Archive for November, 2010

More centers offering nicotine replacement therapy

The percentage of substance abuse treatment facilities offering nicotine replacement therapy to clients gradually increased by about 6 percentage points from 2006 to 2009, according to a new Spotlight report issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) released in conjunction with the “Great American Smokeout.” The report showed that in 2009, 2,613 (19 percent) of 13,513 facilities surveyed were offering nicotine replacement therapy up from 13 percent in 2006.

Tobacco use remains the single most preventable cause of death — causing about 440,000 deaths per year in the United States. Almost half of these deaths occur among people with mental and substance use disorders.

Effective Smoking Cessation

According to the Spotlight report, nicotine replacement therapy including patches, gum and lozenges is a safe and effective way of promoting smoking cessation. The report noted that smokers who use nicotine replacement therapy are twice as likely as nonusers to quit smoking.

“The report shows that substance abuse programs are increasingly recognizing the need to address nicotine addiction as part of treating the whole person. Including nicotine replacement therapy as part of addiction treatment can make a life-saving difference to people who are also often addicted to tobacco and tobacco products,” said SAMHSA Administrator Pamela S. Hyde, J.D. “These efforts are critically important because individuals in substance abuse treatment are more likely to smoke cigarettes than the general population. By helping individuals in treatment say no to cigarettes — we are helping them to take an important step towards a healthier, more productive life.”

The study provided details on what type of treatment facilities were more likely to offer smoking cessation services. Hospital inpatient facilities were much more likely than residential or outpatient facilities to provide nicotine replacement therapies (ranging from 79 percent of hospitals to only16 percent of outpatient programs).

Helping Smokers Quit

In light of this report, SAMHSA encourages all substance abuse treatment facilities to observe the 35th Great American Smokeout each year by instituting their own plans to help smokers quit smoking. (The American Cancer Society sponsors the annual event)

The SAMHSA Data Spotlight was developed as part of the agency’s strategic initiative on data, outcomes, and quality — an effort to inform policymakers and service providers on the nature and scope of behavioral health issues. It is based on SAMHSA’s National Survey of Substance Abuse Treatment Services (NSSATS).

November 22nd, 2010  in Tobacco No Comments »

Energy drink use may lead to alcohol dependence

A hallmark of college life is staying up late to study for an exam the following morning, and many students stay awake by consuming an energy drink. Also increasing in popularity is the practice of mixing alcohol with energy drinks. But these drinks are highly caffeinated and can lead to other problems, in addition to losing sleep. Unfortunately, the contents of energy drinks are not regulated.

New research indicates that individuals who have a high frequency of energy drink consumption (52 or more times within a year) were at a statistically significant higher risk for alcohol dependence and episodes of heavy drinking.

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

Energy Drinks Without Alcohol

Amelia M. Arria, the lead author of the study, Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health, and a Senior Scientist at the Treatment Research Institute, said that prior research has highlighted the dangers of combining energy drinks with alcohol.

“We were able to examine if energy drink use was still associated with alcohol dependence, after controlling for risk-taking characteristics. The relationship persisted and the use of energy drinks was found to be associated with an increase in the risk of alcohol dependence.”

The study utilized data from more than 1,000 students enrolled at a public university who were asked about their consumption of energy drinks and their alcohol drinking behaviors within the past 12 months.

More Likely to Become Dependent

The researchers found that individuals who consumed energy drinks at a high frequency were more likely to get drunk at an earlier age, drink more per drinking session, and were more likely to develop alcohol dependence compared to both non-users of energy drinks and the low-frequency users.

The results of this study confirm and extend earlier research about the risks of energy drink consumption. A major concern is that mixing energy drinks with alcohol can lead to “wide-awake drunkenness,” where caffeine masks the feeling of drunkenness but does not decrease actual alcohol-related impairment. As a result, the individual feels less drunk than they really are, which could lead them to consume even more alcohol or engage in risky activities like drunk driving.

Caffeine Disguises Impairment

“Caffeine does not antagonize or cancel out the impairment associated with drunkenness—it merely disguises the more obvious markers of that impairment,” says Kathleen Miller, a research scientist from the Research Institute on Addictions at the University at Buffalo. According to her, the next steps in this research include identifying links between energy drinks and other forms of substance abuse, as well assessing the overall prevalence of energy drink use by adolescents and young adults.

