Wednesday, November 26, 2008

Huesik: Korean for binge drinking

A classic South Korean working day usually ends up in Huesiks, binge drinking sessions cast as social events. But behind the drunken smiles lurks an alarming variety of health problems that stem from heavy drinking.

Night falls on Seoul as workers leave their offices. It is time for Huesiks, boozy meals shared by coworkers at least twice a week. Taking part in them is highly recommended as those who do not can find themselves quickly ostracized from the group.

This means drinking a lot; and quickly. Part of the aim is to find summon courage to lose one’s inhibition and criticize the boss. We follow one group as they treated a client in a Japanese restaurant. They are going to talk business. But, above all, they will raise toast after toast. That's already four in less than ten minutes.

Soju is Korean people’s favorite drink. It is made of rice, potatoes or barley, is very cheap and usually contains about 25% of alcohol. So, a few hours and several bars later, these employees aren’t exactly in professional shape anymore.

Having left the bar, these heavy drinkers drunkenly wait on subway platforms or stumble out onto Seoul’s streets. One businessman we come across has drunk one bottle of whisky every day for the last 20 years. Despite a recent recovery from stomach cancer, he remains a heavy drinker.

In Korea, warnings against heavy drinking are still very rare. Advertising is legal. Yet, for the local authorities, the cost of alcohol abuse is mounting. One in 10 korean adults suffers from various health problems stemming from heavy drinking. And it is not about to change as average alcohol consumption rose again in September.
source: France 24

Monday, November 24, 2008

Heroin treatment also works on cocaine: study

Methadone, a drug used for many years to treat heroin addiction, appears to work well in cocaine addiction, too, a new Canadian study suggests.

Psychologist Francesco Leri of the University of Guelph has been making rats addicted to cocaine, and then treating them with methadone.

Most of the rats responded well, he says. They lost their powerful urge for cocaine, and in addition, their brains "re-set" themselves into the same pattern that existed before they first used cocaine.

"It can be done tomorrow with humans, and should be done tomorrow," he said.

That's because methadone -- unlike a new drug -- already exists as a tested drug, with clear prescription rules and clinical staff trained in giving it out.

"There is an entire system that is already in place for the employment of methadone," that could be used for cocaine addicts.

Mr. Leri said the U.S. National Institute for Drug Abuse is looking into the use of methadone -- or a similar drug such as buprenorphine -- in a clinical setting.

The idea came up because in real life, people mix drugs.

There's no such thing as a "pure heroin addict," he said. "The norm is people who are addicted to opiates, so heroin or prescription opiates, and they co-abuse cocaine at the same time."

Researchers have wondered what happens to their cocaine problem when they start taking methadone for the heroin addiction.

But it's hard to tease apart the two addictions in humans. In his Guelph lab, Mr. Leri worked on rats with a cocaine addiction, but no exposure to heroin.

The cocaine-addicted rats in his lab didn't get a cocaine high on methadone, he said. Instead, "the methadone may be able to curb the desire that they have for that drug (cocaine)."

In addition, methadone actually reversed changes in the rats' brains that are caused by cocaine, and are known to play a key role in addictive behaviour.

"What's interesting is that, among the rats given cocaine and then methadone, these regions of the brain looked similar to how they appeared in the rats that were never exposed to cocaine.

"We feel we may have the hope of re-setting the brains of some individuals to a type of normality," he said. "I think it should be tried and I guarantee you there will be some individuals -- not everybody -- who will do better on methadone, who will be stabilized on methadone."

The study means a person who is motivated to stop taking cocaine may benefit from methadone as one tool to help, the psychologist says.

"You cannot give methadone left and right and hope that it is going to work. You need to work with individuals who in addiction to social support, in addition to cognitive therapy, will need something to curb their desire" for cocaine.

His study is published in European Neuropsychopharmacology, a research journal.
source: The Ottawa Citizen

Friday, November 21, 2008

Task force could help stem underage college drinking

Colleges and universities should take lead on setting and enforcing rules on their campuses.

Stopping underage drinking on college campuses should be a top concern of parents and academia. In recent years, there have been tragic alcohol-related deaths, and something should be done to address this issue.

Yet, we agree with state Sen. Shirley Turner, D-Mercer, the solution is unlikely to be found in legislation that imposes a uniform fix for the state's many campuses. As Turner said, the universities and colleges should be allowed to set and enforce their own rules. If the problem spills off campus, there already are laws to handle underage drinkers.

