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Problems related to early use of alcohol

It just may be that it doesn’t matter which came first, the chicken or the egg. At least when it comes to the issue of later development of alcohol-related problems.

It now appears that age at first drink (AFD) and rapid progression from first drink to intoxication are both major – and independent – risk factors for the development of alcohol-related problems among college undergraduates.

“Many studies have found relationships between an early AFD and a range of negative alcohol-related outcomes in life, including the development of alcohol use disorders, legal problems like DUI, and health problems like cirrhosis of the liver,” noted Meghan Rabbitt Morean, a postdoctoral fellow in the department of psychiatry at Yale University School of Medicine.

“There is also evidence that beginning to drink at an early age is associated with more immediate problems, such as compromised brain development and liver damage during adolescence, risky sexual behaviors, poor performance in school, and use of other substances like marijuana and cocaine,” said Morean, a corresponding author of the study which will be reported in the November 2012 issue of Alcohol: Clinical & Experimental Research and is now available at Early View.

Morean and her colleagues studied 766 incoming freshman females and 194 males, using data obtained from bi-annual assessment from the summer after senior year of high school through the fall of their fourth year of college – four years. Participants self-reported their age of drinking onset and age of first self-defined intoxication, as well as frequency of heavy drinking and alcohol-related problems.

When the researchers looked at the effects of AFD and the time from first use to first intoxication as predictors of heavy drinking and problems across the four years, they found “… beginning to use alcohol at an earlier age was associated with heavier drinking and the experience of more negative consequences during senior year of college,” reported Morean. “Quickly progressing from first alcohol use to drinking to intoxication was also an important predictor of heavy drinking and the experience of alcohol related problems during senior year of college.

“It is important to speak to children and adolescents openly about the dangers of heavy drinking and provide them with correct information, for example, ‘how many drinks does an average male/female need to drink to exceed the legal level for intoxication?” said Morean. “It is also extremely important to remember that heavy drinking during adolescence and early adulthood is not confined to college campuses. Most adolescents begin drinking during high school, a significant portion of whom begin drinking heavily. To help address this, we suggest that new alcohol prevention and intervention efforts targeting high school students be developed with the goal of delaying onset of heavy drinking among those at increased risk due to an early onset of drinking.”

Francis J. (Skip) Flynn, Psy. D.

Posted in: Addiction, Featured

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Supportive relationships may protect us from consequences of impulsivity

What do the Beatles tune “With A Little Help From My friends,” kamikazes (the drinks not the warriors), and an unexpected trip to a cemetery have in common?

Well, almost nothing except that alcohol and impulsivity are a dangerous mix and people with current drinking problems and poor impulse control are more likely to die in the next 15 years, according to researchers at the Center for Health Care Evaluation of the Palo Alto Veterans Affairs Medical Center.

Supportive-Relationships-Brain-Training-Centers-FloridaThe study, which appears online and in the November 2011 issue of the journal Alcohol: Clinical and Experimental Research, indicates that alcohol abusers with poor impulse control could get by with a little help from their friends and a strong social support network may buffer the toxic effects of impulsivity.

While alcohol misuse has long been associated with increased risk of premature death, impulsivity – excessive risk-taking, disregard of consequences and poor self-control – has been shown to affect life expectancy regardless of drinking habits.

Lead author Daniel Blonigen, PhD. And his team tested 515 people when they first sought help for drinking problems and again one year later, and then followed them for another 15 years. During this period, 93 individuals died and those who scored high on a measure of impulsivity a year after seeking help for their drinking problems were more likely to die in the following years. These results also held true even after researchers took factors like drinking severity and existing physical health problems into account.

Although the research did not explain why impulsivity compounds the risk of alcohol misuse, “Based on past research, impulsivity is related to a wide range of health risk behaviors [besides heavy alcohol consumption], like smoking, drug use, dangerous driving and risky sexual activities,” Blonigen reported. Impulsive behavior can also increase exposure to stressful situations, with a negative physiological impart.

