Telephone counseling might be an effective primary care intervention for men who are not seeking treatment for their alcohol dependence or abuse, according to a new study.
Men benefited more from the short-term telephone counseling used in the study, which appears in the August issue of the journal Alcoholism: Clinical and Experimental Research.
Lead researcher Richard Brown, M.D., said that the study could empower time-strapped doctors to persuade reluctant alcoholism patients to seek treatment.
"The study shows that we shouldn't just give up on those alcohol-dependent patients who cannot or choose not to get treatment. If we can identify these folks in primary care waiting rooms and provide telephone counseling ??¦ we can start to help many of these patients," said Brown, of the University of Wisconsin School of Medicine and Public Health.
The researchers looked at nearly 900 men and women with alcohol abuse or dependence, recruiting study participants from primary care clinic waiting rooms in Madison and Milwaukee. The 445 people in the experimental group received up to six protocol-based phone interventions from counselors trained in a technique called motivational interviewing. The 452 members of the control group received a short pamphlet on healthy lifestyles.
Enrollment in the study was voluntary, and the researchers paid patients a small fee at each step; no participant earned more than $125. Members of the experimental group had assigned counselors who helped them identify their goals and examine how their alcohol use affected the achievement of those goals. Counselors gave feedback on the pitfalls and ramifications of alcohol use.
"Getting patients to participate in the counseling sessions was actually much easier than we thought it would be," Brown said. "Once they had established rapport with that counselor over the phone, many patients really looked forward to their sessions."
Of particular interest was the experimental treatment's effect on men with alcohol dependence, which unlike alcohol abuse results in changes in brain physiology. Alcohol-dependent men receiving the counseling reduced both their total alcohol consumption and "risky drinking days" over a three-month period, with risky drinking days declining the most, by 31.8 percent. Peers who received only the self-help literature cut back by 9.7 percent over the same period.
Women who received phone counseling reduced their drinking behaviors as well, but their improvements were not significantly different from those achieved by women in the control group.
Petros Levounis, M.D., director of the Addiction Institute of New York at St. Luke's and Roosevelt Hospitals, agreed with the study conclusions. "This is exactly the direction that we should be working toward. We can actually help our patients through the phone and provide support and counseling with different methods, not just with the more traditional one-to-one psychotherapy." Levounis, who was not involved with the study, said the prevalence of alcohol disorders makes screening and brief intervention in primary care settings necessary.
The authors noted that the study enrollment interview itself had an effect on drinking behaviors independent of the counseling intervention and said that patient tracking and follow-up posed a challenge. The researchers are currently studying the durability of treatment benefits over a 12-month period.
Brown RL, et al. Randomized controlled trial of a telephone and mail intervention for alcohol use disorders: three-month drinking outcomes. Alcoholism: Clinical and Experimental Research 31(8), 2007.
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
hbns
понедельник, 20 июня 2011 г.
воскресенье, 19 июня 2011 г.
The risks and benefits of drinking alcohol, Royal Society of Medicine conference. 30 Sept-1 Oct
The risks and benefits of drinking alcohol
Scientists, doctors and the media have taken two sides to the debate over the positive and negative effects of alcohol consumption. While excessive drinking can lead to a number of health problems, recent studies have revealed that a daily moderate intake of alcohol may decrease the risk of cardiovascular disease and diabetes and may help to ward of Alzheimer's disease and other types of dementia. Genetic variations and predisposition have major input into the effects on the individual. At the Drinking Alcohol: Risks & Benefits conference at the Royal Society of Medicine on 30 September - 1 October, speakers will discuss the benefits of moderate alcohol consumption, the health problems associated with drinking and the various external factors affecting our decision to drink in both the UK and Sweden.
The role of alcohol marketing
Professor Gerard Hastings, University of Strathclyde
Alcohol companies work hard to market their products to the public, with their efforts being increasingly focused on young people. Professor Hastings will discuss the impact alcohol marketing - mass media advertising, in particular - on individuals and the collective population.
Psychological benefits of alcohol
Dr Lars Hokan Nilsson, Uppsala University Hospital
The diagnosis of alcohol dependence is defined as a pattern of impaired control over substance abuse. The diagnosis of substance abuse, however, is defined as adverse consequences of drinking or use of drugs, but only in the absence of dependence. This paradox leads to the question: why do people engage in the self-destructive act of alcohol abuse? Many experts have emphasized the importance of socio-economic influences, but the results of some studies have disproved this link. Dr Nilsson, a chief consultant in addiction psychiatry, will investigate the biological argument for substance abuse and dependence. He will emphasise the brain's responses to drinking, the role of neurotransmitters and our own psychological expectations when deciding to drink. These findings are being used to identify and treat alcohol dependence and abuse.
Population drinking and resulting damage
Professor Thor Norstrom, Stockholm University
The development of a 'total consumption model,' associating population drinking with alcohol-related harm has been created from the Northern European drinking patterns and the relationship to chronic outcomes such as liver cirrhosis. Professor Norstrom will present the latest findings that more comprehensively represent geography and possible outcomes. The public health perspective of alcohol consumption is supported by his information that per capita intake has the most influence on alcohol-related harm, but a society's drinking culture and patterns can affect the impact of this harm on a population.
Cardiovascular benefits of alcohol
Professor Anders Waldenstrom
Epidemiological studies imply that alcohol beverages may have protective effects on coronary artery disease and stroke. These conclusions are drawn from death rates when comparing risks for coronary artery disease in people consuming small to moderate amounts of alcohol and those who don't drink at all.
Other related articles
Drinking Alcohol And Benefits
This relationship has been described as a J-shaped curve which means that the risk is highest for those that drink a lot, lower for those that drink moderately and higher again for those that abstain from drinking alcoholic beverages. A protective effect has been claimed for most types of alcoholic beverages and many possible mechanisms have been suggested. Professor Waldenstrom will talk in detail about the difficulties in interpreting published studies.
The Royal Society of Medicine
rsm.ac
Scientists, doctors and the media have taken two sides to the debate over the positive and negative effects of alcohol consumption. While excessive drinking can lead to a number of health problems, recent studies have revealed that a daily moderate intake of alcohol may decrease the risk of cardiovascular disease and diabetes and may help to ward of Alzheimer's disease and other types of dementia. Genetic variations and predisposition have major input into the effects on the individual. At the Drinking Alcohol: Risks & Benefits conference at the Royal Society of Medicine on 30 September - 1 October, speakers will discuss the benefits of moderate alcohol consumption, the health problems associated with drinking and the various external factors affecting our decision to drink in both the UK and Sweden.
The role of alcohol marketing
Professor Gerard Hastings, University of Strathclyde
Alcohol companies work hard to market their products to the public, with their efforts being increasingly focused on young people. Professor Hastings will discuss the impact alcohol marketing - mass media advertising, in particular - on individuals and the collective population.
Psychological benefits of alcohol
Dr Lars Hokan Nilsson, Uppsala University Hospital
The diagnosis of alcohol dependence is defined as a pattern of impaired control over substance abuse. The diagnosis of substance abuse, however, is defined as adverse consequences of drinking or use of drugs, but only in the absence of dependence. This paradox leads to the question: why do people engage in the self-destructive act of alcohol abuse? Many experts have emphasized the importance of socio-economic influences, but the results of some studies have disproved this link. Dr Nilsson, a chief consultant in addiction psychiatry, will investigate the biological argument for substance abuse and dependence. He will emphasise the brain's responses to drinking, the role of neurotransmitters and our own psychological expectations when deciding to drink. These findings are being used to identify and treat alcohol dependence and abuse.
Population drinking and resulting damage
Professor Thor Norstrom, Stockholm University
The development of a 'total consumption model,' associating population drinking with alcohol-related harm has been created from the Northern European drinking patterns and the relationship to chronic outcomes such as liver cirrhosis. Professor Norstrom will present the latest findings that more comprehensively represent geography and possible outcomes. The public health perspective of alcohol consumption is supported by his information that per capita intake has the most influence on alcohol-related harm, but a society's drinking culture and patterns can affect the impact of this harm on a population.
Cardiovascular benefits of alcohol
Professor Anders Waldenstrom
Epidemiological studies imply that alcohol beverages may have protective effects on coronary artery disease and stroke. These conclusions are drawn from death rates when comparing risks for coronary artery disease in people consuming small to moderate amounts of alcohol and those who don't drink at all.
Other related articles
Drinking Alcohol And Benefits
This relationship has been described as a J-shaped curve which means that the risk is highest for those that drink a lot, lower for those that drink moderately and higher again for those that abstain from drinking alcoholic beverages. A protective effect has been claimed for most types of alcoholic beverages and many possible mechanisms have been suggested. Professor Waldenstrom will talk in detail about the difficulties in interpreting published studies.
The Royal Society of Medicine
rsm.ac
суббота, 18 июня 2011 г.
How Strong Is Your Booze? True Strength Of Alcohol Revealed By New Portable Device
Both legitimate brewers and distillers and authorities on the track of illicit alcohol from home stills will soon have a helping hand. Measurement experts have unveiled a portable device to determine the strength of alcoholic drinks quickly and easily, almost anywhere. Published in the open access Chemistry Central Journal, the researchers show that their technique is just as accurate, and more sophisticated, than widely used lab-based methods.
Along with his colleagues, Dirk Lachenmeier of testing agency Chemisches und Veterin?¤runtersuchungsamt (CVUA) in Karlsruhe, Germany, decided to use a simple, patented multiple-beam infrared sensor combined with a flow-through cell for automated alcohol analysis. His team tested the device, which is portable to allow for on-site measurements, on a range of alcoholic samples.
Their tests on 260 different alcoholic drinks showed that the flow-through infrared device was much easier to handle than typical reference procedures, while time-consuming sample preparation steps such as distillation weren't necessary. Their sensor was equal to or better than current densimetric or Fourier transform infrared (FTIR) methods: repeatability, as determined in six different wine samples, was 0.05% vol and the relative standard deviation was below 0.2%. They also tested wines partway through the fermentation process, and unrecorded (non-commercial or illicit) alcohol samples, with good results. The test took less than a minute per drink.
"The device gives the opportunity for mobile on-site control in the context of labeling control of wine, beer and spirits, the process monitoring of fermentations, or the evaluation of unrecorded alcohols," says Lachenmeier. He adds that the device can also be used easily in developing country settings, with results that compare well to a more sophisticated lab set up.
Only beers and other sparkling drinks need more time-consuming preparation, to first remove the fizz, which can interfere with measurements.
The authors say that not only does unrecorded alcohol account for a quarter of all alcohol consumed worldwide, but in most cases, "not even the most basic chemical composition such as alcoholic strength is known for these beverages."
Ever since French chemist Gay-Lussac's work on alcohol-water mixtures, scientists have measured alcoholic strength by volume (% vol) using distillation and then a pycnometer to measure the liquid's density. Infrared spectroscopy is a more recent, popular method, but typically requires expensive equipment, and complicated calibration.
Source: BioMed Central Limited
Along with his colleagues, Dirk Lachenmeier of testing agency Chemisches und Veterin?¤runtersuchungsamt (CVUA) in Karlsruhe, Germany, decided to use a simple, patented multiple-beam infrared sensor combined with a flow-through cell for automated alcohol analysis. His team tested the device, which is portable to allow for on-site measurements, on a range of alcoholic samples.
Their tests on 260 different alcoholic drinks showed that the flow-through infrared device was much easier to handle than typical reference procedures, while time-consuming sample preparation steps such as distillation weren't necessary. Their sensor was equal to or better than current densimetric or Fourier transform infrared (FTIR) methods: repeatability, as determined in six different wine samples, was 0.05% vol and the relative standard deviation was below 0.2%. They also tested wines partway through the fermentation process, and unrecorded (non-commercial or illicit) alcohol samples, with good results. The test took less than a minute per drink.
"The device gives the opportunity for mobile on-site control in the context of labeling control of wine, beer and spirits, the process monitoring of fermentations, or the evaluation of unrecorded alcohols," says Lachenmeier. He adds that the device can also be used easily in developing country settings, with results that compare well to a more sophisticated lab set up.
Only beers and other sparkling drinks need more time-consuming preparation, to first remove the fizz, which can interfere with measurements.
The authors say that not only does unrecorded alcohol account for a quarter of all alcohol consumed worldwide, but in most cases, "not even the most basic chemical composition such as alcoholic strength is known for these beverages."
Ever since French chemist Gay-Lussac's work on alcohol-water mixtures, scientists have measured alcoholic strength by volume (% vol) using distillation and then a pycnometer to measure the liquid's density. Infrared spectroscopy is a more recent, popular method, but typically requires expensive equipment, and complicated calibration.
Source: BioMed Central Limited
пятница, 17 июня 2011 г.
Identification Of Distinctive Gene Expression In Brains Of Relapsing Heroin-Addicted Rats
A group of genes whose expression is significantly altered following exposure to drug paraphernalia after an enforced 'cold-turkey' period have been identified. Researchers writing in the open access journal BMC Neuroscience studied gene expression in the brains of heroin-addicted rats, identifying those genes that may be involved in precipitating a relapse.
Kara Kuntz-Melcavage, from Pennsylvania State University College of Medicine, USA, is part of a team of researchers who carried out the experiments. She said, "A number of gene expression studies have investigated changes induced by drug exposure, but few reports describe changes associated with the mental state that leads to relapse. We identified 66 genes involved in the relapse response, including some that are important for neuroplasticity, and through that role may impact learning and behavior".
Kuntz-Melcavage and her colleagues attached rats to a drug supply that for 3 hours each day delivered heroin into their jugular veins when they licked a particular empty spout. Over a two-week period, these animals were free to self-administer heroin, while control rats to whom they were linked received saline instead. One group of addicted rats and their yoked non-addicted partners were then kept without heroin for two weeks before being re-exposed to the spout, which no longer yielded drug infusions. After 90 minutes in this narcotic-associated environment, during which the addicted rats compulsively returned to lick the unrewarding empty spout, they and their yoked control mates were humanely killed and gene expression in their brains was studied. By comparing the gene expression in the drug-seeking animals with that in a second group of addicted rats re-exposed to the narcotic environment after only one day of abstinence, and with the saline-yoked controls, the researchers were able to identify genes involved in relapse behavior. According to Kuntz-Melcavage, "The session with the inactive spout served not only to provide an opportunity to observe drug-seeking behavior, but also mimicked a real-life situation in which environmental cues precipitate relapse behavior following an extended period of abstinence".
Speaking about the results of the study, Kuntz-Melcavage said, "As data accumulate, the existence of a single 'relapse gene' is looking increasingly unlikely - it is likely to be a constellation of different genes. Therefore, large scale views of gene expression, like this one, will prove very useful for guiding research into human drug-associated behavior".
Notes:
Gene expression changes following extinction testing in a heroin behavioral incubation model
Kara L Kuntz-Melcavage, Robert M Brucklacher, Patricia S Grigson, Willard M Freeman and Kent E Vrana
BMC Neuroscience (in press)
biomedcentral/bmcneurosci/
Source:
Graeme Baldwin
BioMed Central
Kara Kuntz-Melcavage, from Pennsylvania State University College of Medicine, USA, is part of a team of researchers who carried out the experiments. She said, "A number of gene expression studies have investigated changes induced by drug exposure, but few reports describe changes associated with the mental state that leads to relapse. We identified 66 genes involved in the relapse response, including some that are important for neuroplasticity, and through that role may impact learning and behavior".
