Binge Drinking Can Lead Quickly to Liver Disease

Alcohol consumed during just seven weeks of intermittent binge drinking harms the liver in ways that more moderate daily drinking does not, according to researchers at UC San Francisco.

The scientists discovered that just 21 binge drinking sessions in mice were enough to cause symptoms of early-stage liver disease. Binge drinking produced fatty liver tissue and triggered early stages of inflammation, both indicators of alcohol-induced liver disease. Binging also increased the levels of alcohol-metabolizing enzymes, whose activity can produce oxidative damage and other forms of harm to the liver. Their work appears in the January 19, 2017 “EarlyView” online edition of the journal Alcoholism: Clinical and Experimental Research.

Binge Drinking as Dangerous as Long-Term Drinking

“We sometimes think of alcoholic liver damage as occurring after years of heavy drinking. However, we found that even a short period of what in humans would be considered excessive drinking resulted in liver dysfunction,” said Frederic “Woody” Hopf, PhD, the study’s senior researcher, an associate adjunct professor of neurology at UCSF, and a member of UCSF’s Alcohol Center for Genes and Translation (ACGT). “It is important to intervene early to counter the dangers associated with binge drinking habits,” said Hopf, also a member of UCSF’s Wheeler Center for the Neurobiology of Addiction.

For a man, binge drinking is defined as consumption of five or more drinks within two hours, an amount equivalent to five bottles of beer, a bottle of wine, or five shots of hard liquor. For a woman, binge drinking involves consumption of four or more drinks in two hours.

88,000 Preventable Deaths Yearly

Reducing binge drinking is particularly important because many binge drinkers go on to develop an alcohol use disorder and associated health risks. Excessive alcohol use, which includes binge drinking, results in about 88,000 preventable deaths yearly in the United States and about 2.5 million years of lost life, according to the U.S. Centers for Disease Control and Prevention (CDC). Most people with an alcohol use disorder develop fatty liver, and of those, about one in five goes on to develop liver cirrhosis, which often is fatal.

In the UCSF study, liver triglycerides were almost 50 percent higher in binge drinkers’ livers compared to mice that abstained from alcohol, and triglyceride levels in the blood were almost 75 percent higher. Fat droplets were clearly visible in liver slices from binge drinkers. In contrast, moderate-drinking mice and mice that completed just one binge drinking session did not have significantly elevated triglyceride levels compared to abstainers. “Our results strongly suggest that repeated, excessive alcohol drinking, even without alcohol dependence, can cause fatty liver, evidence of early alcohol-related liver dysfunction,” Hopf said.

Binge Drinking Increases Enzyme Levels

The researchers also found that even a single episode of binge drinking elevated the levels of the liver enzyme CYP2E1, which metabolizes alcohol into toxic by-products that can cause oxidative damage and other forms of tissue injury. After seven weeks of binging, there was even more CYPE1 produced in response to binge drinking. Alcohol dehydrogenase, the major alcohol-metabolizing enzyme, was also more abundant in binge-drinking mice. These results suggest that repeated binging increases the levels of these enzymes, which could lead to greater cellular damage.

Repeated binge drinking also increased activation of a gene that immune cells use to make an inflammatory cytokine protein called IL-1B, which is implicated in the liver inflammation seen in alcohol-induced liver disease. The scientists did not detect other alterations in the inflammatory system that are known to accompany later stages of liver cell damage.

Can Damage Be Undone?

“It’s not yet clear whether the changes to the liver associated with binge drinking are completely reversible. It could even be that these changes sensitize and prime the liver, so that a subsequent return to binge drinking after long abstinence will more easily cause harm,” Hopf said. “Those are experiments we are planning to do next.”

For several decades, alcohol researchers have regarded mice as a validated model for learning about mechanisms that drive excessive drinking in humans, according to Hopf. In the newly published study, binge-drinking mice could drink 20 percent alcohol on just three nights per week. “On Monday, Wednesday and Friday nights, they got to drink all they wanted,” Hopf said.

On the Road to Liver Damage

On the other hand, mice that had continuous access to alcohol drank more moderately, about half as much as binge drinkers. Alcohol binging in mice produces blood alcohol levels that are comparable to human binge drinking, Hopf said.

