Monday, September 22, 2008

Understanding Addictions

CAMDEN (Sep 22): “Understanding Addictions” will be the subject of a free evening program open to anyone in the Midcoast area and presented by the First Congregational Church, Camden, from 7 p.m. to 9 p.m. on Thursday, September 25.

“’Understanding Addictions” is intended both for people who may be suffering from an addiction and for individuals who would like to be more helpful to a family member or a friend who is struggling with addiction,” said program leader, Mary Ellen Ostherr who works as a substance abuse therapist for Mid-Coast Mental Health and also has a private practice. She has worked in the field helping individuals and families with substance abuse and recovery for 15 years.

“Part of the program will be about how to understand the signs of addiction and what you can do about it as a friend or family member. The program will also cover how to recognize enabling behaviors and what to do to help stop those behaviors that can contribute to someone’s addiction,” she said. “An important part of the program will cover how we can reach out and help others.”

Denial—how to recognize it and how to deal with it as a friend or family member will also be covered, Ostherr said.

Maine currently leads the nation in per capita addiction to opiates and the state is number two in alcohol addiction. Factors that make the problem worse for the people of Maine, she said, include the long winters, the ready availability of drugs and alcohol, and the high risk nature of some jobs in Maine.

It is easy to get hurt and take prescription drugs as part of the rehabilitation, she said. Good people can find that weeks later they may develop an addiction. Another factor is the Internet. There are now websites that make it all too easy to get prescription medications. Some of these websites have doctors standing by who will write the prescription.

“Understanding Addictions” is offered through the “Live and Learn” series of free seminars and workshops presented for residents of the Midcoast area by the First Congregational Church, Camden.

“Understanding Addictions” will be held in the Mayflower Room of the church at 55 Elm Street in Camden. Participants should park in the Church parking lot behind the Church and enter through the door on the parking lot side. The Church is handicapped accessible.

Sunday, September 21, 2008

Younger drinkers risk ruining their lives

As a college president, I have many reasons to be concerned about the consumption of alcohol by my students. Perhaps the most clear-cut reasons are legal. Students who consume alcohol under the age of 21 are breaking state law. Furthermore, even those who are of legal drinking age might cause civil liability to accrue to the college if they drink to excess and cause harm to themselves or others.

However, the most important issues surrounding excessive and underage student drinking are, for me and my fellow presidents, not legal. Of much greater concern are the potential adverse consequences to the students themselves. Nationally almost 2,000 college students between the ages of 18 and 24 die each year from unintentional injuries in which alcohol was a factor. Additional hundreds of thousands of students are injured; many of them seriously. These deaths and injuries are avoidable.

Every empirical study I have seen in 25 years of studying the issue in Canada and the United States confirms that there is a direct relationship between the legal drinking age and the incidence of alcohol-related death and injury. For that reason, I would not support any reduction in the legal drinking age. This was one of the alternatives posited by the Amethyst Initiative as a way of combating underage and binge drinking. It is unfortunate that the drinking age has attracted the most attention, especially since it seems doubtful that lowering the drinking age would lead to any appreciable amelioration of the most serious consequences.

In the first place, patterns of high-risk drinking behavior are already typically well-established before students arrive at college. Findings from the Harvard School of Public Health College Alcohol Study, published in the Journal of American College Health (Volume 50, No.5, 223-236), state that in 2001, 43.6 percent of underage college students were classified as binge drinkers, meaning consumption of at least five drinks in a row for men or four drinks in a row for women during the two weeks before completion of the study questionnaire. The vast majority of these began drinking in high school and, increasingly, underage drinking and binge drinking are regularly occurring as low as the eighth grade or earlier.

The National Institute on Alcohol Abuse has found that the reported first use of alcohol went from age 17 1/2 in 1965 to 14 in 2003. Research further shows that the earlier students begin consuming alcohol, the more likely they will engage in behavior harmful to themselves and others.

Clearly this problem is as wide-ranging as the adverse consequences it brings about. Unsafe sexual practices, sexual abuse, health problems, drunk driving, property damage, vandalism, assault and alcohol dependence can all be added to the list.

And then there is the often less visible but very real matter of academic consequences. In the 1980s I reviewed thousands of files from students applying to Canadian law schools. Hundreds of those revealed a similar pattern: poor grades in the freshman year, a modest GPA increase in the sophomore year and then substantial improvement in the junior and senior years. Usually no explanation would be given for this other than a vague reference to "problems of adjustment."

Requests for a more detailed explanation typically yielded a rueful account of how the first year and a half of college were spent in a beery fog before reality intervened. Sadly too late for those whose grades, averaged over four years, were uncompetitive for law school or graduate school and who had to lower their expectations as a result. What a waste of human capital, individually sad but cumulatively tragic.

How do we as a society deal with this? Senate President Richard Codey has asked New Jersey's colleges to provide details of their alcohol policies. It is a fair request and one to which we should be glad to respond given the extensive policy frameworks, policing regimens, educational programs and health intervention measures we have developed. More importantly, it holds out the opportunity to frame the discussion properly.

Why are so many — but by no means all — college students acculturated to abusing alcohol? It can't just be about "adjustment" and new-found freedom since many of our students are sophisticated and experienced in ways that previous generations were not. We also need to go further and ask why alcohol abuse has been matched by a similar abuse of prescription pain relievers, tranquilizers, stimulants and sedatives. And why are these drugs so accessible?

I and my fellow presidents look forward to making progress in answering these questions.
Dr. Peter P. Mercer is president of Ramapo College of New Jersey.
source: My Central Jersey,

Friday, September 19, 2008

Drug addicts shun mobile needle exchange

Far fewer needles handed out and returned since fixed-site exchange was closed

Victoria's mobile needle exchange is handing out far fewer needles to addicts than its fixed-site predecessor, statistics released yesterday show.

