Archive for October, 2010

Heavy drinkers consume less over time

Problem drinkers in the general population may reduce the amount of alcohol they consume over a period of years but not to the level of the average adult, according to a new study in the Journal of Studies on Alcohol and Drugs.

Given that heavy drinkers often don’t become “normal” drinkers on their own, the takeaway message for clinicians and family members is to help connect a problem drinker to a community social service agency or Alcoholics Anonymous. Simply telling someone that they had a drinking problem did not seem to be helpful in this study, but being specific about how to get help did.

Reduced, But Not Safe Consumption

Using a telephone screening program, researchers identified 672 problem and dependent drinkers who had not been in an alcohol treatment program for at least 12 months. Eleven years later, men in the study had reduced their average number of drinks per month by 51%, and women had reduced their average number of drinks by 57%. However, even after this reduction, male and female problem drinkers still consumed 160% and 223% more alcohol, respectively, than the average adult without a drinking problem.

The researchers point out that the greatest reductions in alcohol consumption occurred within one to two years after the initial screening and then slowed, suggesting that problem drinkers and heavy drinkers may never lower their consumption to the level of the general population.

Sustained Drinking Level

“Most heavy drinkers maintain a steady level of heavy alcohol consumption over time,” said lead researcher Kevin L. Delucchi, Ph.D., Professor of Biostatistics in Psychiatry at the University of California San Francisco. “It’s pretty toxic, but somehow they manage to keep drinking at a fairly sustained level. Our people were functional, for the most part. They had addresses, a lot of them had insurance at baseline, and they’re not at the ‘bottom of the barrel,’ which is interesting.”

The researchers say their study is one of the first to examine heavy alcohol use in the general population. Most studies have focused on the most severe drinkers — those who were already in a treatment program, said Delucchi.

Not Getting Treatment

“Not everyone who has an alcohol problem is in treatment or is in a program,” said Delucchi. “People are out there on their own.”

The researchers also examined which factors appeared to be linked with continued heavy drinking. Participants who received help from Alcoholics Anonymous or community social service agencies were likely to drink less. However, those who had heavy-drinking friends in their social network, received general suggestions that they do something about their drinking, and went to a formal treatment program were actually likely to drink more. Delucchi said they were unable to determine why formal treatment appeared to be linked with continued elevated drinking, although the researchers theorize that perhaps those who sought this type of treatment were likely to have experienced the greatest level of alcohol-related problems and, therefore, were more likely to have sought such treatment.

October 29th, 2010  in Alcoholism No Comments »

Anxiety disorders make it tougher to quit cigarettes

Researchers may have pinpointed a reason many smokers struggle to quit. According to new research published in the journal Addiction, smokers with a history of anxiety disorders are less likely to quit smoking. The study, conducted by the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI), offered free coaching and medications to smokers in Madison and Milwaukee.

While overall quit rates for the study were high, participants with anxiety diagnoses were much less likely to quit smoking.

Anxiety Diagnosis Is Common

Study results also showed that anxiety diagnoses were very common among participants — more than a third of them met criteria for at least one anxiety diagnosis in their lifetime. Out of all 1,504 study participants, 455 had had a panic attack in the past, 199 social anxiety disorder, and 99 generalized anxiety disorder (some reported having more than one diagnoses). Other research has shown that up to 25 percent of the more than 50 million smokers in the U.S. had at least one anxiety disorder in their lifetime. And yet, very little research has addressed smoking in this population.

Lead author Megan Piper says it surprised her that the nicotine lozenge and patch — alone or in combination — failed to help patients with an anxiety history to quit smoking. In the general population, the lozenge and patch — especially when combined — have been very effective in helping patients quit smoking. Bupropion (Zyban) alone, or in combination with the nicotine lozenge, also did not increase cessation rates among patients with a history of anxiety disorders.

“Further research is needed to identify better counseling and medication treatments to help patients with anxiety disorders to quit smoking,” Piper says.

Anxiety and Nicotine Dependence

Smokers in the study with anxiety disorders also reported higher levels of nicotine dependence and withdrawal symptoms prior to quitting. Smokers often experience craving, negative feelings and difficulty concentrating in the minutes or hours after finishing a cigarette, and those feelings can be heightened simply because the smokers know they’re about to attempt to quit. In addition, participants with a history of panic attacks or social-anxiety disorder experienced more negative feelings on their quit day than did smokers in the study without this history.

These findings suggest that clinicians should assess anxiety-disorder status when helping patients quit smoking. While anxiety medications alone haven’t boosted cessation rates, Piper is planning further research to test other quit-smoking counseling interventions and medications with patients who have had an anxiety diagnosis.

In the meantime, all smokers can call the national tobacco quit line at 1-800-QUIT-NOW for free, confidential coaching and support to quit smoking.