UCSF researchers at the ACGT are particularly interested in investigating whether changes in the brains of alcohol-binging mice might shed light on human binge drinking, especially the compulsive drives for alcohol associated with binge drinking that continues despite damaging consequences. The present studies suggest that even more limited alcohol binging is already sufficient to start one on the road to liver damage, Hopf said.

January 23rd, 2017  in Alcohol No Comments »

119,000 Children With FAS Born Each Year

Worldwide, an estimated 119,000 children are born with Fetal Alcohol Syndrome (FAS) each year, a new study from the Centre for Addiction and Mental Health (CAMH) shows.

The study, published in The Lancet Global Health, provides the first-ever estimates of the proportion of women who drink during pregnancy, as well as estimates of FAS by country, World Health Organization (WHO) region and worldwide.

Globally, nearly 10 per cent of women drink alcohol during pregnancy, with wide variations by country and WHO region. In some countries, more than 45 per cent of women consume alcohol during pregnancy. In Canada, which has clinical guidelines advising abstinence during pregnancy, an estimated 10 per cent of pregnant women still drink, which is close to the estimated world average.

Prevalence of FAS Increasing

Nearly 15 per 10,000 people around the world are estimated to have FAS, the most severe form of Fetal Alcohol Spectrum Disorder (FASD). FAS is characterized by mental, behavioural and learning problems, as well as physical disabilities. In Canada, the estimate is 10.5 cases of FAS per 10,000 people.

Not every woman who drinks while pregnant will have a child with FAS. “We estimated that one in 67 mothers who drink during pregnancy will deliver a child with FAS,” says lead author Dr. Svetlana Popova, Senior Scientist in CAMH’s Institute for Mental Health Policy Research.

She notes that this figure is very conservative and does not include other types of FASD that may occur from alcohol consumption during pregnancy, including partial FAS (pFAS) and Alcohol-related Neurodevelopmental Disorders (ARND).

Safest to Completely Abstain

Although it’s well established that alcohol can damage any organ or system in the developing fetus, particularly the brain, it’s still not known exactly what makes a fetus most susceptible, in terms of the amount or frequency of alcohol use, or timing of drinking during pregnancy. Other factors, such as the genetics, stress, smoking and nutrition also contribute to the risk of developing FASD.

“The safest thing to do is to completely abstain from alcohol during the entire pregnancy,” says Dr. Popova.

The study involved comprehensive literature reviews and statistical analyses to determine the estimates, which are intended to help countries plan public health initiatives and policies, such as FAS surveillance systems and educational efforts on the risks of alcohol use during pregnancy, the researchers note.

Rates Highest in Europe

The five countries with the highest alcohol use in pregnancy were in Europe: Russia, United Kingdom, Denmark, Belarus and Ireland. As a region, Europe also had a 2.6 higher prevalence of FAS than the global average. The lowest levels of drinking and FAS were found for the Eastern Mediterranean and South East Asia regions, as there are high rates of alcohol abstinence in these regions.

The predictive model that the research team developed in this study could also be used to estimate the prevalence of other disease conditions, notes Dr. Popova. Her team is currently extending this work to study the global scale of all fetal alcohol spectrum disorders (FASD). An earlier study by Dr. Popova and her team, published in The Lancet last year, showed that more than 400 disease conditions co-occur with FASD.

January 17th, 2017  in Alcoholism No Comments »

Alcohol Ads Promote Underage Drinking

A new analysis of 12 long-term studies published since 2008 from across the globe finds that young people under the legal drinking age who are more exposed to alcohol marketing appear more likely to start drinking early and also to engage in binge drinking.

A 2008 analysis established a link between exposure to alcohol marketing and drinking behavior in young people. This new systematic review — the first in nearly a decade — identifies 12 additional studies, broadening and strengthening the science in this area. All of the new studies found an association between level of marketing exposure and youth drinking behavior and found that exposure to ads was even more strongly associated with progression to binge drinking than with initiation of alcohol use.

Evidence Growing That Youth Is Targeted

The research was led by the Center on Alcohol Marketing and Youth (CAMY), part of the Johns Hopkins Bloomberg School of Public Health, and published in a special issue of the journal Addiction focused entirely on alcohol marketing and public health.

“This latest review of the scientific literature adds stronger evidence to the claim that exposure to alcohol marketing among youth is linked to more underage youth drinking and, in particular, binge drinking,” says study leader David Jernigan, PhD, the director of CAMY and an associate professor in the Department of Health, Behavior and Society at the Bloomberg School. “Studies are documenting this exposure, which includes marketing and ads on television, the internet and social media, as well as on the radio, in magazines and at sporting and other events.”

