Moderate Drinkers Less Likely To Develop Dementia

People who drink light to moderate amounts of alcohol in later life are less likely to develop dementia than people who abstain from alcohol consumption, a study from The Australian National University has found.



The meta-analysis analysed the outcomes of 15 research studies meeting rigorous scientific criteria exploring links between drinking and dementia, drawing on the results for more than 10,000 people worldwide.



"We looked at the results of studies that followed up with participants at intervals over two to eight years," said study leader Prof Kaarin Anstey from the Centre for Mental Health Research (CMHR) at ANU. "We then used statistical analysis to synthesise the results and to weight the studies according to their sample size.



"We found that light to moderate drinkers were 28 per cent less likely to develop Alzheimer's than non-drinkers, 25 per cent less likely to develop vascular dementia, and 26 per cent less likely to develop 'any dementia'."



Dr Anstey said that some of the research projects considered in the ANU synthesis study only reported whether participants were 'drinkers' or 'non-drinkers' without exploring the extent of people's drinking. In these studies drinkers had 44 per cent reduced risk of developing Alzheimer's and 47 per cent reduced risk of developing 'any dementia'.



The meta-analysis also found that the relationship between drinking and dementia was the same for men and women, with light to moderate drinkers showing decreased incidence of dementia regardless of sex.



"It should be noted that the studies we found on this topic nearly all focussed on older adults and their drinking habits," Prof Anstey said. "There is not yet enough scientific data published to draw conclusions about how early life alcohol consumption affects later dementia risk. We also did not analyse the type of alcohol beverages consumed as there are not enough studies that reported results separately for beer, wine etc."



Prof Anstey, who heads the Ageing Research Unit at the CMHR, said that it wasn't clear why light to moderate drinkers were less likely to develop dementia, but suggested that it could be to do with a protective effect of alcohol in reducing inflammation and heart disease, the benefits of social interactions associated with alcohol consumption, or Characteristics of individuals recruited into the studies.


The report is published in the American Journal of Geriatric Psychiatry and the research was also supported by the ANU Dementia Collaborative Research Centre.



Source
The Australian National University

New Cigarette Smoking Strategy Reduces Nicotine Addiction

Scientists are reporting the first successful strategy to reduce smokers' nicotine dependence while allowing them to continue smoking. The study provides strong support for proposals now being considered in Congress to authorize FDA regulation of cigarette smoking, according to the research team.



The key to the clinical trial's success was providing smokers with cigarettes of gradually decreasing nicotine content over a number of weeks. If such cigarettes were federally mandated, smokers would find it easier to quit, and more young smokers could avoid addiction, according to the scientists. Tobacco company products marketed as low-nicotine alternatives, in fact, do not change the level of nicotine taken in by smokers, they added.



The research was carried out by scientists at UCSF and San Francisco General Hospital Medical Center and is reported in the November 14 issue of the journal Cancer Epidemiology, Biomarkers & Prevention.



Legislation giving the FDA authority to regulate tobacco products is currently being considered in Congress. Such regulatory authority would empower the agency to develop and enforce standards to make cigarettes less harmful -- including the reduction of the nicotine yields so that cigarettes would be less addictive, said Neal Benowitz, MD, leader of the study team and an expert on the pharmacology and health effects of nicotine and other smoking products.



Smoking and health experts have been concerned that reducing the nicotine content of cigarettes would lead to smoking a greater number of cigarettes and therefore increased exposure to other tobacco smoke toxins, as is seen in smokers of the currently marketed low-nicotine yield cigarettes, Benowitz said. The new research on reduced-nicotine content cigarettes strongly counters that prediction.



In the study, 20 healthy adult smokers smoked their usual brand for a week and then followed a six-week regimen of smoking cigarettes with progressively decreased nicotine content.



At the end of this period, they were free to return to their usual commercial cigarette brand, and most of them did. When tested one month later, they were smoking about 40 percent fewer cigarettes per day, with a comparable reduction in nicotine intake, compared to when the study began. Even more promising, one fourth of the smokers quit smoking entirely while the study was in progress, the researchers found.



"This study supports the idea that if tobacco companies were required to reduce the levels of nicotine in cigarette tobacco, young people who start smoking could avoid becoming addicted, and long-time smokers could reduce or end their smoking, Benowitz said.



"This could spare millions of people from the severe health effects of long-term smoking," he added.
















Benowitz is a UCSF professor of medicine, psychiatry and biopharmaceutical sciences, and chief, Division of Clinical Pharmacology and Experimental Therapeutics at SFGH.



In 1994, Benowitz and colleague Jack Henningfield proposed in the "New England Journal of Medicine" that federal regulations should require cigarette manufacturers to gradually reduce nicotine content of all cigarettes sold in the U.S.



Scientists have conducted studies to test nicotine-reduction strategies, using commercial low-yield cigarettes. Such cigarettes do reduce nicotine yield when tested by smoking machines because manufacturers have engineered the cigarettes to burn faster, and they have used highly porous paper and ventilation holes above the filter. These cigarettes contain significant levels of nicotine and such "cigarette engineering" does not lead to decreased nicotine intake, because smokers are easily able to obtain the nicotine by taking more frequent and bigger puffs, Benowitz and his co-authors noted.



In contrast, in the new study, the absolute content of nicotine in the tobacco was reduced so that it was very difficult or impossible to compensate by smoking more intensely.