Kuntz-Melcavage and her colleagues attached rats to a drug supply that for 3 hours each day delivered heroin into their jugular veins when they licked a particular empty spout. Over a two-week period, these animals were free to self-administer heroin, while control rats to whom they were linked received saline instead. One group of addicted rats and their yoked non-addicted partners were then kept without heroin for two weeks before being re-exposed to the spout, which no longer yielded drug infusions. After 90 minutes in this narcotic-associated environment, during which the addicted rats compulsively returned to lick the unrewarding empty spout, they and their yoked control mates were humanely killed and gene expression in their brains was studied. By comparing the gene expression in the drug-seeking animals with that in a second group of addicted rats re-exposed to the narcotic environment after only one day of abstinence, and with the saline-yoked controls, the researchers were able to identify genes involved in relapse behavior. According to Kuntz-Melcavage, "The session with the inactive spout served not only to provide an opportunity to observe drug-seeking behavior, but also mimicked a real-life situation in which environmental cues precipitate relapse behavior following an extended period of abstinence".
Speaking about the results of the study, Kuntz-Melcavage said, "As data accumulate, the existence of a single 'relapse gene' is looking increasingly unlikely - it is likely to be a constellation of different genes. Therefore, large scale views of gene expression, like this one, will prove very useful for guiding research into human drug-associated behavior".
Notes:
Gene expression changes following extinction testing in a heroin behavioral incubation model
Kara L Kuntz-Melcavage, Robert M Brucklacher, Patricia S Grigson, Willard M Freeman and Kent E Vrana
BMC Neuroscience (in press)
biomedcentral/bmcneurosci/
Source:
Graeme Baldwin
BioMed Central
четверг, 16 июня 2011 г.
National Institute On Drug Abuse To Highlight Latest Drug Abuse Research At Cincinnati Conference
The National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health, will convene a 2-day conference to explore how the latest scientific findings in drug abuse can fill the current gap between research and clinical treatment practices. The conference is part of NIDA's Blending Initiative, designed to stimulate engaging dialogue between those who work with substance abusers in communities with those engaged in the latest treatment research.
Targeting treatment professionals in the Ohio/Pennsylvania region, the Blending conference will equip participants with evidence based tools to use in their community-based practices, and will give treatment professionals an opportunity to share real-life challenges with researchers. The conference highlights NIDA's involvement as a crucial resource and partner for making the best drug addiction treatments available to those who need them.
What: Blending Science and Treatment: The Impact of Evidence-Based Practices on Individuals, Families, and Communities
When: Monday, June 2, 2008
9:00 a.m. - 5:30 p.m.
Tuesday, June 3, 2008
9:00 a.m. - 5:30 p.m.
Where: Duke Energy Center
525 Elm Street
Cincinnati, OH 45202
Who: Featured Speakers
Dr. Nora D. Volkow, Director, NIDA
Info: Topics that will be covered include, but are not limited to, the following:
- Addiction and the Brain
- Co-Occurring Psychiatric and Substance Use Disorders
- Addiction Treatments of the Future: The Role of Genetics
- Challenges in Determining, Implementing, and Sustaining Best Practices in Criminal Justice
- Community Reinforcement Approach and Family Training
For registration, please visit this link.
Interview opportunities with some of the world's top treatment researchers will be available. A full agenda and speaker list is available here.
Additional NIDA-related events open to media include a reception and screening of the HBO Emmy Award winning documentary, "Addiction,"which wasproduced in partnership with the Robert Wood Johnson Foundation, NIDA, and the National Institute on Alcohol Abuse and Alcoholism (NIAAA); and a student conversation at Walnut Hills High School where NIDA Director Dr. Volkow will engage students in a practical discussion on drug abuse and addiction.
The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at drugabuse..
National Institute on Drug Abuse
Targeting treatment professionals in the Ohio/Pennsylvania region, the Blending conference will equip participants with evidence based tools to use in their community-based practices, and will give treatment professionals an opportunity to share real-life challenges with researchers. The conference highlights NIDA's involvement as a crucial resource and partner for making the best drug addiction treatments available to those who need them.
What: Blending Science and Treatment: The Impact of Evidence-Based Practices on Individuals, Families, and Communities
When: Monday, June 2, 2008
9:00 a.m. - 5:30 p.m.
Tuesday, June 3, 2008
9:00 a.m. - 5:30 p.m.
Where: Duke Energy Center
525 Elm Street
Cincinnati, OH 45202
Who: Featured Speakers
Dr. Nora D. Volkow, Director, NIDA
Info: Topics that will be covered include, but are not limited to, the following:
- Addiction and the Brain
- Co-Occurring Psychiatric and Substance Use Disorders
- Addiction Treatments of the Future: The Role of Genetics
- Challenges in Determining, Implementing, and Sustaining Best Practices in Criminal Justice
- Community Reinforcement Approach and Family Training
For registration, please visit this link.
Interview opportunities with some of the world's top treatment researchers will be available. A full agenda and speaker list is available here.
Additional NIDA-related events open to media include a reception and screening of the HBO Emmy Award winning documentary, "Addiction,"which wasproduced in partnership with the Robert Wood Johnson Foundation, NIDA, and the National Institute on Alcohol Abuse and Alcoholism (NIAAA); and a student conversation at Walnut Hills High School where NIDA Director Dr. Volkow will engage students in a practical discussion on drug abuse and addiction.
The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at drugabuse..
National Institute on Drug Abuse
среда, 15 июня 2011 г.
Risk of death among homeless women
Homeless people are at high risk for illness and have higher death rates than the general population.
From the Women's Health Program, University Health Network (Cheung), the Inner City Health Research Unit, St. Michael's Hospital (Hwang), and the Department of Medicine, University of Toronto (Cheung, Hwang), Toronto, Ont.
Abstract
Background:
Homeless people are at high risk for illness and have higher death rates than the general population. Patterns of mortality among homeless men have been investigated, but less attention has been given to mortality rates among homeless women.
We report mortality rates and causes of death in a cohort of women who used homeless shelters in Toronto. We also compare our results with those of other published studies of homeless women and with data for women in the general population.
Methods:
A cohort of 1981 women not accompanied by dependent children who used homeless shelters in Toronto in 1995 was observed for death over a mean of 2.6 years. In addition, we analyzed data from published studies of mortality rates among homeless women in 6 other cities (Montreal, Copenhagen, Boston, New York, Philadelphia and Brighton, UK).
Results:
In Toronto, mortality rates were 515 per 100 000 person-years among homeless women 18-44 years of age and 438 per 100 000 person-years among those 45-64 years of age. Homeless women 18-44 years of age were 10 times more likely to die than women in the general population of Toronto.
In studies from a total of 7 cities, the risk of death among homeless women was greater than that among women in the general population by a factor of 4.6 to 31.2 in the younger age group and 1.0 to 2.0 in the older age group. In 6 of the 7 cities, the mortality rates among younger homeless women and younger homeless men were not significantly different.
In contrast, in 4 of the 6 cities, the mortality rates were significantly lower among older homeless women than among older homeless men.
Interpretation:
Excess mortality is far greater among homeless women under age 45 years than among older homeless women. Mortality rates among younger homeless women often approach or equal those of younger homeless men. Efforts to reduce deaths of homeless women should focus on those under age 45.
Homelessness is an important problem in the United States, Canada and the United Kingdom. Earlier studies have documented the high burden of illness among homeless people due to mental illness and addictions, medical conditions, tuberculosis and HIV infection, and traumatic injuries. These illnesses, in conjunction with severe poverty and often inadequate access to health care, lead to high mortality rates among homeless people.
Previous studies have focused on excess mortality observed among homeless people relative to their counterparts in the general population.
In Philadelphia, the mortality rate among homeless adults was 3.5 times higher than the rate in the general population. In a study of homeless people in Boston, mortality rates among men were 5.9, 3.0 and 1.6 times higher than those in the general population for people 18-24, 25-44 and 45-64 years of age respectively.
A study of people using homeless shelters in New York found age-adjusted death rates 2 to 3 times higher than those in the city's general population. Among men using homeless shelters in Toronto, mortality rates were 8.3, 3.7 and 2.3 times higher than rates among men in the general population aged 18-24, 25-44 and 45-64 years respectively.
Although a significant proportion of homeless people are women, relatively little attention has been focused on patterns of mortality in this subgroup. Among homeless people, single men, single women and women accompanied by children tend to have different health problems.
For example, the prevalence of substance abuse is lower among homeless single women than among homeless single men, but the rate of major depression is higher.
Such differences may have an effect on mortality rates. In this study, we focus on homeless single women, who tend to have more health problems than homeless women accompanied by children.
In the general population, mortality rates among younger women are one-third to one-half those among younger men. Low socioeconomic status is strongly associated with shorter life expectancy, but within every socioeconomic stratum women have a longer life expectancy than men do.
Whether this survival advantage is attenuated or lost altogether among homeless women is an important question, because the underlying mechanisms (e.g., addictions leading to drug overdose, or depression leading to suicide) might be amenable to targeted intervention.
We therefore conducted this study to determine whether homeless women lose the survival advantage associated with being female.
Our first objective was to determine mortality rates among women who use homeless shelters in Toronto. Our second objective was to analyze published data on mortality rates among homeless women compared with those among women in the general population and among homeless men.
To continue reading this report go to the Canadian Medical Association web site page:
cmaj.ca/cgi/content/full/170/8/1243
From the Women's Health Program, University Health Network (Cheung), the Inner City Health Research Unit, St. Michael's Hospital (Hwang), and the Department of Medicine, University of Toronto (Cheung, Hwang), Toronto, Ont.
Abstract
Background:
Homeless people are at high risk for illness and have higher death rates than the general population. Patterns of mortality among homeless men have been investigated, but less attention has been given to mortality rates among homeless women.
We report mortality rates and causes of death in a cohort of women who used homeless shelters in Toronto. We also compare our results with those of other published studies of homeless women and with data for women in the general population.
Methods:
A cohort of 1981 women not accompanied by dependent children who used homeless shelters in Toronto in 1995 was observed for death over a mean of 2.6 years. In addition, we analyzed data from published studies of mortality rates among homeless women in 6 other cities (Montreal, Copenhagen, Boston, New York, Philadelphia and Brighton, UK).
Results:
In Toronto, mortality rates were 515 per 100 000 person-years among homeless women 18-44 years of age and 438 per 100 000 person-years among those 45-64 years of age. Homeless women 18-44 years of age were 10 times more likely to die than women in the general population of Toronto.
In studies from a total of 7 cities, the risk of death among homeless women was greater than that among women in the general population by a factor of 4.6 to 31.2 in the younger age group and 1.0 to 2.0 in the older age group. In 6 of the 7 cities, the mortality rates among younger homeless women and younger homeless men were not significantly different.
In contrast, in 4 of the 6 cities, the mortality rates were significantly lower among older homeless women than among older homeless men.
Interpretation:
Excess mortality is far greater among homeless women under age 45 years than among older homeless women. Mortality rates among younger homeless women often approach or equal those of younger homeless men. Efforts to reduce deaths of homeless women should focus on those under age 45.
Homelessness is an important problem in the United States, Canada and the United Kingdom. Earlier studies have documented the high burden of illness among homeless people due to mental illness and addictions, medical conditions, tuberculosis and HIV infection, and traumatic injuries. These illnesses, in conjunction with severe poverty and often inadequate access to health care, lead to high mortality rates among homeless people.
Previous studies have focused on excess mortality observed among homeless people relative to their counterparts in the general population.
In Philadelphia, the mortality rate among homeless adults was 3.5 times higher than the rate in the general population. In a study of homeless people in Boston, mortality rates among men were 5.9, 3.0 and 1.6 times higher than those in the general population for people 18-24, 25-44 and 45-64 years of age respectively.
A study of people using homeless shelters in New York found age-adjusted death rates 2 to 3 times higher than those in the city's general population. Among men using homeless shelters in Toronto, mortality rates were 8.3, 3.7 and 2.3 times higher than rates among men in the general population aged 18-24, 25-44 and 45-64 years respectively.
Although a significant proportion of homeless people are women, relatively little attention has been focused on patterns of mortality in this subgroup. Among homeless people, single men, single women and women accompanied by children tend to have different health problems.
For example, the prevalence of substance abuse is lower among homeless single women than among homeless single men, but the rate of major depression is higher.
Such differences may have an effect on mortality rates. In this study, we focus on homeless single women, who tend to have more health problems than homeless women accompanied by children.
In the general population, mortality rates among younger women are one-third to one-half those among younger men. Low socioeconomic status is strongly associated with shorter life expectancy, but within every socioeconomic stratum women have a longer life expectancy than men do.
Whether this survival advantage is attenuated or lost altogether among homeless women is an important question, because the underlying mechanisms (e.g., addictions leading to drug overdose, or depression leading to suicide) might be amenable to targeted intervention.
We therefore conducted this study to determine whether homeless women lose the survival advantage associated with being female.
Our first objective was to determine mortality rates among women who use homeless shelters in Toronto. Our second objective was to analyze published data on mortality rates among homeless women compared with those among women in the general population and among homeless men.
To continue reading this report go to the Canadian Medical Association web site page:
cmaj.ca/cgi/content/full/170/8/1243
вторник, 14 июня 2011 г.
Release of detailed Canadian Addiction Survey improves understanding of substance use and abuse in Canada
Health Canada, the Canadian Executive Council on Addictions (CECA) and the Canadian Centre on Substance Abuse (CCSA) released detailed results of the Canadian Addiction Survey (CAS)-the first national survey devoted to alcohol and other drug use since 1994. CAS data is expected to guide program and policy development and inform the substance use and abuse research agenda for the next several years.
The 100-page detailed CAS report provides an in-depth national and province-by-province look at how Canadians use alcohol, cannabis and other drugs, and the impact these substances have on their lives.
The report also examines differences in rates of consumption and harm since the 1994 Canada's Alcohol and Other Drugs Survey (CADS) and the 1989 National Alcohol and Other Drugs Survey (NADS). Highlights of the CAS were released on November 24, 2004. The CAS reveals a rise in alcohol and cannabis use since 1994 with Canadians under the age of 25 accounting for much of the increase and problematic use. The detailed report also outlines self-reported harms that individuals attribute to their use of alcohol and drugs, including problems with friendships and social life, physical health, home life and marriage, work and studies, financial well-being, legal matters, housing, and learning.
"The CAS is the result of an impressive and effective partnership involving CECA, Health Canada and ourselves," said Michel Perron, CCSA's Chief Executive Officer. "We are very pleased that our collective efforts will help inform and assist decision-makers in their prevention and policy efforts." "The release of this report is the crucial next step in sharing the valuable CAS data with the research and treatment community to provide them with the additional clarity and understanding they need to validate or modify their work in the substance abuse and addictions field," said CECA president John Borody. "We hope that future detailed analyses will continue to build on this new understanding."
The full CAS data set will be made public in June 2005, providing Canadian researchers with further opportunities to conduct more detailed analyses from the rich data source. Some areas targeted for further exploration include health systems, treatment barriers and access; drinking, drugs and driving; psychosocial aspects of alcohol use; attitudes, beliefs and public opinion; detailed analysis of cannabis findings; youth and older adults.
The CAS was designed to provide a detailed assessment of how Canadians aged 15 years and older use alcohol and other drugs. The survey focused on the impact that alcohol and drug use has on physical, mental and social well-being.