Alcohol Leading Cause of Death for Young Men

Binge drinking, defined by the Centers for Disease Control and Prevention as consuming four or more drinks within two hours for women and five or more drinks for men, is associated with a long list of negative public health consequences, including sexual assaults, violence, attempted suicide and illicit drug use.

Alcohol is the leading cause of death and disability for males ages 15 to 24 in nearly every region of the world, and females of the same age in the wealthy countries and the Americas. In the United States, excessive alcohol use is responsible for an average of 4,350 deaths every year among people under the legal drinking age of 21.

Studies Included 35,000 Participants

The researchers relied upon four different medical and scientific databases to identify articles for possible inclusion in the review. Studies were included in the final review if they met a number of criteria, including whether they used original data and included measures of marketing exposure and alcohol consumption for at least 500 underage youth.

Studies were included only if they used self-reported and observed actual alcohol use such as binge drinking, as opposed to just measures of intentions to consume alcohol in the future. The studies were conducted in seven countries and involved more than 35,000 participants.

Self-Regulation Not Working

In the United States, alcohol advertising and marketing is primarily self-regulated by the alcohol industry, whereby the industry sets its own guidelines with respect to limiting exposure to young people.

Several of the included studies found that levels of marketing exposure appear to be as high or nearly as high among younger adolescents as they are among older adolescents and young adults, suggesting that current voluntary alcohol industry marketing codes are not protecting kids as young as 10 years old.

“Public health policies that can reduce or mitigate the effect of alcohol marketing exposure on youth drinking behavior are sorely needed,” Jernigan says. “With numerous countries considering greater restrictions on alcohol marketing, the findings of these studies signal the public health importance of that debate.”

January 12th, 2017  in Alcohol No Comments »

Ignition Interlock Devices Reduce Fatal Crashes

State laws requiring ignition interlocks for all drunk driving offenders appear to reduce the number of fatal drunk driving crashes, a new study by Johns Hopkins Bloomberg School of Public Health and Colorado School of Public Health researchers suggests.

The study — published Jan. 5 in the American Journal of Preventive Medicine — found that mandatory interlock laws were associated with a seven percent decrease in the rate of fatal crashes with at least one driver with a blood alcohol content over the legal limit. The decrease translates into an estimated 1,250 prevented fatal crashes in states with mandatory interlock laws since states first started passing such laws in 1993.

An ignition interlock is an alcohol-sensing device, connected to the ignition of a vehicle, which detects alcohol in the driver’s breath. If alcohol in excess of a preset limit is detected by the sensor, the vehicle will not start. While all 50 states have some type of ignition interlock laws, 26 have mandatory laws requiring all individuals convicted of a DUI offense to use an interlock in order to drive legally, as of March 2016.

Mandatory Interlocks for All Are Most Effective

This is the first study to look at all the different types of interlock laws across all 50 states. The researchers found that interlock laws which are mandatory for all DUI offenders were much more effective than those applicable to only some offenders, such as only repeat offenders or those with a very high blood alcohol content.

In the United States in 2014, alcohol-involved fatal motor vehicle crashes caused approximately 10,000 deaths, about one-third of all motor vehicle crash deaths.

Interlock Laws Save Lives

“Our study demonstrates the value of mandatory ignition interlock laws across the United States,” says study leader Emma E. “Beth” McGinty, PhD, MS, deputy director at the Johns Hopkins Center for Mental Health and Addiction Policy Research at the Bloomberg School. “We already know that alcohol plays a tragic role in the number of motor vehicle crash fatalities each year. Interlock laws which are mandatory for all DUI offenders save lives. ”

To estimate the effects of existing ignition interlock laws, the researchers studied the effects of interlock laws on trends in alcohol-involved fatal crashes over a 32-year period, 1982 to 2013, and controlled for other motor vehicle safety laws and trends in crashes over time. The team assessed changes in pre- and post-interlock law rates of alcohol-involved fatal crashes with crash data obtained from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System (FARS), and measured them against the different categories of interlock laws: permissive (at the discretion of a judge), partial (applicable to only some DUI offenders), and mandatory for all.

More States Adopting Interlock Laws

The researchers used two measures based on FARS data: alcohol-involved fatal crashes with a driver having a blood alcohol level of 0.08–the legal limit–and a second data set with a driver with a blood alcohol level greater than 0.15.