The experiences of Peter, who has used both services, might explain why.

Before the Cormorant Street needle exchange closed on May 31, Peter picked up a supply of clean needles every day.

"I had my routine of going down there," the 32-year-old cocaine and heroin addict, who declined to give his last name, said last night as he sat on the grass outside the Our Place shelter on Pandora Avenue. "Now I have to chase the mobile exchange all over the streets in a 10-block radius and I miss them sometimes and I end up going without clean needles."

Needle exchanges are promoted as a service that reduces the spread of disease among addicts by providing them with clean syringes to inject their drugs. But critics have also suggested that exchanges encourage illicit drug use.

A report released yesterday shows the number of needles supplied by the mobile exchange is down 23 per cent, from about 35,000 a month at the fixed site to 27,000 in August from the mobile unit.

Needles returned amount to just 40 per cent of those going out, a sharp drop from the 70 per cent return rate at the Cormorant Street exchange.

The figures were released by the Vancouver Island Health Authority and AIDS Vancouver Island in a summary of the first three months of the mobile service.

The Cormorant Street needle exchange closed after neighbours complained about illegal drug activity. The mobile service is supposed to be a stop-gap measure until a new permanent site can be located.

A decrease in needles coming back could indicate a number of things, said Katrina Jensen, executive director for AIDS Vancouver Island. "There are a number of factors, one is that they're disposing of them in other ways, like putting them in the garbage," said Jensen. Another possibility is that clients are keeping them and haven't used them yet, she said.

"Some clients may be taking extra syringes to keep them going for several months, and that's why we're not seeing those ones come back. It could also be that clients are using their own syringes and refusing ours."

There haven't been reports of a spike in the number of syringes discarded on the streets, said Jensen.

Aside from the syringes, clients aren't taking part in counselling services to the extent they did at the permanent site. There is no privacy and those working on the mobile service don't have the time, said Jensen.

"Due to the public nature of the mobile service a lot of clients aren't comfortable engaging in long conversations with workers. They just want to get their stuff and be gone."

Concern is mounting over how the mobile service will fare when cooler weather sends illicit drug users indoors, Jensen said.

Victoria Coun. Charlayne Thornton-Joe is concerned by the decrease in the number of needles exchanged by the mobile service.

"It concerns me that a major city does not have a fixed site," Thornton-Joe said. "It's a loss. I've always been an advocate for a fixed site which offers support and services."

Thornton-Joe has discussed the issue at meetings with the Downtown Service Providers and the clean and safe committee of the Downtown Victoria Business Association.

Thornton-Joe would like to see statistics from other local groups who hand out or take back needles. Some groups take in needles, but don't give them out, she explained.

The councillor would also like to see statistics on addicts' increased use of crack pipes, instead of needles.

"I'm hearing from street nurses that people are re-using needles and health issues are going to increase because of that," said Thornton-Joe.

Back on the grass outside Our Place, Peter pulled up his pant leg to show an abscess on his leg that became infected two weeks ago after he injected drugs with a dirty needle. The abscess required surgery at Royal Jubilee Hospital. But because he only runs into the mobile exchange service about every three days, Peter said he continues to put his health at risk.

"An hour ago, I had to use a dirty needle to suck dope out of a spoon and transfer it into another dirty needle and put it in my arm," he said.

Then by chance, five minutes before speaking to the Times Colonist, Peter ran into the mobile needle exchange and took a handful of syringes.

"Here's a lost soul looking for one right now," he said, handing a syringe to a young girl who sat down beside him. "If I don't give her one, she'll find one in the sewers."
source: © Times Colonist (Victoria) 2008

Thursday, September 18, 2008

Drinkers fall into 'nine groups'

The government believes it has identified nine types of heavy drinker as it launches a new alcohol campaign.

Research by the Department of Health in England with focus groups found heavy drinkers often fell into one of a number of categories.

These ranged from de-stress and depressed drinkers to people who boozed because of boredom or to bond.

Experts said helping people to understand the reasons for their drinking habits was "very useful".

The nine types of heavy drinker

The research showed that those drinking heavily - defined as consuming 35 units a week for women, 50 for men, which is twice the recommended limit - did so for a variety of reasons.

For example, de-stress drinkers were defined as people in pressured jobs who used alcohol to relax.

Whereas it said bonding drinkers could be anyone in society who had hectic social lives and lost track of their drinking.

The research was done to inform a new drive by ministers to crack down on heavy drinkers.

A pilot is being run in the north west of England over the coming months to specifically target heavy drinkers.

Over 900,000 households will receive leaflets through the post highlighting the link between drinking and conditions such as cancer and liver disease.

The campaign is focusing on adults aged over 35 who fall into the nine drinking categories.


Along with the information about disease risk, people will be given details about where they can go to get help.

This will include a website where they can calculate their own individual risk from drinking and get access to a self-help manual. A telephone helpline will also be set up.

The government hopes the tailored approach will help 4,000 people in the region to reduce their drinking within a year.

If it is successful, officials hope to roll it out to other parts of England.

Public health minister Dawn Primarolo admitted these heavy drinkers were a "tough one to crack".

But she added: "This is a totally fresh approach to helping people understand the effects of their drinking habits and help them make changes for the better."

Alcohol Concern chief executive Don Shenker said: "This type of marketing is very useful.

"In order to get people to examine their drinking they need to become aware of why they are doing it and what motivates them."