“Also needed is research that directly assesses students’ reported reasons for mixing alcohol and energy drinks. Anecdotal reports suggest that part of this phenomenon may be driven by the perpetuation of myths (e.g., mixing alcohol and caffeine reduces drunkenness, prevents hangovers, or fools a breathalyzer test) that could be debunked through further education.”

Arria agrees, adding that further research and regulations are needed to curb this disturbing trend.

“The fact that there is no regulation on the amount of caffeine in energy drinks or no requirements related to the labeling of contents or possible health risks is concerning.”

November 18th, 2010  in Alcohol, Alcoholism No Comments »

College campus-community interventions successful

Heavy drinking among college students results in over 1800 deaths each year, as well as 590,000 unintentional injuries, almost 700,000 assaults and more than 97,000 victims of sexual assaults. In a new study published in the American Journal of Preventive Medicine, researchers report on the results of the Safer California Universities study, a successful community-wide prevention strategy targeted at off-campus settings.

This is one of the first studies to focus on the total environment rather than on prevention aimed at individuals.

Reducing Off-Campus Drinking

The authors found significant reductions in the incidence and likelihood of intoxication at off-campus parties and bars/restaurants for Safer intervention universities. Students from Safer universities were 6% less likely to drink to intoxication during the last time they were at any of the targeted settings, 9% for off-campus parties, and 15% for bars/restaurants.

There was also evidence that drinking was reduced at fraternities and sororities. These declines were equivalent to 6,000 fewer incidents of intoxication at off-campus parties and 4,000 fewer incidents at bars & restaurants during the fall semester at each intervention schools relative to controls. Furthermore, stronger intervention effects were achieved at Safer universities with the highest level of implementation.

“These findings should give college administrators some degree of optimism that student drinking is amenable to a combination of well-chosen, evidence-based universal prevention strategies,” commented lead investigator Robert F. Saltz, PhD, Pacific Institute for Research and Evaluation (PIRE), Berkeley, CA. “Here, one set of alcohol control strategies was found to be efficacious, but other combinations may work as well, or even better. With a growing body of such evidence, and combined with strategies already shown to be effective, it will be possible to craft a comprehensive prevention program that ratchets down the harm currently produced by alcohol use on and near college campuses.”

Off-Campus Consumption

The Safer California Universities study involved 8 campuses of the University of California and 6 campuses in the California State University system. Half of these schools were randomly assigned to the Safer intervention, which took place in the fall semesters of 2005 and 2006.

Student surveys were completed by undergraduates in four fall semesters (2003 through 2006) and random samples of 1,000 to 2,000 students per campus per year were analyzed. Students were asked about where they drank, whether they had gotten drunk, and whether they had engaged in so-called “binge drinking.” They were also questioned about their grade point averages and their general health, as well as other sociodemographic characteristics.

Safer environmental interventions included nuisance party enforcement operations, minor decoy operations, DUI checkpoints, social host ordinances, and use of campus and local media to increase the visibility of environmental strategies. Intervention campuses differed in their level of implementation, but all concentrated on off-campus activities for drinking.

November 13th, 2010  in Alcohol No Comments »

Alcohol damages much more than the liver

Alcohol does much more harm to the body than just damaging the liver. Drinking also can weaken the immune system, slow healing, impair bone formation, increase the risk of HIV transmission and hinder recovery from burns, trauma, bleeding and surgery.

Researchers released the latest findings on such negative effects of alcohol during a meeting Nov. 19 of the Alcohol and Immunology Research Interest Group, held at Loyola University Medical Center.

The Effects of Alcohol

At Loyola, about 50 faculty members, technicians, post-doctoral fellows and students are conducting alcohol research. Studies at Loyola and other centers could lead to therapies to boost the immune system or otherwise minimize the effects of alcohol, said Elizabeth J. Kovacs, PhD, director of Loyola’s Alcohol Research Program and associate director of Loyola’s Burn & Shock Trauma Institute.

“Of course, the best way to prevent the damaging effects of alcohol is to not drink in the first place,” Kovacs said. “But it is very difficult to get people to do this.”

Sessions at the conference included Alcohol and Infection, Alcohol and Oxidative Stress and Alcohol and Organ Inflammation. Findings were presented by researchers from centers around the country, including Loyola, Cleveland Clinic, University of Iowa, University of Colorado, University of Massachusetts, Mississippi State University, Chicago State University and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

November 11th, 2010  in Alcohol No Comments »

Hyper-texting poses new health risks for teens

Texting while driving can be a deadly combination for anyone. Yet, new data released today reveal that the dangers of excessive texting among teens are not limited to the road. Hyper-texting and hyper-networking are now giving rise to a new health risk category for this age group.