Some academic leaders have proposed lowering the drinking age from 21 to 18, when people are considered adult in other areas of society, such as the health-care, criminal justice and military systems. The Amethyst Initiative, a group of 134 college presidents and chancellors, favor making it legal for their 18- to 20-year-old students to drink. Most now do so illegally and colleges have proved inadequate to stop this behavior.

Under federal law, states can set the legal drinking age for their residents, but would lose 10 percent of their federal highway funds. The federal penalty recognizes that young people too often are involved in drinking-and-driving accidents.

On the other hand, many European countries have a much lower drinking age than the United States but balance that with much tougher drunken driving laws. Generally, there are not higher rates of alcohol-related incidents among European youths than here.

It is an issue worthy of more study, as Turner has proposed. She and Senate President Dick Codey, D-Essex, support creating a task force to look into the issue. But lowering the drinking age probably won't be acceptable to many New Jerseyans, especially those who have lost a loved one in an alcohol-related incident. But that doesn't mean the whole issue should not be reviewed. Students, parents, educators and lawmakers need to have this conversation to figure out how to get students and others to act more responsibly.
source: Courier Post Online

Tuesday, November 18, 2008

Vodka makers may have to pay for addicts' treatment

Amid criticism from alcohol producers, a bill was introduced in the lower house of the Russian parliament (Duma) according to which
producers of vodka and other alcoholic beverages will have to pay for the treatment of chronic alcoholics.

Lawmaker Viktor Zvagelsky of the ruling United Russia party has introduced the bill which will bound the producers of alcoholic beverages to bear the 'moral and financial responsibility' and pay for the treatment of chronic alcoholics, according to a report.

Zvagelsky proposes to set a mandatory mechanism for compensation of damage to health of citizens caused by consuming alcoholic drinks

Earlier last month, Russian interior minister Rashid Nurgaliyev had recommended to restore the Soviet-era system of forced treatment of alcohol abusers.

According to the lawmaker, the alcohol producers will have to pay approximately four roubles for per litre of vodka produced by them into a self-regulated fund to finance the network of clinics and sanatoria involved in the treatment of alcoholics.
source: Times of India

Wednesday, November 12, 2008

Avoiding alcohol's temptations in 'overwhelming' war zone

Once each week, in a fluorescent-lit room in a stout building near the heart of Kandahar Air Field, a multinational mix of troops and civilians gather to take on a battle that can't be fought with conventional weapons.

Sitting around a table, or on overstuffed furniture, they talk about bad days, frustrating bosses and how it is that a fellow soldier can become a drunk on a dry base in a mostly dry country.

Called Sober in the Sand, the group is this base's own chapter of Alcoholics Anonymous. For many who spend much of the year living abroad in Afghanistan, their weekly meetings have become a lifeline to staying sober far from the supports of home.

Jennifer, a 31-year-old from Winnipeg, has been sober for 10 years. Still, when she arrived to work at the base five months ago as a civilian, she was anxious about the strain that living in a war zone might cause.

"It's not like I'm shaking for a drink all the time," she said.

But she added that the base, which serves as a temporary home for more than 10,000 people from dozens of countries and is the frequent target of insurgent rocket attacks, can be "overwhelming" at times.

"It's a really crazy place."

That craziness was tempered, though, when she walked into her first AA meeting.

Instantly, she felt she belonged.

"There's a base level of understanding between alcoholics. They know you, you know them. It's almost like family."

The group operates like most conventional AA groups, meeting once a week and setting up links between new recovering alcoholics and those with more sober years under their belts. But there are unconventional elements that come with operating in a war zone.

"Here we worry about our fellow alcoholics going out and not coming back alive, which is a little harder to deal with," said Ed, a 47-year-old mechanic from Midland, Ont.

Typically, the group has about five regular members, but has swelled to more than 15 at different times.

Often, the group will gather for special meetings if soldiers are coming through who are normally stationed off base at one of the smaller outposts.

"If they need a meeting, well, darn it all, somebody should be there," said Ed, adding that those who come to the AA group for support but have to leave to work off base are usually given literature, including copies of The Big Book, a step-by-step guide to getting sober that explains the Alcoholics Anonymous tradition.

"My book I was carrying around for 14 years went out to a forward operating base with them," Ed said. "If you have no meetings out there and guys at least have something to read, at least you have some comfort."