The Nine Types of Drinker

Name Characteristics Key motivations

Depressed drinker | Life in a state of crisis eg recently bereaved, divorced or in financial crisis | Alcohol is a comforter and a form of self-medication used to help them cope

De-stress drinker | Pressurised job or stressful home life leads to feelings of being out of control and burdened with responsibility | Alcohol is used to relax, unwind and calm down and to gain a sense of control when switching between work and personal life. Partners often support or reinforce behaviour by preparing drinks for them

Re-bonding drinker | Relevant to those with a very busy social calendar | Alcohol is the ‘shared connector' that unifies and gets them on the same level. They often forget the time and the amount they are consuming

Conformist drinker | Traditional guys who believe that going to the pub every night is ‘what men do' | Justify it as ‘me time'. The pub is their second home and they feel a strong sense of belonging and acceptance within this environment

Community drinker | Drink in fairly large social friendship groups | The sense of community forged through the pub-group. Drinking provides a sense of safety and security and gives their lives meaning. It also acts a social network

Boredom drinker | Typically single mums or recent divorcees with restricted social life | Drinking is company, making up for an absence of people. Drinking marks the end of the day, perhaps following the completion of chores

Macho drinker | Often feeling under-valued, disempowered and frustrated in important areas of their life | Have actively cultivated a strong ‘alpha male' that revolves around their drinking ‘prowess'. Drinking is driven by a constant need to assert their masculinity and status to themselves and others

Hedonistic drinker | Single, divorced and/or with grown up children | Drinking excessively is a way of visibly expressing their independence, freedom and ‘youthfulness' to themselves. Alcohol used to release inhibitions

Border dependents | Men who effectively live in the pub which, for them, is very much a home from home | A combination of motives, including boredom, the need to conform, and a general sense of malaise in their lives
source: BBC News

Wednesday, September 17, 2008

Study finds mom's beliefs may impact their kids' alcohol use

Mothers, take note. If you really want to curb your teens' chances of using alcohol, help them develop a self-view that doesn't include drinking. According to a new Iowa State University study, the power of positive thinking by moms may limit their children's alcohol use. But beware. The opposite is also true.

"When mothers overestimated their teens' future use of alcohol, the teens developed the self-view that they were likely to drink alcohol in the future, which ultimately led them to drink more," said Stephanie Madon, an ISU associate professor of psychology and lead author of the study.

Madon collaborated on the study with ISU graduate students Ashley Buller, Kyle Scherr and Jennifer Willard; Max Guyll, an assistant professor of psychology; and Richard Spoth, director of the Partnerships in Prevention Science Institute at Iowa State. They analyzed data obtained from a series of interviews with nearly 800 Iowa mothers and their children over three to five years.

Their paper, "The Mediation of Mothers' Self-Fulfilling Effects on Their Children's Alcohol Use: Self-Verification, Informational Conformity, and Modeling Processes," was recently published in the Journal of Personality and Social Psychology, a professional journal of the American Psychological Association.

Previous research found self-fulfilling prophecy

The team's previous research had found a link between a mother's belief about her child's likelihood of using alcohol and her child's actual use in junior high school and high school.

"We previously found that mothers' beliefs about their teen's future use of alcohol were about 50 percent correct and 50 percent incorrect, and that the incorrect portion of mothers' beliefs created a self-fulfilling prophecy -- teens behaved like their mothers had incorrectly expected them to," Madon said.

Their latest study builds upon those results.

"What we were trying to do in this paper was understand the mechanisms involved in the self-fulfilling prophecy process," Madon said. "We know that mothers have self-fulfilling effects on their kids' alcohol use through the past work that we've done. What we wanted to do here was understand 'How is that happening? What are the mechanisms that are creating that?'

"We derived our hypothesis from three large, well-known theories in the social/psychological literature -- self-verification theory, research on conformity and social learning theory as it pertains to modeling processes," she said.

According to Madon, self-verification theory proposes that people are motivated to confirm what they already believe to be true about themselves. The study found strong evidence that a mother's beliefs regarding her child's likelihood of using alcohol altered her child's self-view in either a positive or negative direction. The child then validated that new self-view by acting consistently with it later on.

"What people believe ultimately has an impact on what actually occurs," Madon said. "But it's not just because they believe it. It's not magic. When we believe something -- even if we're wrong -- when we believe it's true, we act as though it is. And sometimes when you act as though something's true, your behaviors will cause the belief to become true.

"So I think the moral here is to help children develop positive and pro-social self-concepts about themselves, because children are likely to make choices that match how they view themselves," she said.

Kids model their friends' drinking behavior

The study also found some evidence that modeling -- a tendency for people to learn by watching others -- may alter a child's alcohol use. Madon says they had a little bit of support for modeling as it related to friends' alcohol use.

"We hypothesized that mothers may influence who their children are friends with and that children may learn how to behave by watching what their friends do," she said.

But there was no evidence that children conformed their own belief to their mothers' on how acceptable it was for adolescents, in general, to use alcohol.

"How acceptable children thought it was for adolescents to drink alcohol was explained by their own self-views, not by their mothers' beliefs about them. And that's not surprising given that what you think about yourself is going to be strongly tied to what you think is acceptable behavior," Madon said.

She says that it's still a good idea for mothers to instill in their children the belief that adolescent alcohol use is unacceptable, since the study did show a direct effect of teens' perceptions regarding the acceptability of alcohol use on their own drinking.

"The more acceptable teens believed adolescent alcohol use was, the more alcohol they tended to drink themselves," Madon said.
source: Iowa State University

Tuesday, September 16, 2008

Feeling thirsty or dying for drink?

It is Northern Ireland's drug of choice, but our relationship with alcohol can be problematic.