The survey also questioned Canadians about their attitudes toward measures to control drug use, and on their beliefs about the availability of drugs and the risks associated with use. A total of 13,909 Canadians participated in the CAS, with a minimum of 1,000 in each province.
With Health Canada support, Yukon and the Northwest Territories are being surveyed separately with results anticipated in the summer of 2005.
The CAS is a collaboration of Health Canada, the Canadian Executive Council on Addictions (CECA)-which includes the Canadian Centre on Substance Abuse (CCSA), the Alberta Alcohol and Drug Abuse Commission (AADAC), the Addictions Foundation of Manitoba (AFM), the Centre for Addiction and Mental Health (CAMH), Prince Edward Island Provincial Health Services Authority, and the Kaiser Foundation/Centre for Addictions Research of BC (CAR-BC)-and the provinces of Nova Scotia, New Brunswick and British Columbia.
The Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms (both the highlights and detailed report) are available at ccsa.ca. Backgrounder: ccsa.ca/pdf/ccsa-bckgrd-20050323-e.pdf For further information, contact Enid Harrison Paul Duchesne Canadian Centre on Substance Abuse (CCSA) and Health Canada Canadian Executive Council on Addictions (CECA) (613) 954-4807 613) 235-4048 ext. 237; (613) 355-6894 (mobile) e-mail mailto:eharrisonccsa.ca
Health Canada
The 100-page detailed CAS report provides an in-depth national and province-by-province look at how Canadians use alcohol, cannabis and other drugs, and the impact these substances have on their lives.
The report also examines differences in rates of consumption and harm since the 1994 Canada's Alcohol and Other Drugs Survey (CADS) and the 1989 National Alcohol and Other Drugs Survey (NADS). Highlights of the CAS were released on November 24, 2004. The CAS reveals a rise in alcohol and cannabis use since 1994 with Canadians under the age of 25 accounting for much of the increase and problematic use. The detailed report also outlines self-reported harms that individuals attribute to their use of alcohol and drugs, including problems with friendships and social life, physical health, home life and marriage, work and studies, financial well-being, legal matters, housing, and learning.
"The CAS is the result of an impressive and effective partnership involving CECA, Health Canada and ourselves," said Michel Perron, CCSA's Chief Executive Officer. "We are very pleased that our collective efforts will help inform and assist decision-makers in their prevention and policy efforts." "The release of this report is the crucial next step in sharing the valuable CAS data with the research and treatment community to provide them with the additional clarity and understanding they need to validate or modify their work in the substance abuse and addictions field," said CECA president John Borody. "We hope that future detailed analyses will continue to build on this new understanding."
The full CAS data set will be made public in June 2005, providing Canadian researchers with further opportunities to conduct more detailed analyses from the rich data source. Some areas targeted for further exploration include health systems, treatment barriers and access; drinking, drugs and driving; psychosocial aspects of alcohol use; attitudes, beliefs and public opinion; detailed analysis of cannabis findings; youth and older adults.
The CAS was designed to provide a detailed assessment of how Canadians aged 15 years and older use alcohol and other drugs. The survey focused on the impact that alcohol and drug use has on physical, mental and social well-being.
The survey also questioned Canadians about their attitudes toward measures to control drug use, and on their beliefs about the availability of drugs and the risks associated with use. A total of 13,909 Canadians participated in the CAS, with a minimum of 1,000 in each province.
With Health Canada support, Yukon and the Northwest Territories are being surveyed separately with results anticipated in the summer of 2005.
The CAS is a collaboration of Health Canada, the Canadian Executive Council on Addictions (CECA)-which includes the Canadian Centre on Substance Abuse (CCSA), the Alberta Alcohol and Drug Abuse Commission (AADAC), the Addictions Foundation of Manitoba (AFM), the Centre for Addiction and Mental Health (CAMH), Prince Edward Island Provincial Health Services Authority, and the Kaiser Foundation/Centre for Addictions Research of BC (CAR-BC)-and the provinces of Nova Scotia, New Brunswick and British Columbia.
The Canadian Addiction Survey: A National Survey of Canadians' Use of Alcohol and Other Drugs: Prevalence of Use and Related Harms (both the highlights and detailed report) are available at ccsa.ca. Backgrounder: ccsa.ca/pdf/ccsa-bckgrd-20050323-e.pdf For further information, contact Enid Harrison Paul Duchesne Canadian Centre on Substance Abuse (CCSA) and Health Canada Canadian Executive Council on Addictions (CECA) (613) 954-4807 613) 235-4048 ext. 237; (613) 355-6894 (mobile) e-mail mailto:eharrisonccsa.ca
Health Canada
понедельник, 13 июня 2011 г.
Co-existing alcohol-use and psychiatric disorders - Promising new treatment
Individuals who have co-existing alcohol-use and psychiatric disorders must overcome a number of significant hurdles on their way to recovery: multiple health and social problems, double the stigma, a poor response to traditional treatments, a lack of joint treatment options, and a chronic cycle of treatment entry and re-entry.
Symposium proceedings published in the February issue of Alcoholism: Clinical & Experimental Research examine treatment options for this group, with a focus on four major psychiatric disorders: social anxiety disorder, depression, bipolar disorder, and schizophrenia.
'The United States has typically separated services for mental health from those associated with addictions,' said Charlene E. Le Fauve, symposium organizer and health scientist administrator at the National Institute on Alcohol Abuse and Alcoholism.
'Because of this separation, when a person with comorbid disorders enters one type of care, they are inadequately treated for the other condition.
If one disorder goes untreated, both usually worsen and additional complications occur, which can include serious medical problems such as liver disease, HIV, or other organ damage, suicide, criminalization, unemployment, and homelessness.
As a result, some individuals with comordid disorders often require high-cost services such as inpatient and emergency room care.'
Symposium speakers at the June 2003 Research Society on Alcoholism meeting in Fort Lauderdale, Florida presented findings from recent trials and clinical studies:
A selective serotonin reuptake inhibitor (SSRI) called paroxetine shows promise in the treatment of social anxiety in alcohol-dependent subjects.
'Since this was the first study to examine the effectiveness of paroxetine in this dual-diagnosis population,' said Le Fauve, 'we need to see if the results can be replicated by other researchers before we can determine how promising the results are.'
Response to SSRIs among individuals with co-existing alcohol dependency and depression seems to depend on various factors, including the severity of the depression, whether the depression is primary or secondary to the alcohol use, alcoholic typology (Type A or B), and gender.
'When someone is severely depressed, addicted to alcohol, needs inpatient mental health treatment, and has a history of attempting suicide,' explained Le Fauve.
'SSRIs are effective at improving the depression and decreasing alcohol consumption. Whereas, for alcoholics who do not need inpatient treatment because their symptoms of depression are mild to moderate, SSRIs are not very effective at treating both disorders. On the other hand,' she added.
'A heavy drinker who does not require formal addiction treatment may take SSRIs and notice that they will substantially reduce their alcohol intake.'
Research indicates that gender may also play a role in the effectiveness of SSRIs, in that women with both alcohol and depressive disorders tend to respond better than men.
In addition, the type of alcoholic receiving SSRIs - Type A versus Type B - can influence its effectiveness in reducing alcohol consumption. Type A individuals are considered to have a less severe form of the disorder than Type B individuals:
Type As become alcoholics at a later age, have less severe symptoms or fewer psychiatric problems, and have a better outlook on life than Type Bs, who become alcoholics at an early age, have a high family risk for alcoholism, demonstrate more severe symptoms, and have a more negative outlook on life than Type A individuals.
'Type B alcoholics are considered to be more severe and at greater risk for poor health outcomes,' said Le Fauve.
'Type B alcoholics also significantly worsen when they are treated with SSRIs when compared to Type A alcoholics. Clearly,' she added, 'SSRIs will not be the best method of treatment for all people who have both depression and alcoholism.'
In the first study of its kind, researchers found that an anticonvulsant, mood stabilizer called sodium valproate, used previously to treat bipolar disorder, may also be useful for both stabilizing mood states and decreasing alcohol use among bipolar alcoholics.
Researchers have also found that treatment with the antipsychotic clozapine is associated with a decrease in alcohol and other substance use in patients with schizophrenia.
''Atypical' or 'novel' antipsychotics are generally safer and better tolerated than older or 'typical' antipsychotic medicines,' explained Le Fauve.
'Emerging studies suggest that atypical antipsychotics can also be effective for a broad range of psychiatric syndromes beyond the primary indication of schizophrenia, such as mania, depression, anxiety, hostility and aggression. In addition, clinicians are increasingly using these medicines for conditions such as dementia, autism, developmental delay/mental retardation and personality disorders. So, it is not entirely surprising that a new atypical antipsychotic such as clozapine … may be a useful treatment modality for a broad range of non-psychotic conditions, including alcoholism.'
Le Fauve noted that researchers are just beginning to unravel the complexities of how to treat people with comorbid mental illness and alcohol-use disorders. Including more people with comorbid psychiatric and substance abuse disorders in clinical research studies is an important first step, she added, to addressing the numerous issues that remain.
'We need to determine how individuals develop comorbid disorders and establish multidisciplinary teams to collaborate on the cause of these illnesses,' she said.
'We need to determine the role of genes and the environment in increasing risk of and/or offering protection against comorbid illnesses. We need to establish treatment approaches for comorbid conditions that take various situations, severity, gender, and alcohol subtypes into account.
'We need to develop better screening tools to diagnose complex comorbid disorders. We need to explore how fetal exposure to alcohol may lead to comorbid psychiatric disorders across the lifespan. Finally, we must develop comorbid training units in outpatient settings for health care providers to become credentialed mental health and addictions treatment providers.'
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors/presenters of the symposium proceedings published in ACER included: Raye Z. Litten of the National Institute on Alcohol Abuse and Alcoholism; Carrie L. Randall and Darlene H. Moak of the Center for Drug and Alcohol Programs at the Medical University of South Carolina in Charleston; Ihsan M. Salloum of the Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center; and Alan I. Green of the Department of Psychiatry at Dartmouth Medical School in Lebanon, New Hampshire. All of the symposium research was funded by the National Institute on Alcohol Abuse and Alcoholism.
Contact:
Ann Bradley
abradleywillco.niaaa.nih
301-443-0595.
National Institute on Alcohol Abuse and Alcoholism
Alcoholism: Clinical & Experimental Research
Symposium proceedings published in the February issue of Alcoholism: Clinical & Experimental Research examine treatment options for this group, with a focus on four major psychiatric disorders: social anxiety disorder, depression, bipolar disorder, and schizophrenia.
'The United States has typically separated services for mental health from those associated with addictions,' said Charlene E. Le Fauve, symposium organizer and health scientist administrator at the National Institute on Alcohol Abuse and Alcoholism.
'Because of this separation, when a person with comorbid disorders enters one type of care, they are inadequately treated for the other condition.
If one disorder goes untreated, both usually worsen and additional complications occur, which can include serious medical problems such as liver disease, HIV, or other organ damage, suicide, criminalization, unemployment, and homelessness.
As a result, some individuals with comordid disorders often require high-cost services such as inpatient and emergency room care.'
Symposium speakers at the June 2003 Research Society on Alcoholism meeting in Fort Lauderdale, Florida presented findings from recent trials and clinical studies:
A selective serotonin reuptake inhibitor (SSRI) called paroxetine shows promise in the treatment of social anxiety in alcohol-dependent subjects.
'Since this was the first study to examine the effectiveness of paroxetine in this dual-diagnosis population,' said Le Fauve, 'we need to see if the results can be replicated by other researchers before we can determine how promising the results are.'
Response to SSRIs among individuals with co-existing alcohol dependency and depression seems to depend on various factors, including the severity of the depression, whether the depression is primary or secondary to the alcohol use, alcoholic typology (Type A or B), and gender.
'When someone is severely depressed, addicted to alcohol, needs inpatient mental health treatment, and has a history of attempting suicide,' explained Le Fauve.
'SSRIs are effective at improving the depression and decreasing alcohol consumption. Whereas, for alcoholics who do not need inpatient treatment because their symptoms of depression are mild to moderate, SSRIs are not very effective at treating both disorders. On the other hand,' she added.
'A heavy drinker who does not require formal addiction treatment may take SSRIs and notice that they will substantially reduce their alcohol intake.'
Research indicates that gender may also play a role in the effectiveness of SSRIs, in that women with both alcohol and depressive disorders tend to respond better than men.
In addition, the type of alcoholic receiving SSRIs - Type A versus Type B - can influence its effectiveness in reducing alcohol consumption. Type A individuals are considered to have a less severe form of the disorder than Type B individuals:
Type As become alcoholics at a later age, have less severe symptoms or fewer psychiatric problems, and have a better outlook on life than Type Bs, who become alcoholics at an early age, have a high family risk for alcoholism, demonstrate more severe symptoms, and have a more negative outlook on life than Type A individuals.
'Type B alcoholics are considered to be more severe and at greater risk for poor health outcomes,' said Le Fauve.
'Type B alcoholics also significantly worsen when they are treated with SSRIs when compared to Type A alcoholics. Clearly,' she added, 'SSRIs will not be the best method of treatment for all people who have both depression and alcoholism.'
In the first study of its kind, researchers found that an anticonvulsant, mood stabilizer called sodium valproate, used previously to treat bipolar disorder, may also be useful for both stabilizing mood states and decreasing alcohol use among bipolar alcoholics.
Researchers have also found that treatment with the antipsychotic clozapine is associated with a decrease in alcohol and other substance use in patients with schizophrenia.
''Atypical' or 'novel' antipsychotics are generally safer and better tolerated than older or 'typical' antipsychotic medicines,' explained Le Fauve.
'Emerging studies suggest that atypical antipsychotics can also be effective for a broad range of psychiatric syndromes beyond the primary indication of schizophrenia, such as mania, depression, anxiety, hostility and aggression. In addition, clinicians are increasingly using these medicines for conditions such as dementia, autism, developmental delay/mental retardation and personality disorders. So, it is not entirely surprising that a new atypical antipsychotic such as clozapine … may be a useful treatment modality for a broad range of non-psychotic conditions, including alcoholism.'
Le Fauve noted that researchers are just beginning to unravel the complexities of how to treat people with comorbid mental illness and alcohol-use disorders. Including more people with comorbid psychiatric and substance abuse disorders in clinical research studies is an important first step, she added, to addressing the numerous issues that remain.
'We need to determine how individuals develop comorbid disorders and establish multidisciplinary teams to collaborate on the cause of these illnesses,' she said.
'We need to determine the role of genes and the environment in increasing risk of and/or offering protection against comorbid illnesses. We need to establish treatment approaches for comorbid conditions that take various situations, severity, gender, and alcohol subtypes into account.
'We need to develop better screening tools to diagnose complex comorbid disorders. We need to explore how fetal exposure to alcohol may lead to comorbid psychiatric disorders across the lifespan. Finally, we must develop comorbid training units in outpatient settings for health care providers to become credentialed mental health and addictions treatment providers.'
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors/presenters of the symposium proceedings published in ACER included: Raye Z. Litten of the National Institute on Alcohol Abuse and Alcoholism; Carrie L. Randall and Darlene H. Moak of the Center for Drug and Alcohol Programs at the Medical University of South Carolina in Charleston; Ihsan M. Salloum of the Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center; and Alan I. Green of the Department of Psychiatry at Dartmouth Medical School in Lebanon, New Hampshire. All of the symposium research was funded by the National Institute on Alcohol Abuse and Alcoholism.
