message, so that compared to seeing another ad, they planned to drink more. The opposing impacts on their ratings of their own versus other students’ intentions proves they had not simply ‘switched off’ in response to the ads – they were switched on and processing the messages, but not as the ads’ developers might have wished.

Study 2 extended the findings of study 1 from intentions to actual drinking. It recruited 71 students and followed a similar procedure to study 1 – a shame- or guilt-arousing recall task followed by viewing the shame- or guilt-arousing ad. Then the students were asked to evaluate the ad, and after a break, told they would be sampling and rating a new alcoholic drink mixer, of which they could drink as much they wanted. Among other questions, they were then asked to rate how likely they would be to shame themselves (or for students assigned to the guilt-arousing task, do something they felt guilty about) after having had a couple of drinks at a party, an attempt to assess whether they really had been provoked by the ads in to being defensive about their drinking.

When a shame- or guilt-inducing ad followed a task intended to arouse the same emotion, students drank more than when task and ad had been intended to arouse different emotions. They also saw themselves as less likely to get in to a situation causing the same feelings after drinking at a party. It seemed that piling on the same negative emotion led them to deny the link between their drinking and possibly behaving in ways which cause shame or guilt, a defensive posture which led them to actually drink more than if these emotions had not been serially provoked.

Unlike the previous studies, study 3 used ads to prime shame or guilt, more like what might happen in real life. The first ads shown to 182 students were unrelated to alcohol, but explicitly sought to generate shame about cheating, or guilt about the environmental consequences of buying bottled water. A test confirmed the intended effects. Then they were shown one of the two anti-drinking ads, and after a break asked to rate the likelihood that during the next two weeks they would patronise a bar, or consume three or more drinks in one evening. Combining these answers created a single measure of drinking intentions.

As expected, when a shame-inducing anti-drink ad followed another shame-inducing ad, students expressed firmer intentions to go out and drink heavily, but not because they had ignored the anti-drink ad – in fact, they recalled the ad better than the other students. Moreover, even though they had serially been exposed to shame-inducing ads, these students felt less shame at the end than other students in the study (but not less guilt). Similarly for the guilt-inducing ads. This pattern was consistent with the students successfully resisting the alcohol ads’ attempts to generate yet more of the same uncomfortable emotion already generated by the preceding ad, and as a result also resisting its anti-drink message.

The assumption was that students exposed to the shame-inducing adverts ended up feeling less shame than before, and similarly with guilt – but with no pre-ad measures of shame and guilt, this was just an assumption which fit the evidence. Study 4 rectified this by replicating study 1 with another 64 students, but this time taking before-and-after measures of guilt and shame.

As before, first the students described a shame or guilt-inducing incident from their lives. This time they were then asked to rate their feelings of shame and guilt, measures repeated after they later watched one of the two anti-alcohol adverts. When the advert was intended to arouse the same emotion as the preceding task, the opposite happened – feelings of that emotion actually fell from before to after watching the ad, relative to watching one intended to arouse a different emotion. In contrast, students primed to feel shame did feel more guilt after seeing the guilt-inducing ad. When processed defensively by people already burdened by these emotions, it seemed that a message designed to induce shame or guilt actually reduced the intended emotion.

The preceding studies had ‘artificially’ induced feelings of guilt or shame before exposing students to the anti-alcohol ads. Study 5 instead investigated the effects of the ads on people naturally prone to feel either guilt or shame. A questionnaire was used to assess these propensities among 233 students, who after a break were then shown one of the two anti-alcohol adverts. As in study 1, they were then asked, “Compared to last year, how often do you plan to binge drink this year?” The results were similar to the other studies. Shame-prone students were more likely to plan to drink heavily more often if they had been shown the shame-inducing advert, but not the other. For guilt-prone students there was a corresponding finding.

The authors’ conclusions

In relation to ‘irresponsible’ drinking, these studies show that when emotions which entail an uncomfortable perception of oneself are further stimulated in ways which threaten to heighten this discomfort, viewers tend to convince themselves that the message does not apply to them (‘defensive’ processing), leaving them freer to do what the message warned against than if it had never been received. In particular, shame-laden consumers exposed to messages which asserted that drinking might lead to additional shame-inducing situations, believed that their own drinking would not lead to those consequences, and similarly for guilt. In contrast, when there was no threat to the self and the viewer was asked to think about the behaviour of others, the warnings had the intended impacts.

The findings also suggests that people ‘repair’ negative mood states not in general but in relation to the specific mood they are experiencing; shame-laden consumers resist messages that might lead to greater shame, but are open to messages that lead to guilt, and vice versa.

In some of the studies effects were not large, but much larger in study 2 which assessed actual drinking, suggesting that guarding against the ‘piling up’ of negative emotions might strongly influence health-related behaviour.

Public service health promotion messages often highlight how friends or others might see you if you behave in the way the ad is seeking to deter. In relation to binge drinking, commonly ads arouse concern over ‘making a fool of oneself’ or ‘losing control and doing something bad’. Commonly these ads also highlight emotions which play on these concerns (eg, ‘Avoid the shame and embarrassment of a drunk-driving arrest’) and the consequences of one’s actions on others (eg, ‘Think about those you may harm if you cause an accident while driving drunk’).

The featured research suggests that emotional appeals such as these playing on guilt or shame should be used cautiously, and that attention should be paid to the broader milieu within which the ad will be embedded. For instance, a guilt-inducing message may not be optimal if inserted in a guilt-ridden television drama. However, such appeals may work as intended if the viewer is directed to the behaviour of others rather than themselves, as for example in the popular public service message, ‘Friends don’t let friends drive drunk’.

This intriguing series of studies might well reinforce a feeling that the ways anti-substance use campaigns can backfire are so various, the safest option is not to mount them. Describing the implications of the findings, one of the featured article’s authors warned that “public health and marketing communities expend considerable effort and capital on [anti- or ‘responsible’ drinking] campaigns but have long suspected they were less effective than hoped. But the situation is worse than wasted money or effort. These ads ultimately may do more harm than good because they have the potential to spur more of the behaviour they’re trying to prevent.”

It can happen, he said, because “Advertisements are capable of bringing forth feelings so unpleasant that we’re compelled to eliminate them by whatever means possible. This motivation is sufficiently strong to convince us we’re immune to certain risks.” The implication for health promoters was that “If you’re going to communicate a frightening scenario, temper it with the idea that it’s avoidable. It’s best to use the carrot along with the stick.”

The mechanism the authors propose for this effect is distinct from the ‘reactance’ thought partly to underlie counterproductive reactions to the anti-drug messages of the US National Youth Anti-Drug Media Campaign. Seeing these ads, some young viewers may have resented being (as they saw it) ‘told what to do’, and reacted by moving in the opposite direction. Another way these ads may have backfired is by implying that drug use was so common and so hard to resist that the government had to warn young people about it. Ads which contradict personal experience may also be counter-productively discounted by viewers. Yet another mechanism is that ads can generate discussion between young people, which may be dominated by the more voluble risk-takers among them who tend to favour substance use. Another proposed mechanism is that ads which generate too much emotion lead recipients to ‘shut down’ and simply not process the message. One way to avoid these reactions is to end on a more positive note after presenting a warning, relieving the negative emotion and defusing defensiveness – found in a Spanish study to lead students to say they were less likely to drink excessively than a totally negative anti-drinking message or no message at all.

For the authors of the featured article, none of these explanation account for their findings. Instead they deduce that the students did pay attention to and process the messages of the two anti-alcohol ads, but in such a way as to defensively divorce themselves (if not others) from the risks portrayed. If this, as they persuasively argue, was the case, it may however have been due to the situation. The students had ‘signed up’ (sometimes in return for course credits) to participate in a study which involved assessing the ads; they may not have considered themselves at liberty not to ‘process’ them – that the situation and their obligations demanded they do not simply ignore them. To avoid further unpleasant emotions, perhaps they were left with little option but the ‘defensive processing’ hypothesised by the researchers. In real-life situations, viewers normally can simply turn over the page, look the other way, or stop paying attention to the TV, reactions which might neutralise the ad’s messages but not lead to counter-productive reactions.

