Archive for the ‘ Substance Abuse ’ Category

Marijuana Use Up Among Oregon College Students

College students attending an Oregon university are using more marijuana now that the drug is legal for recreational use, but the increase is largely among students who also report recent heavy use of alcohol, a new study has found.

Oregon State University researchers compared marijuana usage among college students before and after legalization and found that usage increased at several colleges and universities across the nation but it increased more at the Oregon university. None of the universities were identified in the study.

“It does appear that legalization is having an effect on usage, but there is some nuance to the findings that warrant further investigation,” said the study’s lead author, David Kerr, an associate professor in the School of Psychological Science in OSU’s College of Liberal Arts.

Increase Not Due to Legalization Alone

“We found that overall, at schools in different parts of the country, there’s been an increase in marijuana use among college students, so we can’t attribute that increase to legalization alone.”

The results were published today in the journal Addiction. Co-authors are Harold Bae and Sandi Phibbs of OSU’s College of Public Health and Human Sciences and Adam Kern of the University of Michigan.

The study is believed to be the first to examine marijuana usage patterns following legalization of recreational marijuana in Oregon and the first to examine the effects of any state’s legalization on college students. Voters in Oregon approved legalization in 2014 and the law took effect in 2015.

Legalization Raises More Questions

Oregon’s legalization of marijuana is part of a larger trend among U.S. states, but little research has been done so far to understand the impact. In their study, Kerr and his colleagues set out to begin addressing some of those questions.

“It’s an important current issue and even the most basic effects have not been studied yet, especially in Oregon,” he said. “There are a lot of open questions about how legalization might affect new users, existing users and use of other substances.”

Researchers used information collected in the Healthy Minds Study, a national survey of college students’ mental health and well-being – including substance use – conducted by the University of Michigan. The study is designed to give colleges and universities information to help them understand the needs of their student populations.

Binge Drinking Rates About the Same

As part of the survey, participants are asked about marijuana and cigarette use in the previous 30 days, as well as frequency of heavy alcohol use within the previous two weeks.

Using data from a large public university in Oregon and six other four-year universities around the country where recreational marijuana is not legal, researchers compared rates of marijuana use before and after the drug was legalized in Oregon. They also examined frequency of heavy alcohol use and cigarette use at those points.

The researchers found that the overall rates of marijuana use rose across the seven schools. Rates of binge drinking – where a person consumes four to five or more drinks in a period of about two hours – stayed the same and cigarette use declined in that period.

Widespread Changing Attitudes

“It’s likely that the rise in marijuana use across the country is tied in part to liberalization of attitudes about the drug as more states legalize it, for recreational or medical purposes or both,” Kerr said. “So legalization both reflects changing attitudes and may influence them even outside of states where the drug is legal.”

Researchers also found that marijuana use rates were generally higher, overall, among male students; those living in Greek or off-campus housing; those not identifying as heterosexual; and those attending smaller, private institutions.

One area where legalization had a marked impact was among college students who indicated recent binge drinking; students at the Oregon university who reported binge drinking were 73 percent more likely to also report marijuana use compared to similar peers at schools in states where marijuana remains illegal.

Underage Marijuana Use Rates Even Higher

“We think this tells us more about the people who binge drink than about the effects of alcohol itself,” Kerr said. “Those who binge drink may be more open to marijuana use if it is easy to access, whereas those who avoid alcohol for cultural or lifestyle reasons might avoid marijuana regardless of its legal status.”

The researchers also found that Oregon students under age 21 – the minimum legal age for purchasing and using marijuana – showed higher rates of marijuana use than those over 21.

“This was a big surprise to us, because legalization of use is actually having an impact on illegal use,” said Bae, the study’s primary statistician.

These initial findings about marijuana use among college students help form a picture of how legalization may be affecting people, Kerr said, but more study is needed before researchers can quantify the harms or net benefits of legalization for young people.

“Americans are conducting a big experiment with marijuana,” Kerr said. “We need science to tell us what the results of it are.”

June 17th, 2017  in Substance Abuse No Comments »

Primary Care Should Include Drug Screening in L.A.