In addition to the reduced smoking and nicotine levels, the UCSF scientists looked for changes in exposure to carbon monoxide, tobacco smoke carcinogens and cardiovascular disease risk factors. All these remained stable or decreased, indicating that smokers were not exposed to higher levels of tobacco smoke toxins when they switched, and therefore would not be put at risk by a nicotine reduction intervention.



Benowitz and his colleagues are now conducting a much larger and longer clinical study on the effectiveness and safety of reducing nicotine levels in cigarettes. They plan also to examine whether reduced-nicotine cigarettes result in reduced addiction potential among adolescent experimental smokers.







The study was funded by the National Cancer Institute, National Institute on Drug Abuse, California Tobacco Research Program, and Division of Research Resources, National Institutes of Health.



Collaborators with Benowitz on the study and co-authors on the paper are UCSF researchers Sharon M. Hall, PhD; Susan Stewart, PhD; Margaret Wilson, MS; Delia Dempsey, MD, and Peyton Jacob III, PhD. Benowitz, Wilson, Dempsey and Jacobs are based at SFGH.



UCSF is a leading university dedicated to defining health worldwide through advanced biomedical research, graduate level education in the life sciences and health professions, and excellence in patient care.



Source: Wallace Ravven


University of California - San Francisco

The Accuracy Of Personal Breathalyzers - Lifeloc Technologies Releases New Research

Lifeloc Technologies, Inc., a leading manufacturer of professional breathalyzers has released the industry's first independent report on the accuracy and reliability of popular semiconductor (silicone oxide) breath testers sold in mass retail, pharmacy, specialty stores and on the Internet.



"Anecdotal reports and experiences of consumers, law enforcement and other industry players have centered on the inaccuracy of semiconductor alcohol testers," said Barry Knott, president of Lifeloc. "New third party research has confirmed that popular semiconductor personal breathalyzers are notoriously inaccurate and should not be trusted for accurate BAC measurement. What we didn't know, until the test results came in, was just how inaccurate these devices are."



The report also exposes questionable marketing practices of consumer breathalyzer distributors and retailers whose advertising claims suggest a high level of BAC measurement accuracy that is not supported by the test results.



"This report should serve as a warning to consumers to avoid semiconductor breath testers if they want accurate BAC measurement. It's also an invitation to retailers to take more responsibility in how they market personal breathalyzers," said Knott. "Consumer and public safety is not being well served by misleading product claims."



The report entitled "An Evaluation of the Accuracy and Reliability of Popular Consumer Breathalyzers as compared to their Marketing Statements" is of interest to anyone considering the purchase or sale of personal semiconductor breath testers. It is available for free download from lifeguardbreathtester, or lifeloc.



Source:

Tammy Stratton

Lifeloc Technologies, Inc.

Addiction Treatment May Benefit From Nicotine-Alcohol Interaction Study

The interaction between nicotine and alcohol, two of the most abused and co-abused drugs, can impact a person's ability to learn and could have implications for treating addiction, according to researchers at Temple University.



The researchers, Thomas J. Gould and Danielle Gulick, presented their findings, "Acute, chronic, and withdrawal from chronic nicotine interacts with acute ethanol to modulate fear conditioning," at the annual meeting of the Society for Neuroscience in San Diego. The study has also been accepted for publication in the peer-reviewed journal, Psychopharmacology.



"Whenever someone uses these two drugs together, there must be a reason why," says Gould, an associate professor of psychology at Temple. "The goal of our research is to understand the interactive effects of these two drugs and, by understanding how they are altering behavior and producing neural changes, we will hopefully be in a better position to develop treatments for drug addiction."



In examining the drugs' interactive effects on learning, the researchers looked at the ability to learn and process contextual information, which is important for multiple reasons. According to Gould, contextual learning taps into the part of the brain that is involved in declarative memory processes that define who we are, such as memories of our family, our wedding day, or graduating from school. This type of learning involves an area of the brain called the hippocampus, an area that is involved in strengthening short-term memories, and putting them into long-term memory storage, thus making those memories the ones that define who we are.



"We wanted to see if nicotine and alcohol are interacting in the hippocampus, or at another level, and what processes within the brain are they interacting with," Gould says. "If we can understand how these neural processes are changing and how they interact, then when someone is going through withdrawal or experiencing a cognitive deficit because of one of these two substances, we then may be able to use a therapeutic that blocks or activates a receptor, or that blocks a certain pathway which prevents the occurrence of the withdrawal symptoms and falling back into relapse."



Using an animal model, Gould and Gulick examined the effects of alcohol and nicotine on learning to determine what happens as the drugs are combined at different doses and different stages of administration.



"Our study showed that initially nicotine in a dose-dependent manner reverses alcohol-induced deficits in learning, but tolerance develops for this effect of nicotine with continued administration," he says. "We also found that a low dose of alcohol reverses nicotine withdrawal-associated deficits in learning. Furthermore, we found that chronic nicotine produces cross-tolerance to the effects of a low dose of alcohol on learning."



What does this all mean in terms of addiction?



"Think of a situation in which somebody is drinking and having cognitive difficulties," says Gould. "Smoking may take the edge off of it at first, so they begin smoking and they smoke more and more until tolerance develops and they lose that edge.



"Now they are drinking and smoking and they are addicted to both," he adds. "But if they try to quit smoking, they go into nicotine withdrawal, which results in a learning deficit. Maybe a drink will actually help them out initially, but then they consume more and they develop even worse learning deficits, so now they begin smoking again and they end up relapsing."