Contact:
Ann Bradley
abradleywillco.niaaa.nih
301-443-0595.
National Institute on Alcohol Abuse and Alcoholism
Alcoholism: Clinical & Experimental Research
воскресенье, 12 июня 2011 г.
Positive Thinking Can Lead To Financial Irresponsibility, Like Compulsive Gambling
Looking on the bright side can lead to irresponsible financial behavior, reveals a paper from the June 2008 issue of the Journal of Consumer Research. In a series of studies, Elizabeth Cowley (University of Sydney) examines repeat gambling in the face of loss. She finds that people often engage in too much positive thinking, selectively focusing on one win among hundreds of losses when they think back on the overall experience.
"When we want to justify engaging in an activity which could potentially be irresponsible - like gambling - we may need to distort our memory of the past to rationalize the decision," Cowley explains. "People who have frequently spent more money than planned on gambling edit their memories of the past in order to justify gambling again."
For example, Cowley had participants in one study play a computer game in which they could win credits with the financial equivalent of one cent per credit. Each participant played the game 300 times. Everyone experienced one big win and one big loss. But for the other 298 games, one half of the group experienced all small losses, while the other experienced all small wins.
Cowley also manipulated the distance between the big win and the big loss.
A week later, participants were surveyed for their memories of the experience. Surprisingly, Cowley found that even some losers remembered having a positive experience. If the big win and the big loss occurred far apart, losers had fond memories and indicated a willingness to spend their own money on the game.
As Cowley explains, the further apart the big win and the big loss, the easier it was for losers to isolate their memories and focus only on the positive, a "silver lining" effect.
"The tendency to segregate positive and negative events in a mixed-loss experience is based on the logic that remembering a large gain allows people to feel good even when the objective outcome was negative," Cowley says.
Conversely, Cowley found that winners - those who experienced 298 small wins - were happier when the big win and the big loss were closer together, allowing them to lump all the games together and ignore the big loss. She termed this the "cancellation effect."
"When the outcome of an experience including both positive and negative events results in a net gain, people look for ways to integrate positive and negative events to reduce, if not cancel, the pain associated with the negative events," Cowley explains.
The research is the first to consider a motivated memory explanation for justifying irresponsible behavior. Apparently, positive thinking can sometimes be negative.
Elizabeth Cowley, "The Perils of Hedonic Editing." Journal of Consumer Research: June 2008.
About the Journal of Consumer Research: Founded in 1974, the Journal of Consumer Research publishes scholarly research that describes and explains consumer behavior. Empirical, theoretical, and methodological articles spanning fields such as psychology, marketing, sociology, economics, and anthropology are featured in this interdisciplinary journal. The primary thrust of JCR is academic, rather than managerial, with topics ranging from micro-level processes (e.g., brand choice) to more macro-level issues (e.g., the development of materialistic values).
Source: Suzanne Wu
University of Chicago Press Journals
"When we want to justify engaging in an activity which could potentially be irresponsible - like gambling - we may need to distort our memory of the past to rationalize the decision," Cowley explains. "People who have frequently spent more money than planned on gambling edit their memories of the past in order to justify gambling again."
For example, Cowley had participants in one study play a computer game in which they could win credits with the financial equivalent of one cent per credit. Each participant played the game 300 times. Everyone experienced one big win and one big loss. But for the other 298 games, one half of the group experienced all small losses, while the other experienced all small wins.
Cowley also manipulated the distance between the big win and the big loss.
A week later, participants were surveyed for their memories of the experience. Surprisingly, Cowley found that even some losers remembered having a positive experience. If the big win and the big loss occurred far apart, losers had fond memories and indicated a willingness to spend their own money on the game.
As Cowley explains, the further apart the big win and the big loss, the easier it was for losers to isolate their memories and focus only on the positive, a "silver lining" effect.
"The tendency to segregate positive and negative events in a mixed-loss experience is based on the logic that remembering a large gain allows people to feel good even when the objective outcome was negative," Cowley says.
Conversely, Cowley found that winners - those who experienced 298 small wins - were happier when the big win and the big loss were closer together, allowing them to lump all the games together and ignore the big loss. She termed this the "cancellation effect."
"When the outcome of an experience including both positive and negative events results in a net gain, people look for ways to integrate positive and negative events to reduce, if not cancel, the pain associated with the negative events," Cowley explains.
The research is the first to consider a motivated memory explanation for justifying irresponsible behavior. Apparently, positive thinking can sometimes be negative.
Elizabeth Cowley, "The Perils of Hedonic Editing." Journal of Consumer Research: June 2008.
About the Journal of Consumer Research: Founded in 1974, the Journal of Consumer Research publishes scholarly research that describes and explains consumer behavior. Empirical, theoretical, and methodological articles spanning fields such as psychology, marketing, sociology, economics, and anthropology are featured in this interdisciplinary journal. The primary thrust of JCR is academic, rather than managerial, with topics ranging from micro-level processes (e.g., brand choice) to more macro-level issues (e.g., the development of materialistic values).
Source: Suzanne Wu
University of Chicago Press Journals
суббота, 11 июня 2011 г.
The EU Policy In The Drugs Field: Present Priorities
EU policy in the drugs field has been developed in the 1990's, and is today firmly on the European agenda. There is no simple answer to drugs, but definitely the most effective answer is a European answer on a European scale, one that applies the principles of safeguarding health of people and ensuring security and respect of law in the European space.
The work undertaken by the European Commission within the EU Action Plan on Drugs 2005-2008 is oriented towards four main goals:
-- to develop sensible and effective European responses to reduce both demand and supply. This balance between public health and law enforcement reflects the balance between peoples' rights and public safety. Whatever we do, it should be based on an objective analysis of the situation, on the increasingly reliable data that are coming through from the member States and from the EMCDDA and
-- to connect with citizens in order to reach the millions of Europeans - mostly young people - for whom taking drugs has become a normal recreational activity, to improve our understanding of this phenomenon, and to convince drug users across the EU that they are harming themselves and others, not only in our own societies, but also in more distant countries;
-- to take due account of the frequent close links between lack of economic and social opportunities and marginalisation on one side and drugs use on the other;
-- to help countries outside the EU where drugs are cultivated to strengthen their chance to develop their economies away from drug dependence.
The scale of the problem
Drug consumption and mortality are at unprecedented levels and show little sign of coming down: it is estimated that in any given month 1.5 million Europeans take cocaine and 12 million take cannabis, of whom 3 million take it on a more or less daily basis. 20 % of treatment requests are now related to cannabis, placing it second only to heroin. Ecstasy, produced in Europe, is now the second most common drug after cannabis. According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) , in some Member States up to 8 % of young people take it on a regular basis. Polydrug use - the systematic and intensive mixing of drugs, often with alcohol and medicines - is a growing problem and difficult to treat.
HIV infection continues to have a major public health impact. In Western and Central Europe more than 26 000 people were infected with HIV in 2005. In this region heterosexual intercourse has become the main mode of transmission, and harm reduction programmes have helped to reduce the spread of HIV among injecting drug users. The main challenge is to sustain this positive development and to prevent HIV transmission from infected injecting drug users to their sexual partners.
In order to save lives it is important to make sure that people do not to use drugs but it is equally important to work with injecting drug users and implement comprehensive harm reduction services as an essential component of a comprehensive HIV/AIDS programme.
On the supply side drugs are becoming cheaper, purer (particularly cocaine), stronger (cannabis), and more easily available. Judging by the quantities seized, the flow of cocaine and heroin to Europe is rising. The industry that is behind all this, producing and moving illicit drugs around the world, is in excellent health; it is truly global, uses the latest technology, and knows no national boundaries - unlike much of the political and law enforcement response, which - in spite of real progress made - has yet to match the international scale and efficiency of organised crime in this field.
The EU's response: a balance between reducing demand and supply
The added value of working at EU level is reflected in the current EU Drugs Strategy and the EU Action Plan on Drugs 2005-2008, which sets out specific goals to strengthen cooperation and coordination between Member States in areas such as prevention, harm reduction, treatment, law enforcement, and international cooperation.
Legislation proposed by the Commission to impose minimum penalties on cross-border traffickers was adopted by the Council in 2004. In 2005 it adopted the Commission's proposal for a Decision to improve the information exchange and control of new substances -which will provide a more effective means of dealing with emerging trends and new patterns of drug use, bringing together in one legal framework all the actors concerned: the Member States, European Institutions, specialized agencies, and Europol.
While much remains to be done to establish a solid EU network of law enforcement cooperation with specialised bodies like Europol and Eurojust at its centre, the Commission for its part provides funding under the AGIS programme to support such efforts. Close to 3 million Euros was spent last year on promoting EU cross border law enforcement cooperation between the Member States to fight drug trafficking, such as the use of joint investigation teams or cooperation on fighting cocaine smuggling through airports. The Commission is planning to spend at least 21 million Euros from 2007 on implementing the prevention and information part of the EU Action Plan on Drugs alone. In addition, 600 million Euros has been set aside for fighting organised crime over the next 7 years - including drug-related crime.
Other Commission efforts in the drugs field include worldwide action against the diversion of chemical drug precursors used in the production of illicit drugs: EU wide rules to monitor trade, increased focus on EU border controls and border protection to combat diversion of synthetic drugs precursors, strong EU involvement and support in international cooperation on the operational side (in particular Project Prism, initiated by the Commission in close cooperation with the USA), and bilateral drug precursor cooperation agreements with major players (e.g. Andean States, USA, Turkey and in the near future China). A major investment is also ongoing for the development of drugs and driving safety and control measures to create an effective and EU-wide response to drug-related road accidents.
Demand reduction issues are currently being addressed through the EU Public Health Programme 2003-2008, which has already spent 4.1 million euros directly on drug-related projects up to 2004. In 2005, projects were financed on evaluating the effectiveness of drug prevention programmes in schools and access to treatment. In 2006, priority is given to projects dealing with harm reduction responses to emerging trends in drug use, including the development of joint prevention programmes focusing on socially disadvantaged groups, best practices in drug treatment, and social reintegration. From 2007 the Commission will continue to support demand reduction projects from the new Public Health Action Programme 2007-2013.
Solidarity with producing countries
The EU fully subscribes to the principle of shared responsibility: demand at home feeds production elsewhere, blurring the distinction between producer and consumer countries.
This is reflected in the external role of the EU, which has become the main provider of civil anti-drugs and alternative development programmes around the world. At last count, the total stock of anti-drugs projects implemented by the Member States and the European Commission amounted to more than 500 million euros. Overall, the EU's assistance has almost doubled in the last 3 years. By 2005, Commission projects in the major cocaine producing countries in Latin America totalled 136 million euros. In Afghanistan, responsible for over 90 % of the world's opium production, the EU provided, in 2005, 250 million euros to the Afghan government's Counter Narcotics Campaign, and last year alone the European Commission committed 15 million to Afghanistan's Counter Narcotics Trust Fund.
The way forward
Based on the political approach defined at EU level, it is important to unite forces. Within the Action Plan on Drugs 2005-2008, great emphasis is put on the dialogue with organisations from civil society.
The Commission is presently consulting (until the end of September) the European organisations with a view to structure such a dialogue and place the specific experience and knowledge of these organisations at the disposal of the policy making process at EU level in a practical and sustainable form.
ec.europa.eu/comm/external_relations/drugs/index.htm
European Commission
The work undertaken by the European Commission within the EU Action Plan on Drugs 2005-2008 is oriented towards four main goals:
-- to develop sensible and effective European responses to reduce both demand and supply. This balance between public health and law enforcement reflects the balance between peoples' rights and public safety. Whatever we do, it should be based on an objective analysis of the situation, on the increasingly reliable data that are coming through from the member States and from the EMCDDA and
-- to connect with citizens in order to reach the millions of Europeans - mostly young people - for whom taking drugs has become a normal recreational activity, to improve our understanding of this phenomenon, and to convince drug users across the EU that they are harming themselves and others, not only in our own societies, but also in more distant countries;
-- to take due account of the frequent close links between lack of economic and social opportunities and marginalisation on one side and drugs use on the other;
-- to help countries outside the EU where drugs are cultivated to strengthen their chance to develop their economies away from drug dependence.
The scale of the problem
Drug consumption and mortality are at unprecedented levels and show little sign of coming down: it is estimated that in any given month 1.5 million Europeans take cocaine and 12 million take cannabis, of whom 3 million take it on a more or less daily basis. 20 % of treatment requests are now related to cannabis, placing it second only to heroin. Ecstasy, produced in Europe, is now the second most common drug after cannabis. According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) , in some Member States up to 8 % of young people take it on a regular basis. Polydrug use - the systematic and intensive mixing of drugs, often with alcohol and medicines - is a growing problem and difficult to treat.
HIV infection continues to have a major public health impact. In Western and Central Europe more than 26 000 people were infected with HIV in 2005. In this region heterosexual intercourse has become the main mode of transmission, and harm reduction programmes have helped to reduce the spread of HIV among injecting drug users. The main challenge is to sustain this positive development and to prevent HIV transmission from infected injecting drug users to their sexual partners.
In order to save lives it is important to make sure that people do not to use drugs but it is equally important to work with injecting drug users and implement comprehensive harm reduction services as an essential component of a comprehensive HIV/AIDS programme.
On the supply side drugs are becoming cheaper, purer (particularly cocaine), stronger (cannabis), and more easily available. Judging by the quantities seized, the flow of cocaine and heroin to Europe is rising. The industry that is behind all this, producing and moving illicit drugs around the world, is in excellent health; it is truly global, uses the latest technology, and knows no national boundaries - unlike much of the political and law enforcement response, which - in spite of real progress made - has yet to match the international scale and efficiency of organised crime in this field.
The EU's response: a balance between reducing demand and supply
The added value of working at EU level is reflected in the current EU Drugs Strategy and the EU Action Plan on Drugs 2005-2008, which sets out specific goals to strengthen cooperation and coordination between Member States in areas such as prevention, harm reduction, treatment, law enforcement, and international cooperation.
Legislation proposed by the Commission to impose minimum penalties on cross-border traffickers was adopted by the Council in 2004. In 2005 it adopted the Commission's proposal for a Decision to improve the information exchange and control of new substances -which will provide a more effective means of dealing with emerging trends and new patterns of drug use, bringing together in one legal framework all the actors concerned: the Member States, European Institutions, specialized agencies, and Europol.
While much remains to be done to establish a solid EU network of law enforcement cooperation with specialised bodies like Europol and Eurojust at its centre, the Commission for its part provides funding under the AGIS programme to support such efforts. Close to 3 million Euros was spent last year on promoting EU cross border law enforcement cooperation between the Member States to fight drug trafficking, such as the use of joint investigation teams or cooperation on fighting cocaine smuggling through airports. The Commission is planning to spend at least 21 million Euros from 2007 on implementing the prevention and information part of the EU Action Plan on Drugs alone. In addition, 600 million Euros has been set aside for fighting organised crime over the next 7 years - including drug-related crime.
Other Commission efforts in the drugs field include worldwide action against the diversion of chemical drug precursors used in the production of illicit drugs: EU wide rules to monitor trade, increased focus on EU border controls and border protection to combat diversion of synthetic drugs precursors, strong EU involvement and support in international cooperation on the operational side (in particular Project Prism, initiated by the Commission in close cooperation with the USA), and bilateral drug precursor cooperation agreements with major players (e.g. Andean States, USA, Turkey and in the near future China). A major investment is also ongoing for the development of drugs and driving safety and control measures to create an effective and EU-wide response to drug-related road accidents.