BBC presenter William Crawley has taken a look at the unique drink culture in the television documentary Dying For A Drink.

Made by Doubleband Films, director and producer Brian Henry Martin outlines the challenge set to the presenter.

As an experienced documentary filmmaker for Doubleband Films, I have made films over the past few years on many big and powerful subjects, everything from the Normandy landings on D-Day to the Heysel stadium disaster.

But no subject has daunted me more than what I faced in Dying for a Drink, this society's strange and obsessive relationship with alcohol.

Firstly, the question was where to begin?

From the outside, alcohol is this society's drug of choice, it lubricates every part of our lives. And then secondly, where to stop with such a huge subject?

Ultimately, the answer for our documentary Dying For A Drink lay in the approach.

We wanted to take the issue of this society's relationship with alcohol out of the daily news, out of the tabloid headlines and take a more measured approach. But is our drinking already out of control?

The use and abuse of alcohol is a rapidly growing problem in Northern Ireland.

We have doubled the amount of alcohol we drink in 20 years, the number of alcohol related deaths has also doubled in the same period and we have cut the price of alcohol, so that it is now cheaper in some cases than water.

In this timely, authored documentary, William Crawley sets out on a personal journey to explore our curious and frequently unhealthy relationship with alcohol and to consider the impact that it has on us all - as individuals and as a society.

William meets people from all sides of the alcohol debate, who talk frankly about how alcohol has affected their lives.

These are ordinary people with extraordinary attitudes towards drink; people like young teenage pioneers taking the pledge never to drink alcohol for the rest of their lives; people like the chronic alcoholics of a wet hostel whose drastic drinking habits reveal a lifetime's addiction and people like the sophisticated drinkers at a social wine tasting who drink alcohol not for the affect but for the taste.

Along with leading medical experts in Northern Ireland like Dr Neil McDougall, Consultant Hepatologist at the Royal Victoria Hospital, Dr Cathal Cassidy from the Royal College of Psychiatrists and Professor Mahen Varma, Consultant Cardiologist, at the Erne Hospital, these range of people with very different experiences and opinions provide the film with a revealing perspective on our relationship with alcohol.

It was important for me as a filmmaker, to set William a personal challenge over the course of the film.

His challenge was to abstain from alcohol for one month; five completely dry weeks.

We wanted to see what happens when someone in our society completely removes alcohol from their lives. The challenge proved to be more difficult and life changing than William first thought.

For the month long booze free challenge William recorded his own tee-total video diary at home with both surprising and compelling results.

And at the end of the abstaining challenge - and the film - William has the choice to drink alcohol again or not.

On the final day of filming, when William was poured a pint of the finest Hilden Brewery beer, we genuinely did not know what decision he was going to make.

For me, the biggest revelation from this journey to the bottom of the bottle - was this society's all or nothing attitude towards alcohol.

We are one of the largest consumers of alcohol in Europe with an ever increasing binge drinking problem, but also with a record number of teetotallers, people young and old completely abstaining from alcohol.

It would appear that the middle ground, which some of us may have witnessed abroad, responsible, enjoyable, healthier drinking (maybe even with food around the family table!) has passed most of us in Northern Ireland by.

Dying For a Drink is a documentary that will touch the lives of practically all viewers, as it is about the role that alcohol has in all our lives.

We want this film not to be the end of the discussion, but to be the starting point for a debate about our relationship with alcohol.
source: BBC News

Sunday, September 14, 2008

New Drug Arrests Alcohol Addiction in Rats

A compound with fewer side effects offers hope that alcoholism could one day be cured by a pill.

More than 15 million Americans drink too much, according to the National Institute on Alcohol Abuse and Alcoholism. New research on rats may help them curb that addiction.

At present, there are three approved drugs for battling alcoholism, none of which work very well. Among them: naltrexone, which is effective for some alcoholics (as well as opiate addicts) because it blocks a pain pathway in the brain associated with the pleasures of drinking.

In an effort to boost its effectiveness, neuroscientist Selena Bartlett of the Ernest Gallo Clinic & Research Center at the University of California, San Francisco, and her colleagues chemically manipulated naltrexone so that it cut off a related pleasure pathway in the brain. Their findings, published in the journal Biological Psychiatry: rats (trained to crave alcohol) given the new compound, dubbed SoRI-9409, consumed half as much hooch. In addition, there were fewer side effects. Researchers say that unlike naltrexone, this drug did not diminish the animals' desire for water and other nonalcoholic beverages, such as sugar water. "It is much more selective in its effect on drinking," Bartlett says.

Rats given the drug for 28 days refrained from heavy drinking for another four weeks after they were taken off the drug. "That is currently the biggest challenge in alcoholism treatment," which relies primarily on rehabilitation centers, Bartlett notes. When people return home, they typically also return to drinking. "Drinking stays down without the drug in place. It's done something to permanently change and reduce the drinking."

Efficacy trials in humans are already ongoing for another drug known as varenicline, which, in addition to curbing smoking, also cuts drinking. But SoRI-9409 might prove more specifically focused on alcoholism as well as free of some of the side effects reported by those who use varenicline to stop their craving for nicotine.

"We've got a pipeline of different medications targeting different aspects of the disease," Bartlett says. "It's an exciting time for people that suffer from this disease as there are more treatments coming through. Once upon a time, this wasn't really considered possible."
source: Scientific American

Friday, September 12, 2008

How to Decrease Your Chance of Becoming Addicted to Narcotic Painkillers

It's the patient's responsibility to find a doctor who knows how to screen for addiction.

The chance of becoming addicted to narcotic painkillers is around 1 in 500 when patients are properly screened before their doctors hand over a prescription, according to a 2008 meta-analysis that examined 2,500 chronic pain patients. With less careful screening, the risk can rise to 1 in 30.