The misuse of both prescription and illicit drugs is so prevalent in Tijuana and East Los Angeles that community clinics in those areas should routinely, though discreetly, screen for it, according to new UCLA research.

The study, published in the peer-reviewed journal Substance Use and Misuse, found that 19.4 percent of people answering a computerized self-administered survey in East Los Angeles community clinics admitted to moderate-to-high drug use. In Tijuana it was 5.7 percent. Rates of drug use among the participants in the study were much higher than what has been found in household surveys in the two countries.

The researchers also found that Los Angeles patients born in Mexico were twice as likely, and Los Angeles patients born in the United States were six times more likely, of being moderate-to-high drug users compared with Tijuana patients born in Mexico.

High Rate of Drug Use Was Surprising

The findings of high rates of drug use ran counter to assumptions, said Dr. Lillian Gelberg, the study’s lead investigator and a professor of family medicine at the David Geffen School of Medicine at UCLA.

“Prevailing expectations were that alcohol would be the major problem and drug use would be lower,” said Gelberg, who is also a professor of health policy and management at the UCLA Fielding School of Public Health. “But what we found was that the rate of problem drug use — that is, moderate-to-high use — was very similar to problem alcohol use.”

Moderate-to-high alcohol use was 15.2 percent in East Los Angeles compared to 6.5 percent in Tijuana. Moderate-to high tobacco use was 20.4 percent in East Los Angeles and 16.2 percent in Tijuana.

Drug Screening Should Be Routine

While drug use was higher in Los Angeles than it was in Tijuana, the rates in both cities are high enough that screening for drug, alcohol and tobacco use should be integrated into routine primary care in community clinics on both sides of the border, said Melvin Rico, clinical research coordinator in the UCLA Department of Family Medicine who served as the field research coordinator for the study.

“Being able to reach a vulnerable population while waiting for a doctor is, I think, very important,” Rico said.

The paper is part of a larger study of an intervention that found a few minutes of counseling in a primary care setting could steer people away from risky drug use and full-fledged addiction.

Self-Reported Substance Abuse

For this study, which ran from March 2013 through October 2013, the researchers recruited 2,507 adults in Los Angeles and 2,890 in Tijuana who were eligible for the World Health Organization’s Alcohol, Smoking and Substance Involvement Screening Test. The researchers designed a simple tool that allowed participants to anonymously self-report substance abuse on a computer tablet with a touch screen. Given the stigma associated with drug use, the researchers wanted to remain sensitive to people’s fears of privacy in a way that still encouraged them to be truthful about their substance use.

Questions about substance use were combined with others about healthy eating, exercise, and chronic illnesses so that the patients would not feel stigmatized about a particular behavior, Gelberg said.

Quiz Adapted for Cultural Differences

“We aren’t using interviews and the patients are filling it in on their own,” she said. “We developed this program so that it would work even for patients of low-literacy levels, asking one question at a time and allowing for an audio option with headsets according to patient’s preference. For instance, it would ask ‘did you use cocaine in the last three months and a ‘yes’ or ‘no’ would light up on the computer screen.'”

The tool could also easily switch between English and Spanish and the questions and approach were adapted to Latinos in Mexico, whose culture and characteristics had differences compared to those in Los Angeles.

Results Subject to Under-Reporting

Participants took the survey while they were in the clinic waiting room, and it took very little time — a mean of 1.3 minutes in Tijuana and 4.2 minutes in Los Angeles.

This tool can be of use in a primary care clinic because people generally don’t volunteer their drug use to their doctors, who for their part don’t know how to broach the subject, Gelberg said.

The study has some limitations. Substance use was based on patient self-reporting, which could make the findings subject to under-reporting. Also, the findings may or may not be the same in health care settings other than community health centers or in other cities in the United States and Mexico.

January 2nd, 2017  in Substance Abuse 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 »

Marijuana smokers more likely to develop an alcohol problem

Adults who use marijuana are five times more likely to develop an alcohol use disorder (AUD) –alcohol abuse or dependence– compared with adults who do not use the drug. And adults who already have an alcohol use disorder and use marijuana are more likely to see the problem persist.

