Archive for June, 2011

Brain Damage Seen in Young Adult Binge-Drinkers

It’s considered a rite of passage among young people – acting out their independence through heavy, episodic drinking. But a new University of Cincinnati study, the first of its kind nationally, is showing how binge drinking among adolescents and young adults could be causing serious damage to a brain that’s still under development at this age.

Researcher Tim McQueeny, a doctoral student in the UC Department of Psychology, is presenting the findings this week at the 34th annual meeting of the Research Society on Alcoholism in Atlanta.

Binge Drinking and the Brain

High-resolution brain scans on a sample of 29 weekend binge drinkers, aged 18 to 25, found that binge-drinking – consuming four or more drinks in one incident for females and five or more drinks for males – was linked to cortical-thinning of the pre-frontal cortex, the section of the brain related to executive functioning such as paying attention, planning and making decisions, processing emotions and controlling impulses leading to irrational behavior.

McQueeny examined the brain’s gray matter, the parts of brain cells that do the thinking, receiving and transmitting of messages. “We have seen evidence that binge drinking is associated with reduced integrity in the white matter, the brain’s highways that communicate neuron messaging, but alcohol may affect the gray matter differently than the white matter,” he says.

The pilot study examined whether the researchers could see a relationship between gray matter thickness and binge drinking among college-aged young adults. They found that greater number of drinks per binge is associated with cortical thinning. McQueeny is now interested in pursuing future research to examine whether binge drinking is affecting the brain’s gray matter and white matter differently, or if they’re both equally affected.

Brain Is Still Growing

“Alcohol might be neurotoxic to the neuron cells, or, since the brain is developing in one’s 20s, it could be interacting with developmental factors and possibly altering the ways in which the brain is still growing,” he says.

The findings affect a significant population. A publication from the National Institute on Drug Abuse reports that 42 percent of young American adults between 18 and 25 have engaged in binge drinking.

McQueeny adds that the depressant effects of alcohol emerge later in life, so for young adults, the effect of alcohol can be very stimulating and activate tolerance over time.

“In the past, in terms of what’s known about the physical toll of alcohol, the focus on neurobiology has been in pathological populations and adult populations who were disproportionately male, so there was a significant gap in research in terms of when people started risky drinking. We’re looking at developmental aspects at an age when binge drinking rates are highest, and we’re also looking at gender effects,” says McQueeny. “There might actually be indications of early micro-structural damage without the onset of pathological symptoms such as abuse, or dependence on alcohol.”

Resonsible Drinking Suggested

McQueeny’s advisor, UC Psychology Professor Krista Lisdahl Medina, served as senior author on the paper. She adds, “Our preliminary evidence has found a correlation between increased abstinence of binge drinking and recovery of gray matter volume in the cerebellum. Additional research examining brain recovery with abstinence is needed.”

In terms of educating young adults about responsible drinking, Medina says there appear to be better efforts about communicating the dangers of drinking and driving. “However, people can still be doing damage to their brain as a result of the prevalence and acceptance of binge drinking. There is also evidence that drinking below the binge level may be less harmful,” she says.

The high-resolution imaging was conducted at UC’s Center for Imaging Research.

The research was supported by a $300,000 grant awarded to Medina’s lab by the National Institute on Drug Abuse. McQueeny was also awarded a University Research Council Summer Graduate Fellowship.

June 30th, 2011  in Alcohol No Comments »

Menthol cigarettes marketed in ‘predatory’ pattern?

Tobacco companies increased the advertising and lowered the sale price of menthol cigarettes in stores near California high schools with larger populations of African-American students, according to a new study from the Stanford School of Medicine.

Although cigarette makers have denied using race or ethnicity to target customers, the lead researcher for the study said the data shows a “predatory” marketing pattern geared to luring young African Americans into becoming smokers.

Racial Targeting Denied

“The tobacco companies went out of their way to argue to the Food & Drug Administration that they don’t use racial targeting,” said Lisa Henriksen, PhD, senior research scientist at the Stanford Prevention Research Center. “This evidence is not consistent with those claims.”

Henriksen is the first author of this study, which will be published online June 24 in Nicotine & Tobacco Research.

