Archive for June, 2010

Parenting style can prevent binge drinking

Parents may be surprised, even disappointed, to find out they don’t influence whether their teen tries alcohol.

But now for some good news: Parenting style strongly and directly affects teens when it comes to heavy drinking – defined as having five or more drinks in a row – according to a new Brigham Young University study.

The researchers surveyed nearly 5,000 adolescents between the ages of 12 and 19 about their drinking habits and their relationship with their parents. Specifically, they examined parents’ levels of accountability – knowing where they spend their time and with whom – and the warmth they share with their kids.

Less Likely to Binge Drink

Here’s what they found:

  • The teens least prone to heavy drinking had parents who scored high on both accountability and warmth.
  • So-called “indulgent” parents, those low on accountability and high on warmth, nearly tripled the risk of their teen participating in heavy drinking.
  • “Strict” parents – high on accountability and low on warmth – more than doubled their teen’s risk of heavy drinking.

Prior research on parenting style and teen drinking was a mixed bag, showing modest influence at best. Unlike previous research, this study distinguished between any alcohol consumption and heavy drinking.

“While parents didn’t have much of an effect on whether their teens tried alcohol, they can have a significant impact on the more dangerous type of drinking,” said Stephen Bahr, a professor in BYU’s College of Family, Home and Social Sciences.

Bahr, along with co-author John Hoffmann, will publish the study in the July issue of the Journal of Studies on Alcohol and Drugs.

The statistical analysis also showed that religious teens were significantly less likely to drink any alcohol. The effect of religiosity mirrors findings from this 2008 study Bahr and Hoffmann conducted on teens’ marijuana use.

Non-Drinking Friends

Not surprisingly, a teen’s peers play an important role on whether a teen drinks. The BYU researchers note that teens in this new study were more likely to have non-drinking friends if their parents scored high on warmth and accountability.

“The adolescent period is kind of a transitional period and parents sometimes have a hard time navigating that,” Bahr said. “Although peers are very important, it’s not true that parents have no influence.”

For parents, the takeaway is this:

“Realize you need to have both accountability and support in your relationship with your adolescent,” Hoffmann said. “Make sure that it’s not just about controlling their behavior – you need to combine knowing how they spend their time away from home with a warm, loving relationship.”

June 29th, 2010  in Alcohol No Comments »

Addiction: a loss of plasticity of the brain?

Why is it that only some drug users become addicts? This is the question that has been addressed by the teams of Pier Vincenzo Piazza and Olivier Manzoni, at the Neurocentre Magendie in Bordeaux (Inserm unit 862). These researchers have just discovered that the transition to addiction could result from a persistent impairment of synaptic plasticity in a key structure of the brain. This is the first demonstration that a correlation exists between synaptic plasticity and the transition to addiction. The results from the teams at Neurocentre Magendie call into question the hitherto held idea that addiction results from pathological cerebral modifications which develop gradually with drug usage. Their results show that addiction may, instead, come from a form of anaplasticity, i.e. from incapacity of addicted individuals to counteract the pathological modifications caused by the drug to all users.

This research is published in the journal Science on 25 June 2010.

Developing Drug Addiction

The voluntary consumption of drugs is a behaviour found in many species of animal. However, it had long been considered that addiction, defined as compulsive and pathological drug consumption, is a behaviour specific to the human species and its social structure. In 2004, the team of Pier Vincenzo Piazza showed that the behaviours which define addiction in humans, also appear in some rats which will self administer cocaine. Addiction exhibits astonishing similarities in men and rodents, in particular the fact that only a small number of consumers (humans or rodents) develop a drug addiction. The study of drug dependent behaviour in this mammal model thus opened the way to the study of the biology of addiction.

Today, thanks to a fruitful collaboration, the teams of Pier Vincenzo Piazza and Olivier Manzoni are reporting discovery of the first known biological mechanisms for the transition from regular but controlled drug taking to a genuine addiction to cocaine, characterised by a loss of control over drug consumption.