Results of a study by researchers at Columbia University’s Mailman School of Public Health and the City University of New York appear online in the journal Drug and Alcohol Dependence.

Increased Risk of Alcohol Problems

“Our results suggest that cannabis use appears to be associated with an increased vulnerability to developing an alcohol use disorder, even among those without any history of this,” said Renee Goodwin, PhD, associate professor of Epidemiology at the Mailman School of Public Health. “Marijuana use also appears to increase the likelihood that an existing alcohol use disorder will continue over time.”

The researchers analyzed data from 27,461 adults enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions who first used marijuana at a time when they had no lifetime history of alcohol use disorders.

The population was assessed at two time points. Adults who had used marijuana at the first assessment and again over the following three years (23 percent) were five times more likely to develop an alcohol use problem, compared with those who had not used marijuana (5 percent).

Marijuana Smokers Delay Alcohol Treatment

Adult problem drinkers who did not use cannabis were significantly more likely to be in recovery from alcohol use disorders three years later.

“From a public health standpoint we recommend that further research be conducted to understand the pathways underlying these relationships as well as the degree to which various potentially vulnerable population subgroups — youth, for example — are at increased risk,” noted Goodwin. “If future research confirms these findings, investigating whether preventing or delaying first use of marijuana might reduce the risk of developing alcohol use disorders among some segments of the population may be worthwhile.”

February 26th, 2016  in Substance Abuse No Comments »

Gambling by teens linked to other risk-taking behaviors

Gambling among young teens may be associated with increased use of alcohol, cigarettes, or marijuana according to a study that surveyed sixth- to eighth-graders in Italian schools. The research is reported in the February issue of the Journal of Developmental & Behavioral Pediatrics, the official journal of the Society for Developmental and Behavioral Pediatrics. The journal is published by Wolters Kluwer.

The high prevalence of gambling and its association with substance use “provides further evidence of the need for a greater awareness of gambling behavior in early adolescence,” according to the new research by Dr. Alessandra Buja of University of Padova, Italy, and colleagues.

Gambling Associated with ‘Risk-Taking Behavior’ in Young Teens

The study included 1,325 sixth- to eighth-graders from Italian schools participating in a program for the prevention of underage substance abuse. In surveys, the students answered questions about their experience with certain types of gambling: video poker, online betting, and “scratch-and-win” cards (such as lottery tickets).

The students were also asked about their use of alcohol, cigarettes, marijuana, and energy drinks. (Use of energy drinks, which contain stimulants, has been linked to substance use and other risk-taking behaviors.) Associations between gambling and substance use were evaluated, including adjustment for a wide range of other factors.

The results suggested a high rate of gambling in this group of children and young teens. Among eighth-graders, about 46 percent of boys and 35 percent of girls said they had engaged in at least one sort of gambling. Scratch cards were the most common type of gambling.

Gambling Linked to Substance Abuse

Children who had experience with gambling were also more likely to report substance use. Gambling was reported by 60 percent of children who smoked cigarettes, 73 percent of those who used alcohol, and 63 percent of those who used marijuana.

Gambling remained significantly associated with substance use and other risk-taking behaviors, after adjustment for demographic, family, peer, personality, and behavioral characteristics previously linked to substance abuse in young people

Previous studies in older adolescents have linked gambling to substance use disorders. Dr. Buja and coauthors note, “Today’s youth are the first generation for whom gambling opportunities are as close as the neighborhood corner store and as easily accessible as the Internet.”

Parents Think It’s Harmless

The new findings are consistent with previous reports suggesting that many adolescents and even younger children are involved in gambling, despite legal age limits. Parents may see gambling as a harmless activity–rather than restricting or warning against it, they may even initiate their children into betting and gambling.

“Our data show that a history of gambling is associated with risk-taking behavior relating to the use of other substances in very young adolescents,” Dr. Buja and coauthors write. However, they note that the direction of the relationship remains open to debate: “Impulsiveness may be an important common denominator linking gambling with substance abuse in adolescence.”