Demand reduction issues are currently being addressed through the EU Public Health Programme 2003-2008, which has already spent 4.1 million euros directly on drug-related projects up to 2004. In 2005, projects were financed on evaluating the effectiveness of drug prevention programmes in schools and access to treatment. In 2006, priority is given to projects dealing with harm reduction responses to emerging trends in drug use, including the development of joint prevention programmes focusing on socially disadvantaged groups, best practices in drug treatment, and social reintegration. From 2007 the Commission will continue to support demand reduction projects from the new Public Health Action Programme 2007-2013.
Solidarity with producing countries
The EU fully subscribes to the principle of shared responsibility: demand at home feeds production elsewhere, blurring the distinction between producer and consumer countries.
This is reflected in the external role of the EU, which has become the main provider of civil anti-drugs and alternative development programmes around the world. At last count, the total stock of anti-drugs projects implemented by the Member States and the European Commission amounted to more than 500 million euros. Overall, the EU's assistance has almost doubled in the last 3 years. By 2005, Commission projects in the major cocaine producing countries in Latin America totalled 136 million euros. In Afghanistan, responsible for over 90 % of the world's opium production, the EU provided, in 2005, 250 million euros to the Afghan government's Counter Narcotics Campaign, and last year alone the European Commission committed 15 million to Afghanistan's Counter Narcotics Trust Fund.
The way forward
Based on the political approach defined at EU level, it is important to unite forces. Within the Action Plan on Drugs 2005-2008, great emphasis is put on the dialogue with organisations from civil society.
The Commission is presently consulting (until the end of September) the European organisations with a view to structure such a dialogue and place the specific experience and knowledge of these organisations at the disposal of the policy making process at EU level in a practical and sustainable form.
ec.europa.eu/comm/external_relations/drugs/index.htm
European Commission
пятница, 10 июня 2011 г.
The body's biological clock: alcohol may lead to physiological anarchy
Circadian rhythms refer to biological phenomena that oscillate within a 24-hour cycle, in keeping with the earth's rotation. A review in the August issue of Alcoholism: Clinical & Experimental Research summarizes new findings on interactions between alcohol and the "clock genes" that underlie circadian rhythmicity.
"The human body, like many other mammals and some bacteria, displays changes in functions and behavior that wax and wane through the cycle of day and night," said Dipak K. Sarkar, director of the endocrinology program and biomedical division of the Center of Alcohol Studies at Rutgers University, and corresponding author for the study. "These rhythms are not simply a response to 24-hour changes in the physical environment but instead arise from a timekeeping system or 'biological clock' within the body. An individual has more than 100 circadian rhythms that are unique and influence various aspects of body functions, including heart rate, blood pressure, body temperature, hormone levels, pain threshold and even the ability to fight against harmful invaders like bacteria and virus. Almost no area of our body is unaffected by these rhythms."
"This review shows that alcohol exposure can alter biological rhythmicity and, as a result, have deleterious consequences on a number of important physiological systems," noted Robert J. Handa, professor of neuroscience at Colorado State University. "The fact that alcohol intake may influence the molecular underpinnings of circadian rhythmicity is an emerging concept with potentially important biomedical ramifications. Although a majority of these studies have been performed in rodent models … observations of humans correlate with the animal studies and imply that similar types of pathology are associated with alcohol intake."
Some of the review's key findings were:
-- The chronobiological disruptions observed in human alcoholics appear to be partially due to alcohol-induced disruption of fundamental biological timing processes, and partially due to genetic associations.
"Generally speaking," said Handa, "fluctuations in physiological function are synchronized to the 24-hour day by a 'master' clock which resides within the suprachiasmatic nucleus (SCN) of the brain's hypothalamus. The SCN collects temporal information from the retina and elsewhere, passing it to various physiological systems of the body. By disrupting the ability of the 'master clock' to synchronize physiological systems across the 24-hour day, or by rendering individual physiological systems unable to respond to the signals of the master clock, alcohol intake may result in what could be considered 'physiological anarchy.' The pathology resulting from such generalized disorder could be widespread."
Handa added that it is still unknown whether the genetics underlying alcohol preference drives the circadian dysregulation, or whether the genetics of circadian dysregulation is what drives alcohol preference. "Presumably it is the latter," he said. "In animals where there is a genetic predisposition to weakened circadian rhythmicity, the stress associated with the absence of physiological order results in alcohol preference. This could also be the case in some human conditions, such as Seasonal Affective Disorder."
Sarkar concurred. "Alcohol-preferring rats have an altered light response in their central clock, and alcoholic humans have abnormality in the expression of Period genes that regulate the biological clock," he said. "We cannot say that people are genetically predisposed to drinking through their circadian rhythmicity, but one could interpret the data to mean that if an individual's biological clock does not function properly, they may have increased motivation to consume more alcohol."
-- Chronic alcohol administration appears to significantly alter central and internal clocks that govern neuroendocrine functions.
"Both 'central clocks' in the SCN, and 'internal clocks' in many neuroendocrine and other cells, depend on the coordinated expression of specific 'clock genes,'" said Sarkar. "Animal models have shown us that chronic alcohol drinking hampers the daily expression of these clock genes, which can disrupt the circadian release of neuroendocrine hormones that govern stress reactivity, food intake and various other body functions."
-- Alcohol consumption may influence immune function by altering an individual's central and internal clock activities.
"It is well known that immune function can be influenced by stress hormones and that stress hormones undergo daily rhythmic fluctuations," said Handa. "As a result, immune function possesses a circadian component. A new twist on this story, however, is that the immune system is not just a passive partner responding to circadian signals, but possesses an intrinsic clock of its own that is synchronized to an individual's central clock via hormonal and autonomic signals."
-- There may be a molecular basis for greater alcohol consumption among shift workers and people suffering from jet lag.
"In both cases," said Handa, "the activity of the individual and the physiological requirements for such activity are at odds with the regulatory timing cues provided by the SCN. For example, in the case of the individual working the late shift, light signals providing synchronizing information to the SCN are normal, yet the individual is active during a period when physiological rhythms are normally set for rest. Such activity resets peripheral rhythms away from that of the master clock and disorder ensues until activity rhythms are realigned with that of the SCN."
-- Alcohol may interact with different human physiological systems that are subject to circadian rhythmicity.
"Alcohol can directly alter the molecular clock machinery in different cell types, such as neuroendocrine cells and immune cells, and the molecular components of the central clock in the hypothalamus that coordinates the circadian rhythms in physiology and behavior," said Sarkar. "In addition, chronic alcohol consumption may also affect the synchronizing signals by which clocks in different tissues talk to each other."
In summary, said Sarkar, new discoveries in the emerging field of Chronobiology of Alcohol Abuse indicate that alcohol consumption has long-term adverse effects on the body's internal clocks, that altered circadian rhythm due to rotating shift work and traveling over time zones may increase the propensity of alcohol-drinking behavior, and that chronic drinking may increase the risk for sleep disturbances, depression, compromised immune function, and increased incidence of certain forms of cancers.
"We are now conducting studies using laboratory animals to understand how alcohol drinking in the adult alters the molecular machinery governing the body's biological clock," said Sarkar. "We are also determining the negative health consequences of maternal alcohol abuse on the offspring's circadian neuroendocrine and immune system functions."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Alcohol Consumption and the Body's Biological Clock," were: Rainer Spanagel of the Department of Psychopharmacology at the Central Institute of Mental Health in Germany; Alan M. Rosenwasser of the Department of Psychology at the University of Maine; and Gunter Schumann of the Department of Psychiatry and Psychotherapy, and the Department of Addictive Behaviour and Addiction Medicine, at the Central Institute of Mental Health in Germany. The review was funded by the National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism, and several European research funding agencies.
Contact: Dipak K. Sarkar, Ph.D., D.Phil.
sarkaraesop.rutgers
732-932-1529
Rutgers University
Add'l contact: Robert J. Handa, Ph.D.
robert.handacolostate
970-491-7130
Colorado State University
Alcoholism: Clinical & Experimental Research
alcoholism-cer
"The human body, like many other mammals and some bacteria, displays changes in functions and behavior that wax and wane through the cycle of day and night," said Dipak K. Sarkar, director of the endocrinology program and biomedical division of the Center of Alcohol Studies at Rutgers University, and corresponding author for the study. "These rhythms are not simply a response to 24-hour changes in the physical environment but instead arise from a timekeeping system or 'biological clock' within the body. An individual has more than 100 circadian rhythms that are unique and influence various aspects of body functions, including heart rate, blood pressure, body temperature, hormone levels, pain threshold and even the ability to fight against harmful invaders like bacteria and virus. Almost no area of our body is unaffected by these rhythms."
"This review shows that alcohol exposure can alter biological rhythmicity and, as a result, have deleterious consequences on a number of important physiological systems," noted Robert J. Handa, professor of neuroscience at Colorado State University. "The fact that alcohol intake may influence the molecular underpinnings of circadian rhythmicity is an emerging concept with potentially important biomedical ramifications. Although a majority of these studies have been performed in rodent models … observations of humans correlate with the animal studies and imply that similar types of pathology are associated with alcohol intake."
Some of the review's key findings were:
-- The chronobiological disruptions observed in human alcoholics appear to be partially due to alcohol-induced disruption of fundamental biological timing processes, and partially due to genetic associations.
"Generally speaking," said Handa, "fluctuations in physiological function are synchronized to the 24-hour day by a 'master' clock which resides within the suprachiasmatic nucleus (SCN) of the brain's hypothalamus. The SCN collects temporal information from the retina and elsewhere, passing it to various physiological systems of the body. By disrupting the ability of the 'master clock' to synchronize physiological systems across the 24-hour day, or by rendering individual physiological systems unable to respond to the signals of the master clock, alcohol intake may result in what could be considered 'physiological anarchy.' The pathology resulting from such generalized disorder could be widespread."
Handa added that it is still unknown whether the genetics underlying alcohol preference drives the circadian dysregulation, or whether the genetics of circadian dysregulation is what drives alcohol preference. "Presumably it is the latter," he said. "In animals where there is a genetic predisposition to weakened circadian rhythmicity, the stress associated with the absence of physiological order results in alcohol preference. This could also be the case in some human conditions, such as Seasonal Affective Disorder."
Sarkar concurred. "Alcohol-preferring rats have an altered light response in their central clock, and alcoholic humans have abnormality in the expression of Period genes that regulate the biological clock," he said. "We cannot say that people are genetically predisposed to drinking through their circadian rhythmicity, but one could interpret the data to mean that if an individual's biological clock does not function properly, they may have increased motivation to consume more alcohol."
-- Chronic alcohol administration appears to significantly alter central and internal clocks that govern neuroendocrine functions.
"Both 'central clocks' in the SCN, and 'internal clocks' in many neuroendocrine and other cells, depend on the coordinated expression of specific 'clock genes,'" said Sarkar. "Animal models have shown us that chronic alcohol drinking hampers the daily expression of these clock genes, which can disrupt the circadian release of neuroendocrine hormones that govern stress reactivity, food intake and various other body functions."
-- Alcohol consumption may influence immune function by altering an individual's central and internal clock activities.
"It is well known that immune function can be influenced by stress hormones and that stress hormones undergo daily rhythmic fluctuations," said Handa. "As a result, immune function possesses a circadian component. A new twist on this story, however, is that the immune system is not just a passive partner responding to circadian signals, but possesses an intrinsic clock of its own that is synchronized to an individual's central clock via hormonal and autonomic signals."
-- There may be a molecular basis for greater alcohol consumption among shift workers and people suffering from jet lag.
"In both cases," said Handa, "the activity of the individual and the physiological requirements for such activity are at odds with the regulatory timing cues provided by the SCN. For example, in the case of the individual working the late shift, light signals providing synchronizing information to the SCN are normal, yet the individual is active during a period when physiological rhythms are normally set for rest. Such activity resets peripheral rhythms away from that of the master clock and disorder ensues until activity rhythms are realigned with that of the SCN."
-- Alcohol may interact with different human physiological systems that are subject to circadian rhythmicity.
"Alcohol can directly alter the molecular clock machinery in different cell types, such as neuroendocrine cells and immune cells, and the molecular components of the central clock in the hypothalamus that coordinates the circadian rhythms in physiology and behavior," said Sarkar. "In addition, chronic alcohol consumption may also affect the synchronizing signals by which clocks in different tissues talk to each other."
In summary, said Sarkar, new discoveries in the emerging field of Chronobiology of Alcohol Abuse indicate that alcohol consumption has long-term adverse effects on the body's internal clocks, that altered circadian rhythm due to rotating shift work and traveling over time zones may increase the propensity of alcohol-drinking behavior, and that chronic drinking may increase the risk for sleep disturbances, depression, compromised immune function, and increased incidence of certain forms of cancers.
"We are now conducting studies using laboratory animals to understand how alcohol drinking in the adult alters the molecular machinery governing the body's biological clock," said Sarkar. "We are also determining the negative health consequences of maternal alcohol abuse on the offspring's circadian neuroendocrine and immune system functions."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Alcohol Consumption and the Body's Biological Clock," were: Rainer Spanagel of the Department of Psychopharmacology at the Central Institute of Mental Health in Germany; Alan M. Rosenwasser of the Department of Psychology at the University of Maine; and Gunter Schumann of the Department of Psychiatry and Psychotherapy, and the Department of Addictive Behaviour and Addiction Medicine, at the Central Institute of Mental Health in Germany. The review was funded by the National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism, and several European research funding agencies.
Contact: Dipak K. Sarkar, Ph.D., D.Phil.
sarkaraesop.rutgers
732-932-1529
Rutgers University
Add'l contact: Robert J. Handa, Ph.D.
robert.handacolostate
970-491-7130
Colorado State University
Alcoholism: Clinical & Experimental Research
alcoholism-cer
четверг, 9 июня 2011 г.
Stigma Deters Those With Alcohol Disorders From Seeking Treatment
Despite the existence of effective programs for treating alcohol dependencies and disorders, less than a quarter of people who are diagnosed actually seek treatment. In a recent study by Columbia University's Mailman School of Public Health researchers report that people diagnosed with alcoholism at some point in their lifetime were more than 60% less likely to seek treatment if they believed they would be stigmatized once their status is known.
This is the first study to address the underuse of alcohol services specifically with regard to alcohol-related stigma. Findings are published in the November issue of the American Journal of Epidemiology.
Based on a survey of 34,653 individuals in the general population (6,309 of whom had an alcohol use disorder) drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), researchers found that individuals with an alcohol use disorder who perceived negative stigma were 0.37 times less likely to seek treatment for their disorder compared to individuals with similarly serious alcohol disorders who did not perceive stigma.
In the general population, younger individuals perceived less stigma, and also were less likely to seek treatment for an alcohol disorder. Men perceived more stigma compared to women (38.1%vs. 37.7%). Non-Hispanic blacks and Hispanic adults overall reported a higher mean stigma compared to Whites (39 % vs. 37%) and were less likely to utilize alcohol services. However, the data also suggest that individuals with more severe alcohol disorders had a greater likelihood to seek treatment. Overall, perceived stigma was significantly higher for those with lower personal income, lower education, and individuals previously married compared to those who had never married.