According to Gould, this could feed into a spiral in which initially nicotine and alcohol each block the adverse effects of the other. But as that happens, he says, smokers and drinkers develop tolerance and consume greater amounts of each drug, and then when they try quitting one or the other, they then have this cognitive deficit and may reach for either alcohol or nicotine or both to try and reverse it, but they just spiral into the addiction again.







This study was funded by the National Institute on Alcoholism and Alcohol Abuse (NIAAA) and the National Institute on Drug Abuse (NIDA).


Source: Preston M. Moretz


Temple University

Changing the face of drug addiction treatment, Rockefeller University researchers

People addicted to heroin, alcohol and other drugs of abuse often fail to stay clean because they won't go to or won't
stay in treatment. Reporting in the January issue of the Journal of Substance Abuse Treatment, Scott Kellogg, Ph.D., and Mary
Jeanne Kreek, M.D., at The Rockefeller University, and colleagues at the New York City Health and Hospitals Corporation (HHC)
and at Johns Hopkins University, show that a treatment approach called contingency management improves patients' motivation
to stay in treatment and increases their therapeutic progress.


The new study is one of the largest ever done to examine the merits of contingency management, a positive-reinforcement
treatment method in which patients are given rewards for constructive actions taken towards their recovery, for treating
addiction.


"This type of behavior research will help us understand what type of treatments and interventions, often used in conjunction
with targeted specific pharmacotherapies such as methadone for opiate addiction, are effective and how they can be translated
into real life," says Kreek, Patrick E. and Beatrice M. Haggerty Professor and head of the Laboratory on the Biology of
Addictive Disease.


The Journal of Substance Abuse Treatment paper tells the story of a transformation within the system, says Kellogg, who is a
clinical psychologist in Kreek's laboratory.


"We are hoping this study, which describes the experience of using contingency management from the vantage point of each
group of participants, will inspire other people to think that this is something that they might want to bring into their
clinic or their treatment system," he says. "To transform the field, we need to have both numbers and the stories. Together,
this is a powerful mechanism for change."


The intervention was first used in the addiction field in the mid-60s with alcoholic patients. The treatment was partially
based on the behaviorist B. F. Skinner's idea of operant conditioning, which proposes that behavior is more likely to
continue if it is reinforced. In the mid-70's, Maxine Stitzer, Ph.D., from Johns Hopkins University and a co-author of this
paper, began to test the effectiveness of this theory and intervention method on patients addicted to drugs.


"There was a debate between the scientific and the traditional worlds of drug treatment," says Kellogg. "At first, the
traditionalists were not able to take in a behavioral perspective as they saw addiction as an innate disease; therefore
external circumstances should not affect an addicted person's behavior. But those ideas are changing now, and that change is
part of our story."


The National Institute of Drug Addiction (NIDA) developed the Clinical Trials Network to both test and publicize various
science-based addiction treatments, and the contingency management program was one of the first chosen to study. At a
conference sponsored by NIDA, Kellogg, who is the scientific director for the contingency management intervention in New
York, met Peter Coleman and Marylee Burns, from the Office of Behavioral Health at the HHC, who are contributing authors to
the paper. Their meeting produced one of the largest adoptions ever done of contingency management, which involved five
addiction clinics in New York City.















"The Health and Hospitals Corporation was already preparing to apply something similar to the contingency management
approach," Kellogg says. "They were thinking of giving people rewards when they reached significant treatment benchmarks,
such as holding a job for six months. Using the science of operant conditioning, we suggested to them that you could achieve
a better outcome if you don't simply reward the attainment of goals, but, instead, you reinforce all of the steps along the
way."


"Scott developed the concept of a modified, practical but formal contingency management intervention within a community-based
treatment setting," Kreek says, "and he educated people at the HHC so they could implement it."


Contingency management is designed to reinforce small steps, especially at the beginning, like celebrating each attendance at
a group meeting or each drug-free test result. Later, patients can move on to larger achievements like stable housing.
Easy-to-earn material goods, such as movie passes and food vouchers, help to both initiate and maintain positive changes. The
program is not thought of as a substitute for counseling or pharmacotherapy, but something that adds to the therapy.


Documentation for the study included not only collected data, but also letters from patients and videotaped interviews with
staff and patients. Kellogg remembers one patient saying, "I felt like I was going down the drain with drug use, that I was
going to die soon. This [intervention] got me connected, got me involved in groups and back into things. Now I'm clean and
sober."


"We did have some opposition at first from the staff, people who come from different therapeutic traditions," Kellogg says.
"In general, we tend to punish people for doing things that are wrong, so it's not necessarily intuitive to reinforce
positive behavior when it does occur in our patients. But once the patients began to respond to the reinforcements, it
changed the counselors. The counselors want the patients to get better, and when they saw the patients get better, it was
really persuasive."


"I've heard several patients say 'My life has changed, I'm feeling better,'" he says. "It is so powerful to hear, so powerful
to witness. I would love to see the whole treatment system adopt this intervention."


This research was supported in part by the National Institute on Drug Abuse. Joyce B. Wale from the New York Health and
Hospitals Corporation also contributed to this paper.