However, the study found that individuals who reported strong supportive relationships with peers and friends may be somewhat protected from the consequences of their impulsivity – and less likely to die than those who lacked those social resources.

“One of the great lessons to be drawn from this research is that individuals with histories of risk taking and alcohol or drug abuse really benefit from support groups like Alcoholics and Narcotics Anonymous,” observed Francis J. (Skip) Flynn, Psy.D., founder of the Brain Training Centers of Florida. “This new research indicates that when clients take active participation in a Twelve Step program as a serious and critical adjunct to any other form of substance abuse therapy, it may have the additional benefit of adding years to their lives in recovery,” said Flynn.

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If you want to stop learn HALT!

It’s one of the most basic principles taught in any drug/alcohol/gambling/compulsive eating treatment program: If you want to stop, learn HALT.

The acronym stands for Hungry-angry-Lonely-Tired. They’re four mental/emotional/leading to relapse.

Now, a study that will be published in the November 2011 issue of Alcoholism: Clinical and Experimental Research adds to what physicians and mental health professionals have known for generations: “Drinking alcohol may reduce maintaining a healthy diet, leading to adverse metabolic effects which in turn add to those directly produced by alcohol.” In short, excessive drinking and an unbalanced diet are two preventable contributors to health problems.

← Parental conflict may find its expression in infants sleep difficulties Posted on August 23, 2011 by Brain Training Centers Of Florida  It’s one of the most basic principles taught in any drug/alcohol/gambling/compulsive eating treatment program: If you want to stop, learn HALT.“On average, people who drink excessive alcohol are more likely to be careless in their dietary habits,” noted Miguel A. Martinez-Gonzalez, chair of the department of preventive medicine and public health at the University of Navarra (Spain) and co-author of the report. “A high alcohol intake is especially unhealthy with respect to liver disease. A high-energy food pattern rich in trans fats – such as ‘fast-foods’ or items from a commercial bakery — is also likely to be related to liver disease. In this sense, if both unhealthy lifestyles cluster together, they can act synergistically to produce very adverse effects.”

“The specific influence of alcohol on diet may depend upon the overall quantity of alcohol ingested, frequency of consumption, beverage preference, and whether alcohol intake takes place during meals,” said Jose Lorenzo Valencia-Martin, a doctor at the Universidad Autonoma de Madrid and corresponding author for the study. “Alcohol may indirectly contribute to several chronic diseases such as obesity, diabetes mellitus, cardiovascular disease, or cancer.”

The researchers found “drinking at mealtimes is associated with insufficient intake of healthy foods, such as fruits and vegetables, and with excessive intake of animal protein,” according to Valencia-Martin.

The researchers conducted 12,037 telephone surveys between 2000 and 2005, among other issues, looked at binge drinking. In the end, “Excessive drinkers, either with or without binge drinking, showed a poor adherence to dietary recommendations,” said Valencia-Martin. “Although drinking at mealtimes has traditionally been considered a safe or even a healthy behavior, our results point to some unintended consequences that the general population should be aware of. In particular, drinking at mealtimes is associated with poor adherence to most of the food consumption guidelines.”

“’What do I have to change?’ is a standard question from men and women new to recovery from alcoholism and substance abuse. Most of the time, the answer is ‘Everything,’” noted Francis J. (Skip) Flynn, Psy.D., CAP  director of clinical services of the Brain Training Centers of Florida and an addictions counselor. “And we always caution them about HALT. If you’re hungry, alcohol is quick and easy calories. Angry? Have a drink or two and you won’t be angry – until you are again. Lonely? Substance abusers have a relationship with their drugs of choice; alcohol or drugs are often their closest friends. And tired? The extra calories can be a quick picker-upper until it slams you,” said Flynn. “This new research takes the conventional wisdom about recovery one step further and applies it to many men and women who are not yet in trouble because of their alcohol use.”

Francis J. (Skip) Flynn, Psy. D.

