Substance Abuse News

In a 1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence, Inc. (NCADD) and the American Society of Addiction Medicine (ASAM) published this definition for alcoholism:

“Alcoholism is a primary chronic disease with genetic, psychosocial and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic.”

To dispel any uncertainty about the serious harm caused by smoking to babies and pregnant women, the first-ever comprehensive systematic review of all studies over the past 50 years has established clearly that maternal smoking causes a range of serious birth defects including heart defects, missing/deformed limbs, clubfoot, gastrointestinal disorders, and facial disorders (for example, of the eyes and cleft lip/palate).

Smoking during pregnancy is also a risk factor for premature birth, says Dr. Michael Katz, senior Vice President for Research and Global Programs of the March of Dimes. He says the March of Dimes urges all women planning a pregnancy or who are pregnant to quit smoking now to reduce their chance of having a baby born prematurely or with a serious birth defect.

Serious Health Problems

Babies who survive being born prematurely and at low birthweight are at risk of other serious health problems, Dr. Katz notes, including lifelong disabilities such as cerebral palsy, intellectual disabilities and learning problems. Smoking also can make it harder to get pregnant, and increases the risk of stillbirth.

About 20 percent of women in the United States reported smoking in 2009. Around the world, about 250 million women use tobacco every day and this number is increasing rapidly, according to data presented at the 2009 14th World Conference on Tobacco or Health in Mumbai.

The new study, “Maternal smoking in pregnancy and birth defects: a systematic review based on 173,687 malformed cases and 11.7 million controls,” by a team led by Allan Hackshaw, Cancer Research UK & UCL Cancer Trials Centre, University College London, will be published online today in Human Reproduction Update from the European Society of Human Reproduction and Embryology.

Dangerous Chemicals

When women smoke during pregnancy, the unborn baby is exposed to dangerous chemicals like nicotine, carbon monoxide and tar, Dr. Katz says. These chemicals can deprive the baby of oxygen needed for healthy growth and development.

During pregnancy, smoking can cause problems for a woman’s own health, including:

• ectopic pregnancy;
• vaginal bleeding;
• placental abruption, in which the placenta peels away, partially or almost completely, from the uterine wall before delivery;
• placenta previa, a low-lying placenta that covers part or all of the opening of the uterus.

Smoking is also known to cause cancer, heart disease, stroke, gum disease and eye diseases that can lead to blindness.

A study by University of Washington psychologists shows some people continue to drink heavily because of perceived positive effects, despite experiencing negative effects such as hangovers, fights and regrettable sexual situations.

According to participants in the study, boosts of courage, chattiness and other social benefits of drinking outweigh its harms, which they generally did not consider as strong deterrents.

‘Not Going to Happen to Me’

The findings offer a new direction for programs targeting binge drinking, which tend to limit their focus to avoiding alcohol’s ill effects rather than considering its rewards.

“This study suggest why some people can experience a lot of bad consequences of drinking but not change their behavior,” said Kevin King, co-author and UW assistant professor of psychology.

“People think, ‘It’s not going to happen to me’ or ‘I’ll never drink that much again.’ They do not seem to associate their own heavy drinking with negative consequences,” he said.

The paper was published online May 30 in Psychology of Addictive Behaviors.

500 Students Surveyed

Nearly 500 college students completed an online survey measuring their drinking habits during the previous year. The survey assessed how often the participants had experienced 35 different negative consequences of drinking, such as blackouts, fights, hangovers, missed classes and work, and lost or stolen belongings, as well as 14 positive effects of drinking, including better conversational and joke-telling abilities, improved sexual encounters and more energy to stay up late partying and dancing.

The researchers also measured the participants’ beliefs about how likely all of these drinking consequences would happen again and how positive or negative they were.

Participants rated the upsides to drinking as more positive and likely to happen in the future, a finding the researchers call “rose-colored beer goggles.”

Keeps Getting Better?

“It’s as though they think that the good effects of drinking keep getting better and more likely to happen again,” said Diane Logan, lead author and a UW clinical psychology graduate student.

Respondents’ perceptions of drinking’s negative consequences differed according to how many bad experiences they had had. Those who experienced a small to moderate number of ill effects of drinking did not consider the experiences to be not so bad and did not think that they were any more likely to experience them again compared with students who hadn’t experienced them.

The researchers call this cognitive-dissonance reasoning. It leads to people, on the morning after a night of heavy partying, telling themselves “I’ll never drink that much again” or “I threw up that one time, but that’s not me; I won’t do it again.” Or, it may be that once a bad consequence of drinking happens, people think that it wasn’t really as bad as they initially thought, the researchers speculated.

But the participants reporting the most bad experiences rated the episodes as more negative and more likely to happen again. “Until high levels of negative consequences are experienced, participants aren’t deterred by the ill effects of drinking,” Logan said.

Focusing on Drinking Consequences

The findings have implications for alcohol intervention programs for college students, which tend to focus on how to avoid the negative consequences of drinking. “We should take into account how people don’t think of negative consequences as all that bad or likely to happen again,” Logan said, adding that factoring in how people view alcohol’s positive effects “might have a bigger impact” on drinking habits.

She suggests a risk reduction approach by helping people reduce their drinking such that they still get some of the positive effects while avoiding many of the negative and recommends training exercises to increase social skills in the absence of alcohol.