Contact: Kristine Kelly

kkellyrockefeller

212-327-7146

Rockefeller University

rockefeller

Gender And Genes May Determine Effectiveness Of Treatment For Alcohol Dependence

Results from a new study suggest that one of the most prescribed medications for alcohol dependence may be more effective in some people. Preliminary results show that naltrexone (Revia), one of the only medications approved for treating people with alcohol abuse problems, may only be effective in women and those with a specific genetic variation. The new study, conducted by researchers from the Research Institute of the McGill University Health Centre (RI MUHC) and McGill University, will be published in the journal Alcoholism: Clinical and Experimental Research.



Previous work suggested that naltrexone only helped some people with alcohol problems, but the reason for that was unclear. "Our results suggest that we might now be able to predict beforehand who will benefit most," says Dr. Marco Leyton, lead investigator of the study and a researcher in the Mental Illnesses and Addiction axis at the RI MUHC. "We were quite excited to find that our results supported that naltrexone was specifically effective in women and in people who carried a gene related to the brain's natural morphine system called the mu opioid receptor gene (OPRM1)."



In this study, researchers followed a small group of "social drinkers" in an effort to validate some very preliminary hints that the efficacy of the treatment might be related to gender and a particular gene that may be inherited. These findings could help ensure that we give the right medication to the right people," says Dr. Leyton, who is also and associate professor in the Department of Psychiatry at McGill.



Researchers and clinicians might be able to determine who might best respond to this treatment, before it was administrated. "If a particular individual with alcohol dependence had these features, we could then say with much more confidence that this is going to help you. For other individuals who don't have those features, we'll be able to say, don't waste your time with this medication, we should try something else for you", explains Dr. Leyton. "These findings have the potential to improve the quality of treatment for alcohol dependent patients and they could ultimately lead to a form of personalized medicine."



Alcohol stimulates the release of the brain's natural opioids, which conveys a feeling of euphoria in individuals when drinking alcohol. There seem to be individual differences in the magnitude of that effect as well as in the sensitivity of the receptors to those natural opioids. "In other words, an opioid receptor blocker, such as naltrexone, might be an effective treatment for people with alcohol problems by decreasing the euphoria of drinking," explains Ms. Elaine Setiawan, first author of the study and PhD candidate in McGill's Integrated Program in Neuroscience.



At this point there is no particular reason to think that these findings couldn't be applied to other groups, such as those with a family history of alcoholism or those with high alcohol craving. But as Dr. Leyton suggests, "further research needs to be done in all sorts of populations and with a much larger sample to better understand the connection between the brain's opioid system, genetics and different responses to naltrexone."



About the paper:


The study entitled "The Effect of Naltrexone on Alcohol's Stimulant Properties and Self-Administration Behavior in Social Drinkers: Influence of Gender and Genotype" was supported by McGill University, the Canadian Institutes of Health Research (CIHR), and GlaxoSmithKline Inc. The co-authors of the study are Sylvia M.L. Cox of the Department of Neurology and Neurosurgery at McGill University; Robert O. Pihl of the Department of Psychology and the Department of Psychiatry at McGill University; Christina Gianoulakis and Roberta M. Palmour of the Department of Psychiatry at McGill University; and Chawki Benkelfat of the Department of Neurology and Neurosurgery, and the Department of Psychiatry at McGill University.



Source:

Julie Robert

McGill University Health Centre


View drug information on Naltrexone Hydrochloride Tablets.

Heavy Marijuana Use And Schizophrenia Risk

Heavy use of marijuana may put adolescents who are genetically predisposed to schizophrenia at greater risk of developing the brain disorder, according to research presented today at the annual meeting of the Radiological Society of North America (RSNA).


Using a sophisticated brain imaging technique called diffusion tensor imaging (DTI), researchers at Zucker Hillside Hospital in Glen Oaks, New York, studied the brains of groups of adolescents: healthy, non-drug users; heavy marijuana smokers (daily use for at least one year); and schizophrenic patients. Unlike magnetic resonance imaging (MRI), which provides a static picture of brain structures, DTI detects and measures the motion of water molecules in the brain, which can reveal microscopic abnormalities.


Manzar Ashtari, Ph.D., Sanjiv Kumra, M.D., and colleagues used DTI to examine the arcuate fasciculus, a bundle of fibers connecting the Broca's area in the left frontal lobe and the Wernicke's area in the left temporal lobe of the brain. The investigators found that repeated exposure to marijuana was related to abnormalities in the development of this fiber pathway, which is associated with the higher aspects of language and auditory functions.


"Because this language/auditory pathway continues to develop during adolescence, it is most susceptible to the neurotoxins introduced into the body through marijuana use," explained Dr. Ashtari, associate professor of radiology and psychiatry at New York's Albert Einstein College of Medicine.


In the study, DTI was performed on 12 healthy, early adolescent males compared with 12 late adolescent males to show normal human brain development; 11 schizophrenic patients compared with 17 matched controls; 15 schizophrenic patients who smoke marijuana compared with 17 matched controls; and 15 marijuana smokers compared with 15 matched non-drug users. The scans revealed no abnormal developmental changes in the language pathway in the healthy adolescents, but showed abnormalities in both the marijuana users and schizophrenic patients.


"These findings suggest that in addition to interfering with normal brain development, heavy marijuana use in adolescents may also lead to an earlier onset of schizophrenia in individuals who are genetically predisposed to the disorder," said co-principal-investigator Sanjiv Kumra, M.D., assistant professor of psychiatry at Albert Einstein College of Medicine.


