Archive for December, 2016

Alcohol Risks Increasing for Older Adults

Alcohol is the most commonly used psychoactive substance among older adults, and this group can have unique risks associated with alcohol consumption — in even lower amounts — compared to younger persons.

“Older adults have particular vulnerabilities to alcohol due to physiological changes during aging, including increasing chronic disease burden and medication use,” said Benjamin Han, MD, MPH, a geriatrician and health services researcher at the Center for Drug Use and HIV Research (CDUHR) and in the Division of Geriatric Medicine and Palliative Care at NYU Langone Medical Center (NYU Langone). “However, no recent studies have estimated trends in alcohol use, including binge alcohol use and alcohol use disorders among older adults.”

Significant Increases in Alcohol Use, Binge Drinking

To address the lack of research, Dr. Han and his team examined data from the National Survey on Drug Use and Health (years 2005 to 2014) in a paper published in the journal Drug and Alcohol Dependence. Trends of self-reported past-month binge alcohol use and alcohol use disorder were examined among adults age 50 and older.

The researchers found significant increases in past-year alcohol use, past-month alcohol use, past-month binge drinking, and alcohol use disorders. The paper, “Demographic trends of binge alcohol use and alcohol use disorders among older adults in the United States, 2005-2014.” Published on-line 12 December 2016.

Binge Drinking Increased for Women

Results also suggest that while men had a higher prevalence of binge alcohol use and alcohol use disorders than women, binge alcohol use and alcohol use disorder increased among women in this nationally representative sample.

“As females age, they tend to experience a larger impact of physiological changes in lean body mass compared to men,” commented Dr. Han. “Thus, they may experience the adverse effects associated with consuming alcohol even in lower amounts.”

Risking Sexual Situations a Factor

“The increase in binge drinking among older women is particularly alarming” said Dr. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone. “Both men and women are at risk for getting themselves into risky sexual situations while drinking, but women are at particularly high risk.” Dr. Palamar also stated that “heavy drinking can not only have unintended health consequences, but it can also lead to socially embarrassing or regretful behavior.”

For the researchers, the results also raise public health concerns, given the significant increases in binge alcohol use among older adults who reported “fair/poor” health and/or multiple chronic conditions. This population is particularly vulnerable to the negative effects of alcohol as it can impact chronic disease management or increase the risk of injury.

“Health care providers need to be made aware of this increasing trend of unhealthy alcohol use, particularly among older females, and ensure that screening for unhealthy alcohol use is part of regular medical care for this population” said Dr. Han.

December 19th, 2016  in Alcohol No Comments »

Alcohol consumption shows no effect on coronary arteries

Researchers using coronary computed tomography angiography (CCTA) have found no association between light to moderate alcohol consumption and coronary artery disease (CAD), according to a study being presented today at the annual meeting of the Radiological Society of North America (RSNA).

Some previous studies have suggested that light alcohol consumption may actually reduce the risk for CAD. However, data regarding regular alcohol consumption and its association with the presence of CAD remains controversial. For the new study, researchers looked at alcohol consumption, type of alcohol consumed, and presence of coronary plaques using CCTA.

How Alcohol Contributes to Fatty Plaques

“CCTA is an excellent diagnostic modality to noninvasively depict the coronary wall and identify atherosclerotic lesions,” said study author Júlia Karády, M.D., from the MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center at Semmelweis University in Budapest, Hungary. “Furthermore, we’re able to characterize plaques and differentiate between several types. Prior studies used cardiovascular risk factors–like high cholesterol levels–and cardiovascular outcomes to study the effects of alcohol, but our study is unique in that we analyzed both drinkers and non-drinkers using CCTA, which may shed some light on how alcohol may or may not contribute to the development of fatty plaques in the arteries of the heart.”

The researchers studied 1,925 consecutive patients referred for CCTA with suspected CAD. Information on alcohol consumption habits was collected using questionnaires about the amount and type of alcohol consumed. Using an in-house reporting platform that contained the patients’ clinical and CCTA data, researchers were able to assess the relationship between atherosclerosis, clinical risk factors and patient drinking habits.