October 28th, 2010  in Tobacco No Comments »

Fetal alcohol exposure linked to cognitive performance

It has been known for many years that drinking alcohol while pregnant can cause serious and irreversible damage to the fetus. However, new research exploring memory deficits in children diagnosed with fetal alcohol spectrum disorder (FASD) or fetal alcohol syndrome (FAS) may be able to aid in the creation of new therapies and treatments.

The results will be published in the January 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

Mental Difficulties of FAS Children

Joseph Jacobson, one of the study’s authors and Professor in the Department of Psychiatry and Behavioral Neurosciences at the Wayne State University School of Medicine, said that the mechanisms associated with the deficits in children with FASD and FAS are still not well understood. Therefore, the researchers decided to focus on the mental difficulties that the children experience to help determine the specific mechanisms that cause them.

“FASD is associated with learning problems in children, including having difficulties in response inhibition and memory,” says Jacobson. “Additional understanding of the nature of these problems has the potential to help develop more effective remediation programs for children with fetal alcohol-related learning problems.”

The deficits associated with FASD and FAS are varied said Jacobson, and the myriad of possible causes underlying these problems are still not widely understood. What is known, he added, is that, “prenatal alcohol exposure affects many different aspects of brain development, including brain size, neuronal development, and development of white matter tracts.”

Binge Drinking While Pregnant

Data for this research was collected from 217 Inuit children that were placed in either the alcohol-exposed group, where mothers reported binge drinking while pregnant, or the control. The data was recorded using electroencephalography (EEG) to observe the changing voltage of the brain’s electrical activity during the memory and coordination trials.

This allowed the researchers to explore the differences in the brain’s electrical activity, called event-related potentials, which change in specific ways depending on what task was presented, between the alcohol-exposed and control groups.

The researchers discovered that the alcohol-exposed group, while similar to the control in accuracy and reaction time, showed a statistically significant decrease in understanding the meaning of a stimulus, attention dedication to a specific task, and memory processing.

Prenatal Alcohol Exposure

“The study demonstrates that there are alterations in this group of children on their processing of information related to these functions,” said Claire Coles, a Professor of the Department of Psychiatry and Behavioral Science and Pediatrics at the Emory University School of Medicine. “Hopefully, such information can be used to develop more effective teaching methods for children affected by prenatal exposure.”

Jacobson agrees that this research is only the first step in helping the children affected by fetal alcohol disorders.

“These findings help specify in greater detail the deficits associated with fetal alcohol exposure, which can then be informative in the development of remediation programs for children with FASD.”

October 25th, 2010  in Alcohol No Comments »

The Partnership at Drugfree.org

The Partnership for a Drug-Free America announced today that it is changing its name to The Partnership at Drugfree.org. The new name reflects the nonprofit’s commitment to serving and supporting parents and families.

The change further reflects how the organization has grown since its founding in 1986 as a prevention-focused, anti-drug advertising campaign to a reliable partner and online community for parents and families seeking guidance and support on teen drug and alcohol use.

By focusing on parents and caregivers, working at the grassroots level and embracing the power of the web to communicate and connect, the organization has evolved to fulfill its important mission to help parents prevent, intervene in and find treatment for drug and alcohol use by their children. Parents will find deep, credible and science-based resources to help them and their families at drugfree.org.

11 million of America’s teens and young adults are struggling with drugs or alcohol[1], yet unlike most other adolescent health issues or diseases, parents haven’t found a clear path to resources and support for teen addiction.

Resources for Parents

“When it comes to preventing or helping a child involved with drug use and drinking, already a stigmatized issue, parents are at a loss,” said Steve Pasierb, president and CEO of The Partnership at Drugfree.org. “Over the past six years, we have created programs and resources to fill that gap and be a trustworthy, non-judgmental place to get answers and support, whether that’s online via drugfree.org or in their community through our grassroots education programs.”

While both parents and research point to a need for an organization like The Partnership at Drugfree.org, the nonprofit’s first celebrity champion, Melissa Gilbert, added, “I believe that the most compelling reality is that all parents will move heaven and earth to protect their children’s health because they love their kids.” She applauded the organization’s changes, saying, “Both as a mother and as a person who is living a life in recovery, I know firsthand what a struggle it is for both a teen or young adult in trouble and their parent who feels helpless and utterly alone. The Partnership at Drugfree.org is here for all parents, myself included, at whatever their stage of need – from prevention to recovery – and most importantly reinforces that we are not alone.”

Embracing “Partnership”

The change is also the culmination of more than a year of parent interviews, analysis and qualitative and quantitative research. New omnibus research from The Partnership at Drugfree.org also shows that when discovering what the organization does, an overwhelming majority of parents (94 percent) with children ages 10-17 would consider The Partnership at Drugfree.org as valuable to parents with kids at risk of using drugs and drinking. Embracing this learning, the 24-year-old nonprofit organization preserved the known strengths and attributes of its name: the concept of a partnership with parents and families. The new name is consistent with its mission, making it more relevant to parents and explicit as to where they can find the important tools and resources that position the organization as a cause leader on this issue.