According to the National Institute on Drug Abuse, approximately 3.1 million Americans age 12 and older use marijuana on a daily or almost daily basis. In 2004, 5.6 percent of 12 th graders reported daily use of marijuana.


Schizophrenia is a chronic, severe and disabling brain disorder that affects about one percent of the entire population. Although the causes of the disease have not been determined, it is believed to result from a combination of environmental and genetic factors.


Drs. Ashtari and Kumra said longitudinal studies are needed to determine whether these changes in the brain are permanent or change over time. It is also important to mention that at this time, DTI and MRI are not diagnostic means for schizophrenia patients or marijuana smokers.


Co-authors are Jinghui Wu, B.S., Kelly Cervellione, M.A., John Kane, M.D., Philip Szeszko, Ph.D., and Babak Ardekani, Ph.D.


Maureen Morley

mmorleyrsna

Radiological Society of North America

rsna

NIDA Survey Shows A Decline In Smoking And Illicit Drug Use Among Eighth Graders

The nation's eighth graders took center stage in this year's Monitoring the Future (MTF) survey, showing a significant decline in both smoking and illicit drug use in the past year, part of a downward trend for all measured age groups in the last decade. In addition, eighth graders showed a substantial long-term decline in past-year alcohol use, down to 31.8 percent from its recent peak of 46.8 percent in 1994. The Monitoring the Future project-now in its 33rd year-is a series of independent surveys of 8th, 10th, and 12th graders conducted by researchers at the University of Michigan under a grant from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH). Results from the 2007 survey were announced at a news conference at the White House.


The 2007 results appear to reflect an ongoing cultural shift among teens and their attitudes about smoking and substance abuse. Lifetime, past-month, and daily smoking among eighth graders has dropped considerably in the past year, and daily cigarette smoking among eighth graders dropped from 4 percent to 3 percent; down from its 10.4 percent peak in 1996. Similarly, annual prevalence of marijuana use by eighth graders fell from 11.7 percent in 2006 to 10.3 percent in 2007, and is down from its 1996 peak of 18.3 percent.


"Over the last decade, there has been a large science-based effort throughout the public health community to drive down the rates of smoking, illicit drug, and alcohol use among teens," said NIH Director Elias A. Zerhouni, M.D. "These results show us we are definitely seeing a decline in substance abuse among our youngest and most vulnerable teens, and we are committed to continuing our efforts."


"We are especially heartened to see the decrease in smoking among eighth graders, and will be watching the next two years closely to see if this decline will stick as these kids get older," said NIDA director Nora D. Volkow. "If this change in attitude is carried with them throughout the rest of their teen years, we could see a dramatic drop in smoking-related deaths in their generation."


The survey also showed that while past-year use of marijuana declined among 8th graders in 2007, it remained steady among 10th and 12th graders. However, in the past decade, there has been a slow downward trend in overall illicit drug use driven by gradual declines in marijuana smoking. Past-year marijuana use among 10th graders sits at 24.6 percent after it peaked in 1997 at 34.8 percent. Similarly, past-year marijuana use among 12th graders registers at 31.7 percent after a 1997 peak of 38.5 percent.


The survey results are not without concerns, however. Prescription drug abuse remains high with virtually no significant drop in nonmedical use of most individual prescription drugs. Vicodin remains one of the most commonly abused drugs among 12th graders: 1 in 10 reported nonmedical use in the past year. The Monitoring the Future Survey traditionally measures misuse of a variety of different prescription drugs including opiates like Vicodin and OxyContin, amphetamines (including Ritalin), sedatives/barbiturates, and tranquilizers, as well as over-the-counter drugs, such as cough syrup. However, for the first time this year, researchers pulled together data for all prescription drugs as a measurable group, and 15.4 percent of high school seniors reported nonmedical use of at least one of these prescription medications within the past year. Recent data for consuming 5+ drinks in a row in the last two weeks--an especially dangerous pattern of consumption--have remained steady at worrisome levels for all three grades. In addition, recent data for drinking have remained steady at high levels, particularly for 10th and 12th graders.















Another concern in the survey is the softening of attitudes towards MDMA (ecstasy) and LSD in the younger grades. For the third year in a row, there was a decrease in perceived harmfulness of MDMA among eighth graders. Among 10th graders, there was a decrease in perceived harmfulness of LSD and MDMA and a decrease in disapproval of LSD. Concurrently, there has been an increase in past-year MDMA use in 10th and 12th graders over the past two years.


"We will be watching what happens with MDMA and LSD use in future surveys," said Dr. Volkow. "This decrease in both disapproval and perceived harmfulness among eighth graders shows us that we need to be vigilant in our educational efforts with every drug in each succeeding generation."


Since 1975, the MTF survey has measured drug, alcohol, and cigarette use and related attitudes among adolescent students nationwide. Survey participants report their drug use behaviors across three time periods: lifetime, past year, and past month. Overall, 48,025 students from 403 public and private schools in the 8th, 10th, and 12th grades participated in this year's survey. The survey has been conducted since its inception by investigators at the University of Michigan. Additional information on the Monitoring the Future Survey, as well as comments from Dr. Nora Volkow can be found at here.


MTF is one of three major Health and Human Services (HHS)-sponsored surveys that provide data on substance use among youth. Its Web site is monitoringthefuture . More information on MTF can be found at hhs/news ; or whitehousedrugpolicy . Additional details are also available here.