“Until recently, there hasn’t been any evidence on whether these laws prevent alcohol-involved fatal crashes, and specifically whether mandatory/all laws are more effective than permissive and partial laws,” McGinty says. “Our study suggests that they are effective, and it’s encouraging to see more and more states moving towards this evidence-based policy change. Since 2005, we’ve seen over 20 states adopt interlock laws for all drunk-driving offenses. We’d like to see the remaining states follow suit.”

January 7th, 2017  in Drunk Driving No Comments »

Alcohol Abuse Increases Risks of Heart Conditions

Alcohol abuse increases the risk of atrial fibrillation, heart attack and congestive heart failure as much as other well-established risk factors such as high blood pressure, diabetes, smoking and obesity, according to a study published today in the Journal of the American College of Cardiology.

Despite advances in prevention and treatments, heart disease is the No. 1 killer of men and women in the US. Reducing alcohol abuse might result in meaningful reductions of heart disease, according to the researchers.

“We found that even if you have no underlying risk factors, abuse of alcohol still increases the risk of these heart conditions,” said lead researcher Gregory M. Marcus, MD, director of clinical research in the Division of Cardiology at the University of California, San Francisco.

Double the Risk of Atrial Fibrillation

The researchers analyzed data from a database of all California residents ages 21 and older who received ambulatory surgery, emergency or inpatient medical care in California between 2005 and 2009. Among the 14.7 million patients in the database, 1.8 percent, or approximately 268,000, had been diagnosed with alcohol abuse.

The researchers found that after taking into account other risk factors, alcohol abuse was associated with a twofold increased risk of atrial fibrillation, a 1.4-fold increased risk of heart attack and a 2.3-fold increased risk of congestive heart failure. These increased risks were similar in magnitude to other well-recognized modifiable risk factors such as diabetes, high blood pressure and obesity.

Completely eradicating alcohol abuse would result in over 73,000 fewer atrial fibrillation cases, 34,000 fewer heart attacks, and 91,000 fewer patients with congestive heart failure in the United States alone, the researchers said.

Drinking Not Good for the Heart

“We were somewhat surprised to find those diagnosed with some form of alcohol abuse were at significantly higher risk of a heart attack,” Marcus said. “We hope this data will temper the enthusiasm for drinking in excess and will avoid any justification for excessive drinking because people think it will be good for their heart. These data pretty clearly prove the opposite.”

Previous research has suggested that moderate levels of alcohol consumption may help prevent heart attack and congestive heart failure, while even low to moderate levels of alcohol consumption have been shown to increase the incidence of atrial fibrillation.

Documented Alcohol Abuse

“The great majority of previous research relied exclusively on self-reports of alcohol abuse,” Marcus said. “That can be an unreliable measure, especially in those who drink heavily. In our study, alcohol abuse was documented in patients’ medical records.” He said that the study did not quantify how much alcohol patients drank.

In an editorial accompanying the new study, Michael H. Criqui, MD, MPH, of the University of California San Diego, wrote that previous studies that found a benefit from alcohol consumption in protecting against heart attack and congestive heart failure were so-called cohort studies, which include defined populations. Such studies tend to recruit stable, cooperative and health-conscious participants who are more likely to be oriented toward a heathier lifestyle.

“Cohort studies have minimal participation by true alcohol abusers, so the current study likely presents a more valid picture of heavy drinking outcomes,” Criqui said.

January 4th, 2017  in Alcohol No Comments »

Primary Care Should Include Drug Screening in L.A.

The misuse of both prescription and illicit drugs is so prevalent in Tijuana and East Los Angeles that community clinics in those areas should routinely, though discreetly, screen for it, according to new UCLA research.

The study, published in the peer-reviewed journal Substance Use and Misuse, found that 19.4 percent of people answering a computerized self-administered survey in East Los Angeles community clinics admitted to moderate-to-high drug use. In Tijuana it was 5.7 percent. Rates of drug use among the participants in the study were much higher than what has been found in household surveys in the two countries.

The researchers also found that Los Angeles patients born in Mexico were twice as likely, and Los Angeles patients born in the United States were six times more likely, of being moderate-to-high drug users compared with Tijuana patients born in Mexico.