The tricky part for pain patients, says David Fishbain, MD, a professor of psychiatry at the University of Miami, is finding a doctor who knows how to do the screening.

The patient's responsibility

Pain patients are often bounced from family doctors to specialists and back, with no one taking the time to monitor their ongoing use of the medication, or to “qualify” them for what the medical profession calls chronic opioid analgesic therapy (COAT)—the taking of narcotic painkillers for a long period of time.

That means it falls to patients to find health-care practitioners who are experienced in working with chronic pain patients, so that the physicians are comfortable deciding both when to prescribe narcotics and how their use can be safely monitored.

The top warning signs of addiction risk are, not surprisingly, a history of illicit drug use or alcohol abuse in the patient or his family. But smoking is also on Dr. Fishbain’s radar, because “any addiction is a potential risk factor for another addiction.” And there's a long list of factors that may be less predictive but still relevant, including depression and anxiety disorders, which means that doctors need to consider the patient's entire history and not just how he or she answers a few targeted questions.

More work for the doctor

Once a patient is on COAT, physicians have to watch for behavior that may presage or signal addiction, which includes the use of multiple doctors and pharmacies for prescriptions, as well as calling in early for refills. Doctors often ask patients to sign narcotics contracts; they also may issue only short-term prescriptions, and some docs even require urine tests.

So having a patient on narcotics is a lot of work for a careful doctor, and that, Dr. Fishbain says, explains why family doctors, also known as general practitioners (GPs), can feel caught in the middle.

“GPs are in the unfortunate position of having patients who have been put on COAT by specialists," he says. "But the specialists don’t have the time to [screen and monitor]; they want to do more invasive procedures [such as back surgery], so they send the patients back to the GPs. The GPs then have the patients but don’t know what to do.”

This all adds up to a lot of narcotic prescriptions being prescribed by poorly informed doctors, says Dr. Fishbain.

How to find the right care

“You should try to find a physician who has experience in pain management and who has experience in chronic opioid analgesic therapy," recommends Dr. Fishbain. "They need to be up on the literature and aware of the screening.”

In other words, the educated patient has to do his own screening to find the educated doctor. Referrals—to a pain clinic, for example—are reassuring, but there’s no substitute for asking questions up front and starting out with a GP who knows how to prescribe for chronic pain.

Thursday, September 11, 2008

Novel Compound Shows Promise for Treatment of Alcoholism

BIRMINGHAM, Ala., Sept 11, 2008 /PRNewswire-USNewswire via COMTEX/ -- - Southern Research Institute and Gallo Research Center today announced that peer-reviewed results from a study testing Naltrexone-derived pyridomorphinan (SoRI-9409) will be published in the December 2008 issue of the journal Biological Psychiatry. The publication is available online today at the journal's website, and suggests that a new compound that causes selective and long-lasting reduction in ethanol consumption might be a promising candidate as a novel treatment for alcoholism.

The article, "A Novel Delta Opioid Receptor Antagonist, SoRI-9409, Produces a Selective and Long-Lasting Decrease in Ethanol Consumption in Heavy-Drinking Rats" by Selena Bartlett, BPharm PhD, Director of Preclinical Development Group at the Gallo Research Center at University of California San Francisco, et al presents the effects of SoRI-9409 on ethanol consumption. These are promising developments for the treatment of alcoholism. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates 15.1 million people are alcohol-abusing or alcohol-dependent individuals. There are currently only three FDA-approved options for the treatment of alcoholism.

The compound, SoRI-9409, was first designed and synthesized in Southern Research's Drug Discovery research division by Dr. Subramaniam (Sam) Ananthan under U.S. Government Grant DA008883. "Southern Research has been particularly interested in ligands that interact with opioid delta receptor subtype since such ligands hold promise as therapeutic agents for treatment of drug addictions and other disorders," said Dr. Ananthan, senior scientist and manager of Computational Chemistry and CNS Discovery Chemistry at Southern Research Institute. "The present findings by Dr. Bartlett and her group on the effect of SoRI-9409 on its ability to reduce alcohol intake not only provides us with a new drug lead, but also serves as the impetus for further research aimed at discovery of new therapeutic compounds for treating alcoholism and related disorders."

The Preclinical Development Group that Dr. Bartlett leads at the UCSF-affiliated Gallo Center was established to develop new treatments and bridge the gap between research and clinical treatment. The purpose of the study was to find improved compounds for the treatment of alcoholism. "The study results demonstrate that this compound causes selective and long-lasting reductions of ethanol consumption and suggests the compound might be a promising candidate as a novel treatment for alcoholism. This study indicates that compounds with a higher affinity for delta opioid receptors and reduced affinity for mu opioid receptors might be better treatment candidates than Naltrexone, the current FDA approved treatment for alcoholism", said Dr. Bartlett.

"The study on SoRI-9409 and alcohol cessation has yielded vital data that will help fuel novel treatments for a devastating and very difficult-to-treat illness," said Dr. Bartlett. "To date, we have considered and evaluated other compounds, and theories, but the information yielded from this study, along with previous research on this particular compound, has proven to be the most promising to date. We are looking forward to collaborating with our partner, Southern Research, to enter the next phase of research." The research was also supported by the State of California for Medical Research on Alcohol and Substance Abuse and Department of Defense.
Southern Research operates a successful drug discovery research program resulting in six FDA approved drugs with six additional drug candidates in late-stage preclinical and early clinical development.