The National Survey on Drug Use and Health (NSDUH), sponsored by HHS' Substance Abuse and Mental Health Services Administration, is the primary source of statistical information on illicit drug use in the U.S. population 12 years of age and older. The survey collects data in household interviews, currently using computer-assisted self-administration for drug-related items. More information is available here.


The Youth Risk Behavior Survey (YRBS), part of HHS' Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System, is a school-based survey that collects data from students in grades 9-12. The survey includes questions on a wide variety of health-related risk behaviors, including drug abuse. More information is available here.


The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at drugabuse .


The National Institutes of Health (NIH) - The Nation's Medical Research Agency - includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary Federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases.

nih


View drug information on OxyContin; Ritalin LA.

Close Proximity To Alcohol Outlets Puts Adolescents At Greater Risk

Researchers found that alcohol outlets are concentrated in disadvantaged neighborhoods and can contribute to adolescent drinking.


Using data from the California Health Interview Survey, this study investigated the socio-demographic disparities in alcohol environments and their relationship to adolescent drinking. Researchers found that alcohol outlets within walking distance from homes were associated with two adverse alcohol behaviors among adolescents: increased binge drinking and driving after drinking. Furthermore, alcohol availability, measured by mean and median number of alcohol licenses, was significantly higher around residences of minority and lower-income families.


"Our findings suggest that the proximity rule needs to be tightened and more stringently enforced and that environmental interventions are needed to curtail young people's access to commercial sources of alcohol, through tightening licensure or enforcing minimum-age drinking laws," concluded the study's authors.



Title of original article

"Alcohol Environments: Disparities in Exposure and Adolescent Drinking in California"




The American Journal of Public Health is the monthly Journal of the American Public Health Association (APHA), the oldest and most diverse organization of public health professionals in the world. APHA is a leading publisher of books and periodicals promoting sound scientific standards, action programs and public policy to enhance health. More information is available at apha.

American Journal of Public Health

Possible Link Found Between Memory Storage And Addiction

Our experiences -- the things we see, hear, or do -- can trigger long-term changes in the strength of the connections between nerve cells in our brain, and these persistent changes are how the brain encodes information as memory. As reported in Neuron, Johns Hopkins researchers have discovered a new biochemical mechanism for memory storage, one that may have a connection with addictive behavior.



Previously, the long-term changes in connection were thought to only involve a fast form of electrical signaling in the brain, electrical blips lasting about one-hundredth of a second. Now, neuroscience professor David Linden, Ph.D., and his colleagues have shown another, much slower form of electrical signaling lasting about a second can also be persistently changed by experience.



They simulated natural brain activity by applying short electrical jolts to slices of rat brain and measuring the current flowing across the cells. After repeated jolting, the strength of the slow nerve signals had dramatically decreased and remained at a low intensity for 30 minutes after electrical jolts ceased.



These slow signals are produced by a nerve cell receptor called mGluR1, which has been associated with behaviors such as addiction and epilepsy. "Both of these conditions also involve long-term changes in the function of nerve connections," says Linden. "So in addition to furthering our basic understanding of memory storage, our work suggests that drugs designed to alter mGluR1 are promising candidates for the treatment of addiction, epilepsy, and diseases of memory."







The research was funded by the Republic of Korea Ministry of Health and Welfare and the National Institutes of Health



Authors on the paper are Paul Worley and Linden of Johns Hopkins and Sang Jeong Kim, Yunju Jin and Jun Kim of Seoul National University College of Medicine



On the Web:

neuroscience.jhu/DavidLinden.php

neuron/



Source: Nick Zagorski


Johns Hopkins Medical Institutions

It's Not Easy Being Gay

Members of 'sexual minorities' are around twice as likely as heterosexuals to seek help for mental health issues or substance abuse treatment. A model of treatment-seeking behavior, described in the open access journal BMC Psychiatry supports the idea that lesbian, gay and bisexual people may have specific treatment needs.



Susan Cochran worked with a team of researchers from the University of California, Los Angeles using data they collected from 2074 people first interviewed in the California Health Interview Survey. They found that 48.5% of lesbian/gay/bisexual individuals reported receiving treatment in the past year as compared to 22.5% of heterosexuals. In addition, gender was shown to play a large role; lesbians and bisexual women were most likely to receive treatment and heterosexual men were the least likely.



According to Cochran, "It is well known that health services utilization is greater among women generally. Here we have shown that minority sexual orientation is also an important consideration. Lesbians and bisexual women appear to be approximately twice as likely as heterosexual women to report having received recent treatment for mental health or substance use disorders."



The researchers speculate that the causes driving this increased use of healthcare may include higher exposure to discrimination, violence, and other stressful life events. Cochran adds, "The pervasive and historically rooted societal pathologizing of homosexuality may contribute to this propensity for treatment by construing homosexuality and issues associated with it as mental health problems".



Notes:

Influence of gender, sexual orientation, and need on treatment utilization for substance use and mental disorders: findings from the california quality of life survey

Christine E. Grella, Lisa Greenwell, Vickie M. Mays and Susan D. Cochran

BMC Psychiatry (in press)

biomedcentral/bmcpsychiatry/



Source:
Graeme Baldwin


BioMed Central

Alcohol: Global Burden on Health Similar to Tobacco and High Blood Pressure

The amount of death and disability caused by alcohol globally is similar to that caused by tobacco and high blood
pressure, concludes a review in this week's issue of The Lancet. Overall, four percent of the global burden of disease is
attributable to alcohol, 4•1% to tobacco and 4•4% to high blood pressure. Alcohol is causally related to more than 60
different medical conditions, including breast cancer and coronary heart disease. In most cases alcohol has a detrimental
effect on health.