The study comes at a time when the FDA is gathering information on whether to ban menthol as a flavoring agent in cigarettes. A federal law passed in 2008 banned 13 candy flavorings in cigarettes but allowed for the continued use of menthol. Menthol makes the smoke from tobacco smoother and less harsh; even non- menthol cigarettes often have low levels of the substance.

A draft report by the Tobacco Products Scientific Advisory Committee, which the FDA asked to investigate the harms from the use and marketing of menthol cigarettes, found that the use of menthol cigarettes is highest among minorities, teenagers and low-income populations. Advertisements often tout the “freshness” of menthol cigarettes, and the report said many smokers mistakenly believe that the addition of menthol makes cigarettes less of a health risk.

The committee’s report says that “removal of menthol cigarettes from the marketplace would benefit public health in the United States,” but the FDA doesn’t have to follow the group’s recommendation. The committee is scheduled to meet July 21 in Rockville, Md., to discuss final changes to the document. An FDA spokesman said the edited version of the report will be posted soon on the agency’s website, but there is no timeline yet as to when the FDA will make a decision on menthol.

“The committee was charged with considering a broad definition of harm to smokers and other populations, particularly youth,” said Henriksen. “We think our study, which shows the predatory marketing in school neighborhoods with higher concentrations of youth and African-American students, fits a broad definition of harm.”

Preference for Menthol Cigarettes

In the Stanford study, Henriksen and her colleagues note that the preference for menthol cigarettes among teenage smokers increased from 43.4 percent in 2004 to 48.3 percent in 2008. Menthol cigarettes were also most popular among African-American smokers ages 12-17 (71.9 percent), compared to Hispanics (47 percent) and non-Hispanic whites (41 percent) of the same ages.

To find out how the leading brands of menthol and non-menthol cigarettes were promoted near California high schools, the researchers randomly selected convenience stores, small markets and other tobacco retailers within easy walking distance of 91 schools. The researchers then rated how the cigarettes were marketed in those stores. The data were collected in 2006.

The researchers found that for every 10-percentage-point increase in the proportion of African-American students at a school, the proportion of advertisements for menthol cigarettes increased by 5.9 percentage points. Additionally, the odds of an advertised discount for Newport, the leading brand of menthol cigarettes, were 1.5 times greater.

When it came to price, the average per-pack price for Newport was $4.37 at the time of the study, with Marlboro – the leading non-menthol brand – averaging $3.99. It also found that for every 10-percentage-point increase in the proportion of African-American students at the nearby school, the per-pack price for Newport was 12 cents lower. Advertised discounts and prices for Marlboro, however, were unrelated to school or neighborhood demographics.

“That’s important because lower prices tend to lead to increased cigarette use,” Henriksen said.

In addition, the study found that for each 10-percentage-point increase in the proportion of neighborhood residents ages 10-17, the proportion of menthol advertisements increased by 11.6 percentage points, and the odds of an advertised discount for Newport was 5.3 times greater.

Although the study was limited to California high schools, the authors believe the findings would be similar throughout the country.

Advertising Targets Teens

“When kids are exposed to more cigarette advertising they are more likely to start smoking, which will undoubtedly lead to dire health consequences,” said senior author Stephen Fortmann, MD, a professor emeritus of medicine at Stanford who is now a senior investigator at Kaiser Permanente Center for Health Research in Portland, Ore. “Our study finds that tobacco companies are trying to make smoking more attractive to teens, when we as a society should be doing just the opposite.”

Given previous research that young smokers and African-American smokers are more sensitive to prices than other groups, Fortmann and Henriksen said they believe this study clearly shows how tobacco companies are trying to target black teens in marketing menthol cigarettes.

“Adding menthol to cigarettes makes it easier to smoke and harder to quit, so the public health community strongly supports an FDA ban on menthol flavoring,” Fortmann said.

June 25th, 2011  in Tobacco No Comments »

Alcohol’s damaging effects on the brain

While alcohol has a wide range of pharmacological effects on the body, the brain is a primary target. However, the molecular mechanisms by which alcohol alters neuronal activity in the brain are poorly understood. Participants in a symposium at the June 2010 annual meeting of the Research Society on Alcoholism in San Antonio, Texas addressed recent findings concerning the interactions of alcohol with prototype brain proteins thought to underlie alcohol actions in the brain.