"Much of our success stems from having a highly successful medicinal chemistry group, and seeking out collaborators who are driven to help us develop new lead compounds and bring those drugs to market," said David Harris, director of Business Development for the Drug Discovery Division at Southern Research. "We're happy to be working with Gallo on this promising new drug to treat alcohol addiction. It is another example of Southern Research's commitment to finding therapies for some of our society's most challenging diseases."

First author on the paper is Carsten Nielsen, PhD, a postdoctoral scientist working with Bartlett. Co-authors are Jeffrey A. Simms, Haley B. Pierson, Rui Li at the Gallo Clinic and Research Center and Surendra K. Saini and Subramaniam (Sam) Ananthan at Southern Research Institute.

Painkiller Abuse Can Predispose Adolescents to Lifelong Addiction

Adolescent mice exposed to the painkiller Oxycontin can sustain lifelong and permanent changes in their reward system – changes that increase the drug’s euphoric properties and make such adolescents more vulnerable to the drug’s effects later in adulthood.

No child aspires to a lifetime of addiction. But their brains might. In new research to appear online in the journal Neuropsychopharmacology this week, Rockefeller University researchers reveal that adolescent brains exposed to the painkiller Oxycontin can sustain lifelong and permanent changes in their reward system – changes that increase the drug’s euphoric properties and make such adolescents more vulnerable to the drug’s effects later in adulthood.

The research, led by Mary Jeanne Kreek, head of the Laboratory of the Biology of Addictive Diseases, is the first to directly compare levels of the chemical dopamine in adolescent and adult mice in response to increasing doses of the painkiller. Kreek, first author Yong Zhang, a research associate in the lab, and their colleagues found that adolescent mice self-administered Oxycontin less frequently than adults, suggesting that adolescents were more sensitive to its rewarding effects. These adolescent mice, when re-exposed to a low dose of the drug as adults, also had significantly higher dopamine levels in the brain’s reward center compared to adult mice newly exposed to the drug.

“Together, these results suggest that adolescents who abuse prescription pain killers may be tuning their brain to a lifelong battle with opiate addiction if they re-exposed themselves to the drug as adults,” says Kreek. ”The neurobiological changes seem to sensitize the brain to the drug’s powerfully rewarding properties.”

During adolescence, the brain undergoes marked changes. For example, the brain's reward pathway increases production of dopamine receptors until mid-adolescence and then either production declines or numbers of receptors decline. By abusing Oxycontin during this developmental period, adolescents may inadvertently trick the brain to keep more of those receptors than it really needs. If these receptors stick around and the adolescent is re-exposed to the drug as an adult, the rush of euphoria may be more addictive than the feeling experienced by adults who had never before tried the drug.

In contrast to illicit drug use among adolescents, the problem of nonmedical use of painkillers such as Oxycontin and Vicodin has escalated in recent years, with the onset of abuse occurring most frequently in adolescents and young adults. Recent studies by the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration have shown that 11 percent of persons 12 years old or older have used a prescription opiate illicitly. “Despite the early use of these drugs in young people, little is known about how they differentially affect adolescent brains undergoing developmental change,” says Kreek. “These findings gives us a new perspective from which to develop better strategies for prevention and therapy.”

This research was supported by the National Institute on Drug Abuse.

Tuesday, September 9, 2008

Curbing Binge Drinking Takes Group Effort

Every state has a minimum drinking age of 21, and the vast majority of college students are younger than that. Yet drinking, and in particular drinking to get drunk, remains a major health and social problem on campuses. Car crashes and other accidental injuries, sexual assaults, fights, community violence, academic failure and deaths from an overdose of alcohol are among the consequences.

College students spend about $5.5 billion a year on alcohol, more than they spend on books, soft drinks and other beverages combined. Alcohol is a factor in the deaths of about 1,700 college students each year.

The consequences can be particularly severe when people binge drink, a drinking pattern adopted by 44 percent of college students, national surveys have shown. Binge drinking is defined as consuming five or more drinks for men or four or more for women in a row, usually within two hours.

“Most alcohol-related harms experienced by college students occur among drinkers captured by the five/four measure of consumption,” Henry Wechsler of the Harvard School of Public Health and Toben F. Nelson of the University of Minnesota wrote in July in The Journal of Studies on Alcohol and Drugs.

A petition circulating among college presidents seeks to lower the drinking age to 18 on the theory that it would reduce the number of students who binge drink beyond the boundaries of college campuses. But opponents say there is no hard evidence for this belief and a better plan would be to change the drinking culture on campus.

About half of college binge drinkers arrive on campus having engaged in similar behavior in high school; an equal number acquire this behavior in college, Elissa R. Weitzman of Harvard and colleagues reported.

Every year, tens of thousands of college students wind up in emergency rooms suffering from the life-threatening effects of alcohol intoxication. And every year, about a dozen students, including some of the best and brightest and most athletically talented, die from acute alcohol poisoning. In one study of students who suffered alcohol-related injuries, 21 percent reported consuming eight or more drinks in a row.

Although Greek houses, which have the highest rates of binge drinking, are infamous for a free-flowing alcohol culture, studies have found that student athletes and sports fans are also among the heaviest drinkers, often gathering to drink to oblivion after an athletic event.

A Community Approach

A concerted effort has been made in the last decade to define the factors that prompt binge drinking on campuses and devise effective methods to combat it. What has become most obvious to researchers is that colleges cannot achieve this on their own.

“Basically, having programs to reduce binge drinking on college campuses in the absence of broad-based community interventions to do likewise may be a bit like rearranging deck chairs on the Titanic,” said Dr. Timothy S. Naimi of the Centers for Disease Control and Prevention.