All the studies involved young people in the USA, who below the age of 21 are not permitted to legally buy alcohol and usually also forbidden to drink. All too were students, a group newly liberated from parental control and known to in some quarters value excessive drinking. Rather bluntly, in some of the studies they were asked “Compared to last year, how often do you plan to binge drink this year?” Their reactions to the ads and to this loaded question may not transfer to other sub-populations in the USA or to students in the UK.

Another limitation is that only the pilot study compared the ads to no ad at all; in all the others, students were allocated to see one or other of the two anti-alcohol ads. None of the studies tell us whether, compared to no ad at all, the ads led students to intend to drink excessively or actually do so. All we know is that in certain circumstances, seeing one ad was counterproductive vis-à-vis seeing the other; it may nevertheless have been better (or at least, no worse) than no health promotion at all.

Also, both adverts look amateur and seem to give not very persuasively framed messages, the content of which may easily be discounted. Better expressed and produced ads may have lent themselves less easily to ‘defensive processing’, and produced a different reaction.

However, the general ineffectiveness of anti-drinking advertising campaigns suggest that the featured studies’ results are not merely due to context or ad quality. When experts assessed the full panoply of strategies to prevent or minimise alcohol-related harm, they could find no media campaign strategies to recommend: “Media campaigns prepared by government agencies and non-governmental organizations (NGOs) that address responsible drinking, the hazards of drink-driving and related topics are an ineffective antidote to the high-quality pro-drinking messages that appear much more frequently as paid advertisements in the mass media”. In respect of illegal drugs too, in controlled studies anti-drug adverts have if anything bolstered intentions to use these substances.

Source: Agrawal N., Duhachek A. Journal of Marketing Research: 2010, 47(2), p. 263–273. Last revised 26 September 2013.

Filed under: Alcohol,Prevention and Intervention :

University of Otago, Christchurch researchers have for the first time quantified exactly what damage alcohol abuse is inflicting on 20-somethings, and in turn society.

The Christchurch Health and Development Study researchshows up to a quarter of New Zealanders aged 21 to 30 have a problem with alcohol (classified as a subclinical alcohol problem) which affects their daily life to some extent.

More than 5 per cent of this age group met the clinical criteria for alcohol addiction.

Researchers were able to account for factors such as family background or previous substance abuse issues to shine the spotlight on the exact role alcohol plays in creating multiple serious social and personal issues. The study shows those with clinical alcohol addictions are:

* Almost nine times more likely than those with no alcohol problems to inflict physical violence on others.

* Three times more likely to commit property crimes such as burglary, car theft or vandalism.

* Almost 11 times more likely to have ten or more sexual partners and twice as likely to have a sexually transmittedinfection (STI).

* Almost seven times more likely to contemplate suicide.

* Almost three times more likely to be the victims of violence.

Those who have some problem with alcohol, or a subclinicalcondition (typically those whose drinking has some negative effect on their job, family, friends or criminal behaviour but who have not been diagnosed as an addict) are:

* Three times more likely to commit a violent crime and twice as likely to commit property crime.

* Twice as likely to commit family violence.

* Almost twice as likely as those with no problem to have an STI.

* Most three times more likely to contemplate suicide.

* Almost twice as likely to have been the victim of a violent crime.

Researcher Dr Joe Boden says much attention has been paid to the effects of the effects of problematic youth drinking but little on those aged in their 20s.

This study shows this group is still very much at risk, despite perceptions their drinking may be tapering off.

Dr Boden says the study showed the wide-ranging effect of alcohol misuse in 20-somethings on themselves and society.

“It seems that young people don’t need to misuse alcohol for a long time before they experience some serious negative outcomes, and often multiple serious outcomes.’’

“There could be great benefits to society in addressing alcohol misuse in those aged in their 20s.”

For example, the study showed that people aged in their 20s did not abuse alcohol violent crime committed by that age group would drop by almost half.

Dr Boden says becoming a parent has the biggest effect on minimising drinking. Many adults today however were having children later and experiencing an ‘extended adolescence’. This may have some impact on the reasonably high number of people in their 20s with drinking problems.

The research was recently published in the prestigious Drug and Alcohol Dependence journal.

This study was funded by the Health Research Council of New Zealand.

Source: healthcanal.com 3rd Sept.2013

Filed under: Alcohol,Australia :

A study of risk factors for early-onset dementia finds alcohol abuse tops the list, HealthDay reports.

In contrast, the influence of hereditary factors is small, according to the researchers.

They define early-onset dementia as occurring before age 65. The researchers studied 488,484 men drafted at about age 18 into the Swedish military over a 10-year period. They were followed for approximately 37 years. During that time, 487 men developed early-onset dementia, at an average age of 54.

Besides alcohol intoxication, other risk factors included drug abuse, the use of antipsychotic drugs, stroke, depression,having a father with dementia, poor mental functioning as a teen, being short and having high blood pressure. Men who had at least two of these risk factors, and were in the lowest third of overall mental ability, had a 20-fold increased risk.

“These risk factors were multiplicative, most were potentially modifiable, and most could be traced to adolescence, suggesting excellent opportunities for early prevention,” the researchers wrote in JAMA Internal Medicine.

Source: Join Together August 16, 2013

Filed under: Alcohol,Brain and Behaviour,Drug use-various effects,Health :

LARGE numbers of children in Scotland affected by their mothers drinking alcohol during pregnancy have not been diagnosed, experts suspect.

Estimates suggest more than 100 children a year in Scotland could be born with foetal alcohol syndrome (FAS) – the most severe form of disability caused by alcohol use among pregnant women.

However, a monitoring project has received just 37 confirmed reports of the disorder in three-and-a-half years. Experts said lack of awareness and low rates of diagnosis meant children were missing out on special care to deal with their disabilities, while it could also mean missed opportunities to prevent other babies being born to mothers who abuse alcohol when pregnant.

Based on worldwide estimates that FAS affects between 0.5 and two in every 1,000 births, Scotland would expect to see between 29 and 117 affected children born each year.

However, the 37 confirmed reports in more than three years suggests many are being missed. This included just eight cases from Scotland’s biggest health region, Greater Glasgow and Clyde.

Dr Chris Steer, a paediatrician in Fife involved in the monitoring project, said based on the prevalence estimates, his team would expect to see more cases of the condition being identified in Scotland.

“There is a lack of familiarity with clinical presentation, or sometimes lack of reliable information about maternal drinking habits in pregnancy, either because you haven’t taken your enquiries far enough or there has been some evasion and people not giving a truthful account of their drinking,” Dr Steer told The Scotsman. “It is sometimes difficult for people to admit they have been drinking more in pregnancy.”

Symptoms of FAS can vary, but in many severe cases includes distinct facial features such as a small head and short nose. Babies may also be small when they are born and remain so.

Other signs include developmental delay and emotional, behavioural and learning difficulties, but symptoms are not always obvious.

Dr Steer said the figures also showed huge variation in diagnosis across Scotland.“That probably reflects that clinician awareness in some areas is at a more alert level,” he said.

As well as those with FAS, an estimated five to nine times as many children are thought to suffer from foetal alcohol spectrum disorders (FASD), where disabilities may be less severe but also require extra help and support.

Dr Maggie Watts, the Scottish Government’s co-ordinator on foetal alcohol disorders, said identifying children with these disorders was not always easy in cases where symptoms were not obvious or the mother’s history was not known.

“In Canada and the US, they have had established services specifically around FASD for a considerable number of years and they are demonstrating that you can get the diagnosis and you can make a difference,” she said.

The Royal College of Paediatrics and Child Health has been running workshops in Scotland to raise awareness of alcohol disorders in children. More are planned.