Chronic exposure to drugs causes many modifications to the physiology of the brain. Which of these modifications is responsible for the development of an addiction? This is the question the researchers wanted to answer in order to target possible therapeutic approaches to a disorder for which treatments are cruelly lacking.

Some Become Addicted, Some Don’t

The addiction model developed in Bordeaux provides a unique tool to answer this question. Thus it allows comparing animals who took identical quantities of drugs, but of which only few become addicted. By comparing addict and non-addict animals at various time points during their history of drug taking, the teams of Pier Vincenzo Piazza and Olivier Manzoni have demonstrated that the animals which developed an addiction to cocaine exhibit a permanent loss of the capacity to produce a form of plasticity known as long term depression (or LTD). LTD refers to the ability of the synapses (the region of communication between neurons) to reduce their activity under the effect of certain stimulations. It plays a major role in the ability to develop new memory traces and, consequently, to demonstrate flexible behaviour.

After short term usage of cocaine, LTD is not modified. However, after a longer use, a significant LTD deficit appears in all users. Without this form of plasticity, which allows new learning to occur, behaviour with regard to the drug becomes more and more rigid, opening the door to development of a compulsive consumption. The brain of the majority of users is able to produce the biological adaptations which allow to counteract the effects of the drug and to recover a normal LTD. By contrast, the anaplasticity (or lack of plasticity) exhibited by the addicts leaves them without defences and hence the LTD deficit provoked by the drug becomes chronic. This permanent absence of synaptic plasticity would explain why drug seeking behaviour becomes resistant to environmental constraints (difficulty in procuring the substance, adverse consequences of taking the drug on health, social life, etc.) and consequently more and more compulsive. Gradually, control of the taking of the drug is lost and addiction appears.

New Treatment for Addiction?

For Pier-Vincenzo Piazza and his collaborators, these discoveries also have important implications for developing new treatment of addiction. “We are probably not going to find new therapies by trying to understand the modifications caused by a drug in the brains of drug addicts,” explain the researchers, “since their brain is anaplastic.”

For the authors, “The results of this work show that it is in the brain of the non-addicted users that we will probably find the key to a true addiction therapy. Indeed,” the authors estimate, “understanding the biological mechanisms which enable adaptation to the drug and which help the user to maintain a controlled consumption could provide us with the tools to combat the anaplastic state that leads to addiction”.

June 25th, 2010  in Substance Abuse No Comments »

Ignoring stress leads recovering addicts to more cravings

Recovering addicts who avoid coping with stress succumb easily to substance use cravings, making them more likely to relapse during recovery, according to behavioral researchers.

“Cravings are a strong predictor of relapse,” said H. Harrington Cleveland, associate professor of human development, Penn State. “The goal of this study is to predict the variation in substance craving in a person on a within-day basis. Because recovery must be maintained ‘one day at a time,’ researchers have to understand it on the same daily level.”

Craving Triggers

Cleveland and his colleague Kitty S. Harris, director, Center for the Study of Addiction and Recovery, Texas Tech University, used data from a daily diary study of college students who are recovering addicts to identify the processes that trigger cravings and prevent some addicts from building a sustained recovery.

The researchers found that how addicts cope with stress — either by working through a problem or avoiding it — is a strong predictor of whether they will experience cravings when faced with stress and negative mood.

Coping Skills Important

“Whether you avoid problems or analyze problems not only makes a big difference in your life but also has a powerful impact on someone who has worked hard to stay away from alcohol and other drugs,” explained Cleveland. “When faced with stress, addicts who have more adaptive coping skills appear to have a better chance of staying in recovery.” The findings appeared in a recent issue of Addictive Behaviors.

Researchers supplied Palm Pilots to 55 college students who were in recovery from substance abuse ranging from alcohol to cocaine and club drugs. The students were asked to record the their daily cravings for alcohol and other drugs, as well as the intensity of negative social experiences — hostility, insensitivity, interference, and ridicule — and their general strategies for coping with stress.

“We looked at variations in the number of cravings across days and found that these variations are predicted by stressful experiences,” said Cleveland. “More importantly, we found that the strength of the daily link between experiencing stress and the level of cravings experienced is related to the participants’ reliance on avoidance coping.”