High Rate of Drug Use Was Surprising

The findings of high rates of drug use ran counter to assumptions, said Dr. Lillian Gelberg, the study’s lead investigator and a professor of family medicine at the David Geffen School of Medicine at UCLA.

“Prevailing expectations were that alcohol would be the major problem and drug use would be lower,” said Gelberg, who is also a professor of health policy and management at the UCLA Fielding School of Public Health. “But what we found was that the rate of problem drug use — that is, moderate-to-high use — was very similar to problem alcohol use.”

Moderate-to-high alcohol use was 15.2 percent in East Los Angeles compared to 6.5 percent in Tijuana. Moderate-to high tobacco use was 20.4 percent in East Los Angeles and 16.2 percent in Tijuana.

Drug Screening Should Be Routine

While drug use was higher in Los Angeles than it was in Tijuana, the rates in both cities are high enough that screening for drug, alcohol and tobacco use should be integrated into routine primary care in community clinics on both sides of the border, said Melvin Rico, clinical research coordinator in the UCLA Department of Family Medicine who served as the field research coordinator for the study.

“Being able to reach a vulnerable population while waiting for a doctor is, I think, very important,” Rico said.

The paper is part of a larger study of an intervention that found a few minutes of counseling in a primary care setting could steer people away from risky drug use and full-fledged addiction.

Self-Reported Substance Abuse

For this study, which ran from March 2013 through October 2013, the researchers recruited 2,507 adults in Los Angeles and 2,890 in Tijuana who were eligible for the World Health Organization’s Alcohol, Smoking and Substance Involvement Screening Test. The researchers designed a simple tool that allowed participants to anonymously self-report substance abuse on a computer tablet with a touch screen. Given the stigma associated with drug use, the researchers wanted to remain sensitive to people’s fears of privacy in a way that still encouraged them to be truthful about their substance use.

Questions about substance use were combined with others about healthy eating, exercise, and chronic illnesses so that the patients would not feel stigmatized about a particular behavior, Gelberg said.

Quiz Adapted for Cultural Differences

“We aren’t using interviews and the patients are filling it in on their own,” she said. “We developed this program so that it would work even for patients of low-literacy levels, asking one question at a time and allowing for an audio option with headsets according to patient’s preference. For instance, it would ask ‘did you use cocaine in the last three months and a ‘yes’ or ‘no’ would light up on the computer screen.'”

The tool could also easily switch between English and Spanish and the questions and approach were adapted to Latinos in Mexico, whose culture and characteristics had differences compared to those in Los Angeles.

Results Subject to Under-Reporting

Participants took the survey while they were in the clinic waiting room, and it took very little time — a mean of 1.3 minutes in Tijuana and 4.2 minutes in Los Angeles.

This tool can be of use in a primary care clinic because people generally don’t volunteer their drug use to their doctors, who for their part don’t know how to broach the subject, Gelberg said.

The study has some limitations. Substance use was based on patient self-reporting, which could make the findings subject to under-reporting. Also, the findings may or may not be the same in health care settings other than community health centers or in other cities in the United States and Mexico.

January 2nd, 2017  in Substance Abuse No Comments »

Alcohol Risks Increasing for Older Adults

Alcohol is the most commonly used psychoactive substance among older adults, and this group can have unique risks associated with alcohol consumption — in even lower amounts — compared to younger persons.

“Older adults have particular vulnerabilities to alcohol due to physiological changes during aging, including increasing chronic disease burden and medication use,” said Benjamin Han, MD, MPH, a geriatrician and health services researcher at the Center for Drug Use and HIV Research (CDUHR) and in the Division of Geriatric Medicine and Palliative Care at NYU Langone Medical Center (NYU Langone). “However, no recent studies have estimated trends in alcohol use, including binge alcohol use and alcohol use disorders among older adults.”

Significant Increases in Alcohol Use, Binge Drinking

To address the lack of research, Dr. Han and his team examined data from the National Survey on Drug Use and Health (years 2005 to 2014) in a paper published in the journal Drug and Alcohol Dependence. Trends of self-reported past-month binge alcohol use and alcohol use disorder were examined among adults age 50 and older.

The researchers found significant increases in past-year alcohol use, past-month alcohol use, past-month binge drinking, and alcohol use disorders. The paper, “Demographic trends of binge alcohol use and alcohol use disorders among older adults in the United States, 2005-2014.” Published on-line 12 December 2016.