The comprehensive review on alcohol and public health is particularly timely as from February 7, 2005 new legislation in the
UK will permit pubs, bars, off-licences and nightclubs to remain open 24 hours later this year.


In the review, Robin Room (Stockholm University, Sweden) Thomas Babor (University of Connecticut, USA) and J?rgen Rehm
(Centre for Addiction and Mental Health, Canada) assess policy research and options for alcohol control. Studies have shown
that raising the price and reducing the availability of alcoholic beverages can lower consumption. Using price elasticity
estimates and analysis of UK alcohol related mortality data the authors estimate that a 10% rise in British alcohol prices
would produce a drop in cirrhosis mortality of 7% in men and 8•3% in women and a fall of 28•8% in men and 37•4% in women in
deaths from explicitly alcoholinvolved causes (alcohol dependence, poisoning etc.) Besides price, drinking and alcoholrelated
problems can be affected by restricting the hours and days of alcohol purchasing and of the numbers and types of outlets.
Despite this evidence the authors highlight the fact that research findings on effective alcohol control measures fail to
impact on policy decisions.


Professor Room comments: "A stark discrepancy exists between research findings about the effectiveness of alcohol control
measures and the policy options considered by most governments. In many places, the interests of the alcohol industry have
effectively exercised a veto over policies, making sure that the main emphasis is on ineffective strategies such as
education."


He concludes: "There has been a growing contrast between the treatment of alcohol in trade agreements and disputes as an
ordinary commodity and the more restrictive treatment of such other commodities as tobacco and pharmaceuticals, which also
entail a public health risks. In a globalising world of common markets and trade agreements, alcohol policy is thus no longer
only a national or subnational matter. To reverse the trend, a new international agreement on alcohol control, along the
lines of the Framework Convention on Tobacco Control is needed."


Contact: Professor Robin Room, Centre for Social Research on Alcohol and Drugs, Stockholm University,

Sveaplan, SE-106 91 Stockholm, Sweden T) +46 8 674 7047


This is a press release from THE LANCET

Phase 2 Results Of Investigational Abuse-Deterrent Opioid ALO-01presented By Alpharma

Alpharma Pharmaceuticals LLC, a subsidiary of Alpharma Inc.(NYSE: ALO), a leading global specialty pharmaceutical company, presented results from a Phase 2 study that showed ALO-01, an extended-release morphine sulfate plus sequestered naltrexone, provided similar effectiveness to KADIAN® (morphine sulfate extended-release) Capsules in osteoarthritis patients with moderate-to-severe chronic pain. The data were presented at the annual meeting of the American Society of Anesthesiologists in San Francisco, Calif.



Results showed:



* ALO-01 showed similar effectiveness to KADIAN® and maintained pain reduction throughout the study.



* The sequestered naltrexone did not interfere with patients' pain relief.



* The majority of patients rated both medications as good, very good or excellent.



"We are pleased with the results of this Phase 2 trial with ALO-01, which showed our investigational abuse-deterrent product provides similar pain relief and tolerability as our extended-release opioid KADIAN®," commented Joseph Stauffer, DO, Chief Medical Officer, Senior Vice President of Clinical Research & Medical Affairs, Alpharma Pharmaceuticals LLC. "Based on these positive findings, we began Phase 3 trials for ALO-01, which have been fully enrolled, reinforcing our commitment to providing relief to patients with moderate-to-severe chronic pain while helping to reduce the risk of misuse, abuse and diversion."



ALO-01, formerly referred to as KADIAN® NT, is being studied under an investigational new drug application for moderate-to-severe chronic pain. The product is developed with Alpharma's proprietary technology, which combines an extended-release opioid with sequestered naltrexone, an opioid antagonist. When ALO-01 is taken as directed, it provides pain relief and the naltrexone remains sequestered in the pellet core and passes though the gastrointestinal tract without significant absorption. If the product is crushed, chewed or dissolved, the naltrexone is released and designed to block opioid effects (e.g., euphoria).



"These findings show that when patients take ALO-01 as directed, patients achieve measurable relief of their chronic pain and the naltrexone passes through the body without significant absorption," says Nathaniel Katz, MD, MS, Assistant Professor of Anesthesia, Tufts University School of Medicine, Boston, Mass., founder of Analgesic Research, and study author.



Study Design



The Phase 2, double-blind, crossover study assessed effectiveness, tolerability and pharmacokinetics of ALO-01 compared with KADIAN® at nine sites in the U.S. In the study, 69 adult patients with moderate-to-severe pain due to osteoarthritis, after a washout from previous treatments, were administered five periods of treatment with study drugs.
















* Period One: All patients titrated to effective analgesia with KADIAN®;



* Period Two: Randomized to double-blind treatment with either KADIAN® or ALO-01 for 14 days;



* Period Three: All patients treated with KADIAN® open label for 7 days;



* Period Four: Crossed over to the other study medication, either KADIAN® or ALO-01, for 14 days, depending on randomization in period two;



* Period Five: All patients again treated with KADIAN® open label for 7 days.



Once titrated in period one, the morphine dose was held constant at the stabilized dose during periods two through five.