Stress Doubles Cravings

Statistical analyses of the survey data suggests that the magnitude of the link between having a stressful day and experiencing substance use cravings doubles for recovering addicts who cope with stress by avoiding it.

“We found that addicts who deal with stress by avoiding it have twice the number of cravings in a stressful day compared to persons who use problem solving strategies to understand and deal with the stress,” explained Cleveland. “Avoidance coping appears to undercut a person’s ability to deal with stress and exposes that person to variations in craving that could impact recovery from addiction.”

According to Cleveland, the findings suggest the impulse to avoid stress is never going to help recovering addicts because stressful experiences cannot be avoided.

“If your basic life strategy is to avoid stress, then your problems will probably end up multiplying and causing you more problems,” he added.

June 24th, 2010  in Alcoholism No Comments »

Peer drug use may increase genetic tendency to use drugs

The nature-nurture debate is usually about how much of something is due to our genes and how much is caused by our environment. New research just published in the academic journal Addiction shows that the case is more interesting for young women who smoke, drink, or use drugs, for two related reasons.

First, a young woman with a genetic predisposition to substance use is also predisposed to choose friends who smoke, drink, or use drugs, thereby altering her environment in a way that encourages substance use. Second, a young woman’s exposure to substance-using friends not only changes her environment but also increases her genetic inclination to use these drugs regularly, thereby raising even higher her already increased likelihood of substance use.

Friends Influence Substance Abuse

Using a sample of over 2,000 female twins, researchers from Washington University in St. Louis looked for links between two types of data: 1) women in the sample who regularly used tobacco, alcohol, or drugs and 2) women whose friends were involved in regular substance use. The links they found showed that genetic vulnerability to regular use of alcohol, cigarettes and cannabis is exacerbated by exposure to friends who use alcohol, cigarettes and drugs.

It is well known that adolescents often select peers who engage in behaviors similar to their own. But this study showed that peer selection has a genetic basis whereby one’s genetic predisposition to regular substance use is correlated with the likelihood of choosing friends who also use psychoactive substances. The genetic factors that influence our own likelihood of using drugs thus also modify our likelihood of associating with friends who do the same.

Interited Factors

However, exposure to these drug-using peers has a second, important influence on our own liability to use drugs. The study found that heritable influences on an individual’s own regular substance use increased as they affiliated with more drug-using peers – in other words, affiliations with substance-using peers enhances the role that heritable factors play in our own regular substance use. Put simply, increasing affiliations with drug-using peers is correlated with a more ‘genetic’ form of regular substance use.

According to lead author Dr. Arpana Agrawal, “Nature and nurture don’t just combine to produce a woman who smokes, drinks, or uses drugs – nurture can also increase the effect of nature.”

June 23rd, 2010  in Substance Abuse No Comments »

Puberty and sleep regulation can influence alcohol use

While alcohol in the form of a “night cap” may be able to help an individual fall asleep, its pharmacological properties later disrupt the rapid eye movement (REM) and deeper, more restorative stages of sleep. Sleep problems also predict the onset of alcohol abuse in healthy adults and relapse in abstinent alcoholics. A new study of associations among pubertal development, sleep preferences and problems, and alcohol use in early adolescence has found that puberty is related to sleep problems and later bedtimes, which were in turn associated with alcohol use.

Results will be published in Alcoholism: Clinical & Experimental Research.

Early Puberty Predicts Alcohol Use

“Pubertal timing has been found to predict adolescent alcohol use, with early maturing adolescents being more likely to drink,” explained Sara Pieters, a doctoral student in neuropsychology at the University Nijmegen and corresponding author for the study. “Adolescent alcohol use has also been linked to sleep problems, such as trouble falling asleep, maintaining sleep, and perceived tiredness. This study combines these two separate lines of research by examining the impact of pubertal maturation on the relation between sleep problems and alcohol use.”