Binge Drinking Increased for Women

Results also suggest that while men had a higher prevalence of binge alcohol use and alcohol use disorders than women, binge alcohol use and alcohol use disorder increased among women in this nationally representative sample.

“As females age, they tend to experience a larger impact of physiological changes in lean body mass compared to men,” commented Dr. Han. “Thus, they may experience the adverse effects associated with consuming alcohol even in lower amounts.”

Risking Sexual Situations a Factor

“The increase in binge drinking among older women is particularly alarming” said Dr. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone. “Both men and women are at risk for getting themselves into risky sexual situations while drinking, but women are at particularly high risk.” Dr. Palamar also stated that “heavy drinking can not only have unintended health consequences, but it can also lead to socially embarrassing or regretful behavior.”

For the researchers, the results also raise public health concerns, given the significant increases in binge alcohol use among older adults who reported “fair/poor” health and/or multiple chronic conditions. This population is particularly vulnerable to the negative effects of alcohol as it can impact chronic disease management or increase the risk of injury.

“Health care providers need to be made aware of this increasing trend of unhealthy alcohol use, particularly among older females, and ensure that screening for unhealthy alcohol use is part of regular medical care for this population” said Dr. Han.

December 19th, 2016  in Alcohol No Comments »

Alcohol consumption shows no effect on coronary arteries

Researchers using coronary computed tomography angiography (CCTA) have found no association between light to moderate alcohol consumption and coronary artery disease (CAD), according to a study being presented today at the annual meeting of the Radiological Society of North America (RSNA).

Some previous studies have suggested that light alcohol consumption may actually reduce the risk for CAD. However, data regarding regular alcohol consumption and its association with the presence of CAD remains controversial. For the new study, researchers looked at alcohol consumption, type of alcohol consumed, and presence of coronary plaques using CCTA.

How Alcohol Contributes to Fatty Plaques

“CCTA is an excellent diagnostic modality to noninvasively depict the coronary wall and identify atherosclerotic lesions,” said study author Júlia Karády, M.D., from the MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center at Semmelweis University in Budapest, Hungary. “Furthermore, we’re able to characterize plaques and differentiate between several types. Prior studies used cardiovascular risk factors–like high cholesterol levels–and cardiovascular outcomes to study the effects of alcohol, but our study is unique in that we analyzed both drinkers and non-drinkers using CCTA, which may shed some light on how alcohol may or may not contribute to the development of fatty plaques in the arteries of the heart.”

The researchers studied 1,925 consecutive patients referred for CCTA with suspected CAD. Information on alcohol consumption habits was collected using questionnaires about the amount and type of alcohol consumed. Using an in-house reporting platform that contained the patients’ clinical and CCTA data, researchers were able to assess the relationship between atherosclerosis, clinical risk factors and patient drinking habits.

Light Alcohol Consumption Had No Effect

“About 40 percent of our patients reported regular alcohol consumption, with a median of 6.7 alcohol units consumed weekly,” Dr. Karády said.

One unit translates to approximately 2 deciliters (dl) or 6.8 fluid ounces of beer, 1 dl or 3.4 ounces of wine, or 4 centiliters (cl) or 1.35 ounces of hard liquor.

The results showed that the amount of weekly alcohol consumption, whether light or moderate, was not associated with the presence of CAD. In addition, when researchers looked at different types of alcohol and the presence of coronary atherosclerosis, no associations were found.

Neither Protective or Harmful Effects

“When we compared consumption between patients who had coronary artery plaques and those who had none, no difference was detected,” Dr. Karády said. “Evaluating the relationship between light alcohol intake (maximum of 14 units per week) and presence of CAD, we again found no association. Furthermore, we analyzed the effect of different types of alcohol (beer, wine and hard liquor) on the presence of CAD, but no relationship was found.”

Dr. Karády added that while no protective effect was detected among light drinkers, as previously thought, no harmful effects were detected either.

The researchers are in the process of expanding the study to include more patients and perform further analyses.

Independently of whether alcohol has any effect on the coronary arteries, moderate alcohol consumption has been associated with a number of potential side effects, including negative long-term effects on the brain and heart.

December 5th, 2016  in Alcohol No Comments »

Is Kratom an opioid alternative?

A delayed U.S. Drug Enforcement Administration ban on kratom would stifle scientific understanding of the herb’s active chemical components and documented pharmacologic properties if implemented, according to a special report published today in The Journal of the American Osteopathic Association.