The Harvard School of Public Health College Alcohol Study, which began in 1993, has identified several environmental and community factors that encourage binge drinking. Dr. Wechsler, who directed the study, said in an interview that high-volume alcohol sales, for example, and promotions in bars around campuses encourage drinking to excess.

“Some sell alcohol in large containers, fishbowls and pitchers,” he said. “There are special promotions: women’s nights where the women can drink free; 25-cent beers; two drinks for the price of one; and gut-busters, where people can drink all they want for one price until they have to go to the bathroom. Sites with these kinds of promotions have more binge drinking.

“Price is an issue,” he added. “It can be cheaper to get drunk on the weekend than to go to a movie.”

Although it is a college’s duty to educate students about the effects of alcohol and the risks of drinking too much, “education by itself doesn’t work,” Dr. Wechsler said. “You must attack the supply side as well as the demand side.”

More than half the alcohol outlets surrounding colleges that participated in the Harvard study offered promotions with price discounts, and nearly three-fourths that served alcohol on the premises had price discounts on weekends.

The study found that the sites of heaviest drinking by college students were off-campus bars and parties held off-campus and at fraternity and sorority houses.

Strong Policies Work

Among the factors associated with lower levels of drinking were strong state and local drunken-driving policies aimed at youths and young adults, as well as state alcohol-control policies like keg registration and laws restricting happy hours, open containers in public, beer sold in pitchers and billboards and other types of alcohol advertising.

“College sports events should not be sponsored by alcohol purveyors,” Dr. Wechsler said.

Community measures that helped to curtail binge drinking during the eight-year course of the study included a limit on alcohol outlets near campus, mandatory training for beverage servers, a crackdown on unlicensed alcohol sales and greater monitoring of alcohol outlets to curtail under-age drinking and excessive consumption by legal drinkers.

Campus practices that resulted in small but significant reductions in binge drinking included greater supervision of fraternities and sororities and more stringent accreditation requirements for Greek houses, policies to notify parents when students have trouble with alcohol, an increase in substance-free residence halls and more alcohol-free activities like movies and dances, especially on weekend nights.

But, Dr. Wechsler said, “college presidents can’t do it alone. They need help from legislative and community leaders. Alcohol is sold and consumed in the community. Residents need to get together to get it under control.”

What Parents Can Do

Dr. Wechsler urged that parents “put pressure on schools.” They should ask officials at the schools their children attend, or plan to attend, what they are doing to control drinking — especially binge drinking. When visiting schools, parents should check out the quality of life in the dorms. If they detect problems suggestive of heavy drinking, like excessive noise or vomit in the bathrooms, “they should demand that these issues be addressed,” he said.

Of course, he added, “parents should talk to their kids about drinking. Parents shouldn’t think that if it’s a beer and not a drug it’s of no consequence. Beer kills more people than drugs.”

Parents might also make it clear to students that they are expected to perform admirably outside the classroom as well as within it. Studies have shown that there is less drinking by students concerned about their grades, but also by those involved in volunteer work and other activities on and off campus.
source: New York Times

Monday, September 8, 2008

Start discussing ways to educate about alcohol

This summer, I signed the Amethyst Initiative, a statement from university presidents that invites public discussion on how Americans deal with alcohol. It proposes that America has developed a culture of dangerous binge drinking, particularly on college campuses. The signatories call on elected officials and the public to weigh all the consequences of current alcohol policies and invite new ideas on how best to prepare young adults to make responsible decisions about alcohol use.

More than 120 college and university presidents have signed in support of initiating this discussion. Some support the current 21-year-old drinking age; others may want to change it. But they are united in their concern about the effects of binge drinking.

Binge drinking is a cultural pattern that differs from past approaches to alcohol. Let me offer my own story: I did not drink until I was in college at a time when the drinking age in Massachusetts was 18. I was introduced to the graciousness of a sherry hour. Wine or beer was served as part of a semester-end get-together at a professor's house. After church, parishioners would invite students to their homes to discuss the sermon over spaghetti and Chianti. Drinking was part of a larger culture of sociability and community.

That's not true today. The Centers for Disease Control and Prevention cites a report saying that 70 percent of binge-drinking incidents occur among adults over 24. People ages 14-24 are 15.5 percent of the population but account for 30 percent of binge-drinking episodes.

I applaud the efforts of organizations such as MADD in raising awareness that drinking and driving do not mix. But while the current 21-year-old drinking age may have helped discourage drinking and driving, it has not stemmed the incidence of young people who drink. We have taken drinking, particularly for traditional college-age students, and driven it underground. While fewer people between 18 and 21 are dying from alcohol-related accidents, more students are binge drinking and getting drunk before attending an event. More are victims of alcohol poisoning and alcohol-related date rape. More drink to get drunk.

Unlike when I went to college, there is no similar opportunity today to educate students about drinking because it is against the law for faculty, staff and off-campus adults to serve alcohol to students under 21. Responsible drinking is a learned behavior. We know that the overwhelming majority of college-age students drink, but we cannot model what responsible drinking is like.

Over the years, colleges have seen an increase in students coming to us with binge-drinking habits that began in high school. At Butler, we offer alcohol-education programs from the first day students arrive on campus. We remind students of the law and the dangers of drinking to excess. We issue citations for alcohol violations.

Butler has had success in reining in binge drinking, but all universities deal with this issue. It is not enough to preach abstinence, sanction offenders and pick up the pieces after a student has been a victim of alcohol abuse. There must be education about alcohol from childhood through adulthood. That's what the Amethyst discussion is all about.
source: Indy Star

Saturday, September 6, 2008

Fear of alcohol addiction 'pandemic'

Every dollar spent on alcohol and drug treatment could save taxpayers at least $5, say experts.

They warn of a "pandemic waiting to happen" if the country's addiction problems are not addressed.