Comparatively speaking, added Carmen Van Der Zwaluw, a doctoral student in neuropsychology at the University Nijmegen linkages between sleep problems and alcohol use by adolescents have received little scientific attention. “A few studies have shown … that adolescents who experience sleep problems tend to use more alcohol than those without sleep difficulties,” she said. “This has been mainly shown for late adolescents and young adults, but not yet for young adolescents, [however,] adolescent developmental changes such as puberty onset and different circadian rhythms take place [during] early adolescence.”

Puberty and Sleep Problems

Pieters and her colleagues used data collected from a larger study of 725 children in grades one through six in five participating Dutch schools. For this study, questionnaire data from 431 adolescents (236 girls, 195 boys) aged 11 to 14 years of age were analyzed for associations, if these associations changed vis-à-vis adolescent internalizing and externalizing problems, and if they were influenced by gender.

“Our results indicated that puberty was related to sleep problems and more evening-type tendencies such as favoring later bedtimes, which in turn were positively related to early adolescent alcohol use,” said Pieters. “Underlying psychopathology, gender, and educational level did not change these relationships, meaning that these factors are not the explanatory mechanism behind this relation. From this study, it can be concluded that both puberty and sleep regulation are important factors in explaining alcohol use in early adolescence.”

Favoring Later Bedtimes

“[The finding that] puberty was related to alcohol use, via sleep problems and delayed circadian preference,” said Van Der Zwaluw, “means that: [one,] early-maturing adolescents, in terms of puberty, tend to have more ‘owl-like’ tendencies such as favoring later bedtimes, and experience more sleep problems; [and two,] adolescents who have more owl-like tendencies and who experience more sleep problems also report higher levels of alcohol consumption.”

“This study has shown that puberty-dependent sleep regulation is an important aspect of explaining alcohol use in early adolescence,” said Pieters. “Our advice to clinicians would be to better screen for sleep problems when adolescents seem to have other psychosocial or behavioral problems. To parents it is recommended that they monitor their offspring’s sleep, keeping in mind that sleep has an effect on so many other health domains, including risky behaviors such as alcohol consumption.”

June 21st, 2010  in Alcohol No Comments »

Little Progress in Treating Fetal Alcohol Syndrome

It’s long been known that alcohol use in pregnancy can lead to children with mental retardation and birth defects, but researchers who study fetal alcohol syndrome (FAS) have not made definitive progress on preventing the disorder, detecting it early, or effectively treating it, say researchers from Georgetown University Medical Center.

In the journal Developmental Neuroscience, four first-year medical students at Georgetown University School of Medicine looked into the science and clinical treatment of FAS, and found that although there is much ongoing study, no new medical strategies exist to change the grim outcome that can occur when a fetus is exposed to alcohol.

Lack of Diagnosis Tools

“Although there is a lot of research in the field to determine how alcohol acts on the developing brain, there is not much translation into the clinic,” says Sahar Ismail, now a second year medical student. “What surprised us the most was the lack of sensitive and specific diagnostic tools to identify children with FAS, given its prevalence and harmful effects on the child, family, and society.”

Working with her on the study were medical students Stephanie Buckley, Ross Budacki, and Ahmad Jabbar – each student contributed equally. Their study was a project for the Sexual Development and Reproduction Module under directorship of G. Ian Gallicano, PhD, an associate professor in the Department of Biochemistry and Molecular & Cellular Biology.

“This is a very important review, because it combed the research literature on FAS, and concluded that nothing has changed clinically,” Gallicano says. “Not every woman who drinks alcohol will have a child with FAS, but because so much remains unknown, women are still advised not to drink any time during pregnancy.”

Even the question of whether alcohol is a teratogen (a chemical that causes nervous system abnormalities) in the first days or weeks of pregnancy – when a woman may not know she is pregnant – has not been answered fully, says Ismail. Mouse studies show alcohol can have detrimental effects at any stage of fetal development, but “only so much can be concluded about humans from mouse studies,” she says. “All we can say now is that there is no safe period to drink.”

Preventable Mental Retardation

What is clear, however, is that alcohol is the leading cause of preventable mental retardation, the researchers say. FAS is relatively uncommon, affecting .2 to 1.5 live births in every 1,000, but fetal alcohol spectrum disorders (FASD), the less severe form of FAS, is much more common and has a broad range of the same symptoms, they say. “Taken together, both FAS and FASD, are more common than the public realizes but are entirely preventable,” Ismail says.