The high rate of gambling and its association with substance use highlights the need for effective strategies to prevent gambling in early adolescence, according to Dr. Buja and colleagues. They conclude, “It is important for healthcare professionals, teachers, and parents to recognize this problem and take it seriously.”

February 9th, 2016  in Substance Abuse No Comments »

High prevalence of incapacitated rape found among college women

Some 15 percent of women are raped while incapacitated from alcohol or other drug use during their freshman year at college, according to new research.

The report, published in the Nov. issue of the Journal of Studies on Alcohol and Drugs, also helps to offer a clearer idea of which college freshmen are at particular risk of what’s known as ‘incapacitated rape.’

Researchers found that freshmen women who’d been victims of such assaults before college were at substantial risk of being victimized again. Overall, nearly 18 percent of students said they’d been raped while incapacitated before college, and 41 percent of those young women were raped again while incapacitated during their freshman year.

The students’ views on alcohol also seemed to be involved. Young women who said they believed alcohol can enhance a person’s sexual experience were at increased risk of incapacitated rape during their first year of college — regardless of whether they’d been victims in the past.

Increased Risks for Rape

It’s important to get a clearer picture of the risk factors for college sexual assault to inform prevention efforts, explained lead researcher Kate Carey, Ph.D., a professor of behavioral and social sciences at Brown University School of Public Health, in Providence, R.I. No one is suggesting the victims are to blame, Carey stressed. The intoxication of a potential victim does not excuse the perpetration of sexual assault.

“We’re trying to identify modifiable factors that increase risk for incapacitated rape,” she said.

Alcohol, Drugs Are Pervasive on Campus

College programs aimed at preventing sexual assault need to be ‘universal,’ targeting all students, Carey said. But those programs can address specific attitudes or behaviors — such as students’ expectations about alcohol and sex.

Drinking and other drug use is pervasive on college campuses: Four of five college students drink alcohol, with half of these saying they sometimes binge, according to the U.S. National Institute on Alcohol Abuse and Alcoholism.

At the same time, campus sexual assault is being increasingly recognized as a major problem, and many of those incidents involve alcohol or other drugs. Research has found that incapacitated rape is more common on college campuses than forcible rape, in which perpetrators use threats or physical force.

Sex Assault Education Needs to Begin Early

But the current findings, Carey said, show that many young women are victims long before college.

“The pre-college assessment went back to as early as age 14,” she said. “That suggests that sexual assault education needs to begin earlier.”

If prevention efforts are limited to university campuses, Carey noted, they’ll also miss all the young adults who do not go to college.

The findings are based on 483 female freshmen who completed several surveys over their first year of college. The students were from a single university in New York State, so it would be helpful, Carey said, for further studies to confirm the results at other schools as well.

November 21st, 2015  in Substance Abuse No Comments »

Prescription painkillers source of addiction for most women

Painkillers prescribed by doctors are the starting point for an opioid addiction for more than half of female methadone clinic patients, and they need different treatment from men with addiction, says a study led by McMaster University researchers.

The results, published in the open access journal Biology of Sex Differences today, show that more than half (52%) of women and a third (38%) of men reported doctor-prescribed painkillers as their first contact with opioid drugs, a family of drugs which include prescription medicines such OxyContin and codeine, as well as illicit drugs such as heroin.

The study of 503 patients attending Ontario methadone clinics identified significant gender differences between the men and women attending the clinics. Compared to men, women were found to have more physical and psychological health problems, more childcare responsibilities, and were more likely to have a family history of psychiatric illness.

Rising Number of Women Seeking Treatment

Men were more likely than women to be working and more likely to smoke cigarettes. Rates of cannabis use were relatively high (47%) among both men and women.

“Most methadone treatment is based on studies with few or no women at all. We found men and women who are addicted to opioids have very different demographics and health needs, and we need to better reflect this in the treatment options that are available,” said Monica Bawor, first author of the paper and a recent PhD neuroscience graduate of McMaster.

“A rising number of women are seeking treatment for opioid addiction in Canada and other countries yet, in many cases, treatment is still geared towards a patient profile that is decades out of date — predominantly young men injecting heroin, and with few family or employment responsibilities.”