Posted in: Addiction, Featured

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Can’t shed those pounds and inches despite all your best intentions?

Remember that really junk science stuff about how we only use x-y-z percent of our brain. Well, besides being just that – Junk Science – we now have evidence that at least a few parts of our brain are hiding in waiting (or is that weight-ing???) as part of an on-going conspiracy to make some people fat.

Can’t shed those pounds and inches despite all your best intentions? Blame it on your anterior cingulate cortex and the medial orbitofrontal cortex — brain areas that have been implicated in an addict’s urge to use drugs.

Weight loss informationResearcher Ashley Gearhardt, a clinical psychology doctoral student at Yale University and her team studied 48 women with an average age of 21 whose body mass ranged from lean to obese. Subjects completed a research questionnaire that included statements like “I find that when I start eating certain foods, I end up eating much more than I had planned.”  Subjects rated how closely the questionnaire statements, which were based on an established assessment tool for measuring drug addiction, matched their own experience.  Functional magnetic resonant imaging (fMRI) studies were also completed to allow researchers to understand how subjects brains’ responded to the anticipation and consumption of chocolate milkshakes and a tasteless solution

The researchers found that the brains of subjects who scored higher on the food-addiction survey exhibited brain activity similar to that seen in drug addicts, with greater activity in regions of the brain responsible for cravings and less activity in the regions that curb cravings or urges. And, both lean and obese subjects who scored high in the test for food addiction showed the same brain activity indicative of addiction. The researchers reported that simply seeing images of a milkshake triggered brain activity in the anterior cingulate cortex and the medial orbitofrontal cortex — brain areas that have been implicated in an addict’s urge to use drugs.

And more food, diet and anti-obesity news:

Before the Idaho Potato Commission sues me for defaming their spuds’ collective reputation, let me be the first to declare that extra-large, well-baked Idaho potatoes – with crisp skins and garnished with my homemade pesto sauce – are a culinary delight.

But (Isn’t there always a but!), a new study in the June 23, 2011 edition of the New England Journal of Medicine puts a big part of the blame for American obesity at the feet of extra servings of potatoes – French fried, mashed with butter, boiled, baked or crispy chips. (BTW, I know potatoes have eyes, but can they have feet?)

The Harvard University based researchers tracked the lifestyle choices of more than 120,000 health professionals from around the country for at least 12 years. They found that participants gained an average 0.8 pounds a year – 16 pounds over 20 years.

While potatoes have been certified as “heart healthy” by the American Heart Association and good sources of Vitamin C, several B vitamins, and minerals including iron, potassium, phosphorus and magnesium, individuals who ate an extra serving of French fries every day gained an average of 3.4 pounds over a four-year period. An extra serving of potato chips each day added an average of 1.7 pounds every four years.

Problem is that, while taters might be great food if we eat them raw, pack on sour cream or butter or fry ‘em. Ooooooops! Besides, those tubers prompt a quick spike in blood-sugar levels and cause the pancreas to go into overdrive attempting to bring levels back down to normal. While the blood sugar levels spiral down, many individuals experience hunger, resulting in snacking. And this cycle can result in significant weight gain, pancreatic fatigue, and, in the worst cases, the development of Type 2 Diabetes.

And, those taters can hold a lot of calories: 278 in a large backed potato even before you pile on any of the good stuff or 500-600 calories in a serving of French fries

But to be fair to the poor potato, it’s not the only cause of American obesity. Every additional sugary soft drink per day represented an additional one pound per year and extra servinvg of red and processed meats were just under that. And, consuming an extra alcoholic drink equaled close to half a pound more every four years and extra glass of 100 percent fruit juices each day  packed on almost one-third of a pound over four years.

Posted in: Addiction, Health & Exercise

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Drinking or consuming drugs when driving account for many accidents

That line we hear from teens and young adults about being safe drivers when they’ve been smoking marijuana is just that: A line of pure bovine by-product. And there’s good new scientific evidence for calling bull by-product just what it is.