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

Effects of Alcohol on the Brain

“Alcohol is the most common drug in the world, has been used by diverse human communities longer than recorded history, yet our understanding of its effects on the brain is limited when compared to other drugs,” said Rebecca J. Howard, a postdoctoral fellow at The University of Texas at Austin Waggoner Center for Alcohol & Addiction Research and corresponding author for this study.

Howard explained that neuroscientists have discovered how marijuana, cocaine, and heroin each bind to a special type of protein on the surface of brain cells, fitting like a key into a lock to change that protein’s normal function. Yet alcohol has special properties that make it difficult to characterize its lock-and-key binding in detail, for example, alcohol is much smaller than other drugs, and appears to interact with several different types of proteins.

“The adverse effects of alcohol abuse are devastating on a personal level and on a societal level,” added Gregg Homanics, a professor of anesthesiology and pharmacology & chemical biology at the University of Pittsburgh. “Alcohol abuse costs our society more than the costs of all illegal drug abuse combined. For many years, most investigators thought that alcohol exerted nonspecific effects on the brain and simply perturbed neuronal function by dissolving in the membranes of nerve cells. However, our understanding of alcohol action has dramatically shifted in the last 10 to 15 years or so. There is now solid experimental evidence that alcohol binds in a very specific manner to key protein targets in the brain to cause the drug’s well known behavioral effects. This review summarizes some of the most recent research.”

Recent Alcohol Research

Some of the key points were:

Combining X-ray crystallography, structural modeling, and site-directed mutagenesis may be better suited to studying alcohol’s low-affinity interactions than traditional techniques such as radioligand binding or spectroscopy.

“One major problem in studying alcohol binding to brain proteins is that the alcohol key does not fit very tightly into any particular protein lock,” said Howard. “That is, alcohol has a ‘low affinity’ for proteins, compared to how other drugs interact with their own protein targets. We think this is one reason it takes such a large quantity of alcohol to affect the brain: whereas users of cocaine or heroin may consume just a few milligrams at a time, a person drinking a shot of strong liquor consumes about 1,000 times that much alcohol (several grams). The low affinity of alcohol for its protein targets [also] makes it difficult to study by traditional methods that rely on detecting stable drug-protein complexes over a long period of time.”

Some common themes are beginning to emerge from a review of diverse proteins such as inwardly rectifying potassium, transient receptor potential, and neurotransmitter-gated ion channels, as well as protein kinase C epsilon.

Alcohol Targets in the Brain

“It is now very clear that hydrophobic pockets exist in the structure of various brain proteins and alcohols can enter those pockets,” said Homanics. “Alcohols interact with specific amino acids that line those pockets in a very specific manner.”

In particular, evidence is emerging that supports characteristic, discrete alcohol binding sites on protein targets.

“Different drugs bind to different types of proteins on the surface of brain cells, each fitting like a key, or drug, into a lock, or binding site, on a protein to change its normal function,” explained Howard. “Understanding the exact shape of that lock and key helps us to understand how individuals with special mutations may be affected differently by drugs, and can help scientists design new medicines to help people with drug abuse or other problems.”

The Brain’s Binding Sites

“I feel that there is now overwhelming evidence that specific alcohol binding sites exist on a variety of brain protein targets,” added Homanics. “This is significant because we can now focus on defining these sites in greater detail, ultimately at the level of each atom involved. This will allow for, one, a more complete understanding of the molecular pharmacology of alcohol action, two, the discovery of similar sites on other important brain proteins, and three, the rational design of drugs that can selectively target these binding sites.”

“Our review summarizes very recent advances in understanding the molecular details of alcohol binding sites, which now include human brain targets, not just metabolic enzymes and receptors from other species,” said Howard. “This information will give researchers new opportunities to characterize human mutations and design new medicines. Furthermore, common themes emerging about alcohol binding sites may help scientists identify important binding sites in other important brain proteins.”