Injecting Drug Use Declined

The study highlights the changing profile of people addicted to opioids. Compared to results from studies in the 1990s, the average age of patients being treated for opioid addiction is older (38 compared to 25 years), with opioid use starting at a later age (25 rather than 21 years). Injecting drug use has reduced by 60%, and there has been a 50% reduction in rates of HIV in opioid users as a result.

At the same time, there has been a 30% increase in the number of patients becoming addicted to opioids through doctor-prescribed painkillers, usually for chronic pain management. In Canada, the number of opioid painkiller prescriptions has doubled in the last two decades, and according to the World Health Organization (WHO), Canada consumes more opioid painkillers than any other country.

Women Prescribed Painkillers More Often?

Senior author Dr. Zena Samaan added that the reasons are not clear why women are disproportionately affected by opioid dependence originating from prescription painkillers.

“It may be that they are prescribed painkillers more often because of a lower pain threshold or because they are more likely to seek medical care than men,” said Samaan, an associate professor of psychiatry and behavioural neurosciences at the Michael G. DeGroote School of Medicine.

“For whatever reason, this is a growing problem in Canada and in other countries, such as the U.S., and addiction treatment programs need to adapt to the changing profile of opioid addiction.”

November 11th, 2015  in Prescription Drugs No Comments »

Daily marijuana use by college students increasing

Daily marijuana use among the nation’s college students is on the rise, surpassing daily cigarette smoking for the first time in 2014.

A series of national surveys of U.S. college students, as part of the University of Michigan’s Monitoring the Future study, shows that marijuana use has been growing slowly on the nation’s campuses since 2006.

Daily or near-daily marijuana use was reported by 5.9 percent of college students in 2014–the highest rate since 1980, the first year that complete college data were available in the study. This rate of use is up from 3.5 percent in 2007. In other words, one in every 17 college students is smoking marijuana on a daily or near-daily basis, defined as use on 20 or more occasions in the prior 30 days.

21% of Students Smoke Monthly

Other measures of marijuana use have also shown an increase: The percent using marijuana once or more in the prior 30 days rose from 17 percent in 2006 to 21 percent in 2014. Use in the prior 12 months rose from 30 percent in 2006 to 34 percent in 2014. Both of these measures leveled in 2014.

“It’s clear that for the past seven or eight years there has been an increase in marijuana use among the nation’s college students,” said Lloyd Johnston, the principal investigator of the study. “And this largely parallels an increase we have been seeing among high school seniors.”

Much of this increase may be due to the fact that marijuana use at any level has come to be seen as dangerous by fewer adolescents and young adults. For example, while 55 percent of all 19-to-22-year-old high school graduates saw regular marijuana use as dangerous in 2006, only 35 percent saw it as dangerous by 2014.

Illicit Drug Use Up

The study also found that the proportion of college students using any illicit drug, including marijuana, in the prior 12 months rose from 34 percent in 2006 to 41 percent in 2013 before falling off some to 39 percent in 2014. That seven-year increase was driven primarily by the increase in marijuana use, though marijuana was not the only drug on the rise.

The proportion of college students using any illicit drug other than marijuana in the prior 12 months increased from 15 percent in 2008–the recent low point–to 21 percent in 2014, including a continuing increase in 2014. The increase appears attributable mostly to college students’ increased use of amphetamines (without a doctor’s orders) and use of ecstasy.

These and other results about drug use come from Monitoring the Future, an annual survey that has been reporting on U.S. college students’ substance use of all kinds for 35 years. The study began in 1980 and is conducted by the U-M Institute for Social Research with funding from the National Institute on Drug Abuse, one of the National Institutes of Health.

Amphetamine Use at 10%

College students’ nonmedical use of amphetamines in the prior 12 months nearly doubled between 2008 (when 5.7 percent said they used) and 2012 (when 11.1 percent used), before leveling at 10.1 percent in 2014.

“It seems likely that this increase in amphetamine use on the college campus resulted from more students using these drugs to try to improve their studies and test performance,” Johnston said.