Scott Frank, MD, MS, lead researcher on the study and director of the Case Western Reserve School of Medicine Master of Public Health program, presented the findings today at the American Public Health Association’s 138th Annual Meeting & Exposition in Denver. Researchers surveyed a cross section of high school students from an urban Midwestern County and assessed whether use of communication technology could be associated with poor health behaviors, including smoking, drinking and sexual activity.

According to the research, hyper-texting, defined as texting more than 120 messages per school day, was reported by 19.8 percent of teens surveyed, many of whom were female, from lower socioeconomic status, minority and had no father in the home.

Hyper-Texters

Drawing from the data, teens who are hyper-texters are 40 percent more likely to have tried cigarettes, two times more likely to have tried alcohol, 43 percent more likely to be binge drinkers, 41 percent more likely to have used illicit drugs, 55 percent more likely to have been in a physical fight, nearly three-and-a-half times more likely to have had sex and 90 percent more likely to report four or more sexual partners.

“The startling results of this study suggest that when left unchecked texting and other widely popular methods of staying connected can have dangerous health effects on teenagers,” said Frank. “This should be a wake-up call for parents to not only help their children stay safe by not texting and driving, but by discouraging excessive use of the cell phone or social websites in general.”

Depression, Suicide

Additionally, hyper-networking, defined as spending more than three hours per school day on social networking websites, was reported by 11.5 percent of students and associated with higher odds ratios for stress, depression, suicide, substance use, fighting, poor sleep, poor academics, television watching and parental permissiveness.

Teens who are hyper-networkers are 62 percent more likely to have tried cigarettes, 79 percent more likely to have tried alcohol, 69 percent more likely to be binge drinkers, 84 percent more likely to have used illicit drugs, 94 percent more likely to have been in a physical fight, 69 percent more likely to have had sex and 60 percent more likely to report four or more sexual partners.

November 10th, 2010  in Substance Abuse, Tobacco No Comments »

Just 2 drinks slow reactions in older people

Blood alcohol levels below the current legal limit for driving have a significant negative effect on a person’s dexterity. Researchers writing in the open access journal BMC Research Notes found that just two single vodka and orange drinks were enough to make senior volunteers struggle at an obstacle avoidance test while walking.

Judith Hegeman worked with a team of researchers from Sint Maartenskliniek, Nijmegen, The Netherlands, to carry out the tests in 13 healthy men and women (average age 61.5yrs or 62yrs). She said, “The results clearly show that even with low blood alcohol concentrations, reactions to sudden gait perturbations are seriously affected. After ingestion of 2 alcoholic drinks, obstacles were hit twice as often, response times were delayed and response amplitudes were reduced. These changes were most obvious in situations with little available response time.”

Hampered Ability

To carry out the test, the volunteers first started to walk on a treadmill. Once they had attained a steady walking pace, a thin wooden block was placed at the far end of the belt and allowed to move towards the volunteer. Hegeman and her colleagues measured the effects of alcohol on how capable the subjects were of stepping over this obstacle.

She said, “We found that alcohol levels, considered to be safe for driving, seriously hamper the ability to successfully avoid sudden obstacles in the travel path. A possible limitation of this study is the relatively small sample size, however even with the small number, it yielded an unequivocal outcome.”

November 8th, 2010  in Alcohol, Drunk Driving No Comments »

Prescription drug use more common among rural teens

Rural teens appear more likely than their urban peers to use prescription drugs for non-medical purposes, according to a report posted online today that will appear in the March 2011 print issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The non-medical use of prescription drugs is common among U.S. adolescents, with about one in eight reporting lifetime non-medical use of prescription opioids, according to background information in the article. “During adolescence, non-medical prescription drug use is particularly problematic given its association with use of other illicit drugs such as cocaine and heroin, as well as engagement in problem behaviors such as gambling, increased sexual activity and impulsivity,” the authors write. “Moreover, individuals who use prescription drugs earlier in life have a greater chance of later developing prescription drug dependence.”

Abuse Among Urban Teens

Previous studies have examined substance abuse among urban teens, but their conclusions may not apply to those from rural areas, the authors note. Jennifer R. Havens, Ph.D., M.P.H., of University of Kentucky College of Medicine, Lexington, and colleagues analyzed data from 17,872 12- to 17-year-olds participating in the 2008 National Survey on Drug Use and Health. Of these, 53.2 percent lived in urban areas, 51 percent were male and 59 percent were white.