"People with alcohol disorders who perceive high levels of alcohol stigma may avoid entering treatment because it confirms their membership in a stigmatized group," said Katherine Keyes, PhD, in the Mailman School of Public Health Department Epidemiology. "Given that alcohol use disorders are one of the most prevalent psychiatric disorders in the United States, the empirical documentation of stigma as a barrier to treatment is an important public health finding. Greater attention to reducing the stigma of having an alcohol disorder is urgently needed so that more individuals access the effective systems of care available to treat these disabling conditions."
Source:
Stephanie Berger
Columbia University's Mailman School of Public Health
This is the first study to address the underuse of alcohol services specifically with regard to alcohol-related stigma. Findings are published in the November issue of the American Journal of Epidemiology.
Based on a survey of 34,653 individuals in the general population (6,309 of whom had an alcohol use disorder) drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), researchers found that individuals with an alcohol use disorder who perceived negative stigma were 0.37 times less likely to seek treatment for their disorder compared to individuals with similarly serious alcohol disorders who did not perceive stigma.
In the general population, younger individuals perceived less stigma, and also were less likely to seek treatment for an alcohol disorder. Men perceived more stigma compared to women (38.1%vs. 37.7%). Non-Hispanic blacks and Hispanic adults overall reported a higher mean stigma compared to Whites (39 % vs. 37%) and were less likely to utilize alcohol services. However, the data also suggest that individuals with more severe alcohol disorders had a greater likelihood to seek treatment. Overall, perceived stigma was significantly higher for those with lower personal income, lower education, and individuals previously married compared to those who had never married.
"People with alcohol disorders who perceive high levels of alcohol stigma may avoid entering treatment because it confirms their membership in a stigmatized group," said Katherine Keyes, PhD, in the Mailman School of Public Health Department Epidemiology. "Given that alcohol use disorders are one of the most prevalent psychiatric disorders in the United States, the empirical documentation of stigma as a barrier to treatment is an important public health finding. Greater attention to reducing the stigma of having an alcohol disorder is urgently needed so that more individuals access the effective systems of care available to treat these disabling conditions."
Source:
Stephanie Berger
Columbia University's Mailman School of Public Health
среда, 8 июня 2011 г.
Correlation Between Parental Alcoholism And Illicit Drug Use In Emerging Adults
The impacts of parental alcoholism in children are well known, particularly the alcohol consumption habits of children of alcoholics (COA's). However, until now, little research has been conducted on the correlation between parental alcoholism and illicit drug use in emerging adults. A new study by David Flora, PhD of the University of North Carolina, Chapel Hill (now at York University), and Laurie Chassin, PhD of Arizona State University, shows that parental alcoholism represents a risk factor for maladaptive behaviors in adulthood that extend beyond alcoholism and into illicit drug use. The study appears in the current issue of Psychology of Addictive Behaviors, published by the American Psychological Association (APA).
This research identifies parental alcoholism as an important risk factor for escalated use of both alcohol and other drugs during young adulthood. Specifically, parental alcoholism has been associated with both an early onset of drinking and with persistent alcohol abuse throughout adulthood. Currently 1 in 4 children (under the age of 18) grow up in a household affected by alcoholism according to the National Association of Children of Alcoholics. That means 1 in 4 emerging adults and young adults will be faced with an increased risk for alcoholism and illicit drug use, simply because of exposure to an alcoholic parent.
This study followed 545 adolescents over a period of 15 years to monitor their drug use. The researchers were looking for differences in patterns of drug experimentation and drug use into early adulthood between children of alcoholics and children of non-alcoholics.
According to the study findings, COA's maintained consistent levels of drug use, such that by ages 25-30, their level of drug use was substantially higher than that of children of non-alcoholics. The study results indicate that as a consequence of parental alcoholism COA's didn't follow the typical trend by which individuals are expected to "mature out" and decline in drug use before age 30.
In order to test mediational models, the researchers looked at marriage and its effect on declines in drug use. For all participants, both COA's and non-COA's, marriage was associated with lower levels of drug use. However, since COA's were less likely to be married, they were more likely to have continued elevated levels of drug use in young adulthood.
Article: Changes in Drug Use During Young Adulthood: The Effect of Parent Alcoholism and Transition Into Marriage. David Flora, Ph.D., York University; Laurie Chassin, Ph.D., Arizona State University; Psychology of Addiction Behaviors, Vol. 19, No.4.
Full text of the article is available from the APA Public Affairs Office and at apa/releases/alcohol0106.html
The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologist. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 53 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations; APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.
Carla Daniels
cdanielsapa
American Psychological Association
apa
This research identifies parental alcoholism as an important risk factor for escalated use of both alcohol and other drugs during young adulthood. Specifically, parental alcoholism has been associated with both an early onset of drinking and with persistent alcohol abuse throughout adulthood. Currently 1 in 4 children (under the age of 18) grow up in a household affected by alcoholism according to the National Association of Children of Alcoholics. That means 1 in 4 emerging adults and young adults will be faced with an increased risk for alcoholism and illicit drug use, simply because of exposure to an alcoholic parent.
This study followed 545 adolescents over a period of 15 years to monitor their drug use. The researchers were looking for differences in patterns of drug experimentation and drug use into early adulthood between children of alcoholics and children of non-alcoholics.
According to the study findings, COA's maintained consistent levels of drug use, such that by ages 25-30, their level of drug use was substantially higher than that of children of non-alcoholics. The study results indicate that as a consequence of parental alcoholism COA's didn't follow the typical trend by which individuals are expected to "mature out" and decline in drug use before age 30.
In order to test mediational models, the researchers looked at marriage and its effect on declines in drug use. For all participants, both COA's and non-COA's, marriage was associated with lower levels of drug use. However, since COA's were less likely to be married, they were more likely to have continued elevated levels of drug use in young adulthood.
Article: Changes in Drug Use During Young Adulthood: The Effect of Parent Alcoholism and Transition Into Marriage. David Flora, Ph.D., York University; Laurie Chassin, Ph.D., Arizona State University; Psychology of Addiction Behaviors, Vol. 19, No.4.
Full text of the article is available from the APA Public Affairs Office and at apa/releases/alcohol0106.html
The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologist. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 53 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations; APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.
Carla Daniels
cdanielsapa
American Psychological Association
apa
вторник, 7 июня 2011 г.
Marijuana Smokers Face Rapid Lung Destruction - As Much As 20 Years Ahead Of Tobacco Smokers
A study in a Wiley-Blackwell journal - Respirology - finds that the development of bullous lung disease occurs in marijuana smokers approximately 20 years earlier than tobacco smokers.
A condition often caused by exposure to toxic chemicals or long-term exposure to tobacco smoke, bullous lung disease (also known as bullae) is a condition where air trapped in the lungs causes obstruction to breathing and eventual destruction of the lungs.
At present, about 10% of young adults and 1% of the adult population smoke marijuana regularly. Researchers find that the mean age of marijuana-smoking patients with lung problems was 41, as opposed to the average age of 65 years for tobacco-smoking patients.
The study "Bullous Lung Disease due to Marijuana" also finds that the bullous lung disease can easily go undetected as patients suffering from the disease may show normal chest X-rays and lung functions. High-resolution CT scans revealed severe asymmetrical, variably sized bullae in the patients studied. However, chest X-rays and lung functions were normal in half of them.
Lead author Dr. Matthew Naughton says, "What is outstanding about this study is the relatively young ages of the lung disease patients, as well as the lack of abnormality on chest X-rays and lung functions in nearly half of the patients we tested."
He added, "Marijuana is inhaled as extremely hot fumes to the peak inspiration and held for as long as possible before slow exhalation. This predisposes to greater damage to the lungs and makes marijuana smokers are more prone to bullous disease as compared to cigarette smokers."
Patients who smoke marijuana inhale more and hold their breath four times longer than cigarette smokers. It is the breathing manoeuvres of marijuana smokers that serve to increase the concentration and pulmonary deposition of inhaled particulate matter - resulting in greater and more rapid lung destruction.
This paper is published in the January 2008 issue of Respirology.
The abstract is available free online here.
About Respirology
Respirology is a journal of international standing, publishing peer-reviewed articles of scientific excellence in clinical and experimental respiratory biology and disease and its related fields of research including thoracic surgery, internal medicine, immunology, intensive and critical care, epidemiology, cell and molecular biology, pathology, pharmacology and physiology.
About Wiley-Blackwell
Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley's Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit blackwellpublishing or interscience.wiley.
About Wiley
Founded in 1807, John Wiley & Sons, Inc. has been a valued source of information and understanding for 200 years, helping people around the world meet their needs and fulfill their aspirations. Since 1901, Wiley and its acquired companies have published the works of more than 350 Nobel laureates in all categories: Literature, Economics, Physiology/Medicine, Chemistry and Peace.
Our core businesses include scientific, technical, medical and scholarly journals, encyclopedias, books, and online products and services; professional/trade publishes books, subscription products, training materials, and online applications and websites; and educational materials for undergraduate and graduate students and lifelong learners. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company's Web site can be accessed at wiley. The Company is listed on the New York Stock Exchange under the symbols JWa and JWb.
wiley
A condition often caused by exposure to toxic chemicals or long-term exposure to tobacco smoke, bullous lung disease (also known as bullae) is a condition where air trapped in the lungs causes obstruction to breathing and eventual destruction of the lungs.
At present, about 10% of young adults and 1% of the adult population smoke marijuana regularly. Researchers find that the mean age of marijuana-smoking patients with lung problems was 41, as opposed to the average age of 65 years for tobacco-smoking patients.
The study "Bullous Lung Disease due to Marijuana" also finds that the bullous lung disease can easily go undetected as patients suffering from the disease may show normal chest X-rays and lung functions. High-resolution CT scans revealed severe asymmetrical, variably sized bullae in the patients studied. However, chest X-rays and lung functions were normal in half of them.
Lead author Dr. Matthew Naughton says, "What is outstanding about this study is the relatively young ages of the lung disease patients, as well as the lack of abnormality on chest X-rays and lung functions in nearly half of the patients we tested."
He added, "Marijuana is inhaled as extremely hot fumes to the peak inspiration and held for as long as possible before slow exhalation. This predisposes to greater damage to the lungs and makes marijuana smokers are more prone to bullous disease as compared to cigarette smokers."
Patients who smoke marijuana inhale more and hold their breath four times longer than cigarette smokers. It is the breathing manoeuvres of marijuana smokers that serve to increase the concentration and pulmonary deposition of inhaled particulate matter - resulting in greater and more rapid lung destruction.
This paper is published in the January 2008 issue of Respirology.
The abstract is available free online here.
About Respirology
Respirology is a journal of international standing, publishing peer-reviewed articles of scientific excellence in clinical and experimental respiratory biology and disease and its related fields of research including thoracic surgery, internal medicine, immunology, intensive and critical care, epidemiology, cell and molecular biology, pathology, pharmacology and physiology.
About Wiley-Blackwell
Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley's Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit blackwellpublishing or interscience.wiley.
About Wiley
Founded in 1807, John Wiley & Sons, Inc. has been a valued source of information and understanding for 200 years, helping people around the world meet their needs and fulfill their aspirations. Since 1901, Wiley and its acquired companies have published the works of more than 350 Nobel laureates in all categories: Literature, Economics, Physiology/Medicine, Chemistry and Peace.
Our core businesses include scientific, technical, medical and scholarly journals, encyclopedias, books, and online products and services; professional/trade publishes books, subscription products, training materials, and online applications and websites; and educational materials for undergraduate and graduate students and lifelong learners. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company's Web site can be accessed at wiley. The Company is listed on the New York Stock Exchange under the symbols JWa and JWb.
wiley
понедельник, 6 июня 2011 г.
DrugScope: UN Drug Experts Must Condemn Human Rights Abuses
DrugScope, the UK's leading drug information charity, has responded to the launch of the latest annual report by the UN's International Narcotics Control Board (INCB). DrugScope welcomes the INCB's call for proportionality in the enforcement of drug laws around the world, but considers that the INCB must do much more to condemn the many human rights abuses perpetuated in the so-called 'war against drugs'.
In its latest report, the INCB has highlighted the need for all countries to balance their obligations under the international drug treaties with those of UN human rights legislation. It describes a principle of 'proportionality' that should be applied to all national drug law enforcement (1). The principle states that member countries must ensure that drug law enforcement is proportionate and in full compliance with the rule of law, including international agreements on human rights.
In its consideration of the proportionality principle, however, the INCB makes no specific reference to specific countries where infringements or limitations of human rights are currently taking place. DrugScope and the IDPC are disappointed by these key omissions from the INCB's discussion of proportionality, examples of which include:
Failure to discuss plans announced by Chinese officials to place a million drug users in compulsory detoxification prior to the 2008 Olympic Games in Beijing.
Despite a recent visit to Brazil, the INCB report does not mention the 449 people who were shot and killed in the first half of 2007 in drug enforcement operations by police. Brazilian children, recruited into drug gangs, are considered legitimate targets by police and are shot at frequently in incursions into Rio's favelas.
The INCB has remained silent on the many human rights abuses and deaths in Thailand during Thaksin Shinawatra's 'war on drugs' in 2003/04; lack of such condemnation from the UN may be contributing to Thailand's current willingness to consider another wave of such extreme enforcement tactics.
64 countries retain the death penalty and of those, half apply the death penalty to drug-related offences. This is in violation of international human rights law (1).
Each year, China uses the UN's International Day Against Drug Abuse and Illicit Drug Trafficking (26 June) as a day to carry out mass, public executions of drug offenders. In 2002, the day was marked by 64 public executions across the country (2).
DrugScope is a founding member of the International Drug Policy Consortium (IDPC), a coalition that aims to promote objective and open debate about national and international drug policy. In that capacity, DrugScope's Director of Communications and Information, Harry Shapiro said:
"Drug users are vilified and marginalised worldwide. Some nations feel that any action against them is justified, including murder. We are encouraged that the INCB recognises this is unacceptable and that a balance must be struck between the enforcement of drug laws and the human rights and civil liberties of those with serious problems.
"But DrugScope and the International Drug Policy Consortium feel that the INCB, from their position of international authority, must follow their condemnation of human rights abuses through to its logical conclusion. The INCB must offer public criticism of particular countries with the worst human rights record in this area."
The International Drug Policy Consortium (IDPC) is a global network of national and international NGOs that specialise in issues related to illegal and legal drug use. DrugScope is a founder member of the consortium. You can find out more here: idpc.info where you can also download the ICDP's full response to the INCB report.
The International Narcotics Control Board (INCB) is an independent and quasi-judicial organisation that monitors the implementation of the United Nations drug control conventions. Each year the INCB spotlights a particular issue of concern in international drug policy and this year the focus is on the principle of proportionality and drug-related offences. You can find out more about the work of the INCB and download the full report here: incb.
(1) The principle of proportionality states that member countries are responsible for ensuring that their enforcement actions against the drug market and drug users are:
- allowed for in national legislation;
- not applied in an arbitrary manner;
- in pursuance of a legitimate aim;
- proportionate to that aim, meaning that the state limits or infringes on the human rights of its citizens no more than necessary.
Source: IDPC response to the 2007 Annual Report of the International Narcotics Control Board, available to download from idpc.info
(2) Source: The Death Penalty for Drug Offences: A Violation of International Human Rights Law by Rick Lines, is published by IHRA (ISBN 978-0-9557754-0-6) and can be viewed in its entirety at ihra
(3) Source: ibid.
drugscope
In its latest report, the INCB has highlighted the need for all countries to balance their obligations under the international drug treaties with those of UN human rights legislation. It describes a principle of 'proportionality' that should be applied to all national drug law enforcement (1). The principle states that member countries must ensure that drug law enforcement is proportionate and in full compliance with the rule of law, including international agreements on human rights.