Source: www.scotsman.com 29th July 2013

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Health :

Underage drinkers are more likely than alcohol users ages 21 or older to use illicit drugs within 2 hours of alcohol use, according to data from the 2011 National Survey on Drug Use and Health. One in five (20.1%) underage drinkers reported using at least one illicit drug the last time they used alcohol, compared to 4.9% of those ages 21 or older. Marijuana was the most commonly reported illicit drug used in combination with alcohol by both underage (19.2%) and older (4.4%) drinkers. In contrast, illicit drugs other than alcohol, including cocaine, heroin, and prescription drugs used non-medically, were used with alcohol by only 2.2% of underage drinkers and less than 1% of drinkers ages 21 and older. Future research will be needed to study if the co-occurring use of alcohol and marijuana changes among residents of Colorado and Washington, which have both recently enacted laws legalizing the recreational use of marijuana by adults.

Source: Adapted by CESAR from Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Detailed Tables, 2012. Available online at http://www.samhsa.gov/data/NSDUH/2011SummNatFindDetTables/Index.aspx

Filed under: Alcohol,Cannabis/Marijuana,Youth :

As in Australia, an alcohol harm reduction curriculum adapted for secondary schools in Northern Ireland curbed the growth in alcohol-related problems and also meant pupils drank less. Results suggest this approach might offer a more fruitful focus for education about commonly used substances than simply promoting non-use.

Summary

Alcohol harm reduction approaches aim to decrease the harmful consequences of drinking without requiring abstinence. School-based substance use education programmes in the United Kingdom have mainly tried to delay the onset of use, though more recent programmes have included harm reduction components. Advantages of harm reduction approaches for adolescent pupils may include not stigmatising younger drinkers, not presenting drinking as a moral issue, and being able to tailor education to the specific risk factors of the particular pupil population. Such approaches seem most relevant at the ages when young people are first drinking unsupervised by adults and experiencing intoxication.

Developed and first evaluated in Australia, the School Health and Alcohol Harm Reduction Project (SHAHRP) is an example of harm reduction education, featuring skills training, information and activities designed to encourage behavioural change which reduces harms experienced as a result of drinking. Just such an effect was found in the original evaluation, in which the number of harms experienced by pupils in SHAHRP schools was substantially and significantly less than among pupils in schools not running the lessons, and remained so at the last follow-up 17 months after lessons had ended.

Given the prevalence of underage drinking in Northern Ireland and the associated problems, it was decided to adapt SHAHRP for Northern Irish secondary (or ‘high’) schools. As in the original study, the adapted version was delivered over two school years in two phases. The six lessons of phase one took place when pupils were in year 10 (age 13–14), and the four in phase two the following school year. A pilot study had found pupils and teachers felt the programme was easy to deliver, project materials helpful and easy to follow, and activities and discussions relevant and appropriate.

Having established its feasibility, to test the programme’s effectiveness a new study starting in 2005 recruited 29 secondary schools in the Belfast area. Nine carried on with the normal alcohol education curriculum (the control schools), the remainder also implemented SHAHRP. In eight SHAHRP schools it was delivered by the schools’ own teachers after being trained, in 12 by local voluntary-sector drug and alcohol educators. Rather than being assigned at random, schools were assigned to the three alcohol education options so that they would be comparable in terms of gender, socio-economic profile and location.

2349 pupils were surveyed at the start of the study; about 60% were girls, 17% had not drunk alcohol, and around half had already drunk without adult supervision. Surveys were repeated the following two years after the first and second phases of SHAHRP, and finally in March 2008 when lessons had ended at least 11 months before, at which time 2048 of the 2349 pupils (who now averaged 16½ year of age) could be re-surveyed. Though surveys were anonymous and confidential, identifiers could be used to track changes in each individual pupil across the three years.

Main findings

Generally the trends in how pupils drank and the harms they experienced were most favourable when SHAHRP lessons had been delivered by external specialists, next most favourable when they had delivered by the schools’ own teachers, and least favourable when SHAHRP had not been implemented at all. Selected more detailed findings below.

Each survey asked pupils who had drunk at some time during the study about any resulting harms over the past year, such as drinking more than they had planned, being sick after drinking, having hangover symptoms, being unable to remember what had happened while drunk, becoming verbally and/or physically abusive, and trouble with parents or police. Pupils divided in to four characteristic trajectories over the years of the study. Compared to those in control schools, pupils offered the SHAHRP lessons were more likely to have experienced virtually no harms during the study or a relatively low and stable level, rather than increasing and high levels of harm. When SHAHRP lessons had been delivered by external specialists, pupils were more likely to have experienced virtually no harms than when delivered by the schools’ own teachers. However, both types of SHAHRP delivery significantly improved on usual lessons only.

The drinkers among the pupils were also asked how much they had drunk last time. On this measure pupils again divided in to four characteristic trajectories. Compared to those in control schools, at each follow-up pupils offered the SHAHRP lessons were more likely say they had drunk very little than to have reported increasing and by the end of the study relatively high levels of drinking. When the lessons had been delivered by external specialists, pupils were more likely to consistently have drunk relatively little than when delivered by the schools’ own teachers.

Each survey also included questions about the harms pupils had experienced over the past year arising from someone else’s drinking, such as verbal or physical abuse, sexual harassment, or damage to personal property. Compared to those in control schools, pupils offered the SHAHRP lessons were least likely to have experienced a steep rise in such harms ending in relatively high levels. Whether SHAHRP lessons had been delivered by external specialists or the schools’ own teachers did not significantly affect the trends.

Pupils offered SHAHRP lessons were more likely than those in control schools to have become more knowledgeable about alcohol over the study and to end with relatively high levels of knowledge, more so when the lessons had been delivered by external specialists. However, both SHAHRP delivery options significantly improved on usual lessons only. Results were similar in respect of developing safer attitudes to drinking.

The authors’ conclusions A research review associated with guidance on alcohol education from the National Institute for Health and Clinical Excellence remarked that the Australian SHAHRP evaluation offered evidence that programmes focusing on harm reduction through skills-based activities can produce medium to long term reductions in alcohol use and in particular, risky drinking behaviours. However, the review queried the transferability of these programmes and their results to the UK. The featured study shows that in the UK too, classroom-based harm reduction education can have a significant impact on the harm adolescents experienced from

drinking. The research also suggests these lessons need to incorporate interactive learning, start just prior to and during the times when pupils first try drinking, be culturally sensitive, and provide realistic scenarios and deal with realistic issues.

Compared to control schools, pupils in SHAHRP schools were significantly more likely to be among groups characterised by better growth in knowledge about alcohol and its effects, safer alcohol-related attitudes, fewer harms from one’ own and other’s drinking, and less alcohol consumption. These differences were maintained over the 11 months after lessons had ended, though in some cases with diminished strength. External facilitation of the lessons was associated with the best outcomes, particularly with respect to knowledge and attitudes, harms from one’ own drinking, and alcohol consumption.

SHAHRP offers abstainers, novice drinkers and more experienced drinkers alike the opportunity to reflect on use, harm and personal safety, including the importance of trusted friends, basic first aid techniques, group transport home, mobile phone availability, not to make decisions while drunk, identify friends becoming drunk, drink-spiking, mixing substances, and arguments and aggressive behaviour. The results show that young people are capable of processing such messages developed and presented within the reality of their drinking experiences. SHAHRP addresses harms without causing any increase in drinking (in fact, the reverse) or decreasing rates of abstinence.

It was unfortunate that two of the schools allocated to the control group withdrew from the study, partially upsetting the attempt to ensure comparability of the schools operating the three alcohol education options. However, differences were adjusted for statistically. Also, no systematic record was kept on the alcohol education delivered to control subjects. In Northern Ireland this typically is embedded in the curriculum as part of science or citizenship lessons, so would be identical to that received by intervention students.

Together with the original Australian evaluation, this UK study represents fairly strong evidence that if it focuses on this task, a school curriculum can reduce drink-related problems. In Australia harm-reduction effects were greatest among the higher risk pupils who had already drunk without adult supervision; at each follow-up point they experienced about 20% fewer harms than control pupils.