There were no differences between urban and rural youth in rates of any illicit drug use, including marijuana, cocaine, heroin and hallucinogens. However, 13 percent of rural teens reported ever having used prescription drugs for non-medical purposes, compared with 10 percent of urban teens. When the researchers assessed specific medication types, they found rural teens were also more likely to have used pain relievers (11.5 percent vs. 10.3 percent) or tranquilizers (3.5 percent vs. 2.5 percent) non-medically.

After adjusting for sociodemographic factors, health status and the use of other substances, rural teens remained 26 percent more likely than urban adolescents to say they had used prescription drugs for non-medical purposes. “Data support that one reason for the higher prevalence of non-medical prescription drug use in rural areas may be the lack of availability of drugs such as heroin that are easily accessed in urban areas,” the authors write.

Family Involvement Important

Rural teens were more likely to misuse prescription drugs if they reported poorer health, episodes of depression or other substance abuse. “Residing in a household with two parents was associated with a 32 percent reduction in the odds of non-medical prescription drug use,” the authors write. “These results suggest that interventions aimed at family involvement may be beneficial in preventing or reducing non-medical prescription drug use.” Enrollment in school was also a protective factor.

“The cultural, structural and social realities of rural life can not only affect the prevalence of drug use but also exacerbate its consequences. The isolation and self-reliance of rural communities can negatively affect careseeking behavior, particularly regarding mental health and substance abuse services,” the authors write. “While we were able to identify potential targets for intervention such as increased access to health, mental health and substance abuse treatment, this may be difficult for rural areas where such resources are in short supply or non-existent. Research into the causal mechanisms surrounding initiation of non-medical prescription drug use in rural adolescents is necessary to develop tailored interventions for this population.”

November 7th, 2010  in Prescription Drugs No Comments »

Heavy smoking doubles Alzheimer’s disease, dementia risk

Heavy smoking in midlife is associated with a 157 percent increased risk of developing Alzheimer’s disease and a 172 percent increased risk of developing vascular dementia, according to a Kaiser Permanente study published in the Archives of Internal Medicine.

This is the first study to look at the long-term consequences of heavy smoking on dementia.

Increased Risk Among Smokers

Researchers followed an ethnically diverse population of 21,123 men and women from midlife onward for an average of 23 years. Compared with non-smokers, those who had smoked more than two packs of cigarettes a day had more than a 157 percent increased in risk of Alzheimer’s disease and 172 percent increased risk of vascular dementia during the mean follow-up period of 23 years. Vascular dementia, the second most common form of dementia after Alzheimer’s disease, is a group of dementia syndromes caused by conditions affecting the blood supply to the brain.

“This study shows that the brain is not immune to the long-term consequences of heavy smoking,” said the study’s principal investigator, Rachel A. Whitmer, Ph.D., a research scientist with the Kaiser Permanente Division of Research in Oakland, Calif. “We know smoking compromises the vascular system by affecting blood pressure and elevates blood clotting factors, and we know vascular health plays a role in risk of Alzheimer’s disease.”

Researchers analyzed prospective data from of 21,123 Kaiser Permanente Northern California members who participated in a survey between 1978 and 1985. Diagnoses of dementia, Alzheimer’s disease and vascular dementia made in internal medicine, neurology, and neuropsychology were collected from 1994 to 2008. The researchers adjusted for age, sex, education, race, marital status, hypertension, hyperlipidemia, body mass index, diabetes, heart disease, stroke, and alcohol use.

Brain Vessels Affected

“While we don’t know for sure, we think the mechanisms between smoking and Alzheimer’s and vascular dementia are complex, including possible deleterious effects to brain blood vessels as well as brain cells,” said study co-author Minna Rusanen, MD, of the University of Eastern Finland and Kuopio University Hospital in Finland.

This study is the latest in a series of published Kaiser Permanente research to better understand the modifiable risk factors for dementia. This ongoing body of research adds to evidence base that what is good for the heart is good for the brain, and that midlife is not too soon to begin preventing dementia with good health. The other studies led by Whitmer found that a large abdomen in midlife increases risk of late-life dementia, elevated cholesterol levels in midlife increase risk of Alzheimer’s disease and vascular dementia, and low blood-sugar events in elderly patients with type 2 diabetes increase dementia risk. Another Kaiser Permanente study led by Valerie Crooks of Kaiser Permanente in Southern California found that having a strong social network of friends and family appears to decrease risk for dementia.

November 3rd, 2010  in Tobacco No Comments »