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 »

Mothers’ 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 »

Antibiotic may help in treatment of alcoholism

There are currently few effective therapies for alcohol use disorder (AUD), with only three FDA approved drugs along with behavioral modification programs such as Alcoholics Anonymous. Together or alone, none are particularly effective and relapse is common, making the development of new therapies vital.

A collaborative effort between Texas Tech University Health Sciences Center (TTUHSC) researchers Susan Bergeson, Ph.D., Joseé Guindon, Ph.D., Peter Syapin, Ph.D., clinicians David Edwards, M.D., David Trotter, Ph.D., and Deborah Finn, Ph.D., at Oregon Health and Science University has identified a potential new treatment for AUD.

“Recent research has used new technologies to identify genes and pathways related to neuroinflammation as part of alcohol’s action on addiction processes,” said Bergeson, associate professor in the TTUHSC Department of Pharmacology and Neuroscience. “Minocycline, a tetracycline antibiotic normally used against bacterial infections, has known anti-inflammatory actions and recently was shown to reduce alcohol consumption.”

Tigercycline Is Also Anti-Inflammatory

In research described in four companion papers published by the journal Alcoholism: Clinical and Experimental Research, the teams first reported the screening of several tetracycline drugs to see if all were effective in reducing alcohol use.

The results pointed to a specific structural component of the drugs as responsible for positive outcomes and led to the discovery that tigecycline, a minocycline analog, was highly effective in reducing binge and chronic consumption, in both dependent and non-dependent animals.

Also Helps to Reduce Withdrawal Seizures

In addition, withdrawal seizures, which represent a medical emergency in humans, also were reduced in mice by tigecycline. Finally, binge drinking was shown to cause a persistent change in pain perception, which was reduced in males, but not females, by tigecycline.

The Bergeson, Finn, Guindon and Syapin labs’ research lead to the conclusion that tigecycline, already approved by the FDA for use in humans for Methicillin-resistant Staphylococcus aureus or MRSA infections, may be a good lead drug for the effective reduction of alcohol drinking, withdrawal symptoms and pain.

Already Approved by FDA

“We have known that high levels of alcohol consumption can cause damage to the liver and brain, but it has been more difficult to understand how AUD is cemented,” said Bergeson. “Every person knows a family member or close friend that struggles with AUD, and now with these findings, a simple antibiotic that is already FDA approved could help.”

November 20th, 2016  in Alcohol No Comments »

Video Games Influence Teens to Drink, Smoke

Images and references to alcohol and tobacco in popular video games may be influencing UK teens who play the games and the age restriction system is not working, according to a new study.

Experts from the UK Centre for Tobacco and Alcohol Studies at The University of Nottingham have carried out the first ever analysis of best-selling video games to find out the extent to which the games include this content and to assess the link between playing the games and drinking and smoking behaviour.

Twice as Likely to Smoke, Drink Alcohol

They found that teenagers who play video games featuring alcohol and tobacco references appeared to be directly influenced because they were twice as likely to have tried smoking or drinking themselves.

The research examined the content of 32 UK best-selling video games of 2012/2013 and carried out a large online survey of adolescents playing games with alcohol and tobacco content. An analysis of ‘cut scenes’ uploaded by gamers to YouTube from the five most popular games was also carried out. All the games studied were from the genres of stealth, action adventure, open world, shooter and survival/horror because they involve avatars that look and act like real people.

44% of Video Games Contain Alcohol, Tobacco

The study, published in the journal Cyberpsychology, Behavior and Social Networking, found alcohol and tobacco content in 44% of the most popular video games. They also found this content was not reported by the official regulator, the Pan-European Games Information (PEGI) system which informs the Video Standards Council age ratings that help parents decide whether game content is suitable for their children.

The researchers used YouGov survey tools to ask 1,094 UK adolescents aged 11-17 whether they had played any of the most popular video games identified as containing either tobacco or alcohol imagery. They were also asked whether and to what extent they smoked or drank alcohol. The study found that adolescents who had played at least one game with tobacco or alcohol content were twice as likely to have tried smoking or consumed alcohol themselves.

Grand Theft Auto, Black Ops

Out of the top five most popular games, Grand Theft Auto V & VI contained the highest level of alcohol and smoking content using fictitious brands only. The other top games containing these references were Call of Duty:Black Ops II, Call of Duty:Modern Warfare 3 and Assassin’s Creed III. There was no electronic cigarette content.