Their age-peer high school graduates not in college had higher-reported amphetamine use for many years (1983-2008), but after 2010, college students have had the higher rate of use.

“Fortunately, their use of these drugs appears to have leveled among college students, at least,” he said.

Molly Is Back on Campus

Ecstasy (MDMA, sometimes called Molly), had somewhat of a comeback in use among college students from 2007 through 2012, with past 12-month use more than doubling from 2.2 percent in 2007 to 5.8 percent in 2012, before leveling. Previously, ecstasy had fallen from favor among college students. By 2004, it had fallen to quite low levels and then remained at low levels through 2007.

Past-year use of cocaine showed a statistically significant increase from 2.7 percent in 2013 to 4.4 percent in 2014.

“We are being cautious in interpreting this one-year increase, which we do not see among high school students; but we do see some increase in cocaine use in other young adult age bands, so there may in fact be an increase in cocaine use beginning to occur,” Johnston said. “There is some more welcome news for parents as they send their children off to college this fall. Perhaps the most important is that five out of every 10 college students have not used any illicit drug in the past year, and more than three quarters have not used any in the prior month.”

K-2 Use Decreases

In addition, the use of synthetic marijuana (also called K-2 or spice) has been dropping sharply since its use was first measured in 2011. At that time, 7.4 percent of college students indicated having used synthetic marijuana in the prior 12 months; by 2014 the rate had fallen to just 0.9 percent, including a significant decline in use in 2014. One reason for the decline in synthetic drug use is that an increasing number of young people see it as dangerous.

Likewise, college students’ use of salvia–a hallucinogenic plant which became popular in recent years–fell from an annual prevalence of 5.8 percent in 2009 to just 1.1 percent in 2014.

The nonmedical use of narcotic drugs–which has accounted for an increasing number of deaths in recent years according to official statistics–actually has been declining among college students, falling from 8.8 percent reporting past-year use in 2006 down to 4.8 percent by 2014. This is a particularly welcome improvement from a public health point of view, note the investigators.

Heroin Use Very Low

There is no evidence of a shift over from narcotic drugs to heroin use in this population. Use of heroin has been very low among college students over the past five years or so–lower than it was in the late 1990s and early 2000s.

The non-medical use of tranquilizers by college students has fallen by nearly half since 2003, when 6.9 percent reported past-year use, to 2014, when 3.5 percent did.

The use of LSD and other hallucinogenic drugs, once popular in this age group, remains at low levels of use on campus, with past-year usage rates at 2.2 percent and 3.2 percent, respectively. And use of the so-called club drugs (Ketamine, GHB, Rohypnol) remains very low. Further, the use of so-called bath salts (synthetic stimulants often sold over the counter) never caught on among college students, who have a negligible rate of use.

Fading Drug Popularity

In sum, quite a number of drugs have been fading in popularity on U.S. college campuses in recent years, and a similar pattern is found among youth who do not attend college. Two of the newer drugs, synthetic marijuana and salvia, have shown steep declines in use. Other drugs are showing more gradual declines, including narcotic drugs other than heroin, sedatives and tranquilizers–all used nonmedically–as well as inhalants and hallucinogens.

On the other hand, past-year and past-month marijuana use increased from 2006 through 2013 before leveling; and daily marijuana use continues to grow, reaching the highest level seen in the past 35 years in 2014 (5.9 percent). Amphetamine use grew fairly sharply on campus between 2008 and 2012, and it then stabilized at high levels not seen since the mid-1980s.

Ecstasy use has made somewhat of a rebound since the recent low observed among college students in 2007. Cocaine use among college students is well below the 1980s and 1990s rates, but the significant increase in 2014 among college students suggests a need to watch this drug carefully in the future.

ALCOHOL AND TOBACCO

Use of a number of licit drugs is also covered in the MTF surveys, including alcoholic beverages and various tobacco products.

While 63 percent of college students in 2014 said that they have had an alcoholic beverage at least once in the prior 30 days, that figure is down a bit from 67 percent in 2000 and down considerably from 82 percent in 1981. The proportion of the nation’s college students saying they have been drunk in the past 30 days was 43 percent in 2014, down some from 48 percent in 2006.