The call came in at O’Dark Thirty and I slept through it. So, I responded as soon as I could see to hit the REDIAL button.

Dad is concerned that Junior is abusing alcohol and marijuana and doesn’t know how to proceed. While I wasn’t sure how he found my name and number, I pretty much knew the answers I would be getting to a few questions. Junior is an especially bright, rising senior at a Top 50 university, preparing for his med school admissions test, 21 years old. No, he hasn’t won the lottery, he’s not independently wealthy, and he’s not a trust-fund baby.

My answer: “Exercise the POWER OF THE PURSE STRINGS. The car is in your name. If he thinks he can get away with drinking, smoking marijuana and driving, he’s putting your and your family’s financial wellbeing at risk – especially if he has an accident and injures or kills someone. Oh, and he just might kill himself.”

Go ahead drink and driveIn the July 2011 edition of the Journal of Studies of Alcohol and Drugs, Eduardo Romano, Ph.D. and Robert B. Voas, Ph.D. of the Pacific Institute for Research and Evaluation analyzed data from the Fatality Analysis Reporting System (FARS) and found that approximately 25% of US drivers who died in a crash tested positive for drugs. Marijuana and stimulants, including cocaine and amphetamines, each accounted for about 23% of the positive tests.

While it is unclear whether or not drugs were to blame for the crashes, the 2007 National Roadside Survey found that 16% of nighttime weekend drivers tested positive for illegal drugs and the fact that drug use was almost twice as high among drivers in fatal crashes suggests that drugs do contribute to road deaths.

The researchers examined data from 1998 to 2009 for 44,000 fatally injured drivers involved in single-vehicle crashes and in which drivers were tested for drugs other than alcohol and had a known result. About 25% of drivers tested positive for drugs. Cannabinoids (marijuana and marijuana –related drugs) and stimulants (amphetamines and cocaine) each contributed to about 23% of the drug-positive results (6% among all fatally injured single-vehicle drivers). More than cannabinoids, stimulants were found to be associated with the four types of crashes under the study: speeding, failure to obey/yield, inattention, and seatbelt non-use. Marijuana was strongly linked only to speeding and seatbelt non-use.

Ultimately, however, alcohol is still the biggest roadway danger. Other drugs appear to be key only when drivers have not been drinking and drugging. That is, when someone drinks and uses drugs, the alcohol is the main reason for impaired – sometimes fatal – driving.

“Alcohol is still the largest contributor to fatal crashes,” reports Romano.

“The suspicion is there, because when you look at drivers who’ve been in fatal crashes, the percentage using drugs is a good deal higher,” said co-author Voas, For parents, teens and young adults, the answer is simple: “Don’t drink or don’t consume drugs when you’re going to drive,” said Romano, the lead author on the study.

And I remind parents whose kids don’t believe scientific research applies to them “You have the Power of the Purse Strings. Exercise it. It’s one helluvalot cheaper that losing home and everything you’ve ever worked for if Junior kills someone in your car. And is a infinitely better than spending a lifetime of grief and self-recrimination because you didn’t and he killed himself.”

Posted in: Addiction, Featured

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Levamisole found in cocaine causes dying flesh

“Cocaine is God’s way of telling you your making too much money.”

Robin Williams.

Now, your flesh being eaten away and the risk of having your ear fall off may be God’s way of telling you ‘”Cocaine is just plain stupid and really, really dangerous.”

Oh, and just in case you did not learn this already, your dealers – everyone from Mexico or Columbia to the guy on the corner – only wants your money, even if it means you get a skin eating infection.

That appears to be the summary of research by Dr. Noah Craft, a dermatologist with Los Angeles Biomedical Research Institute, and reported in the Journal of the American Academy of Dermatology.

Levamisole found in cocaine“It’s probably quite a big problem, and we just don’t know yet how big a problem it really is,” notes Craft, referring to his study of six cocaine users recently plagued by dark purple patches of dying flesh – a problem that appears to be national.