John, a 31-year-old U.S. Army soldier from the Bronx, said it took some work to find the AA meetings when he arrived on base.

At times the program has nearly faded away, largely because of the transience of people at the base. But it has always been revived.

"People are not only coming here to talk about problems with alcohol," he said. "We come here for peace of mind. I've actually had the opportunity to help people."

For that reason, no matter how many troops and contractors move on and off the base, the group will always exist, said Chuck, a 55-year-old civilian from Minnesota who with 26 years of sobriety, is the unofficial dean of Sober in the Sand.

"AA is a program of principles. If everybody shipped out, the next recovered alcoholic coming through Kandahar would initiate it again.

"This meeting will always be here after we've gone. The AA will keep reconstituting itself, just like the Taliban."
source: Globe and Mail

Sunday, November 9, 2008

Kicking Depression: Recognize underlying disorders, tackle them, too

By Christine Stapleton

Palm Beach Post Staff Writer

Oh that we could have just one mental illness afflict us at a time.

Many of us diagnosed with one mental illness have another lurking - often undiagnosed or untreated. Doctors call it "co-morbidity." Others call it "dual-diagnosis." I call it "unfair."

Two weeks ago I started sliding. Hours of feeling OK, then hours of feeling down. The OK hours slowly shrunk to OK minutes. The down hours became a day, then another and another. On the second down day the switch between my brain and stomach flicked off.

Three days later, I had already lost 5 pounds. A trainer at the gym told me I was getting too thin. A couple of my girlfriends invited me to dinner. Another threatened an intervention. I ate a sweet potato and a little cup of chicken soup.

My therapist calls this anorexia. I call it lack of appetite. It's not like I'm a waif you could blow over with a hair dryer. I just don't want to eat, and I weigh myself twice a day and track the numbers in my weight journal. Did I mention I don't eat wheat and very little refined sugar? What's the big deal? Apparently that's called an "eating disorder." It's just one of a few other "disorders" I deal with, like hypomania - a type of bipolar.

My brain plays dominoes with these disorders. A bout of mania knocks over the depression domino, which knocks over the anorexia domino, which knocks over the exercise-drug-alcohol addiction domino, which goes on and on.

It took decades for me to figure this out. It took even longer to realize that the chain-reaction that effortlessly topples the dominoes does not work in reverse. They won't automatically pop up if I manage to right just one.

Each disorder has its own treatment. Successfully treating one will not necessarily cure the other. A bipolar drug addict who gets clean is still going to have eye-popping mood swings, bursts of energy and paralyzing depression if the bipolar is not treated, too.

A food addict who smokes and gets treatment for her eating disorder but keeps smoking is still addicted to nicotine. Same with the alcoholic who cuts herself. She is not necessarily going to stop cutting just because she gets sober.

Like I said, it's not fair. It is even worse because many doctors don't understand this. They treat one illness but fail to diagnose the companion disorder(s). Then we blame the antidepressants or therapy for not working and we quit. Life becomes hell, all over again.

My solution: Surrender. Recognize the other disorders and treat them, too. I don't think of it as being a loser. I just joined the winning side.
source: Palm Beach Post

Friday, November 7, 2008

Alcoholics Have Problems Recognizing Danger

Alcoholics have trouble recognizing and avoiding dangerous situations because the area of their brain that is used to appreciate those kinds of concerns is functioning at a reduce level, stunting their ability to perceive danger. This may help explain why they do not react to the concerns of their friends and family members about their drinking.

Previous studies have shown that alcoholics have problems recognizing facial expressions and many other studies have shown cognitive deficits in alcoholics. A new study indicates that alcoholics may also have emotional processing deficits also.

Researchers studied 11 alcoholics and 11 healthy males and used fMRI brain imaging to track their brain-blood oxygenation level dependent (BOLD) responses while they were given facial-emotion decoding tasks.

Sensation Seekers

The subjects were ask to determine the intensity of happy, sad, anger, disgust and fear displayed via facial expressions. The results showed that alcoholics were most deficient at recognizing negative emotional expressions.

These deficits showed up on the fMRI images in the affective division of the anterior cingulate cortex -- part of the prefrontal brain area.

"The cingulate is involved in many higher order executive functions such as focused attention, conflict resolution and decision making," said Jasmin B. Salloum, research scientist at the National Institute on Alcohol Abuse and Alcoholism, in a news release. "Alcoholic patients are known to be sensation seekers and are less likely to shy away from signals that suggest danger."