In that study too, though still very much in the minority, by the last follow up there were a third more abstainers among SHAHRP than control pupils. By the end of the featured study about 6% of control pupils had never drank alcohol compared to 6% of SHAHRP pupils taught by external staff and 3.5% taught by their teachers. These findings offer little support to concerns that safer drinking lessons will encourage more pupils to drink.

In the featured study it seems SHAHRP lessons were additional to usual alcohol education, meaning that impacts might have been due to simply having more time devoted to this topic rather than or as well as the content. In Australia SHAHRP replaced usual alcohol education, thought there too it occupied two years rather than one and occupied more classroom time overall.

In the more restrictive youth drinking environment of the USA, a programme forefronting alcohol problem reduction among its aims has produced similar findings to that in Australia. It retarded growth in alcohol problems (such as getting drunk or sick or complaints from parents and friends), but only among pupils who had already drunk without adult supervision,

and only if the lessons did not occur too early to coincide with the development of this drinking pattern. After disappointing initial results, another US substance use education programme including alcohol adopted harm reduction objectives. The revised programme resulted in a significant reduction in risky or harmful drinking. Parallel and consistent findings in different countries with different curricula suggests that harm reduction education on drinking has a real and transferable impact in Western drinking cultures. Such findings contrast with unconvincing evidence from trials of substance use education in general and alcohol education in particular. For the UK the most important guidance on alcohol education was issued in 2007 by the National Institute for Health and Clinical Excellence. It said this “should aim to encourage children not to drink, delay the age at which young people start drinking and reduce the harm it can cause among those who do drink”. Recommendations included ensuring alcohol education is an integral part of the science and PSHE curricula. The committee stressed that education should be adapted to its cultural context, in particular that in the UK “alcohol use is considered normal for a large proportion of the population [and] a ‘harm reduction’ approach is favoured for young people”. Inspections in 2012 of PSHE lessons suggest English schools are far from adequately implementing NICE’s recommendations, in particular in respect of education aimed at reducing alcohol-related harm. In just under half the inspected schools had pupils learnt how to keep themselves safe in a variety of situations, and the deficits were particularly noticeable in respect of drinking. Inspectors found that although pupils understood the dangers to health of tobacco and illegal drugs, they were far less aware of the physical and social damage associated with risky drinking. Some did not know the strength of different alcoholic drinks or make the links between excessive drinking and issues such as heart and liver disease and personal safety. The report attributed these deficiencies in part to inadequacies in subject-specific training and support for PSHE teachers, particularly in teaching sensitive and controversial topics.

Last revised 18 June 2013. First uploaded 12 June 2013

Source: McKay M.T., McBride N.T., Sumnall H.R. et al. Journal of Substance Use: 2012, 17(2), p. 98–121.

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Treatment and Addiction :

Tuesday 19 March 2013

New figures reveal a huge increase in the number of hospital admissions for people under 30 with alcohol-related liver disease.

The research carried out by Balance, the North East Alcohol Office, looks at the number of alcohol-related liver disease hospital admissions in England between 2002 and 2012.

As well as a full England summary, the data is broken down by region, gender and age .

Key findings:

* 117% increase in alcohol-related liver disease hospital admissions for under 30’s in England since 2002. This figure is worse in certain areas, the north east has seen a 400% increase.

* 91% increase in alcohol-related liver disease hospital admissions for women in England since 2002. It’s a 114% increase in the Yorkshire and the Humber.

* 93% increase in alcohol-related liver disease hospital admissions for men in England since 2002. It’s a 152% increase in the East of England.

Responding to the research, Eric Appleby, Chief Executive of Alcohol Concern said:

“These figures are terrifying, we’re seeing an increase in alcohol-related liver disease across both sexes, in every age group, in every region of the country. It’s particularly sad to see the number of young people with this awful disease more than doubling.

“We have to start taking this seriously, if this was any other illness immediate action would be taken to halt this so we call on the Department of Health to outline what action it intends to take.”

“We have to get the message across that drinking too much, too often can cause huge health problems and we need to create an environment where alcohol isn’t cheaper than water and available on every corner.”

Source: AlcoholConcern.org.uk 19th March 2013

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Health :

National Treatment Agency for Substance Misuse. [UK] National Treatment Agency for Substance Misuse, 2013.

More problem drinkers started specialist treatment in 2010/12 but more successfully completed it, slightly reducing the overall numbers; scope for more to benefit from treatment is indicated by the low levels of referrals from primary medical services. Summary The featured report presents and comments on data from the National Drug Treatment Monitoring System on people who have received specialist treatment for alcohol problems in England between 1 April 2011 and 31 March 2012. This account occasionally draws figures from the data source as well as the featured report.

Main findings

Compared to last year, this year’s statistics show a slight decrease in the number in treatment from 111,025 in 2010/11 to 108,906 in 2011/12, a slight increase in new entrants, and more successfully completing treatment.

The drop in the total is not due to fewer people finding their way to services. New presentations tell a different story, up each year since the statistics were collected from 67,912 in 2008/09 to 74,353 in 2011/12. Instead the drop is due to successful completions rising steadily from 26,270 in 2008/09 to 38,174 in 2011/12 chart. In contrast, the proportion of people dropping out of treatment has fallen to 28% of all those leaving, down from 30% in 2010/11, 33% in 2009/10 and 29% in 2008/09.

In 2011/12, 70% of all people in alcohol treatment were aged 30 to 54 and nearly two-thirds (64%) were men.

People starting specialist treatment came via a number of routes. At 38%, self-referral was most common. Next at 19% was referral from primary care surgeries, but the 14,330 who came this way does not seem an especially high figure given that around one in five people seeing a GP drinks above lower-risk levels. Referrals from hospital accident and emergency departments accounted for just 1% or 872 patients, again seemingly small when an estimated 35% of emergency attendances are alcohol-related. Employment services successfully referred just 177 people.

About half (51%) of all people in treatment in 2011/12 for harmful drinking and alcohol dependency had received a structured psychosocial intervention, normally consisting of

‘talking therapies’ such as cognitive-behavioural therapy, which helps them understand and then change their attitudes and behaviour towards alcohol. Just over 1 in 10 (11%) were prescribed medications to help them detoxify or prevent relapse, 1 in 10 were admitted as inpatients, 9% attended structured day care services, and 4% a residential service.

66,894 people left treatment during 2011/12, 38,174 or 57% because they had successfully completed it. Of these successful completers, 58% were not drinking at all, the remainder drinking in a controlled way. Though 28% of leavers dropped out or left early, some may have done so because they had got all they needed from treatment; others will have failed to make progress. After rising from 2008/09 to 2009/10, numbers dropping out of treatment have since fallen by 10%.

The authors’ conclusions

While long-term trends have yet to emerge, a picture of the alcohol treatment system in England and its performance is beginning to form and will become clearer over the next few years as the bank of data accumulates and the reporting system itself settles further. Latest figures show that while more people came into treatment for alcohol problems during the year, even more got better over the same time, meaning the total number in treatment fell. The declining drop-out rate suggests that services have got better at engaging and holding on to people who need help for an alcohol problem.

Low numbers successfully referred in to specialist treatment by GPs and accident and emergency departments suggest that an aim for the coming years is that these two key routes will become more active in identifying and referring drinkers who need treatment. To meet the challenges ahead we must take every opportunity to identify alcohol misuse and ensure that services are in place in all areas to provide appropriate, evidence-based treatment for those who need it.

Source: editor@findings.org.uk 12.02.13

Filed under: Alcohol :

Abstract

Objectives To determine the prevalence of recent alcohol, nicotine or cannabis use in young persons presenting for mental healthcare.

Design A cross-sectional study of young people seeking mental healthcare completed self-report questionnaires regarding their use of alcohol, nicotine or cannabis.

Setting Data were collected from two sites as part of the national headspace services programme.

Participants 2122 young people aged 12–30 years provided information as part of a patient register; a subset of N=522 participants also provided more detailed information about their patterns of alcohol use.