“Even with a rich history and many widely acclaimed, effective public education campaigns, our name was confusing to parents. Research showed that people assumed we were part of the government or an organization focused on drug policy. These perceptions were limiting our ability to best serve families and meet their individual needs,” added Pasierb. “Parents also thought we focused exclusively on prevention. With resources to also help parents intervene and find treatment, we understand that while most kids don’t use drugs, many do, and far too many suffer problems or need help to overcome an addiction.”

Staggering Cost to Society

Addiction takes a toll on families and an equally devastating toll on society. 35 million families with children ages 9-17 need help with drug and alcohol prevention[2]. “The economic impact of substance abuse is staggering,” said Patricia Russo, chairman of The Partnership at Drugfree.org. With estimated costs to society from illicit drugs at $280 billion,[3] Russo added, “We can’t reduce the costs in the workplace due to drug and alcohol abuse and improve our global competitiveness as a nation until we better prepare and support parents in raising healthy teens, helping them to be more informed, empowered and better able to help their children.”

Gilbert, who has personally struggled with addiction and is now a parent spokesperson for the organization, added, “The burden and the responsibility for taking action on this issue falls to us, to parents. I hope that, like me, other parents will find The Partnership at Drugfree.org as a true partner. Here for us wherever we are and whenever we need help. It is my long-term hope that I will be able to help them achieve their goals, and fewer families will struggle with the pain of addiction. For now, I want families going through the agony and confusion of dealing with addiction to know that they are not alone. We are here. I am here and I understand.”

Redesigned Website at Drugfree.org

Debuting with the new name is the organization’s new web portal, making it easy to navigate expanded online resources that provide answers and support at whatever point parents need help. Drugfree.org is a user-friendly gateway to the nonprofit’s programs and resources, focused on prevention, intervention, treatment, recovery and community education. Featuring interactive tools, compelling videos, engaging blogs, comprehensive e-books and burgeoning online communities, the new site aims to be an online ‘public square’ where parents can support, learn from and encourage one another.

October 23rd, 2010  in Substance Abuse No Comments »

Alcohol consumers are becoming the norm

More people are drinking than 20 years ago, according to a UT Southwestern Medical Center analysis of national alcohol consumption patterns. Gathered from more than 85,000 respondents, the data suggests that a variety of factors, including social, economic and ethnic influences and pressures, are involved in the increase.

“The reasons for the uptick vary and may involve complex sociodemographic changes in the population, but the findings are clear: More people are consuming alcohol now than in the early 1990s,” said Dr. Raul Caetano, dean of the UT Southwestern School of Health Professions and lead author of the paper available online and in the October issue of Alcoholism: Clinical & Experimental Research.

Drinking Levels Monitored

The findings, Dr. Caetano said, suggest that continuous monitoring of alcohol consumption levels is needed to understand better the factors that affect consumption. Monitoring also would help to detect as early as possible signs that rates of risky drinking behaviors such as binge drinking or drinking to intoxication may be increasing, said Dr. Caetano, who also is regional dean of the UT School of Public Health’s campus in Dallas.

“Changes in the population due to aging, the influx of immigrant groups, and a decline in mean income level because of economic recessions can all impact trends in drinking and problems associated with drinking,” he said.

While more Caucasians, Hispanics and African-Americans reported drinking between 1992 and 2002, only Caucasian women consumed more drinks per person. The number of drinks that African-Americans and Hispanics consumed leveled out over the 10-year time period.

Women Drinking More

In addition to an increase in the number of both male and female drinkers within all three ethnic groups, the researchers also found that among women, Caucasians were more likely than Hispanics or African-Americans to consume five or more drinks a day or drink to intoxication. An increase in drinking five or more drinks a day was also detected among the heavier drinkers in the population, suggesting a potential polarization of drinking practices.

Dr. Caetano said the team also identified several sociodemographic predictors for whether someone was more likely to drink to intoxication. They found that males younger than 60 who did not have a college degree were likely to consume more drinks per month. Being unemployed or unmarried also were identified as risk factors for males getting intoxicated more than once a month, he said.

For the study, the researchers culled data from the 1991-92 National Longitudinal Alcohol Epidemiologic Survey and the 2001-02 National Epidemiologic Study on Alcohol and Related Conditions. The National Institute on Alcohol Abuse and Alcoholism conducted both surveys, in which trained interviewers spoke with individuals 18 or older in the respondents’ homes. The interviewers used a standardized questionnaire, so both surveys used the same overall methodology. Each study included about 43,000 participants.