The study authors say FAS research shows:

Effects of Alcohol

Alcohol can have a range of effects on the baby but the fetal brain is particularly at risk because of its complex blood networks. Alcohol is carried from the mother to the child through blood that flows through the umbilical cord.

Many factors influence the severity of alcohol’s effects, such as maternal genetics, increased maternal age, history of alcohol abuse, poor prenatal care. In the genetics realm, for example, researchers have found that women with a more efficient enzyme that breaks down alcohol have a decreased risk of giving birth to a child with FAS.

Alcohol can cause dramatic and irreversible effects on the fetus, such as developmental delay, head and facial irregularities, seizures, hyperactivity, attention deficits, cognitive deficits, learning and memory impairments, poor psychosocial functioning, facial irregularities, and motor coordination deficits. However, the exact developmental phases in which alcohol has these specific effects on the fetus are not entirely known

Based on animal studies, consumption of alcohol during the times in animals that correspond to the first 2-3 weeks in human brain growth are detrimental to the brain. But much remains unknown about alcohol’s vast mechanism in growth development in humans, most importantly on neurogenesis.

It is very important to identify FAS early in life in order to provide the child with the appropriate counseling and guidance as early as possible. But, at this point, there is no treatment or specific and sensitive diagnostic tools to diagnose FAS early in pregnancy or early after birth. Still, the authors say there is ongoing research aimed at devising better diagnostic tools for FAS. These include a panel of genes that are altered in a developing fetus and a kit to examine a newborn’s stool for telltale chemicals.

Detecting Alcohol Use

Research is underway to find biomarkers that can inform physicians if a pregnant woman is using, or chronically abusing, alcohol. One marker, for example, can be detected in a woman’s bloodstream for at least 28 days after alcohol use. Other researchers are studying biomarkers in amniotic fluid that can distinguish between high-risk and low-risk pregnancies. Still, the authors say there is comparatively little investigation on these ideas.

Prevention of FAS is an important goal primarily because so little is understood about the adverse effects that alcohol has on the developing fetus. Current prevention programs focus on educating potential mothers at risk for conceiving a child with FAS. However, potentially powerful approaches are being studied in animals, such as the use of agents to protect the developing brain early in pregnancy or to treat brain malformations caused by alcohol exposure. Although there is vast research in this area, clinical strategies to reverse the effects of alcohol are not foreseeable in the near future, the authors say.

June 17th, 2010  in Alcohol No Comments »

Link found between passive smoking and poorer mental health

Second hand smoke exposure is associated with psychological distress and risk of future psychiatric illness, according to new UCL research that suggests the harmful affects of passive smoking go beyond physical health.

The new research, published in the Archives of General Psychiatry, examined the associations between mental health and second hand smoke (SHS) exposure – known as passive smoking – by measuring the circulating biochemical marker cotinine, which is found in saliva and can be used to measure levels of exposure to tobacco smoke. The study found that SHS exposure is associated with psychological distress and risk of future psychiatric illness in healthy adults.

Secondhand Smoke and Distress

A representative sample of 5,560 non-smoking adults and 2,689 smokers without history of mental illness were drawn from the 1998 and 2003 Scottish Health Surveys. A score greater than 3 on the 12-item General Health Questionnaire was employed as an indicator of psychological distress. Incident psychiatric hospital admissions over 6 years follow up were also recorded.

Psychological distress was apparent in 14.5% of the sample. In an analysis of the data, after adjustments for a range of potential confounding factors such as social status, high SHS exposure among non-smokers (cotinine levels between 0.70 and 15 micrograms per litre) was associated with 50% higher odds of reporting psychological distress in comparison with participants with cotinine levels below the limit of detection. Active smokers were also more likely to report psychological distress. The risk of future psychiatric illness was also related to high SHS exposure and active smoking.