Psychologist Dr Joanne Cranwell from the UK Centre for Tobacco and Alcohol Studies, said “Although around 54% of UK adolescents play video games online, parental concern over exposure to inappropriate content while playing video games seems to be lower than for other media, like movies for example. While 80% of children aged 10-15 play packaged or online video games with an age rating higher than their age, more than half of British parents are unaware of the harmful content this exposes them to.

Descriptors Are Not Working

“Video games are clearly attractive to adolescents regardless of age classification. It appears that official PEGI content descriptors are failing to restrict youth access to age inappropriate content. We think that the PEGI system needs to include both alcohol and tobacco in their content descriptors. Also, game developers could be offered incentives to reduce the amount of smoking and drinking in their games or to at least reference smoking and drinking on their packaging and websites.

“As a child protection method it is naïve for both the games industry and the Interactive Software Federation of Europe, who regulate the PEGI system, to rely on age ratings alone. Future research should focus on identifying the levels of exposure in terms of dose that youth gamers are exposed to during actual gameplay and the effects of this on long- term alcohol and smoking behaviour.”

October 27th, 2016  in Alcohol No Comments »

Drug-use may hamper moral judgment

Regular cocaine and methamphetamine users can have difficulty choosing between right and wrong, perhaps because the specific parts of their brains used for moral processing and evaluating emotions are damaged by their prolonged drug habits. This is according to a study among prison inmates by Samantha Fede and Dr. Kent Kiehl’s laboratory at the University of New Mexico and the nonprofit Mind Research Network. The findings of the study, which was funded by the National Institute on Drug Abuse, are published in Springer’s journal Psychopharmacology.

Research has shown that stimulant users often find it difficult to identify other people’s emotions, particularly fear, and to show empathy. These aspects play an important role in moral decision making. Other studies have pointed to structural and functional abnormalities in especially the frontal regions of their brains among stimulant users. These areas are engaged when moral judgments have to be made.

Drug Use and Criminal Behavior

There is strong link between drug use and criminal behavior, and up to 75 percent of inmates in the US have substance abuse problems. It is not known whether the criminal behavior is in part a result of the drugs’ effects on brain function.

Kiehl’s team is the first to examine how the neural networks and brain functioning of chronic cocaine and methamphetamine users in US jails relate to their ability to evaluate and decide about moral situations or scenarios. Poor judgment about moral situations can lead to poor decision making and subsequent antisocial behavior.

Chemical Changes in the Brain

The researchers recorded the life history of substance abuse of 131 cocaine and methamphetamine users and 80 non-users incarcerated in New Mexico and Wisconsin prisons. The participants’ brains were scanned while they completed a moral decision-making task in which they evaluated whether certain phrases were morally wrong or not.

Compared to the non-users, the regular stimulant users had abnormal neural activity in the frontal lobes and limbic regions of their brains during moral processing. Specifically, lifetime stimulant users showed less activity in the amygdala, a group of neurons in the brain that helps to regulate and understand emotions. The researchers also observed a relationship in the level of engagement of the anterior cingulate cortex: the longer people had been using stimulants, the less activity in this region. This is an area of the brain that coordinates reinforcement, effect and executive action needed in moral decision making.

Impaired Decision-Making

“This is the first study to suggest impairments in the neural systems of moral processing in both cocaine and methamphetamine users,” says lead author Fede. “Although further research into the connectivity of systems in stimulant use is needed, this provides promising initial understanding of fronto-limbic deficits in stimulant users.”

The research team acknowledges that people who are prone to regular stimulant use might already struggle with moral processing even before they begin to use drugs such as cocaine. The effects found related to use over time in the anterior cingulate cortex and the ventromedial prefrontal cortex, another region implicated in moral decision making, however, indicate that methamphetamine and cocaine may have a serious impact on the brain.

July 19th, 2016  in Alcohol No Comments »

Larger wine glasses may lead people to drink more

Selling wine in larger wine glasses may encourage people to drink more, even when the amount of wine remains the same, suggests new research from the University of Cambridge. In a study published today in the journal BMC Public Health, researchers found that increasing the size of wine glasses led to an almost 10% increase in wine sales.

Alcohol consumption is one of the leading risk factors for disease and has been linked to conditions such as type 2 diabetes, cancer and liver disease. The factors that influence consumption are not clear; a recent Cochrane review published by the Behaviour and Health Research Unit (BHRU) at the University of Cambridge found that larger portion sizes and tableware increased consumption of food and non-alcoholic drinks, but found no evidence relating to consumption of alcohol.