Increase in Alcohol Consumption

Both studies defined drinkers as individuals who had consumed at least 12 drinks that contained at least 0.6 ounces of any kind of alcohol within the past year. Those who hadn’t imbibed that much alcohol within the past year or who had never had any kind of alcohol were classified as nondrinkers.

While many uncontrolled variables could skew the results, Dr. Caetano said the overall trend is clear – the proportion of men and women who drink alcohol has risen in all three ethnic groups.

“This suggests to us that a variety of public-health policies such as restrictions on alcohol advertising, regulating high-alcohol-content beverages, increasing taxes on alcohol, as well as treatment and brief interventions may be needed to reduce alcohol-related problems,” he said.

Researchers from the University of North Texas Health Science Center in Fort Worth also contributed to the study.

The study was supported by the National Institute on Alcohol Abuse and Alcoholism.

October 5th, 2010  in Alcohol No Comments »

Alcohol ups risk of breast cancer recurrence

In the Life After Cancer Epidemiology (LACE) study, 1,897 participants diagnosed with early-stage breast cancer between 1997 and 2000 and recruited on average 2 years post-breast cancer diagnosis were evaluated for the association between alcohol intake and breast cancer recurrence and death.

The women, who were generally light drinkers, were followed for an average of 7.4 years. The study reported an increase in risk of breast cancer recurrence and breast cancer death, but no effect on total mortality, to be associated with consumption of 3 to 4 or more drinks per week when compared with women not drinking following their cancer diagnosis.

Alcohol and Breast Cancer

Previous research has been mixed on this topic. Almost all large studies have shown no increase in all-cause mortality for women who drink moderately following a diagnosis of breast cancer (as does this study). As for recurrence of breast cancer, most have shown no increase in risk, although one previous study of women with estrogen-receptor + tumors found an increased risk of a primary cancer developing in the contralateral breast to be associated with alcohol intake of more than 7 drinks per week.

Because of conflicting results among studies on this topic, further research will be needed to determine the extent to which alcohol following a diagnosis of breast cancer may relate to subsequent disease and death.

October 2nd, 2010  in Alcohol No Comments »

Experts urge making cigarettes non-addictive

After a major review of scientific information, six leading tobacco research and policy experts have concluded that a nicotine reduction strategy should be an urgent research priority because of its potential to profoundly reduce the death and disease from tobacco use. Their findings were published today in the journal Tobacco Control.

According to this new report, reducing the amount of nicotine in cigarettes to non-addictive levels could have a significant public health impact on prevention and smoking cessation. Over time, the move could dramatically reduce the number of annual deaths related to cigarette smoking by decreasing adolescent experimentation with cigarettes preventing a progression to addiction, and by reducing dependence on tobacco among currently addicted smokers of all ages.

Reducing Nicotine to Non-Addictive Levels

Dorothy Hatsukami, Ph.D., University of Minnesota Medical School, and Mitch Zeller, J.D., Pinney Associates in Bethesda, MD, led the overall effort as co-chairs of the National Cancer Institute’s Tobacco Harm Reduction Network. They convened several meetings of researchers, policy makers, tobacco control advocates and government representatives that explored the science base for a nicotine reduction strategy.

Currently, about 44 million (or 20 percent) of adults in the United States smoke cigarettes. Other research cited by the authors had found that reducing nicotine to non-addictive levels could potentially reduce smoking prevalence to about 5 percent.

“Nicotine addiction sustains tobacco use. Quitting tobacco can be as difficult to overcome as heroin or cocaine addiction,” said Hatsukami, director of the University of Minnesota’s Tobacco Use Research Center and the Masonic Cancer Center’s Cancer Control and Prevention Research Program “Reducing the nicotine in cigarettes to a level that is non-addicting could have a profound impact on reducing death and disability related to cigarettes and improving overall public health.”

Hatsukami adds that studies to date have found that substantial reduction in nicotine in cigarettes does not lead to smokers smoking more lower-nicotine cigarettes because it is harder to compensate for very low nicotine intake.

“In addition, studies have shown a significantly lower number of cigarettes are smoked when low-nicotine cigarettes are used, resulting in eventual abstinence in a considerable number of smokers,” she said.

Preventing Youthful Addiction

“Imagine a world where the only cigarettes that kids could experiment with would neither create nor sustain addiction,” Zeller said. “The public health impact of this would be enormous if we can prevent youthful experimentation from progressing to regular smoking, addiction, and the resulting premature disease and death later. Reducing the nicotine content in cigarettes may be a very effective way to accomplish this major impact,” he added.

Hatsukami, Zeller, and their colleagues recommend engaging scientific, research and government agencies to conduct the necessary research and set priorities and goals as the next step toward determining the feasibility of a nicotine reduction approach.

October 2nd, 2010  in Tobacco No Comments »