Lead author Dr Mark Hamer, UCL Epidemiology & Public Health, said: “SHS exposure at home is growing in relative importance as restrictions on smoking in workplaces and public places spread. A growing body of literature has demonstrated the harmful physical effects of second hand smoke exposure, but there has been limited research about the affects on mental health.

Nicotine and Mental Health

“Animal data have suggested that tobacco may induce a negative mood, and some human studies have also identified a potential association between smoking and depression. Our data is therefore consistent with other emerging evidence to suggest a causal role of nicotine exposure in mental health. Importantly, this study advances previous research because we obtained an accurate assessment of SHS exposure using a valid biochemical indicator.

“Mental ill health accounts for almost 20% of the burden of disease in the European Region and can affect one in four people at some time in their life. Our findings emphasise the importance of reducing SHS exposure at a population level, not only for the benefit of our physical health but for our mental health as well.”

June 14th, 2010  in Tobacco No Comments »

Drinking and smoking Linked to headaches in Teens

A novel study by German researchers reported that alcohol consumption and cigarette smoking were associated with increased migraines and tension-type headaches (TTH) in high school students. Coffee drinking and physical inactivity were associated specifically with migraines. Results of this study, the first to investigate modifiable risk factors for different types of headaches in a youth population, appear online early in Headache, a journal of the American Headache Society.

Prior studies have indicated that headache is one of the most frequently reported health complaints in adolescents with 5%-15% of this age group suffering from migraine and 15%-25% with TTH. Modifiable risk factors, such as alcohol use, cigarette smoking and coffee drinking which have been associated with headache in adults, have not been fully explored in a youth population.

Headaches and Alcohol, Smoking

Astrid Milde-Busch, Ph.D. and colleagues at the Ludwig-Maximilians-University in Munich, Germany invited 1,260 students in grades 10 and 11 (aged 14-20) from eleven area public schools to participate in the study. The students were asked to fill out a questionnaire on headache and associated lifestyle factors. Students were asked: ‘Did you have headache during the last seven days/three months/six months?’ and were classified as headache sufferers if the response was positive. Furthermore, migraine and TTH were differentiated by questions regarding headache characteristics and symptoms. The questionnaire also inquired about diet and lifestyle (e.g. ‘Do you daily have breakfast before you go to school?’; ‘How much beer, wine and cocktails do you normally drink?’; ‘How much coffee do you normally drink?’; ‘Do you smoke?’).

Research results show 83.1% of students reported headache at least once during the previous six months with 10.2% reporting migraine; 48.7% citing TTH; and 19.8% having combined migraine plus TTH. For diet, 28.4% of students never had breakfast; 16.5% did not eat a daily break meal (snack); and only 24.0% had a daily warm lunch. Researchers found that 22.3% of students consumed less than 1 liter (4.23 8 ounce cups) of non-alcoholic drinks per day. Alcohol consumption, however, was widespread among students in the study with 38.5%, 18.6%, and 25.3% drinking beer, wine, and cocktails at least once per week, respectively. Results also showed that 73.3% of participants reported never smoking and 43.4% students noted that they did not drink coffee.

Coffee Drinking and Migraine

The authors found that a high consumption of alcoholic drinks and coffee, smoking, and lack of physical activity were significantly associated with migraine plus TTH episodes. There was a significant association of coffee drinking and physical inactivity with migraine. “Our study confirms, adolescents with any type of headache might benefit from regular physical activity and low consumption of alcoholic drinks,” commented Dr. Milde-Busch. “In teens suffering from migraine a low coffee consumption should also be suggested.” Skipping meals or insufficient fluid intake was not associated with any type of headache.

According to the Centers for Disease Control and Prevention (CDC), 75% of high school students in the U.S. have had one or more alcoholic drinks during their lifetime (2007). A 2004 report by the World Health Organization (WHO) notes that alcohol consumption by those under 20 varies by country and “a trend of increased drinking to intoxication.” Cigarette smoking is another modifiable risk factor in which youths engage and a 2002 WHO report estimated about 1 in every 5 teens worldwide (aged 13

June 7th, 2010  in Alcohol, Tobacco No Comments »