In its consideration of the proportionality principle, however, the INCB makes no specific reference to specific countries where infringements or limitations of human rights are currently taking place. DrugScope and the IDPC are disappointed by these key omissions from the INCB's discussion of proportionality, examples of which include:
Failure to discuss plans announced by Chinese officials to place a million drug users in compulsory detoxification prior to the 2008 Olympic Games in Beijing.
Despite a recent visit to Brazil, the INCB report does not mention the 449 people who were shot and killed in the first half of 2007 in drug enforcement operations by police. Brazilian children, recruited into drug gangs, are considered legitimate targets by police and are shot at frequently in incursions into Rio's favelas.
The INCB has remained silent on the many human rights abuses and deaths in Thailand during Thaksin Shinawatra's 'war on drugs' in 2003/04; lack of such condemnation from the UN may be contributing to Thailand's current willingness to consider another wave of such extreme enforcement tactics.
64 countries retain the death penalty and of those, half apply the death penalty to drug-related offences. This is in violation of international human rights law (1).
Each year, China uses the UN's International Day Against Drug Abuse and Illicit Drug Trafficking (26 June) as a day to carry out mass, public executions of drug offenders. In 2002, the day was marked by 64 public executions across the country (2).
DrugScope is a founding member of the International Drug Policy Consortium (IDPC), a coalition that aims to promote objective and open debate about national and international drug policy. In that capacity, DrugScope's Director of Communications and Information, Harry Shapiro said:
"Drug users are vilified and marginalised worldwide. Some nations feel that any action against them is justified, including murder. We are encouraged that the INCB recognises this is unacceptable and that a balance must be struck between the enforcement of drug laws and the human rights and civil liberties of those with serious problems.
"But DrugScope and the International Drug Policy Consortium feel that the INCB, from their position of international authority, must follow their condemnation of human rights abuses through to its logical conclusion. The INCB must offer public criticism of particular countries with the worst human rights record in this area."
The International Drug Policy Consortium (IDPC) is a global network of national and international NGOs that specialise in issues related to illegal and legal drug use. DrugScope is a founder member of the consortium. You can find out more here: idpc.info where you can also download the ICDP's full response to the INCB report.
The International Narcotics Control Board (INCB) is an independent and quasi-judicial organisation that monitors the implementation of the United Nations drug control conventions. Each year the INCB spotlights a particular issue of concern in international drug policy and this year the focus is on the principle of proportionality and drug-related offences. You can find out more about the work of the INCB and download the full report here: incb.
(1) The principle of proportionality states that member countries are responsible for ensuring that their enforcement actions against the drug market and drug users are:
- allowed for in national legislation;
- not applied in an arbitrary manner;
- in pursuance of a legitimate aim;
- proportionate to that aim, meaning that the state limits or infringes on the human rights of its citizens no more than necessary.
Source: IDPC response to the 2007 Annual Report of the International Narcotics Control Board, available to download from idpc.info
(2) Source: The Death Penalty for Drug Offences: A Violation of International Human Rights Law by Rick Lines, is published by IHRA (ISBN 978-0-9557754-0-6) and can be viewed in its entirety at ihra
(3) Source: ibid.
drugscope
воскресенье, 5 июня 2011 г.
Adolescent binge drinking issues
During a web-based CME conference on June 14th, two of the nation's leading experts on substance abuse and toxicology presented the latest information on adolescent binge drinking. The conference was co-sponsored by the American College of Preventive Medicine and Medscape/WebMD. A free archive of the session is now available online at medscape.
Dr. Robin B. McFee of Emergistics US, Inc., and Dr. Michael M. Miller of the NewStart Alcohol/Drug Treatment Program at Meriter Hospital, delivered presentations and answered audience questions. Dr. George Lundberg, Editor-in-Chief of Medscape General Medicine, moderated the session. The conference provided critical information for practicing physicians, public health officials, and other front-line health providers who provide primary care and substance abuse treatment to adolescents, as well as to those who are concerned with the health and social implications of adolescent binge drinking.
The conference featured an overview of the epidemiology of binge drinking, including use patterns and trends, and the risks associated with this type of substance use. Participants also learned that approximately 75% of adolescent morbidity and mortality is associated with behavioral health risks, of which a large portion can be attributed to substance and alcohol use.
Dr. Miller, highlighting the impact of alcohol use and addiction on adolescent brain development, noted that "Some of the evidence suggests that there may not be any safe levels of alcohol consumption for kids because of how sensitive the developing adolescent brain is to alcohol, especially in binge amounts." In describing clinical approaches to addressing the problem, Dr. McFee stressed the importance of age-appropriate adolescent health services and building rapport with adolescent patients. By using the 5 A's (anticipate, ask, advise, assist, arrange) method at every office visit, clinicians can build trust and assess an adolescents risk profile.
To view an archive of the web-based conference visit
medscape/viewprogram/4172 and register and log-in as a free Medscape user. You will be able to see and hear the program online. There is no cost to view the program or to obtain CME credit.
The American College of Preventive Medicine is the national professional society for physicians whose expertise and interest lie in disease prevention and health promotion (acpm). ACPM's more than 2,000 members are engaged in preventive medicine practice, teaching and research. Medscape from WebMD is the leading provider of online information and educational services for physicians and health care professionals (medscape).
The American College of Preventive Medicine (ACPM) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. ACPM designates this educational activity for a maximum of 1.5 category 1 credits towards the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.
American College of Preventive Medicine
acpm
Dr. Robin B. McFee of Emergistics US, Inc., and Dr. Michael M. Miller of the NewStart Alcohol/Drug Treatment Program at Meriter Hospital, delivered presentations and answered audience questions. Dr. George Lundberg, Editor-in-Chief of Medscape General Medicine, moderated the session. The conference provided critical information for practicing physicians, public health officials, and other front-line health providers who provide primary care and substance abuse treatment to adolescents, as well as to those who are concerned with the health and social implications of adolescent binge drinking.
The conference featured an overview of the epidemiology of binge drinking, including use patterns and trends, and the risks associated with this type of substance use. Participants also learned that approximately 75% of adolescent morbidity and mortality is associated with behavioral health risks, of which a large portion can be attributed to substance and alcohol use.
Dr. Miller, highlighting the impact of alcohol use and addiction on adolescent brain development, noted that "Some of the evidence suggests that there may not be any safe levels of alcohol consumption for kids because of how sensitive the developing adolescent brain is to alcohol, especially in binge amounts." In describing clinical approaches to addressing the problem, Dr. McFee stressed the importance of age-appropriate adolescent health services and building rapport with adolescent patients. By using the 5 A's (anticipate, ask, advise, assist, arrange) method at every office visit, clinicians can build trust and assess an adolescents risk profile.
To view an archive of the web-based conference visit
medscape/viewprogram/4172 and register and log-in as a free Medscape user. You will be able to see and hear the program online. There is no cost to view the program or to obtain CME credit.
The American College of Preventive Medicine is the national professional society for physicians whose expertise and interest lie in disease prevention and health promotion (acpm). ACPM's more than 2,000 members are engaged in preventive medicine practice, teaching and research. Medscape from WebMD is the leading provider of online information and educational services for physicians and health care professionals (medscape).
The American College of Preventive Medicine (ACPM) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. ACPM designates this educational activity for a maximum of 1.5 category 1 credits towards the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.
American College of Preventive Medicine
acpm
суббота, 4 июня 2011 г.
Scientists' Findings May Lead To New Drug-Abuse Treatments
Increased connections among brain cells caused by excessive drug use may represent the body's defense mechanism to combat addiction and related behaviors, scientists at UT Southwestern Medical Center have found.
Previous studies have shown that repeated use of drugs such as cocaine, amphetamines and nicotine increase the number of anatomical structures called dendritic spines in brain regions associated with pleasure and reward. These dendritic spines represent sites where brain cells communicate with one another. Many scientists believe that this long-lasting brain rewiring underlies the similarly persistent behaviors of drug-taking and drug-seeking associated with addiction and relapse. The mechanism that controls this brain rewiring, however, and its relationship to addiction-related behaviors were previously unknown.
In a study appearing in the Aug. 28 issue of Neuron, researchers found that cocaine suppresses the activity of the protein MEF2 in mice. Because MEF2 normally reduces the number of brain connections, suppressing MEF2 leads to an increase in dendritic spine density. The researchers also found that when they enhanced MEF2 activity in the brain this blocked the drug-induced increase in dendritic spine density and increased addiction-related behavioral responses to cocaine.
"Our findings suggest that increased brain connections during chronic drug use may actually limit behavioral changes associated with drug addiction, rather than support them," said Dr. Christopher Cowan, assistant professor of psychiatry at UT Southwestern and senior author of the study.
Researchers said they hope this finding could lead to a pharmaceutical treatment for addiction.
"Relapse, or the resumption of active drug-taking and drug-seeking, is very common in drug addicts," Dr. Cowan said. "Addiction-related brain changes and behaviors seem to be hardwired and semipermanent, and there are limited treatment options. Our data suggest that rather than trying to block the process of increasing dendritic spine density, we may actually want to look at treatments that try to enhance this process."
MEF2 is activated in response to brain activity. It provides negative feedback to eliminate the potential growth of too many communication sites between nerve cells. Repeated exposure to cocaine disrupts this function of MEF2, resulting in new brain connections.
To investigate the relationship between MEF2 and spine-density changes, the researchers varied the level of the protein in an area of the brain called the nucleus accumbens. This region is associated with the feelings of reward that drug addicts seek. Brain imaging done after mice were given cocaine showed that cocaine stopped MEF2 from limiting dendritic spine increases.
To test MEF2's relationship to behavior, researchers monitored the movement of mice after repeated daily exposure to the same amount of cocaine. This same dose of cocaine produced a larger behavioral response after repeated days of drug injections, resulting in a "sensitized" response. This sensitized behavioral response to the drug is very stable, lasting for many months after the drug is discontinued.
When the researchers manipulated animals so that their MEF2 levels remained high in the presence of cocaine, the animals were more sensitive to the drug. This suggested that increased communication sites might help combat the addiction process.
"This suggests the exciting possibility that MEF2 proteins may control expression of key genes that modulate drug-related brain changes and behavior," Dr. Cowan said. "If we understand which genes are influenced by MEF2, we can intervene and try to help the system resist or reverse these sensitization processes."
In 2006, 23.6 million people ages 12 and older needed treatment for drug or alcohol abuse, according to a Substance Abuse and Mental Health Services Administration survey. Substance abuse costs the U.S. more than half a trillion dollars annually, according to the National Institute on Drug Abuse.
Future research will focus on determining MEF2 target genes and exploring drug-related density changes in other regions of the brain associated with addiction, Dr. Cowan said.
Other UT Southwestern researchers involved in the study were Dr. Suprabha Pulipparacharuvil, instructor of psychiatry; William Renthal, graduate student in psychiatry and neuroscience; Carly Hale, research technician in psychiatry; Dr. Makoto Taniguchi, postdoctoral researcher in psychiatry; Colleen Dewey, graduate student in neuroscience; Dr. Scott Russo, assistant instructor of psychiatry; Dr. Devanjan Sikder, instructor of internal medicine; and Dr. Guanghua Xiao, assistant professor of clinical sciences. Dr. Eric Nestler, former chairman of psychiatry, and former instructor Dr. Arvind Kumar were also involved. Researchers from Yale and Rockefeller University also participated.
The work was funded by the Whitehall Foundation, the National Institute on Drug Abuse and the National Institute of Mental Health.
Visit utsouthwestern/neurosciences to learn more about UT Southwestern's clinical services in the neurosciences.
UT Southwestern Medical Center
Previous studies have shown that repeated use of drugs such as cocaine, amphetamines and nicotine increase the number of anatomical structures called dendritic spines in brain regions associated with pleasure and reward. These dendritic spines represent sites where brain cells communicate with one another. Many scientists believe that this long-lasting brain rewiring underlies the similarly persistent behaviors of drug-taking and drug-seeking associated with addiction and relapse. The mechanism that controls this brain rewiring, however, and its relationship to addiction-related behaviors were previously unknown.
In a study appearing in the Aug. 28 issue of Neuron, researchers found that cocaine suppresses the activity of the protein MEF2 in mice. Because MEF2 normally reduces the number of brain connections, suppressing MEF2 leads to an increase in dendritic spine density. The researchers also found that when they enhanced MEF2 activity in the brain this blocked the drug-induced increase in dendritic spine density and increased addiction-related behavioral responses to cocaine.
"Our findings suggest that increased brain connections during chronic drug use may actually limit behavioral changes associated with drug addiction, rather than support them," said Dr. Christopher Cowan, assistant professor of psychiatry at UT Southwestern and senior author of the study.
Researchers said they hope this finding could lead to a pharmaceutical treatment for addiction.
"Relapse, or the resumption of active drug-taking and drug-seeking, is very common in drug addicts," Dr. Cowan said. "Addiction-related brain changes and behaviors seem to be hardwired and semipermanent, and there are limited treatment options. Our data suggest that rather than trying to block the process of increasing dendritic spine density, we may actually want to look at treatments that try to enhance this process."
MEF2 is activated in response to brain activity. It provides negative feedback to eliminate the potential growth of too many communication sites between nerve cells. Repeated exposure to cocaine disrupts this function of MEF2, resulting in new brain connections.
To investigate the relationship between MEF2 and spine-density changes, the researchers varied the level of the protein in an area of the brain called the nucleus accumbens. This region is associated with the feelings of reward that drug addicts seek. Brain imaging done after mice were given cocaine showed that cocaine stopped MEF2 from limiting dendritic spine increases.
To test MEF2's relationship to behavior, researchers monitored the movement of mice after repeated daily exposure to the same amount of cocaine. This same dose of cocaine produced a larger behavioral response after repeated days of drug injections, resulting in a "sensitized" response. This sensitized behavioral response to the drug is very stable, lasting for many months after the drug is discontinued.
When the researchers manipulated animals so that their MEF2 levels remained high in the presence of cocaine, the animals were more sensitive to the drug. This suggested that increased communication sites might help combat the addiction process.
"This suggests the exciting possibility that MEF2 proteins may control expression of key genes that modulate drug-related brain changes and behavior," Dr. Cowan said. "If we understand which genes are influenced by MEF2, we can intervene and try to help the system resist or reverse these sensitization processes."
In 2006, 23.6 million people ages 12 and older needed treatment for drug or alcohol abuse, according to a Substance Abuse and Mental Health Services Administration survey. Substance abuse costs the U.S. more than half a trillion dollars annually, according to the National Institute on Drug Abuse.
Future research will focus on determining MEF2 target genes and exploring drug-related density changes in other regions of the brain associated with addiction, Dr. Cowan said.
Other UT Southwestern researchers involved in the study were Dr. Suprabha Pulipparacharuvil, instructor of psychiatry; William Renthal, graduate student in psychiatry and neuroscience; Carly Hale, research technician in psychiatry; Dr. Makoto Taniguchi, postdoctoral researcher in psychiatry; Colleen Dewey, graduate student in neuroscience; Dr. Scott Russo, assistant instructor of psychiatry; Dr. Devanjan Sikder, instructor of internal medicine; and Dr. Guanghua Xiao, assistant professor of clinical sciences. Dr. Eric Nestler, former chairman of psychiatry, and former instructor Dr. Arvind Kumar were also involved. Researchers from Yale and Rockefeller University also participated.