Craft has joined an increasing number of physicians across the country who havelinked rotting skin to levamisole-tainted cocaine. The damage appears several days after using cocaine because of an immune reaction that attacks the blood vessels supplying the skin. It’s simple: Without blood, the skin suffocates and starves, turns blue and black and necrotic.

According to an April 2011 report by the U.S. Drug Administration, 82 % of seized cocaine contains levamisole, which is used as a filler probably because it acts on the same brain receptors as cocaine and might enhance or extend the drug’s euphoric effects – on the cheap until your ear or cheeks start to die. Levamisole is a veterinary antibiotic normally used to deworm cattle, sheep, and pigs.

“We don’t know who is this is going to happen to,” reports Dr. Lindy Fox, the University of California, San Francisco, dermatologist who first connected the gruesome lesions on cocaine users to levamisole. Researchers are not yet able to determine why some levamisole users are more at risk than others. However, Fox reported once seeing a photo of a man whose entire body, face included, was black with dying flesh. Even after the drug has cleared the body, levamisole may leave scars.

In addition, levamisole also prevents the cocaine user’s bone marrow from producing infection-fighting white blood cells. “Rich or poor, black or white,” anyone who uses cocaine is at risk, according to Craft. “It’s a bit like having HIV. About 10 percent of those patients will die from severe infections. They may be walking around like a time bomb.”

Posted in: Addiction, Health & Exercise

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Cannabis abuse causes abnormalities of the cannabinoid receptors in the brain

It really, really – I mean really – ain’t your daddy’s dope any more. In fact, it ain’t the weed of the 60s, 70s or 80s. It’s not even the smoke of the 90s.

And now, (Surprise! Surprise! Or maybe not so!?!?) comes news that that today’s more powerful THC (delta-9-tetrahydrocannabinol – the psychoactive ingredient in marijuana) doesn’t just attach to receptor sites in the brain; it also attaches to receptors through the body and involved in a wide range of digestive, cardiovascular, respiratory and other systems. In the brain, it influences mental states including pleasure, concentration, perception of time and memory, sensory perception, and coordination of movement.

While CB1 receptors involve functions in the Central Nervous System, CB2 involved the immune system and stem cells in the circulatory system.

The effects of cannabis and receptors in the brain“With this study, we were able to show for the first time that people who abuse cannabis have abnormalities of the cannabinoid receptors of the brain,” reported Jussi Hirvonen, MD, PhD, lead author of a collaborative study between the National Institute of Mental Health and the National Institute on Drug Abuse. The report was issued during the Society of Nuclear Medicine’s 58th Annual Meeting, June 4-8, 2011, San Antonio, Texas.

One item of good news emerging from the study is that this research shows that the decreased receptors in people who abuse cannabis return to normal when they stop smoking the drug. In addition, this new information may provide critical information for the development of new treatments for cannabis abuse.

The researchers recruited 30 chronic cannabis smokers and monitored them closely at an inpatient facility for approximately four weeks. Positron Emission Tomography (PET) provided information about physiological processes in the body. Subjects received injections of a radioligant, 18F-FMPEP-d2 – a combination of radioactive fluorine isotope and a neurotransmitter analog that binds with CB1 brain receptors.

Results of the study indicate that – when compared to healthy control subjects with limited exposure to cannabis during their lifetime – chronic smokers experienced a decrease of about 20 percent in the number of receptors. These changes were found to have a correlation with the number of years subjects had smoked. After a month of abstinence, 14 of the subjects had a second PET scan that indicated that there was a marked increase in receptor activity in those areas that had been decreased at the outset of the study – an indicator that, although chronic cannabis smoking causes downregulation of CB1 receptors, the damage is reversible with abstinence.

For further information, see the SNM press release: http://interactive.snm.org/index.cfm?PageID=10762

Posted in: Addiction, Neuroplasticity

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