The National Institute on Alcohol Abuse and Alcoholism funded the study. Co-authors are Teague Henry, a UW psychology undergraduate student; Matthew Vaughn, a former UW psychology undergraduate student; and Jeremy Luk, a UW psychology graduate student.

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.

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.

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.”

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.

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.

Teenagers who drink alcohol spend more time on their computers for recreational use, including social networking and downloading and listening to music, compared with their peers who don’t drink.

Results of an anonymous survey of 264 teenagers were reported in the online edition of the journal Addictive Behaviors in a study authored by Weill Cornell Medical College public health researcher Dr. Jennifer Epstein.

Early Exposure to the Internet

“While the specific factors linking teenage drinking and computer use are not yet established, it seems likely that adolescents are experimenting with drinking and activities on the Internet. In turn, exposure to online material such as alcohol advertising or alcohol-using peers on social networking sites could reinforce teens’ drinking,” says Dr. Epstein, assistant professor of public health at Weill Cornell Medical College. “Children are being exposed to computers and the Internet at younger ages. For this reason it’s important that parents are actively involved in monitoring their children’s computer usage, as well as alcohol use.

“According to a national study conducted by the Pew Internet and American Life Project, more than half of parents of teenagers had filters installed on the computers their child uses to block content parents find objectionable, yet many parents do not use any form of parental monitoring, particularly for older teens,” continues Dr. Epstein.

Drinking Linked to Computer Use

The Weill Cornell survey was completed by participants aged 13 to 17 and residing in the United States. Results showed that teens who reported drinking in the last month used a computer more hours per week excluding school work than those who did not; however, there was no demonstrated link between alcohol use and computer use for school work. Drinking was also linked to more frequent social networking and listening to and downloading music. There was no strong link between video games and drinking or online shopping and drinking.

“Going forward, we would like to collect more detailed and longer-term data on adolescent alcohol and computer use, including the degree and duration of their drinking habit,” says Dr. Epstein.

Teenagers typically first experiment with alcohol at age 12 or 13. Family risk factors include lax parental supervision and poor communication, family conflicts, inconsistent or harsh discipline and a family history of alcohol or drug abuse.

Impact of New Media

“Parents may also need to reinforce their family ground rules on alcohol use and computer use,” Dr. Epstein says.

“This is an innovative study that is an important first step to understanding the potential impact that the Internet and new media may have on today’s youth,” says Dr. Gil Botvin, professor of public health and chief of the Division of Prevention and Health Behavior at Weill Cornell Medical College. “The Internet offers a wealth of information and opportunities for intellectual and social enrichment. However, it is becoming clear that there may also be a downside to Internet use. More systematic research is needed to better understand to those potential dangers and how to combat them.”

ncreasing access to rogue online pharmacies – those which dispense medications without a doctor’s prescription – may be an important factor behind the rapid increase in the abuse of prescription drugs. In a report in the journal Health Affairs, investigators from Massachusetts General Hospital (MGH) and the University of Southern California (USC) find that states with the greatest expansion in high-speed Internet access from 2000 to 2007 also had the largest increase in admissions for treatment of prescription drug abuse.

Internet Growth a Factor

“We know we face a growing problem with prescription drug abuse in the United States. One need only look at statistics for college campuses, where prescription drugs are fast replacing illegal substances, to see the magnitude of the problem,” says Dana Goldman, PhD, director of the Schaeffer Center for Health Policy and Economics at USC, the study’s senior author. “Our findings suggest that Internet growth may partly explain the increase in prescription drug abuse, since it is well known that these drugs are easily available online.” Goldman is also the Norman Topping/National Medical Enterprises Chair in Medicine and Public Policy at USC.

In their report, Goldman and lead author Anupam B. Jena, MD, PhD, of the MGH Department of Medicine, note that the recent marked rise in the abuse of prescription narcotic painkillers – drugs like Percocet and Oxycontin – corresponds with an increase in the presence of online pharmacies, many of which do not adhere to regulations requiring a physician’s prescription. Drugs that are frequently abused – painkillers, stimulants, sedatives and tranquilizers – often can be purchased from rogue sites that may be located outside the U.S. The current study was designed to examine the potential link between online availability and prescription drug abuse, an association that has been suspected but not investigated in depth.

Increase in High-Speed Access

Using data available from the Federal Communications Commission, the researchers first compiled statistics on access to high-speed Internet service in each state during the years studied. Since actual rates of prescription drug abuse would be difficult if not impossible to calculate, they used information on admissions to substance abuse treatment facilities from a database maintained by the U.S. Substance Abuse and Mental Health Administration.

Changes in both measures over the seven years were analyzed on a per-state basis, and treatment admissions were categorized by the particular types of abused substances involved.

No Increase in Illegal Drug Use

The analysis indicated that each 10 percent increase in the availability of high-speed Internet service in a state was accompanied by an approximately 1 percent increase in admissions for prescription drug abuse. The increases were strongest for narcotic painkillers, followed by anti-anxiety drugs, stimulants and sedatives. During the same period admissions to treat abuse of alcohol, heroin or cocaine, substances not available online, showed minimal growth or actually decreased.

“The lack of an increase in abuse of drugs not available on the Internet suggests that an overall growth in drug-seeking behavior cannot explain the rise in prescription drug abuse,” Jena says. “Further studies need to better evaluate how easily commonly abused prescription drugs can be purchased online and explore the importance to the problem of foreign Internet pharmacies, which are outside the jurisdiction of the U.S. government.”