Outcome measures Prevalence levels of recent alcohol, nicotine or cannabis use within relevant age bands (12–17, 18–19 and 20–30) or primary diagnostic categories.

Results The rates for use at least weekly of alcohol for the three age bands were 12%, 39% and 45%, and for cannabis 7%, 14% and 18%, respectively. The rates of daily nicotine use for the three age bands were 23%, 36% and 41%. The pattern of alcohol use was characterised by few abstainers as well as many risky drinkers. Age of onset across all three substances was approximately 15 years. Individuals who used any of the three substances more frequently were likely to be older, male or have psychotic or bipolar disorders.

Conclusions Frequent use of alcohol, nicotine or cannabis in young people seeking mental healthcare is common. Given the restricted legal access, the patterns of use in those aged 12–17 years are particularly notable. Reductions in substance use needs to be prioritised within services for at-risk young people.

Source: BMJ Open 2013;3:e002229 doi:10.1136/bmjopen-2012-002229

Filed under: Alcohol,Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Health,Nicotine :

Research commissioned by Action on Addiction suggests mental health approach to teenage drinking is successful Targeted psychological interventions aimed at teenagers at risk of emotional and behavioural problems significantly reduce their drinking behaviour, and that of their schoolmates, according to the results from a large randomised controlled trial published today in JAMA Psychiatry. The authors argue that the intervention could be administered in schools throughout the UK to help prevent teenage alcohol abuse. The ‘Adventure Trial’ is led by Dr Patricia Conrod, King’s College London’s Institute of Psychiatry, in collaboration with the University of Montreal and Sainte-Justine University Hospital Center (Canada) and was commissioned by Action on Addiction. The trial involved 21 schools in London that were randomly allocated to either receive the intervention, or the UK statutory drug and alcohol education curriculum. A total of 2,548 year-10 students (average age 13.8 years) were classed as high or low-risk of developing future alcohol dependency. Those classed as high-risk fit one of four personality risk profiles: anxiety, hopelessness, impulsivity or sensation seeking. All students were monitored for their drinking behaviour over two years. Four members of staff in each intervention school were trained to deliver group workshops targeting the different personality profiles. 11 schools received the intervention where 709 high-risk teenagers were invited to attend two workshops that guided them in learning cognitive-behavioural strategies for coping with their particular personality profiles. Dr Patricia Conrod, from King’s Institute of Psychiatry and lead author of the paper, says: “Through the workshops, the teenagers learn to better manage their personality traits and individual tendencies, helping them to make good decisions for themselves. Depending on their personality profiles, they might learn cognitive-behavioural strategies to better manage high levels of anxiety, to manage their tendency to have pessimistic reactions to certain situations or to control their tendency to react impulsively or aggressively. Our study shows that this mental health approach to alcohol prevention is much more successful in reducing drinking behaviour than giving teenagers general information on the dangers of alcohol.” After two years, high-risk students in intervention schools were at a 29% reduced risk of drinking, 43% reduced risk of binge drinking and 29% reduced risk of problem drinking compared to high-risk students in control schools. The intervention also significantly delayed the natural progression to more risky drinking behaviour (such as frequent binge drinking, greater quantity of drinking, and severity of problem drinking) in the high-risk students over the two years. Additionally, over the two year period, low-risk teenagers in the intervention schools, who did not receive the intervention, were at a 29% reduced risk of taking up drinking and 35% reduced risk of binge drinking compared to the low-risk group in the non-intervention schools, indicating a possible ‘herd effect’ in this population. Dr Conrod adds: “Not only does the intervention have a significant effect on the teenagers most at risk of developing problematic drinking behaviour, there was also a significant positive effect on those who did not receive the intervention, but who

attended schools where interventions were delivered to high-risk students. This ‘herd effect’ is very important from a public health perspective as it suggests that the benefits of mental health interventions on drinking behaviour also extend to the general population, possibly by reducing the number of drinking occasions young people are exposed to in early adolescence.” Dr Conrod concludes: “This intervention could be widely administered to schools: it is successful from a public health perspective, appreciated by students and staff, and because we train school staff rather than professional psychologists, the intervention remains relatively inexpensive to roll out.” Approximately 6 out of 10 people aged 11-15 in England report drinking, and in the UK approximately 5,000 teenagers are admitted to hospital every year for alcohol related reasons. Across the developed world, alcohol accounts for approximately 9% of all deaths of people aged 15-29, and so far, universal community or school-based interventions have proven difficult to implement and shown limited success. Nick Barton, Chief Executive of Action on Addiction says: “Dr Conrod’s study, which helps young people reduce their chances of developing an addiction to alcohol and/or drugs in the future, is an exciting development for prevention work in the UK. This is generally recognised as inadequate, and as we see regularly in the media, currently fails to address binge drinking and drug taking among young people. “We know that problematic relationships with alcohol often start at a young age, so if it is possible to reduce the chances of harmful drinking and dependency in later life through school-based interventions we would welcome seeing this programme rolled out across UK schools. “We hope that the publication of this paper will create discussion and debate about the nature of addiction; to help shed light on the complex causes of addictive behaviour, unravel some of the stigma associated with it, help young people understand the triggers for dependency and, ultimately, bring us closer to our goal of disarming addiction.” Action on Addiction also works with children and young people suffering from the effects of addiction via its Families Plus programme, which offers support groups for families, partners and friends of substance misusers. Families Plus is rolling out M-PACT (Moving Parents and Children Together), a programme that takes a ‘whole family’ approach to tackling addiction, involving parents and children together in the treatment process.

Source: Conrod, P. et al. “A cluster randomized trial evaluating a selective, personality-targeted prevention program for adolescent alcohol misuse: Primary two-year outcomes and possible secondary herd effects” JAMA Psychiatry

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Education :

Oxytocin is best known for its role in creating social bonds, but it may also forge the chains of addiction. The “love hormone” oxytocin can relieve symptoms of withdrawal in people recovering from alcoholism, according to a small new study.

Research has long suggested that oxytocin— called the “love” or “hug” hormone for its role in social bonding— is a complicated chemical. It is released during orgasm and birth and other bonding moments between lovers or family members, but oxytocin may also help create the unhealthy ties that bind alcoholics and addicts to their drugs of choice.

Indeed, in rodents, oxytocin can successfully fight unpleasant alcohol and heroin withdrawal symptoms. And if given before the addiction even occurs, the hormone may even prevent the development of tolerance and symptoms of physical dependence.

The new study included 11 people with alcoholism severe enough to produce withdrawal symptoms, but not so severe that this withdrawal would produce potentially life-threatening seizures.

That was important, because during detox, people with alcoholism are typically given benzodiazepines. These are drugs like Valium (diazepam) or Ativan (lorazepam) and they relieve withdrawal symptoms, including seizures. People who suffer seizures must be given regular doses of the drugs; others can just take them as needed for comfort. The doses taken by those not at risk of seizures, consequently, provide a good measure of how bad the withdrawal is.

And oxytocin was found to help dramatically. Those given the hormone required nearly five times less lorazepam to get through detox, compared to those on placebo. They also had less anxiety.

“Our results are the first evidence that [oxytocin] may block alcohol withdrawal symptoms in humans,” the authors write. They say, however, that the results should be considered “very preliminary” because of the extremely small number of participants.

Oxytocin itself is not addictive: most people given a nasal spray containing the hormone cannot distinguish it from placebo, although about 1/3 of men get erections and people do become more trusting and cooperative in some settings. It does not automatically cause people to fall in love either, at least not in any of the research conducted so far.

So why might it be involved in addiction? It’s not yet clear but some research suggests that oxytocin essentially “wires” your lover or child to your reward system, so that it is activated and you feel good when the person is present— and not so good when he or she is not there or you fear the loss of the relationship. The oxytocin itself isn’t rewarding: it is simply connecting the reward with the memory of the person and the relationship. In the case of addiction, it could instead “wire” the system to the presence or absence of the drug. Increasing oxytocin levels, therefore, might cue the reward system to react the way it does in the presence of the drug, relieving withdrawal. The research was led by Cort Pederson of the University of North Carolina at Chapel Hill and published in Alcoholism: Clinical and Experimental Research.