Findings Have a Silver Lining

"Both sensation seeking and avoidance of danger are characteristic of subjects with axes II personality disorders, which many of our subjects had," Salloum said. "The findings in this study may shed some light on some of the problematic and psychopathological behaviors that are manifest in this patient group. It remains to be determined if the dysfunction of the anterior cingulate precedes alcoholism or is a result of long term drinking."

The study did have a silver lining, according to Andreas Heinz, director and chair of the department of psychiatry at Charite – University Medical Center Berlin.

"Now we can begin to understand why patients have problems avoiding dangerous situations and, particularly, why they may not react to the concerns of their friends and relatives: the brain area that should help them appreciate these concerns is functioning at a reduced level," said Heinz.

But Happy Faces Work

"Furthermore, we observed a normal or even increased brain response to happy faces. Our group recently made a similar observation, in that patients with strong brain responses to pleasant pictures have a reduced relapse risk," Heinz said. "So, relatives and friends may want to support alcoholic patients with positive messages that strengthen their self-esteem while being particularly careful, and even repetitive, in pointing out the dangers of alcohol and alcohol-associated environments. Otherwise, the patients may miss the message."

The study was published in the September 2007 issue of Alcoholism: Clinical & Experimental Research.

Wednesday, November 5, 2008

Somewhat Better Outcomes With Longer-Term Treatment For Opioid-Addicted Youth

New research published in the November 5 issue of JAMA reveals that long-term therapy rather than short-term therapy for opioid-addicted adolescents yields better results. Those who received continuing treatment with the combination medication buprenorphine-naloxone were less likely to test positive for opioids and reported lower rates of opioid use compared to adolescents who participated in a short-term detoxification program with the same medication.

Adolescents tend to abuse opioids in the form of heroin or prescription pain-relief medications. Recent research suggests that more and more young people are abusing these types of drugs, and therefore treatment needs are rising as well. "The usual treatment for opioid-addicted youth is short-term detoxification and individual or group therapy in residential or outpatient settings over weeks or months. Clinicians report that relapse is high, yet many programs remain strongly committed to this approach and, except for treating withdrawal, do not use agonist medication [drugs that mimic the effect of opioids by altering the receptor]," write George Woody, M.D. (University of Pennsylvania, Philadelphia) and colleagues.

To compare outcomes of opioid-addicted adolescents who receive either short-term detoxification or long-term treatment using buprenorphine-naloxone, Dr. Woody and colleagues conducted a study with 152 patients, 15 to 21 years of age. The long-term treatment medication consists of an oral medication that relieves symptoms of opiate withdrawal (buprenorphine) and a drug that prevents or reverses the effects of injected opioids (naloxone). Patients who were randomized to receive the 12-week buprenorphine-naloxone treatment received up to 24 mg. per day for 9 weeks and smaller amounts through the twelfth week. The remaining participants (the detox group) received up to 14 mg. per day, with doses tapering off through day 14. Individual and group counseling was offered to all participants.

Wood and colleagues found that at weeks 4 and 8, the detox group had a higher percentage of opioid-positive urine test results. Specifically, after 4 weeks, 61% of participants in the detox group had opioid-positive urine test results compared to 26% of participants in the 12-week buprenorphine-naloxone group. The figures after 8 weeks were 54% positive in the detox group and 23% positive in the 12-week buprenorphine-naloxone group. By the twelfth week, the buprenorphine-naloxone group had been tapered off of their treatment and 43% tested positive for opioids compared to 51% of detox group patients.

About 21% of detox group patients and 70% of buprenorphine-naloxone patients remained in treatment by week 12. Patients in the 12-week buprenorphine-naloxone group reported, during weeks 1 through 12, less use of opioids, cocaine and marijuana, as well as less injecting and less need for additional addiction treatment. Both groups measured high levels of opioid use at follow-up.

The authors clarify that, "Taken together, these data show that stopping buprenorphine-naloxone had comparably negative effects in both groups, with effects occurring earlier and with somewhat greater severity in patients in the detox group."

"Because much opioid addiction treatment has shifted from inpatient to outpatient where buprenorphine-naloxone can be administered, having it available in primary care, family practice, and adolescent programs has the potential to expand the treatment options currently available to opioid-addicted youth and significantly improve outcomes," conclude Woody and colleagues." Other effective medications, or longer and more intensive psychosocial treatments, may have similarly positive results. Studies are needed to explore these possibilities and to assess the efficacy and safety of longer-term treatment with buprenorphine for young individuals with opioid dependence."