Occasions of heavy or binge drinking–here defined as having five or more drinks in a row on at least one occasion in the prior two weeks–have consistently had a higher prevalence among college students than among their fellow high school classmates who are not in college.

Binge Drinking Declines?

Still, between 1980 and 2014, college students’ rates of such drinking declined 9 percentage points from 44 percent to 35 percent, while their noncollege peers declined 12 percentage points from 41 percent to 29 percent, and high school seniors’ rates declined 22 percentage points from 41 percent to 19 percent.

Of particular concern is the extent of extreme binge drinking in college, first defined as having 10 or more drinks in a row at least once in the prior two weeks, and then defined as having 15 or more drinks in a row in that same time interval. Based on the combined years 2005-2014, the estimates for these two behaviors among college students are 13 percent and 5 percent, respectively.

Dangerous Drinking Continues

“Despite the modest improvements in drinking alcohol at college, there are still a sizable number of students who consume alcohol at particularly dangerous levels,” Johnston said.

Cigarette smoking continued to decline among the nation’s college students in 2014, when 13 percent said they had smoked one or more cigarettes in the prior 30 days, down from 14 percent in 2013 and from the recent high of 31 percent in 1999–a decline of more than half. As for daily smoking, only 5 percent indicated smoking at that level, compared with 19 percent in 1999–a drop of nearly three fourths in the number of college students smoking daily.

“These declines in smoking at college are largely the result of fewer of these students smoking when they were still in high school,” Johnston said. “Nevertheless, it is particularly good news that their smoking rates have fallen so substantially.”

Other Smoking Increases

Unfortunately, the appreciable declines in cigarette smoking have been accompanied by some increases in the use of other forms of tobacco or nicotine. Smoking tobacco using a hookah (a type of water pipe) in the prior 12 months rose substantially among college students, from 26 percent in 2013 to 33 percent in 2014.

In 2014, the use of e-cigarettes in the past 30 days stood at 9.7 percent, while use of flavored little cigars stood at 9.8 percent, of regular little cigars at 8.6 percent and of large cigars at 8.4 percent. The study will continue tracking the extent to which these alternate forms of tobacco use are changing in popularity, not only among college students, but also among their age peers not in college and among secondary school students.

September 3rd, 2015  in Substance Abuse No Comments »

Opiate addiction spreading, becoming more complex

The growing availability of heroin, combined with programs aimed at curbing prescription painkiller abuse, may be changing the face of opiate addiction in the U.S., according to sociologists.

While heroin abuse is still relatively rare, the use of the drug is not only increasing, but it is now being coupled with the abuse of prescription painkillers, said Shannon Monnat, assistant professor of rural sociology, demography, and sociology, Penn State. She added that the heroin-prescription drug combination is also hitting groups that were not traditionally viewed as widespread opiate users.

Painkiller and Heroin Use Increasing

“One of the things we’ve found is that the simultaneous use of heroin and prescription painkillers together has increased dramatically among whites and especially among young white men,” said Monnat, who worked with Khary K. Rigg, assistant professor of mental health law and policy, University of Southern Florida.

Monnat described the recent trend as a domino effect of addiction that began in the 1980s and 1990s when the over-prescription of painkillers led to an increase in addiction to those drugs.

“Over the last several years there have been more restrictions put in place, including prescription-drug monitoring programs and the introduction of a tamper-proof opioid, making it difficult to crush, liquefy and inject the substance,” said Monnat. “What this has done is restrict access to prescription painkillers for people who previously became addicted to them. These people sometimes transition into heroin, which has become incredibly cheap and easily accessible.”

Number of Addicts Increasing

Some addicts who were introduced to heroin also turn to abusing both painkillers and heroin at the same time. While most opiate addicts are still addicted to only painkillers, the number of addicts using heroin and the number of users who are addicted to both painkillers and heroin are increasing faster than painkiller-only abusers.

“You don’t eliminate the addiction simply by eliminating access to the drug,” said Monnat. “People who are addicted to the morphine substance will find a substitute.”