Source: healthland.time.com 15th October 2012

Filed under: Alcohol,Brain and Behaviour :

Cigarettes and alcohol serve as gateway drugs, which people use before progressing to the use of marijuana and then to cocaine and other illicit substances; this progression is called the “gateway sequence” of drug use. An article in Science Translational Medicine by study author Denise Kandel, PhD, of the Mailman School of Public Health; and Amir Levine, MD; Eric Kandel, MD; and colleagues at Columbia University Medical Center provides the first molecular explanation for the gateway sequence. They show that nicotine causes specific changes in the brain that make it more vulnerable to cocaine addiction — a discovery made by using a novel mouse model.

Alternate orders of exposure to nicotine and cocaine were examined. The authors found that pre-treatment with nicotine greatly alters the response to cocaine in terms of addiction-related behavior and synaptic plasticity (changes in synaptic strength) in the striatum, a brain region critical for addiction-related rewards. On a molecular level, nicotine also primes the response to cocaine by inhibiting the activity of an enzyme?histone deacetylase?in the striatum. This inhibition enhances cocaine’s ability to activate a gene called FosB gene, which promotes addiction.

The relationship between nicotine and cocaine was found to be unidirectional: nicotine dramatically enhances the response to cocaine, but there is no effect of cocaine on the response to nicotine. Nicotine’s ability to inhibit histone deacetylase thus provides a molecular mechanism for the gateway sequence of drug use.

Nicotine enhances the effects of cocaine only when it is administered for several days prior to cocaine treatment and is given concurrently with cocaine. These findings stimulated a new analysis of human epidemiological data, which shows that the majority of cocaine users start using cocaine only after they have begun to smoke and while they are still active smokers. People who begin using cocaine after they’ve started smoking have an increased risk of cocaine dependency, compared with people who use cocaine first and then take up smoking.

“These studies raise interesting questions that can now be further explored further in animal models,” said Dr. Kandel, a professor of Sociomedical Sciences at the Mailman School. “Do alcohol and marijuana — the two other gateway drugs — prime the brain by the same mechanism as nicotine? Is there a single mechanism for all gateway sequences, or does each sequence utilize a distinct mechanism?”

The results also emphasize the need for developing effective public health prevention programs encompassing all nicotine products, especially those targeted toward young people. Effective interventions not only would prevent smoking and its negative health consequences but could also decrease the risk of progression to chronic use of illicit drugs.

Source: ScienceDaily (Nov. 2, 2011)

Filed under: Alcohol,Brain and Behaviour,Nicotine :

Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later.

This huge US study set out to test whether widespread screening and brief intervention for illegal drug use (not just heavy drinking) could be implemented in a variety of general medical settings and whether it was effective. Both tests seem to have been passed, but with some important caveats.

Summary Alcohol screening and brief interventions in medical settings can significantly reduce alcohol use. Corresponding data for illicit drug use is sparse. A federally funded screening, brief interventions, referral to treatment (SBIRT) service program, the largest of its kind to date, was initiated by the Substance Abuse and Mental Health Services Administration (SAMHSA) in a wide variety of medical settings. The study compared illicit drug use at intake and 6 months after drug screening and interventions were administered. SBIRT services were implemented in a range of medical settings across six states.

A diverse patient population (Alaska Natives, American Indians, African-Americans, Caucasians, Hispanics), was screened and offered score-based progressive levels of intervention (brief intervention, brief treatment, referral to specialised treatment). In this secondary analysis of the SBIRT service programme, drug use data was compared at intake and at a 6-month follow-up, in a sample of a randomly selected population (10%) who screened positive at baseline. Of 459,599 patients screened, 22.7% screened positive for a spectrum of use (risky/problematic, abuse/addiction).

The majority were recommended for a brief intervention (15.9%), with a smaller percentage recommended for brief treatment (3.2%) or referral to specialised treatment (3.7%). Among those reporting baseline illicit drug use, rates of drug use at 6-month follow-up (4 of 6 sites), were 67.7% lower (p < 0.001) and heavy alcohol use was 38.6% lower (p < 0.001), with comparable findings across sites, gender, race/ethnic, age subgroups. Among persons recommended for brief treatment or referral to specialised treatment, self-reported improvements in general health (p < 0.001), mental health (p < 0.001), employment (p < 0.001), housing status (p < 0.001), and criminal behaviour (p < 0.001) were found. The authors concluded that SBIRT was feasible to implement and that self-reported patient status at 6 months indicated significant improvements over baseline for illicit drug use and heavy alcohol use, with functional domains improved, across a range of health care settings and a range of patients. Source: Drug and Alcohol Dependence: 2008

Filed under: Alcohol,Drug use-various effects,Health :

Almost 30 years after discovery of a link between alcohol consumption and certain forms of cancer, scientists are reporting the first evidence from research on people explaining how the popular beverage may be carcinogenic. The results, which have special implications for hundreds of millions of people of Asian descent, were reported at the 244th National Meeting & Exposition of the American Chemical Society.

Silvia Balbo, Ph.D., who led the study, explained that the human body breaks down, or metabolizes, the alcohol in beer, wine and hard liquor. One of the substances formed in that breakdown is acetaldehyde, a substance with a chemical backbone that resembles formaldehyde. Formaldehyde is a known human carcinogen. Scientists also have known from laboratory experiments that acetaldehyde can cause DNA damage, trigger chromosomal abnormalities in cell cultures and act as an animal carcinogen.

“We now have the first evidence from living human volunteers that acetaldehyde formed after alcohol consumption damages DNA dramatically,” Balbo said. She is a research associate in the laboratory of Stephen Hecht, Ph.D., a noted authority on cancer prevention at the University of Minnesota. “Acetaldehyde attaches to DNA in humans – to the genetic material that makes up genes – in a way that results in the formation of a ‘DNA adduct.’ It’s acetaldehyde that latches onto DNA and interferes with DNA activity in a way linked to an increased risk of cancer.”

Balbo pointed out that people have a highly effective natural repair mechanism for correcting the damage from DNA adducts. Most people thus are unlikely to develop cancer from social drinking, although alcohol is associated with a risk of other health problems and accidents. In addition, most people have an enzyme called alcohol dehydrogenase, which quickly converts acetaldehyde to acetate, a relatively harmless substance.

However, about 30 percent of people of Asian descent – almost 1.6 billion people – have a variant of the alcohol dehydrogenase gene and are unable to metabolize alcohol to acetate. That genetic variant results in an elevated risk of esophageal cancer from alcohol drinking. Native Americans and native Alaskans have a deficiency in the production of that same enzyme.

To test the hypothesis that acetaldehyde causes DNA adducts to form in humans, Balbo and colleagues gave 10 volunteers increasing doses of vodka (comparable to one, two and three drinks) once a week for three weeks. They found that levels of a key DNA adduct increased up to 100-fold in the subjects’ oral cells within hours after each dose, then declined about 24 hours later. Adduct levels in blood cells also rose.

“These findings tell us that alcohol, a lifestyle carcinogen, is metabolized into acetaldehyde in the mouth, and acetaldehyde is forming DNA adducts, which are known major players in carcinogenesis,” said Balbo.

The American Chemical Society is a nonprofit organization chartered by the U.S. Congress. With more than 164,000 members, ACS is the world’s largest scientific society and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.

Source: Thursday, 23 August 2012 WorldPharmaNews.com

Filed under: Alcohol,Health :

SUICIDE is expected to remain the leading cause of death of teenagers over the next decade — especially when alcohol is involved, a new study reveals.

The first analysis of the suicide rates of those under the age of 18 reveals that the number among 15- to 17-year-olds has increased substantially.

The rate for young girls has more than doubled, from 2.5 suicides per 100,000 population to 5.1. For young boys, it has gone up from 9.3 per 100,000 population to 13.5.