The report cited the pharmacologically active compounds in kratom, including mitragynine, 7-hydroxymitragynine, paynantheine, speciogynine and 20 other substances, as one basis for further study. It also emphasized the extensive amount of anecdotal evidence and current scientific research that indicates kratom may be safer and less addictive than current treatments for pain and opioid withdrawal.

Kratom Does Not Depress Respiration

“There’s no question kratom compounds have complex and potential useful pharmacologic activities and they produce chemically different actions from opioids,” said author Walter Prozialeck, chairman of the Department of Pharmacology at Midwestern University Chicago College of Osteopathic Medicine. “Kratom doesn’t produce an intense euphoria and, even at very high doses, it doesn’t depress respiration, which could make it safer for users.”

Kratom (Mitragyna speciosa) is indigenous to Southeast Asia, where the plant was used for centuries to relieve fatigue, pain, cough and diarrhea and aid in opioid withdrawal. Currently sold in the United States as an herbal supplement, kratom drew DEA scrutiny after poison control centers noted 660 reports of adverse reactions to kratom products between January 2010 and December 2015.

Source of Adverse Reactions Unclear

“Many important medications, including the breast cancer treatment tamoxifen, were developed from plant research,” said Prozialeck.

“While the DEA and physicians have valid safety concerns, it is not at all clear that kratom is the culprit behind the adverse effects,” said Anita Gupta, DO, PharmD and special advisor to the FDA.

A Non-Pharmaceutical Remedy?

Dr. Gupta, an osteopathic anesthesiologist, pain specialist and licensed pharmacist, has treated a number of patients who’ve used kratom. “Many of my patients are seeking non-pharmaceutical remedies to treat pain that lack the side effects, risk, and addiction potential of opioids,” she said.

Kratom is currently banned in states including Alabama, Florida, Indiana, Arkansas, Wisconsin and Tennessee. The DEA is scheduled to decide whether to place kratom on its list of Schedule 1 drugs, a classification for compounds thought to have no known medical benefit. Marijuana, LSD and heroin are Schedule 1 drugs, which prevents the vast majority of U.S.-based researchers from studying those substances.

December 2nd, 2016  in Prescription Drugs No Comments »

Moms’ Sensitivity a Key to Preventing Early Substance Abuse

Research from the University at Buffalo Research Institute on Addictions suggests the approach to preventing alcohol and drug use by some adolescents should begin in early childhood.

“The children of parents with alcohol problems are at much greater risk for underage drinking and developing a substance use disorder,” says the study’s author, Rina Das Eiden, PhD, senior research scientist at RIA. “It’s important to understand when and under what circumstances such problems develop, so we can craft interventions to steer this high-risk population away from substance use and its attendant problems.”

Pathway Begins Early for Children of Alcoholics

Eiden examined different pathways to adolescent substance use, starting in infancy, for children of parents with alcohol use disorder (AUD), and found that maternal warmth and sensitivity in early childhood played a significant role.

“When mothers can be warm and sensitive during interactions with their toddlers, even under the stresses associated with their partners’ alcohol problems, there is a lower likelihood of adolescent substance use,” Eiden says.

Drinking Parents Less Sensitive

Parents with AUD demonstrated lower rates of maternal sensitivity toward their toddlers, continuing into kindergarten age, Eiden found. As the children entered middle school (6th grade), their mothers were less likely to monitor peer groups and activities, leading to higher engagement with substance-using and delinquent peers and drinking in early adolescence (8th grade).

These children also displayed lower self-regulation, or the ability to behave according to rules without supervision, at preschool age, leading to problem behaviors from kindergarten age to early adolescence and higher alcohol and marijuana use in late adolescence.

Encouraging Mothers to Be Sensitive

The results have implications for both the timing and content of preventive interventions against substance use among adolescents of parents with AUD. Timing interventions in early childhood and before major developmental transitions, such as transition to school and moving from elementary to middle school, may be most beneficial.

For content, the most helpful interventions would be to encourage and support mothers in being warm and sensitive during interactions with their toddlers, and to keep a close eye their children’s activities and peer groups during the transition from middle childhood to early adolescence.

“This attention also would promote children’s self-regulation in the preschool years, which may lead to a decrease in problem behaviors from school age into adolescence,” Eiden says.

The article appears in the October issue of Developmental Psychology.

November 20th, 2016  in Alcohol No Comments »