A Change of Perception?

To examine whether the size of glass in which alcohol is served affects consumption, the team at the BHRU, together with Professor Marcus Munafo from the University of Bristol, carried out a study in The Pint Shop in Cambridge from mid-March to early July 2015. The establishment has separate bar and restaurant areas, both selling food and drink. Wine (in 125ml or 175ml servings) could be purchased by the glass, which was usually a standard 300ml size.

Over the course of a 16-week period, the owners of the establishment changed the size of the wine glasses at fortnightly intervals, alternating between the standard (300ml) size, and larger (370ml) and smaller (250 ml) glasses.

The researchers found that the volume of wine purchased daily was 9.4% higher when sold in larger glasses compared to standard-sized glasses. This effect was mainly driven by sales in the bar area, which saw an increase in sales of 14.4%, compared to an 8.2% increase in sales in the restaurant. The findings were inconclusive as to whether sales were different with smaller compared to standard-sized glasses.

Drinking Faster With Larger Glasses?

“We found that increasing the size of wine glasses, even without increasing the amount of wine, leads people to drink more,” says Dr Rachel Pechey from the BHRU at Cambridge. “It’s not obvious why this should be the case, but one reason may be that larger glasses change our perceptions of the amount of wine, leading us to drink faster and order more. But it’s interesting that we didn’t see the opposite effect when we switched to smaller wine glasses.”

Professor Theresa Marteau, Director of the Unit, adds: “This suggests that avoiding the use of larger wine glasses could reduce the amount that people drink. We need more research to confirm this effect, but if it is the case, then we will need to think how this might be implemented. For example, could it be an alcohol licensing requirements that all wine glasses have to be below a certain size?”

June 10th, 2016  in Alcohol No Comments »

Marijuana smokers more likely to develop an alcohol problem

Adults who use marijuana are five times more likely to develop an alcohol use disorder (AUD) –alcohol abuse or dependence– compared with adults who do not use the drug. And adults who already have an alcohol use disorder and use marijuana are more likely to see the problem persist.

Results of a study by researchers at Columbia University’s Mailman School of Public Health and the City University of New York appear online in the journal Drug and Alcohol Dependence.

Increased Risk of Alcohol Problems

“Our results suggest that cannabis use appears to be associated with an increased vulnerability to developing an alcohol use disorder, even among those without any history of this,” said Renee Goodwin, PhD, associate professor of Epidemiology at the Mailman School of Public Health. “Marijuana use also appears to increase the likelihood that an existing alcohol use disorder will continue over time.”

The researchers analyzed data from 27,461 adults enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions who first used marijuana at a time when they had no lifetime history of alcohol use disorders.

The population was assessed at two time points. Adults who had used marijuana at the first assessment and again over the following three years (23 percent) were five times more likely to develop an alcohol use problem, compared with those who had not used marijuana (5 percent).

Marijuana Smokers Delay Alcohol Treatment

Adult problem drinkers who did not use cannabis were significantly more likely to be in recovery from alcohol use disorders three years later.

“From a public health standpoint we recommend that further research be conducted to understand the pathways underlying these relationships as well as the degree to which various potentially vulnerable population subgroups — youth, for example — are at increased risk,” noted Goodwin. “If future research confirms these findings, investigating whether preventing or delaying first use of marijuana might reduce the risk of developing alcohol use disorders among some segments of the population may be worthwhile.”

February 26th, 2016  in Substance Abuse No Comments »

Early Binge Drinking Can Cause Hypertension

Having an occasional drink is fine, but “binge” drinking is a known health hazard and now high blood pressure may need to be added to the list of possible consequences.

Young adults in their twenties who regularly binge drink have higher blood pressure which may increase the risk of developing hypertension, concludes a study conducted by researchers at the University of Montreal Hospital Research Centre (CRCHUM).

Binge drinking (i.e. consuming five or more alcoholic beverages in less than two hours), is quite prevalent: previous studies in Canada and the U.S. have shown that about four in ten young adults aged 18 to 24 are frequent binge drinkers.

Binge Drinking Affects Blood Pressure

Now researchers have demonstrated, for the first time, that binge drinking may have an effect on blood pressure, which can increase the risk of developing hypertension and chronic diseases related to hypertension.