The study, published in the ‘Irish Medical Journal’, also found that when alcohol abuse is a factor, the rate among girls aged 15 to 17 is expected to increase five-fold by 2014 from 1993, when there were 2.5 suicides per 100,000 population.

Impulsivity

“Alcohol is long recognised as a significant risk factor for suicide, being linked with depression and impulsivity, particularly in males,” according to the research team from St Vincent’s University Hospital and the School of Public Health, Physiotherapy and Population Science in UCD.

“Given the known high rates of alcohol misuse among Irish adolescents, this, coupled with increased rates of deliberate self-harm (DSH), places both young Irish males and females at continuing increased risk for completed suicide.”

The study’s author, Professor Kevin Malone, urged the Government to review its education and intervention strategies, with an emphasis on “intensified prevention efforts” to be made “earlier in Irish life than was conceived heretofore”

Source: www.independent.ie 16th August 2012

Filed under: Alcohol,Drug use-various effects on foetus, babies, children and youth,Health :

Drug and drink-related deaths in Scotland have reached record levels, with cases relating to methadone making up almost half the figure. There were 584 recorded deaths in 2011 – up 99 on the previous year and a 76% increase on 2001.

Heroin substitute methadone was linked to 47% of deaths, with heroin and morphine accounting for a third. Justice Minister Roseanna Cunningham said the government was committed to helping serious addicts recover. But opposition parties said the proportion of deaths related to methadone, which is prescribed to help heroin users kick their habit, showed ministers had to rethink their policy. According to the figures:

* Heroin and/or morphine was linked to 206 deaths (35%)

* Methadone was linked to 275 deaths (47%)

* Benzodiazepines, like diazepam, were linked to 185 deaths (32%)

* Alcohol was linked to 129 deaths (22%)

* Cocaine, ecstasy and amphetamines were liked to 36, eight and 24 deaths respectively

There have been increases in deaths in six of the past 10 years.

A total of 36% of deaths were among 35 to 44-year-olds, with people aged 24 to 34 involved in 32% of cases.

Men accounted for 73%, but the increase in the number of drug-related deaths was greater for women – at 117%.

Ms Cunningham, Scotland’s minister for community safety, said £28.6m was being invested in drug treatment over 2012-13, while naloxone kits, which help counteract the effects of opiate drug overdoses, were being handed out across Scotland.

She said: “Every one of these deaths is a tragedy and I extend my sympathies to the family members, friends and everyone connected.

“Today’s publication once again underlines Scotland has a legacy of drug misuse that stretches back decades, creating this upward 10-year trend in drug-related deaths. Many of those lost to us are older drug users who after years have become increasingly unwell.

“No government has done more to address the legacy and while it will take time to tackle this tragedy, we will do that through continuing to invest and support the recovery of those affected by drugs in Scotland.”

Biba Brand, of the Scottish Drugs Forum, said families seeking help for drug problems were now in their third generation.

“Drug-dependency is a chronic, relapsing condition for which there is no single solution and no quick or easy answer,” she said.

‘Legalised drug-taking’

Labour justice spokesman Lewis Macdonald said: “With a large proportion of deaths involving methadone, it would appear that the approach being taken to treatment isn’t working properly and fails to prevent addicts combining drugs into lethal cocktails.

“It isn’t good enough for the SNP to say they are spending more money on the same approach.” Scottish Conservative leader Ruth Davidson MSP added: “This appalling loss of life illustrates the human disaster that is the methadone programme. “It would appear hundreds of families are being blighted by what is little more than legalised drug-taking on an industrial scale.”

The Lib Dems’ Alison McInnes MSP said: “It is disappointing the community minister made no mention of prevention. “The starting gun to tackling drug abuse in our communities must be education.”

Elsewhere, the figures showed a total of 33% of deaths happened in the Greater Glasgow and Clyde NHS Board area, with the proportion at 13% in Lothian. The overall figure accounted for 1% of all recorded deaths.

Source: see http://www.bbc.co.uk/news/uk-scotland-19294709 17 August 2012

Filed under: Alcohol,Drug use-various effects,Health :

Say goodbye to the drug-fuelled raver and hello to the clean-living ecowarrior. Teenagers are changing and, for perhaps the first time in history, their parents approve.

Rates of drug- taking, drinking and smoking among children have plummeted in the past decade. Girls, it seems, are more likely to emulate the polite, studious Hermione Granger, played by Emma Watson in the Harry Potter films than wild-child party girls like Peaches Geldof in her heyday.

Among 11 to 15 year olds, the proportion who admitted to having taken drugs fell from 29 per cent in 2001 to 17 per cent in 2011. Regular smokers of at least one cigarette a week halved from one in 10 to one in 20. The number who said they had drunk alcohol in the past week was down from 26 per cent to 12 per cent.

Experts said a “profound shift” had taken place in the new generation’s attitude to drink and drugs. The findings were based on a survey of 6,500 children aged 11 to 15 at secondary schools in England, conducted between September and December 2011.

Tim Straughan, the chief executive of the NHS Health and Social Care Information Centre, said: “The report shows pupils appear to be leading an increasingly clean-living lifestyle and are less likely to take drugs as well as cigarettes and alcohol. All of this material will be of immense interest to those who work with young people and aim to steer them towards a healthier way of life.”

Siobhan McCann, of the charity Drinkaware, said: “While the decline in the number of children trying alcohol is good news, the report still shows there are 360,000 young people who reported drinking alcohol in the past week alone. Parents are the biggest suppliers of alcohol to young people aged 10 to 17 and also the biggest influence on their child’s relationship with drink.”

Drug-taking, drinking and smoking increases with age, the study found. Among 11-year-olds, fewer than one in 30 said they had taken drugs in the past year, compared with almost one in four 15-year-olds.

Cannabis was the most popular drug but its use fell during the decade. In 2011, one in 13 young people said they had smoked it, compared with one in seven in 2001.

Drug use was found to be highest in southern England and lower in the Midlands and the North. The proportion of children saying they had smoked cigarettes at least once was the lowest since the survey was first carried out in 1982 – reflecting the pressure created by anti-smoking laws. Even so, one in five said they had tried cigarettes and one in 20 did so regularly.

In 2001, one in five teenagers said they drank alcohol at least once a week. By 2011, that proportion was down to one in 14. Miles Beale, of the Wine and Spirit Trade Association, said: “The increase in the number of young people who have never drunk alcohol, and the fact those who do drink appear to be drinking less, suggests that the messages about the risks of underage consumption are being heard.”

‘Most of us think of our future, and drink won’t help’
Rosie Brighton, 13, Watford

“I know a few people my age that drink but not many. When you look at people that turn up for school hung-over, not caring and not getting the grades, it is off-putting. Most of us are working hard to get good exam results because we look at the high unemployment rates and think we’ll need all the help we can get. We’re thinking about our future, and drink is not going to help that.

“I don’t know anyone who smokes or takes drugs. A lot of people are afraid of how mad their parents would be if they were caught. I think health authorities and schools have to educate children about drugs early. I had my first lesson in school about drugs in Year 6, but have been made aware of the dangers by my mum.”

Source: The Independent July 2012

Filed under: Alcohol,Cannabis/Marijuana,Nicotine,Parents :

Since May 14, 1988, when 27 people died in the deadliest alcohol-impaired driving crash

in U.S. history, the country has had over 300,000 lives lost, millions injured and 200 law enforcement officers killed, all due to impaired driving.

Since 1988, there have been significant accomplishments such as the percentage of impaired driving fatalities to all highway fatalities dropping from 41% in 1988 to 31% in 2010. Also, the total number of impaired driving fatalities in 1988 was 18,611; in 2010 it was at 10,228.

Mr. Tucker from ONDCP observed that it is just as dangerous as alcohol-impaired driving,

citing such facts as:

In 2009, 1 in 3 drivers killed in a motor vehicle crash with a known drug test result tested positive for an illegal drug.