Highly Selective Targets

“In other words,” said Homanics, “alcohol exerts its effects via binding sites on target molecules just like all other drugs we know about. There is now solid evidence from several different putative alcohol targets using several different techniques that alcohol interacts with specific brain targets in a highly selective manner. This is particularly important for more senior clinicians and researchers that were trained years ago when the predominant theory of alcohol action was via nonspecific effects on the nervous system.” Both Howard and Homanics are hopeful that this research will aid the development of therapies and treatments for individuals with alcohol problems.

“Great progress is being made in understanding how alcohol exerts its effects on the brain at the molecular level,” noted Homanics. “Understanding how alcohol affects brain proteins on a molecular level is essential if we are to effectively develop rational treatments to combat alcohol use disorders.”

June 17th, 2011  in Alcohol No Comments »

Alcoholism 4 times more likely in mentally ill

A new report shows that alcohol dependence is four times more likely to occur among adults with mental illness than among adults with no mental illness (9.6-percent versus 2.2-percent).

Based on a nationwide survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) the report also shows that the rate of alcohol dependency increases as the severity of the mental illness increases. For example, while 7.9-percent of those with mild mental illness were alcohol dependent, 10-percent of those with moderate mental illness and 13.2-percent of those with serious mental illness were alcohol dependent.

“Mental and substance use disorders often go hand in hand. This SAMHSA study adds to the evidence of this connection,” said SAMHSA Administrator Pamela S. Hyde, J.D. “Co-occurring mental illness and substance use disorders are to be expected not considered the exception. Unfortunately, signs and symptoms of these behavioral health conditions are often missed by individuals, their friends and family members and unnoticed by health professionals. The results can be devastating and costly to our society.”

Behavioral Health Issues

The SAMHSA Spotlight report, “Alcohol Dependence is More Likely among Adults with Mental Illness than Adults without Mental Illness” was developed as part of SAMHSA’s strategic initiative on data, outcomes, and quality – an effort to inform policy makers and service providers on the nature and scope of behavioral health issues. The report is based on data from the 2009 National Survey of Drug Use and Health – a state-of-the-art scientific survey of a large representative sample of people throughout the United States.

The full report is available on the web.

June 5th, 2011  in Alcoholism No Comments »

Higher return to prison for women without drug programs

Female prisoners who did not participate in a drug treatment program after their release were 10 times more likely to return to prison within one year than other prisoners, a new study has found.

More than one-third of those women were sent back to prison within six months, according to the national study led by Flora Matheson, a medical sociologist at St. Michael’s Hospital.

The findings, published in the American Journal of Public Health, underline the importance of post-release treatment programs for prisoners with substance abuse problems, Matheson said.

Women Vulnerable to Relapse

Since women are particularly vulnerable to drug relapse in the first two or three weeks after release, it’s important to begin the community care programs as soon as possible, she said.

“We don’t want these women re-offending, we want them to remain in the community and be successful,” said Matheson, a scientist in the hospital’s Centre for Research on Inner City Health who collaborated on the study with the Research Branch of the Correctional Service of Canada.

Matheson evaluated the effectiveness of the Community Relapse Prevention and Maintenance program, which was developed by CSC in 2003 for women on parole from six federal prisons. At the time the study was conducted, the community portion of the program consisted of 20, two-hour group sessions offered on a weekly basis. Cocaine was the most common drug that had been used by women in the program (58.9 per cent), followed by crack cocaine (44.3 per cent).

Women who were not exposed to the program were more than 10 times more likely to be back in prison within 52 weeks.

One-Third of Convictions Drug Related

Women make up five per cent of the federal prison population in Canada, although that number has tripled in the past 20 years. About one-third of them were convicted of drug-related offenses.

Matheson noted that drug-using offenders are twice as likely to have unstable housing in the community, are less able to manage stress, are hospitalized more often for mental health issues and have higher recidivism rates than do non-substance-abusing women. Many of them have experienced trauma in their lives, such as childhood, physical or sexual abuse, or domestic abuse, which may have contributed to their substance abuse and mental health issues.

She said there are many barriers to women who want to participate in post-release treatment programs, including childcare and high unemployment rates that make it difficult to afford transportation. Canada is such a vast country geographically that it’s difficult for CSC and other correctional jurisdictions to offer treatment programs in every community.

June 4th, 2011  in Substance Abuse No Comments »