“We found that the blood pressure of young adults aged 20 to 24 who binge drink was 2 to 4 millimetres of mercury higher than non-binge drinkers,” says Jennifer O’Loughlin, senior author of a study published today in the Journal of Adolescent Health.

Data on alcohol consumption at age 20 were collected from 756 participants in the Nicotine Dependence in Teens study, which has followed 1294 young people from diverse social backgrounds in Montreal, Canada since 1999. Data were collected again at age 24, at which time participants’ systolic blood pressure was also taken.

One in Four Affected, Study Shows

Systolic blood pressure measures the pressure in the arteries when the heart beats (i.e., when the heart muscle contracts), and it should be below 140 millimetres of mercury. A blood pressure reading of more than 140 over 90 indicates high blood pressure. The latter number, diastolic blood pressure, measures the pressure in the arteries between heartbeats (i.e., when the heart muscle is resting between beats and refilling with blood).

“Our findings show that more than one in four young adults who binge drink meet the criterion for pre-hypertension (i.e., a systolic blood pressure between 120 and 139 millimetres of mercury). This is worrisome because this condition can progress to hypertension, which in turn can cause heart disease and premature death,” says O’Loughlin, a researcher at the CRCHUM and professor in the School of Public Health, University of Montreal.

Risk of Chronic Diseases

Health professionals and others may need to adopt a preventive approach, recommends O’Loughlin: “Poor diet, salt intake, and obesity are predictors of high blood pressure.

Since we know there is a link between higher blood pressure and the risk of developing chronic diseases, clinicians should ask young people about their alcohol consumption. A slight and continuous increase in systolic blood pressure may be an important warning sign.”

The study also revealed that 85% of young adults who drink heavily at age 20 maintain this behaviour at age 24. But unlike our genetic make-up, risky behaviour can be changed.

When to Intervene?

The researchers will now investigate whether this trend toward high blood pressure will continue when binge drinkers turn 30. With work and family obligations, binge drinking may become less frequent. Other questions that arise include: will the short-term effects of binge drinking disappear when binge drinking declines?

Is there a critical time period in which to intervene to prevent hypertension? While awaiting for answers to these questions, the old adage “moderation is always in good taste” may apply.

February 26th, 2016  in Alcohol No Comments »

Chronic alcohol use helps bacteria harm the liver

End-stage liver disease or liver cirrhosis is the tenth leading cause of death in the United States, and approximately half of these cases are related to alcohol consumption. There’s no refuting that alcohol itself harms the liver, but new research in mice and humans published February 10 in Cell Host & Microbe reveals that chronic drinking also promotes the growth of gut bacteria that can travel to the liver and exacerbate liver disease.

Gastroenterologist Bernd Schnabl of the University of California, San Diego School of Medicine and his colleagues found that chronic alcohol consumption suppresses the mouse antibacterial defense system in the intestine. It does so by blocking intestinal cells’ ability to produce natural antibiotic proteins (called REG3B and REG3G).

Gut Bacteria Reaching the Liver

“Intestinal bacteria can now not only proliferate, but also slowly migrate through the intestinal wall,” says Schnabl. “Since the liver encounters all the blood coming from the intestine, not only important nutrients but also bacteria can now reach the liver. The direct damage that is caused by alcohol to the liver is augmented by the arrival of these gut bacteria, through mechanisms that are currently unknown.”

The team also found that mice genetically engineered to lack REG3G had more of these bacteria after consuming alcohol, and they developed more severe alcoholic liver disease than their littermates. However, restoring REG3G to the intestine reduced the levels of bacteria that traveled to the liver and protected against alcohol-induced liver damage.

Finally, the researchers found that humans with alcohol dependency had elevated levels of bacteria in their small intestines. The team’s previous research showed that they also had lower levels of REG3G.

Probiotic Bacteria Needed

While it may be best for patients at risk of liver disease to stop drinking altogether, Schnabl notes that it can be difficult for some to do so. These latest findings indicate that it may be possible to help patients with alcoholic liver disease by boosting their intestinal defense against certain bacteria, for example by encouraging the growth of good (probiotic) bacteria or by stimulating the production of intestinal antibiotics such as REG3G.

The National Institute on Alcohol Abuse and Alcoholism states that “low-risk” drinking levels for men are no more than 4 drinks on any single day and no more than 14 drinks per week. For women, “low-risk” drinking levels are no more than three drinks on any single day and no more than 7 drinks per week.

February 13th, 2016  in Alcohol No Comments »