Cannabinoids were reported in almost half (43%) of the fatally injured drivers aged 24 or younger who tested positive for drugs.

Source Mr. Benjamin Tucker, Deputy Director of State, Local, and Tribal Affairs for the Office of National Drug Control Policy (ONDCP). : NADCP 18th Annual Training Conference. DWI Courts Vo.5 Issue 4 July 2012

Filed under: Alcohol,Drugs and Accidents,USA :

A 14-YEAR-old manages to get both the Prime Minister and Kevin Rudd’s wife Therese Rein on the phone, and the media flocks to his home in a bid to be the first to tell his side of the story.

This is not a child protege, nor is it a 14-year-old whose talents will deliver Olympic glory.

This Year 9 teenager is a convicted drug felon, having been caught buying 3.6g of marijuana on the streets of Kuta, and the fact that today he is at home is testament to the narrow escape he’s had from the claws of the Indonesian legal system.

His get-out-of-jail-free card is not a good luck charm he is likely to ever try again, but why after all the publicity generated by the cases of Schapelle Corby and the Bali Nine do so many continue to dice with death in Bali?

The answer is two-fold. Firstly, our acceptance of drugs inAustralia has now reached the point where we think it is relatively “normal” for a 14-year-old to have an addiction to a drug he has been smoking for two years.

A 2008 survey of 24,000 Australian high school students found that 14 per cent of students aged 12-to-17 years used cannabis, peaking at 26 per cent for 17-year-olds.

The Australian Secondary Students Alcohol and Drug survey found 80 per cent of pupils between 12 and 17 had tried alcohol. Eleven per cent of 12-year-olds had used inhalants in the previous month, and by the age of 17, seven per cent of students had used amphetamines.

So why would we raise our eyebrows when a 14-year-old Australian school student conducts a drug deal on the streets of Indonesia?

The catch here relates to where he bought the drugs and the penalties for drug-taking inAustralia, compared to our close neighbours – who make no secret of their bid to stamp it out.

Many, perhaps most, Australians are angry at Schapelle Corby’s on-going punishment, believing she has been unfairly treated. Thousands have signed petitions or offered prayers for those members of the Bali Nine who decided to wrap drugs to their bodies and smuggle it back home. Didn’t they think that other young Australians would use it – and possibly die?

Instead of ongoing outrage, we sympathise with those caught and point the finger of blame at Indonesia.

We have to change that psyche. Drugs are deadly. And in Indonesia the punishment for using them can be deadly too. It’s not a secret. And disagreeing with it doesn’t change it. In fact, in this part of the world,Australia is the odd one out, with other countries mirroring Indonesia’s stance.

So if we are serious about tackling drug use, we need to look at whether we should be ridiculing another country’s policy, or adopting tougher penalties here. Instead, we give movie-star status to a teenager who should know better. We protect him getting from the airport to his home, we don’t use his name, and his family breathes a sigh of relief that he’s relatively unscathed “considering what he went through”.

The next 14-year-old won’t receive the same easy ride, and this one is lucky authorities did not want to make an example of him – particularly at a time when we are laying down tough laws netting Indonesian teenagers lured into people-smuggling rackets in a bid to feed their families.

The problem with drugs is not Indonesia, or how it punishes users. The problem is with us, and how we have “normalised” drug use here – to the point where we’re told experimentation is typical in teenage years. To that extent, it’s not this lad’s fault either. The problem is bigger than he is, and will only grow while we accept its use and refuse to confront the consequences. The Courier-Mail spelt this out graphically in its Drug Scourge investigation, which showed greater crime, a bigger road toll and increasing mental health issues.

Several weeks ago on the Gold Coast, I walked into the female toilets used by diners of an upmarket restaurant to see a well-dressed young man sniffing cocaine off a toilet seat. He apologised – for using the female toilet not the drug-taking – and continued on his high. No shame, but is there any wonder?

Source: Courier Mail Australia. Dec. 2011

mk@madonnaking.com.au.
On Twitter: @madonnamking

Filed under: Addiction,Alcohol,Australia,Cocaine,Drug use-various effects on foetus, babies, children and youth :

The British Liver Trust however says the number now being admitted to hospitals because of alcohol is a big problem for the country and blames the problem on a combination of cheap drink and extended drinking times.

The charity figures show that more than 500 people a day are being admitted to hospital because of alcohol-induced accidents, violence and liver damage and the number of alcohol-related hospital admissions has increased by almost a third since the licensing laws were relaxed almost two years ago.

According to NHS statistics the highest number is in the North East. NHS statistics show that in 2003-04 there were 147,659 admissions to English hospitals where alcohol was given as a cause.

In 2005-06, when the drinking laws were relaxed, the total was 193,637, or 530 admissions a day.

Source:News-Medical.net 2nd Jan.2008

Filed under: Addiction,Alcohol,Education Sector :

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

Filed under: Addiction,Alcohol,Drug use-various effects on foetus, babies, children and youth,Education,Treatment and Addiction,Youth :

Alcohol

Alcohol & Substance Use

Six New Substances under Control

Six resolutions adopted

Abstract and Figures

What is a ‘gateway drug’?

Why alcohol can be a ‘gateway’

Other factors at play

When and how to stop

Abstract

The Spectrum of Unhealthy Alcohol Use

Identifying and preventing AUD

Withdrawal management

Treating AUD

Medications

Behavioral therapies

Recovery supports

Disparities in alcohol-related deaths and treatment access

American Indian and Alaska Native communities

People living in rural areas

Next steps

by Brian Anthony Hernandez

Concrete action needed

October 31, 2024

‘Still work to be done’

The Pennsylvania State University Oct 12 2024

By Vania Patino Los Angeles

What You Need To Know

Remaining Sober In College

Tips For Staying Sober On Campus

Avoid Popular “Party” Spots

Join A Club Or Campus Organization

Start An Exercise Routine

Utilize Campus Resources

Additional Resources For College Students In Recovery

Finding Help

Written by Ania Wellere, Master of Public Health Candidate, UNC Gillings School of Global Public Health.

Youth drinking

Effect on the adolescent brain

Tuesday, July 30, 2024

Experts recommend starting education about substance abuse as early as possible

Teenagers who have experienced distress from substance use

Who have teens gone to for help/support when experiencing distress from substance use?

Bertha Madras, a leading expert on weed, outlines the science linking it to psychiatric disorders, permanent brain damage, and other serious harms.

By HealthDay Feb. 9, 2024, at 7:50 a.m.

Abstract

Abstract and Figures

Summary

Background

Methods

Findings

Interpretation

Funding

Highlights

Abstract

Drug Testing Varies

State Statistics

Abstract

Abstract

Summary

Background

Methods

Findings

Interpretation

Funding

Abstract

Abstract

Depressants

Benzodiazepines

Alcohol

Stimulants

Methamphetamine

Cocaine

What should be done?

Conclusion

Disclaimer

FEATURED ADDICTION EXPERT: Daniel M. Blumenthal, MD, MBA Attending Physician, Division of Cardiology, Massachusetts General Hospital Instructor of Medicine at Harvard Medical School Associate Chief Medical Officer at Devoted Health

FEATURED ADDICTION EXPERT: Frederick S. Southwick, MD Professor of Internal Medicine and Former ​Chief of Infectious Diseases at the University of Florida 2010 Harvard University Advanced Leadership Fellow Expert in Medicine, Infectious Disease and Medical Errors​

Submitted by Andy Travis

Links:

FEATURED ADDICTION EXPERT:
Daniel M. Blumenthal, MD, MBA
Attending Physician, Division of Cardiology, Massachusetts General Hospital
Instructor of Medicine at Harvard Medical School
Associate Chief Medical Officer at Devoted Health

FEATURED ADDICTION EXPERT:
Frederick S. Southwick, MD
Professor of Internal Medicine and Former Chief of Infectious Diseases at the University of Florida
2010 Harvard University Advanced Leadership Fellow
Expert in Medicine, Infectious Disease and Medical Errors