The three groups of opiate abusers are distinct demographically, socioeconomically and psychologically, Monnat added. While heroin abuse is typically characterized as being a problem in black, poor and urban areas, an increasing number of heroin and painkiller-heroin addicts are white, employed and live in rural and small urban areas.

Painkiller Addicts Least Disadvantaged

The researchers, who released their findings in Addictive Behaviors, currently online, said that people who are addicted to painkillers alone tend to be the most socially connected of the three groups. Painkiller addicts are also the least socioeconomically disadvantaged and have better physical and mental health.

Professionals who treat drug addiction should recognize the unique needs of each group of addicts, according to the researchers.

Addicts At Risk

“It’s not enough to know whether someone is just using a prescription painkiller, but the practitioner would also want to know if they are using heroin,” Monnat said. “The use of heroin puts the patient at risk of all kinds of other complications, such as HIV and sexual risk-taking behaviors and a very high risk of overdose.”

The researchers used data from the 2010-2013 National Survey on Drug Use and Health. Respondents in the survey were grouped in three categories: heroin only users, prescription painkiller only users, and combination heroin and prescription painkiller users. Prescription painkiller-only users were the largest group, with 9,516 respondents. Combination heroin and prescription painkiller users were the next largest group, with 506 respondents, followed by 179 heroin-only respondents.

August 18th, 2015  in Prescription Drugs No Comments »

New therapy could ‘erase’ drug-using memories

Recovering addicts often grapple with the ghosts of their addiction–memories that tempt them to relapse even after rehabilitation and months, or even years, of drug-free living. Now, scientists from the Florida campus of The Scripps Research Institute (TSRI) have made a discovery that brings them closer to a new therapy based on selectively erasing these dangerous and tenacious drug-associated memories.

“We now have a viable target and by blocking that target, we can disrupt, and potentially erase, drug memories, leaving other memories intact,” said TSRI Associate Professor Courtney Miller. “The hope is that, when combined with traditional rehabilitation and abstinence therapies, we can reduce or eliminate relapse for meth users after a single treatment by taking away the power of an individual’s triggers.”

Injection to Prevent Relapse

The new study, published by the journal Molecular Psychiatry, demonstrates the effectiveness of a single injection of an early drug candidate called blebbistatin in preventing relapse in animal models of methamphetamine addiction.

The new study builds on previous work in Miller’s lab. In 2013, the team made the surprising discovery that drug-associated memories could be selectively erased by targeting actin, the protein that provides the structural scaffold supporting memories in the brain. However, the therapeutic potential of the finding seemed limited by the problem that actin is critically important throughout the body–taking a pill that generally inhibits actin, even once, would likely be fatal.

Blebbistatin May Block Drug Memories

In the new study, Miller and her colleagues report a major advance–the discovery of a safe route to selectively targeting brain actin through nonmuscle myosin II (NMII), a molecular motor that supports memory formation. To accomplish this, the researchers used a compound called blebbistatin that acts on this protein.

The results showed that a single injection of blebbistatin successfully disrupted long-term storage of drug-related memories–and blocked relapse for at least a month in animal models of methamphetamine addiction.

“What makes myosin II such an exciting therapeutic target is that a single injection of blebbistatin makes methamphetamine-associated memories go away, along with dendritic spines, the structures in the brain that store memory,” said Research Associate Erica Young, a member of the Miller lab and a key author of the new study, along with Research Associates Ashley M. Blouin and Sherri B. Briggs.

Other Memories Left Intact

Blouin added, “Drugs targeting actin usually have to be delivered directly into the brain. But blebbistatin reaches the brain even when injected into the body’s periphery and, importantly, the animals remained healthy.”

Moreover, the effect of this novel treatment approach was specific to drug-associated memories (not affecting other memories), and the animals were still able to form new recollections.

“Our results argue for developing small molecule inhibitors of nonmuscle myosin II as potential therapeutics for relapse prevention, and that’s exactly what we’re doing with our colleagues here at Scripps with expertise in drug development,” said Briggs.

August 8th, 2015  in Substance Abuse No Comments »