A paper released by the National Committee for Addiction Treatment (NCAT) yesterday revealed what one member called "horrifying" statistics, detailing devastation wrought by alcohol and drug addicts.

It also cited a 2005 United Kingdom study, which found that money spent on standard treatment therapies for alcohol problems saved about five times that amount in expenditure on health, social and criminal justice services.

National Addiction Centre director Doug Sellman said the difference was even more marked for drug addicts, where $8 could be saved for every dollar spent.

The statistics included:

89 per cent of serious offences are committed under the influence of alcohol and drugs.

Between 75 per cent and 90 per cent of weekend crime is alcohol-related.

Up to 50 per cent of men who physically abuse their partners have substance-abuse problems.

Alcohol plays a role in 30 per cent of fatal car crashes.

70 per cent of Emergency Department admissions are caused by alcohol abuse.

This happened in an environment where only 22,000 of New Zealanders with addictions accessed treatment services in any given year, leaving an estimated 138,000 unaided, NCAT co-chair Christine Kalin said.

Treatment costs ranged from $80 for an intervention for a low-level problem to more than $8000 for months of residential treatment.

Kalin, who released the paper at the Cutting Edge Addiction Treatment Conference in Christchurch, said staff in the sector were sick of turning away people who needed help.

"Anecdotally, I know that there are services that have waiting lists. Rather than building prisons, having health budgets overspent, having police resources stretched, let's put some of that money into services at the front end rather than the ambulance at the bottom of the cliff.

"At a very minimum, we need to have the capacity to treat the 160,000 who we know need special help, and help now," she said.

Alcohol Healthwatch director Rebecca Williams said the problem was probably worse than it appeared because people who could not access services were likely to be incorrectly recorded.

"This is a sort of pandemic waiting to happen ... I think services, if they were actually presented with all of the cases that needed help and support, they would simply not be able to cope."

Experts warned that turning people away often meant the window of opportunity to help them was missed.

Kalin said investment in the sector could take the form of community-based treatment options, aimed at specific high-risk groups such as schools and prisons.

Only one third of alcohol or drug addicts were thought to receive treatment while incarcerated, she said.

Associate Minister of Health Damien O'Connor, who addressed the conference yesterday, said the Government had increased its spending from $65 million in 2001 to $94m last year.

National health spokesman Tony Ryall said the party also recognised it was an issue, particularly for families of drug-affected young people, and would address it in its health policy.
source: Stuff NZ,

Friday, September 5, 2008

Five Ways Parents Can Help Middle School Kids Delay Their First Drink

The first few weeks of middle school are a frenzy of friends, parties, and school events. It's also time for parents to start talking with their kids about the dangers of drinking alcohol, according to The Science Inside Alcohol Project of the American Association for the Advancement of Science (AAAS).

Twenty percent of 14 year-olds say they've been drunk at least once, according to the Surgeon General, and recent news points out dangers of alcohol use by the young:

-- The Partnership for A Drug-Free America released a study in August, 2008 of 6,500 teens in which 73% said school stress caused them to drink and take drugs.

-- A Columbia University study, also released in August found that "problem parents," those who let their kids stay out past 10:00 PM on school nights in particular, are putting them in situations where they are at risk for drinking and drug use.

-- About 100 university leaders called for a national discussion of lowering the drinking age back to 18, saying it's not clear that 21 works.
The middle school years are crucial in the battle to prevent early alcohol use. Young adolescents' bodies and friendships are changing. They start pulling away from parents; yet seek out other adults for guidance. It's the most vulnerable time, specialists say, but also one of the last times they still can be influenced by adults.

No one sets out to be a disengaged parent. But it's hard to be vigilant and talk to your kids about complicated topics when you are constantly on the go. "As parents better understand the physiological effects of alcohol on the body and the fact that their children might be starting younger, it can motivate them to have this sometimes awkward conversation," says Shirley Malcom, head of the Education & Resources Directorate at AAAS. "That's where the science can help."
Members of AAAS' The Science Inside Alcohol Project are writing a book for middle school parents and developing an interactive Web-based science and health curriculum explaining how alcohol affects adolescents' brains and bodies. Based on extensive research, the AAAS team suggests five steps parents can take to talk with their kids about alcohol.

1. Find Teachable Moments - We live in a culture of celebrity. If a celebrity your child admires admits to a drinking problem, or an instance of alcohol abuse occurs in your community, talk about it. Ask your middle school student if she knows anyone who drinks alcohol and whether it is at parties or has been brought into her school. Answer questions. Have this conversation often.

2. Talk to Your Kids When Everything is Fine - Middle school students are volatile, hormonal beings. They are sweet and wonderful one moment, and blow up the next. Pick a time when things are quiet and they're a captive audience such as in the backseat of your car. Don't take no for an answer.

3. Engage Your Kids in the Science of Alcohol - Adolescents are incredibly self-involved. Alcohol can cause memory loss, impair sports performance, incite embarrassing behavior and affect how they feel and look. Make them aware of these facts. If there is a history of alcoholism in your family explain about genetic predispositions towards alcohol abuse.

4. Be Vigilant - There's no alternative to monitoring your kids. Have an early curfew. Know where they are at all times. Even if you are not home on a weeknight, make sure you can reach your kids by phone. Get to know their new friends and their parents. Find out what their rules and level of engagement are.

5. Learn to Trust Your Child - Now's the time when all the work you've put into creating a value system for your child begins to pay off. Set limits and enforce rules, but remember to give your child room to make his or her decisions, within your comfort zone. Praise them when they do well. It's worth a thousand words.
The Science Inside Alcohol Project of AAAS is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).