David A. Fiellin, M.D. (Yale University School of Medicine, New Haven, Conn.) writes in an accompanying editorial that more evidence is necessary in order to claim any treatment is effective for opioid-addicted individuals.

He concludes that: "The results of this trial should prompt clinicians to use caution when tapering buprenorphine-naloxone in adolescent patients who receive this medication. Supportive counseling; close monitoring for relapse; and, in some cases, naltrexone should be offered following buprenorphine tapers. From a research perspective, additional efforts are needed to provide a stronger evidence base from which to make recommendations for adolescents who use opioids. There is limited research on prevention of opioid experimentation and effective strategies to identify experimentation and intercede to disrupt the transition from opioid use to abuse and dependence."
source: MediLexicon News

Sunday, November 2, 2008

Women and drug addiction

The most shocking thing about the modern drug user? That she could be someone like you.

Andrea Mackenzie 57, a divorced mother of three from Newquay, was first prescribed valium for back pain as a trainee teacher in 1969. She became addicted and continued to take it for almost 40 years.

When I think of the person I was before I took diazepam, or Valium as it was called back then, I don't get angry, I get upset. I was at college in London, training to teach dance and drama and I loved putting on shows. Most students around me looked forward to the holidays, but I looked forward to the start of each term.

I went to my GP because of muscle ache in my back. He prescribed some pills and in those days you didn't ask questions, you just took them. It helped with the pain and seemed to relax me. When I went for a repeat prescription no questions were asked. For year upon year the box was just ticked. They really were handed out like sweets.

Diazepam is probably one of the most addictive drugs there is and that doctor was prescribing me an illness. It gives you a numb feeling, blanks out your emotions so everything becomes sort of dull. If you've suffered a terrible bereavement it can calm you down, but if you take it all through life you sleepwalk; nothing touches you.

My overriding feeling was always, 'I can't be bothered.' I qualified as a teacher but didn't work as one because I met my husband, an engineer, young and started a family. I took those tablets three times a day, as prescribed, and my life revolved around them. I had to have 'my tablets' with me all the time just to feel safe and, if I forgot them, I'd start hysterically panicking and we'd have to go back.

It's funny – even though I built up a tolerance, I didn't ever up the dosage or abuse them because they were on prescription. My body was craving them so I had all sorts of symptoms and went through life feeling unwell with so many non-specific things. I'd feel strange and dizzy, I'd shake, sound would be magnified, lights were too bright. I basically thought I was a hypochondriac. My family used to laugh about it.

We had three children; I loved them, I lived for them, but I was removed from them. The best way to describe it is the way you feel when you have a hangover and you've kids to look after. I didn't crawl around on the floor playing dress-up or jump on a trampoline with them. I didn't participate at children's parties. They weren't neglected, though, and I don't feel guilty because it wasn't my fault. Thank goodness they're all happy, healthy adults. We've never sat down and talked about my addiction – though of course they must know.

No one ever really suggested I should stop taking Valium. After my mother died of a heart attack right in front of me, I became hysterical and the doctor just put me on a higher dose. It comforted me – but stopped me grieving. When my marriage broke down, I really wasn't that bothered. People would talk about the 'trauma of divorce', the 'stress of moving home'; I didn't feel it.

As the years passed, people became more aware of the dangers of diazepam. I read about it, realised what was happening to me – and by the time my last daughter went to university I knew it was time to come off it. It took me three years. By then I had a fantastic, supportive GP who helped me do it so, so gradually. It made me really ill – my speech was slurred, I was permanently exhausted. At one point I had to be tested for Parkinson's.

I've been totally clear for two and a half years now and I'm a different person – the person I would have been. I don't smoke or drink alcohol or caffeine and I exercise daily on my Air Walker. I'm motivated, full of energy. I spent last week with friends at Center Parcs. My daughter joined me for a day and we rode around on our bikes – something I'd never have done when she was younger.

The real difference, though, is emotional. I feel so much more. I'm affected by things. When my own children were born, yes, I was happy – but somehow nothing seemed to stick. When my first grandson was born seven months ago it was absolutely amazing. I couldn't believe how excited I was. I've so many activities planned for him. It's like my second chance.