The work was funded by the Whitehall Foundation, the National Institute on Drug Abuse and the National Institute of Mental Health.
Visit utsouthwestern/neurosciences to learn more about UT Southwestern's clinical services in the neurosciences.
UT Southwestern Medical Center
пятница, 3 июня 2011 г.
Scientists Say UK Drug Classification System Is Flawed
Most Popular Articles For Alcohol
These are the most read articles from this news category for the last 6 months:
Alcohol Is Most Harmful Drug, Followed By Heroin And Crack
01 Nov 2010
Alcohol is the most damaging drug to the drinker and others overall, heroin and crack are the second and third most harmful, Professor David Nutt and colleagues wrote in the medical journal The Lancet today...
Giving Up Smoking Linked To Greater Happiness And Elevated Mood
05 Dec 2010
Energy Drinks: Is It Time To Tighten Regulation?
02 Nov 2010
USA's Drunkest Cities Are Milwaukee, Fargo And San Francisco
31 Dec 2010
Lock Up The Liquor; Parents Giving Children Alcohol
19 Feb 2011
_uacct = "UA-849615-1";
urchinTracker();
These are the most read articles from this news category for the last 6 months:
Alcohol Is Most Harmful Drug, Followed By Heroin And Crack
01 Nov 2010
Alcohol is the most damaging drug to the drinker and others overall, heroin and crack are the second and third most harmful, Professor David Nutt and colleagues wrote in the medical journal The Lancet today...
Giving Up Smoking Linked To Greater Happiness And Elevated Mood
05 Dec 2010
Energy Drinks: Is It Time To Tighten Regulation?
02 Nov 2010
USA's Drunkest Cities Are Milwaukee, Fargo And San Francisco
31 Dec 2010
Lock Up The Liquor; Parents Giving Children Alcohol
19 Feb 2011
_uacct = "UA-849615-1";
urchinTracker();
четверг, 2 июня 2011 г.
Early Alcohol Exposure Can Quickly Lead To Heavy Drinking
* While adolescence is a vulnerable time for alcohol and drug experimentation, not all adolescents develop problems.
* A new study using rodents has found that drinking patterns can emerge quickly among adolescents.
* These findings suggest that humans who consume large quantities of alcohol during early exposure are those most likely to later become heavy drinkers
No one can become alcohol dependent (AD) without repeatedly drinking alcohol, but not everyone who does so will become AD. Certain characteristics - adolescence, novelty seeking, reaction to stress, and response to first alcohol exposure - are believed to influence the vulnerability of developing AD. A new study using adolescent rats has found that early exposure to alcohol during adolescence can quickly lead to heavy drinking patterns.
Results are published in the May issue of Alcoholism: Clinical & Experimental Research.
"We know that adolescence is a vulnerable time," explained Nicole L. Schramm-Sapyta, research associate in the department of pharmacology and cancer biology at Duke University Medical Center.
"People who start drinking the earliest tend to be the most likely to develop drinking problems," said Schramm-Sapyta. "But we also know that not all adolescents get into trouble with alcohol and other drugs. We wanted to examine, within an adolescent population, whether these early 'big drinkers' were different in some way ... if they had individual characteristics that were responsible for the drinking. We chose to examine novelty seeking and stress because these are two characteristics we see in some populations that develop problem drinking." Schramm-Sapyta is the study's first author.
Researchers examined 48 male Sprague-Dawley rats that were 28 days old - the equivalent of rodent adolescence. The rats were exposed to an elevated-plus maze (to measure anxiety) as well as open-field locomotion and novel-object exploration (to measure response to novelty), and also had their blood collected after the maze (to measure stress hormone levels). After testing, the researchers measured how much each rat drank in special lickometer cages. The rats were habituated to the cages with water, which was then switched to an alcohol (10% v/v) solution for three nights, followed by a choice between the water or alcohol solutions for 10 consecutive nights. After two nights of abstinence, the rats were once again given a day's choice between the water or alcohol solutions in order to measure relapse-like behavior.
"Our key finding is that drinking patterns may be established after only a few exposures to alcohol," said Schramm-Sapyta. "Rats that demonstrated a 'taste' for alcohol after only three nights of drinking were very likely to be the biggest drinkers after longer-term exposure to alcohol."
"The adolescent drinking in this study likely relates to those rats with low sensitivity to the sedative effects of alcohol, coupled with high consumption for adolescents in general," commented Fulton T. Crews, Director of the Center for Alcohol Studies at the University of North Carolina. "These findings support the interaction of genetics and environmental exposure to alcohol during adolescence as determining life-long drinking. They also support the hypothesis that adolescent drinking may predict risk of alcohol problems."
Another key finding, said Schramm-Sapyta, was related to the negative results of the study: that measures of novelty seeking and stress responsiveness were not related to drinking outcomes. "This suggests that there are other characteristics that we as scientists should be looking for, which are related to the early experiences of drinking."
Schramm-Sapyta extrapolated these findings to humans, saying that people who drink to excess when they first begin might be at higher risk for developing alcoholism. "The findings suggest that early 'big drinkers' are the people who should be targeted for alcoholism-prevention efforts," she said. "Of course, the findings do not tell us what we should do to help those people, or why they are big drinkers so early in their experience. Future work will focus on determining other factors which can help to more accurately predict which rats will fall into that group."
Both Schramm-Sapyta and Crews said these findings have important implications for parents, as well as parental monitoring. "They suggest that parents should understand the norms of adolescent drinking, that a small amount of drinking is normal," said Schramm-Sapyta. "Drinking will need to be addressed when one's child is outside the norm of his or her peers and other teenagers, or if the child endangers himself or others."
Or, there is another option, said Crews: "Just don't give your kids alcohol."
Alcoholism: Clinical & Experimental Research. (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Early Ethanol Consumption Predicts Relapse-like Behavior in Adolescent Male Rats," were: Nicole L. Schramm-Sapyta, Megan A. Kingsley and Kiayia Propst of the Department of Pharmacology and Cancer Biology at Duke University Medical Center; Amir H. Rezvani of the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center; and H. Scott Swartzwelder of the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center, as well as Durham VA Medical Center. The study was funded by the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism.
Source:
Nicole L. Schramm-Sapyta, Ph.D.
Duke University Medical Center
Fulton T. Crews, Ph.D.
University of North Carolina
Alcoholism: Clinical & Experimental Research
* A new study using rodents has found that drinking patterns can emerge quickly among adolescents.
* These findings suggest that humans who consume large quantities of alcohol during early exposure are those most likely to later become heavy drinkers
No one can become alcohol dependent (AD) without repeatedly drinking alcohol, but not everyone who does so will become AD. Certain characteristics - adolescence, novelty seeking, reaction to stress, and response to first alcohol exposure - are believed to influence the vulnerability of developing AD. A new study using adolescent rats has found that early exposure to alcohol during adolescence can quickly lead to heavy drinking patterns.
Results are published in the May issue of Alcoholism: Clinical & Experimental Research.
"We know that adolescence is a vulnerable time," explained Nicole L. Schramm-Sapyta, research associate in the department of pharmacology and cancer biology at Duke University Medical Center.
"People who start drinking the earliest tend to be the most likely to develop drinking problems," said Schramm-Sapyta. "But we also know that not all adolescents get into trouble with alcohol and other drugs. We wanted to examine, within an adolescent population, whether these early 'big drinkers' were different in some way ... if they had individual characteristics that were responsible for the drinking. We chose to examine novelty seeking and stress because these are two characteristics we see in some populations that develop problem drinking." Schramm-Sapyta is the study's first author.
Researchers examined 48 male Sprague-Dawley rats that were 28 days old - the equivalent of rodent adolescence. The rats were exposed to an elevated-plus maze (to measure anxiety) as well as open-field locomotion and novel-object exploration (to measure response to novelty), and also had their blood collected after the maze (to measure stress hormone levels). After testing, the researchers measured how much each rat drank in special lickometer cages. The rats were habituated to the cages with water, which was then switched to an alcohol (10% v/v) solution for three nights, followed by a choice between the water or alcohol solutions for 10 consecutive nights. After two nights of abstinence, the rats were once again given a day's choice between the water or alcohol solutions in order to measure relapse-like behavior.
"Our key finding is that drinking patterns may be established after only a few exposures to alcohol," said Schramm-Sapyta. "Rats that demonstrated a 'taste' for alcohol after only three nights of drinking were very likely to be the biggest drinkers after longer-term exposure to alcohol."
"The adolescent drinking in this study likely relates to those rats with low sensitivity to the sedative effects of alcohol, coupled with high consumption for adolescents in general," commented Fulton T. Crews, Director of the Center for Alcohol Studies at the University of North Carolina. "These findings support the interaction of genetics and environmental exposure to alcohol during adolescence as determining life-long drinking. They also support the hypothesis that adolescent drinking may predict risk of alcohol problems."
Another key finding, said Schramm-Sapyta, was related to the negative results of the study: that measures of novelty seeking and stress responsiveness were not related to drinking outcomes. "This suggests that there are other characteristics that we as scientists should be looking for, which are related to the early experiences of drinking."
Schramm-Sapyta extrapolated these findings to humans, saying that people who drink to excess when they first begin might be at higher risk for developing alcoholism. "The findings suggest that early 'big drinkers' are the people who should be targeted for alcoholism-prevention efforts," she said. "Of course, the findings do not tell us what we should do to help those people, or why they are big drinkers so early in their experience. Future work will focus on determining other factors which can help to more accurately predict which rats will fall into that group."
Both Schramm-Sapyta and Crews said these findings have important implications for parents, as well as parental monitoring. "They suggest that parents should understand the norms of adolescent drinking, that a small amount of drinking is normal," said Schramm-Sapyta. "Drinking will need to be addressed when one's child is outside the norm of his or her peers and other teenagers, or if the child endangers himself or others."
Or, there is another option, said Crews: "Just don't give your kids alcohol."
Alcoholism: Clinical & Experimental Research. (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Early Ethanol Consumption Predicts Relapse-like Behavior in Adolescent Male Rats," were: Nicole L. Schramm-Sapyta, Megan A. Kingsley and Kiayia Propst of the Department of Pharmacology and Cancer Biology at Duke University Medical Center; Amir H. Rezvani of the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center; and H. Scott Swartzwelder of the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center, as well as Durham VA Medical Center. The study was funded by the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism.
Source:
Nicole L. Schramm-Sapyta, Ph.D.
Duke University Medical Center
Fulton T. Crews, Ph.D.
University of North Carolina
Alcoholism: Clinical & Experimental Research
среда, 1 июня 2011 г.
Long-Time Cannabis Use Associated With Psychosis
Young adults who have used cannabis or marijuana for a longer period of time appear more likely to have hallucinations or delusions or to meet criteria for psychosis, according to a report posted online today that will appear in the May print issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Previous studies have identified an association between cannabis use and psychosis, according to background information in the article. However, concerns remain that this research has not adequately accounted for confounding variables.
John McGrath, M.D., Ph.D., F.R.A.N.Z.C.P., of the Queensland Brain Institute, University of Queensland, Australia, and colleagues studied 3,801 young adults born between 1981 and 1984. At a 21-year follow-up, when participants were an average age of 20.1, they were asked about cannabis use in recent years and assessed using several measures of psychotic outcomes (including a diagnostic interview, an inventory of delusions and items identifying the presence of hallucinations).
At the 21-year follow-up, 17.7 percent reported using cannabis for three or fewer years, 16.2 percent for four to five years and 14.3 percent for six or more years. Overall, 65 study participants received a diagnosis of "non-affective psychosis," such as schizophrenia, and 233 had at least one positive item for hallucination on the diagnostic interview.
Among all the participants, a longer duration since the first time they used cannabis was associated with multiple psychosis-related outcomes. "Compared with those who had never used cannabis, young adults who had six or more years since first use of cannabis (i.e., who commenced use when around 15 years or younger) were twice as likely to develop a non-affective psychosis and were four times as likely to have high scores on the Peters et al Delusions Inventory [a measure of delusion]," the authors write. "There was a 'dose-response' relationship between the variables of interest: the longer the duration since first cannabis use, the higher the risk of psychosis-related outcomes."
In addition, the researchers assessed the association between cannabis use and psychotic symptoms among a subgroup of 228 sibling pairs. The association persisted in this subgroup, "thus reducing the likelihood that the association was due to unmeasured shared genetic and/or environmental influences," the authors continue.
"The nature of the relationship between psychosis and cannabis use is by no means simple," they write. Individuals who had experienced hallucinations early in life were more likely to have used cannabis longer and to use it more frequently. "This demonstrates the complexity of the relationship: those individuals who were vulnerable to psychosis (i.e., those who had isolated psychotic symptoms) were more likely to commence cannabis use, which could then subsequently contribute to an increased risk of conversion to a non-affective psychotic disorder."
The findings should encourage further research to elucidate the mechanisms underlying the relationship between psychosis and cannabis use, the authors conclude.
Arch Gen Psychiatry. 2010;67[5]:(doi:10.1001/archgenpsychaitry.2010.6.
Source
Archives of General Psychiatry
Previous studies have identified an association between cannabis use and psychosis, according to background information in the article. However, concerns remain that this research has not adequately accounted for confounding variables.
John McGrath, M.D., Ph.D., F.R.A.N.Z.C.P., of the Queensland Brain Institute, University of Queensland, Australia, and colleagues studied 3,801 young adults born between 1981 and 1984. At a 21-year follow-up, when participants were an average age of 20.1, they were asked about cannabis use in recent years and assessed using several measures of psychotic outcomes (including a diagnostic interview, an inventory of delusions and items identifying the presence of hallucinations).
At the 21-year follow-up, 17.7 percent reported using cannabis for three or fewer years, 16.2 percent for four to five years and 14.3 percent for six or more years. Overall, 65 study participants received a diagnosis of "non-affective psychosis," such as schizophrenia, and 233 had at least one positive item for hallucination on the diagnostic interview.
Among all the participants, a longer duration since the first time they used cannabis was associated with multiple psychosis-related outcomes. "Compared with those who had never used cannabis, young adults who had six or more years since first use of cannabis (i.e., who commenced use when around 15 years or younger) were twice as likely to develop a non-affective psychosis and were four times as likely to have high scores on the Peters et al Delusions Inventory [a measure of delusion]," the authors write. "There was a 'dose-response' relationship between the variables of interest: the longer the duration since first cannabis use, the higher the risk of psychosis-related outcomes."
In addition, the researchers assessed the association between cannabis use and psychotic symptoms among a subgroup of 228 sibling pairs. The association persisted in this subgroup, "thus reducing the likelihood that the association was due to unmeasured shared genetic and/or environmental influences," the authors continue.
"The nature of the relationship between psychosis and cannabis use is by no means simple," they write. Individuals who had experienced hallucinations early in life were more likely to have used cannabis longer and to use it more frequently. "This demonstrates the complexity of the relationship: those individuals who were vulnerable to psychosis (i.e., those who had isolated psychotic symptoms) were more likely to commence cannabis use, which could then subsequently contribute to an increased risk of conversion to a non-affective psychotic disorder."
The findings should encourage further research to elucidate the mechanisms underlying the relationship between psychosis and cannabis use, the authors conclude.
Arch Gen Psychiatry. 2010;67[5]:(doi:10.1001/archgenpsychaitry.2010.6.
Source
Archives of General Psychiatry
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