Light Alcohol Consumption Had No Effect

“About 40 percent of our patients reported regular alcohol consumption, with a median of 6.7 alcohol units consumed weekly,” Dr. Karády said.

One unit translates to approximately 2 deciliters (dl) or 6.8 fluid ounces of beer, 1 dl or 3.4 ounces of wine, or 4 centiliters (cl) or 1.35 ounces of hard liquor.

The results showed that the amount of weekly alcohol consumption, whether light or moderate, was not associated with the presence of CAD. In addition, when researchers looked at different types of alcohol and the presence of coronary atherosclerosis, no associations were found.

Neither Protective or Harmful Effects

“When we compared consumption between patients who had coronary artery plaques and those who had none, no difference was detected,” Dr. Karády said. “Evaluating the relationship between light alcohol intake (maximum of 14 units per week) and presence of CAD, we again found no association. Furthermore, we analyzed the effect of different types of alcohol (beer, wine and hard liquor) on the presence of CAD, but no relationship was found.”

Dr. Karády added that while no protective effect was detected among light drinkers, as previously thought, no harmful effects were detected either.

The researchers are in the process of expanding the study to include more patients and perform further analyses.

Independently of whether alcohol has any effect on the coronary arteries, moderate alcohol consumption has been associated with a number of potential side effects, including negative long-term effects on the brain and heart.

December 5th, 2016  in Alcohol No Comments »

Is Kratom an opioid alternative?

A delayed U.S. Drug Enforcement Administration ban on kratom would stifle scientific understanding of the herb’s active chemical components and documented pharmacologic properties if implemented, according to a special report published today in The Journal of the American Osteopathic Association.

The report cited the pharmacologically active compounds in kratom, including mitragynine, 7-hydroxymitragynine, paynantheine, speciogynine and 20 other substances, as one basis for further study. It also emphasized the extensive amount of anecdotal evidence and current scientific research that indicates kratom may be safer and less addictive than current treatments for pain and opioid withdrawal.

Kratom Does Not Depress Respiration

“There’s no question kratom compounds have complex and potential useful pharmacologic activities and they produce chemically different actions from opioids,” said author Walter Prozialeck, chairman of the Department of Pharmacology at Midwestern University Chicago College of Osteopathic Medicine. “Kratom doesn’t produce an intense euphoria and, even at very high doses, it doesn’t depress respiration, which could make it safer for users.”

Kratom (Mitragyna speciosa) is indigenous to Southeast Asia, where the plant was used for centuries to relieve fatigue, pain, cough and diarrhea and aid in opioid withdrawal. Currently sold in the United States as an herbal supplement, kratom drew DEA scrutiny after poison control centers noted 660 reports of adverse reactions to kratom products between January 2010 and December 2015.

Source of Adverse Reactions Unclear

“Many important medications, including the breast cancer treatment tamoxifen, were developed from plant research,” said Prozialeck.

“While the DEA and physicians have valid safety concerns, it is not at all clear that kratom is the culprit behind the adverse effects,” said Anita Gupta, DO, PharmD and special advisor to the FDA.

A Non-Pharmaceutical Remedy?

Dr. Gupta, an osteopathic anesthesiologist, pain specialist and licensed pharmacist, has treated a number of patients who’ve used kratom. “Many of my patients are seeking non-pharmaceutical remedies to treat pain that lack the side effects, risk, and addiction potential of opioids,” she said.

Kratom is currently banned in states including Alabama, Florida, Indiana, Arkansas, Wisconsin and Tennessee. The DEA is scheduled to decide whether to place kratom on its list of Schedule 1 drugs, a classification for compounds thought to have no known medical benefit. Marijuana, LSD and heroin are Schedule 1 drugs, which prevents the vast majority of U.S.-based researchers from studying those substances.

December 2nd, 2016  in Prescription Drugs No Comments »