Study Results



After washout, the mean pain intensity was 7.1 ?± 1.5. The mean pain score was reduced to 2.1 ?± 1.0 by the end of the titration period. Brief Pain Inventory scores -- average pain each day rated on a 0 to 10 scale (least to worst pain) -- were KADIAN®, 2.3; ALO-01, 2.4 on treatment day seven and KADIAN®, 2.4; ALO-01, 2.3 on treatment day 14. Most patients rated both medications as good, very good or excellent, (KADIAN®, 78.9%; ALO-01, 91.5%), according to the Patient Global Assessment of the medication.



During each crossover period, patients' blood levels were taken and assessed for naltrexone. In most patients the amount of naltrexone was below the level of quantification. In the few patients in which low levels of naltrexone were present, it did not affect the patients' pain scores or produce symptoms associated with opioid withdrawal.



Adverse events were generally mild to moderate. The most common adverse events during the double-blind treatment period for KADIAN® and ALO-01 were constipation (12.7%; 15.5%), nausea (8.5%; 9.9%) and somnolence/drowsiness (8.5%; 9.9%), respectively.



About KADIAN® Capsules



KADIAN® capsules are an extended-release oral formulation of morphine sulfate indicated for the management of moderate-to-severe pain, when a continuous, around-the-clock opioid analgesic is needed for an extended period of time. The capsules can be taken once-daily (q24h) or twice-daily (q12h), as prescribed, to provide up to 24 hours of pain relief. KADIAN® capsules are not for use as a prn analgesic.



KADIAN® capsules are available in eight strengths: 10 mg, 20 mg, 30 mg, 50 mg, 60 mg, 80 mg, 100 mg and 200 mg. The 100 mg and 200 mg capsules are for use in opioid-tolerant patients only. KADIAN® offers flexible dosing and administration options that allow physicians to fine-tune titration schedules and tailor treatment for individual patient needs.



KADIAN® capsules may be expected to have additive effects when used in conjunction with alcohol, other opioids, or illicit drugs that cause central nervous system depression because respiratory depression, hypotension and profound sedation or coma may result.



KADIAN® side effects are generally consistent with those found with other opioids. The most common include drowsiness, constipation, nausea, dizziness and anxiety. Serious adverse reactions that may be associated with KADIAN® include respiratory depression, respiratory arrest, circulatory depression, cardiac arrest, low blood pressure and/or shock.



KADIAN® capsules contain an opioid agonist which is a Schedule II controlled substance. KADIAN® has an abuse liability similar to other opioids. This should be considered when prescribing or dispensing KADIAN®.



For complete prescribing information, visit kadian/.







About Alpharma



Alpharma Inc. (NYSE: ALO) is a global specialty pharmaceutical company with leadership positions in products for humans and animals. Alpharma is presently active in more than 60 countries. Alpharma has a growing branded pharmaceutical franchise in the U.S. pain market with its KADIAN® (morphine sulfate extended-release) Capsules, and an innovative pharmaceutical product pipeline that consists of several novel approaches to treat pain, including the Flector® Patch (diclofenac epolamine topical patch),which is expected to launch in early 2008. In addition, Alpharma is among the world's leading producers of several specialty pharmaceutical-grade bulk antibiotics and is internationally recognized as a leading provider of pharmaceutical products for poultry and livestock.



KADIAN® is a registered trademark of Alpharma Pharmaceuticals LLC.



Flector® Patch is a registered trademark of Institut Biochemique S.A.
What are Opioids?
For more information on what opioids are, and opioid-induced constipation (OIC), please see:
All About Opioids and Opioid-Induced Constipation (OIC)


Source: Kathleen Makrakis


HealthStar PR



View drug information on Kadian; Naltrexone Hydrochloride Tablets.

Queen's Research Shows Daily Cannabis Use Reported By NI Teenagers

Fourteen and fifteen year olds in Northern Ireland are using cannabis daily a study has found.


Research from Queen's University Belfast has found that one in ten school children who had reported using cannabis at least once had now become daily users.


Dr Patrick McCrystal, Senior Research Fellow, said: "Whilst the numbers in our study who told us they were using cannabis each day may seem small, these young people are telling us that by the age of 15 they have moved beyond experimental or recreational use of an illegal drug to more sustained usage."


Those reporting high levels of cannabis use were also more likely to smoke cigarettes and drink alcohol regularly as well as use other illegal drugs. Approximately one in six of these users also reported abusing solvents on a weekly basis and nearly one third used ecstasy each week. The frequent cannabis users were responsible for almost all use of 'hard' drugs like cocaine.


The Youth Development Study (YDS), being carried out by Queen's Institute of Child Care Research, is a longitudinal study of adolescent drug use. Some 4,000 teenagers covering 43 schools in Belfast, Ballymena and Downpatrick have taken part each year since they entered secondary education making it one of the largest schools-based surveys of its kind.


The research found that 70 percent of the frequent users were male. Nearly two-thirds of all the users belonged to the lowest socio-economic groups, were more likely to live within a disrupted family with just one parent, have poor levels of communication with parents or guardians, and had low levels of motivation to do well at school.


Dr McCrystal continued: "The findings tell us that the school children who use cannabis each day are placing themselves at an increased risk to drug related social and health problems now and in the future. These young people appear to have moved beyond what we consider traditional teenage lifestyles to one that includes regular use of illegal drugs as well as frequent tobacco and alcohol consumption. They are more likely to spend their evenings away from the family home, have poor levels of communication with their families, and be disaffected with school."


The study further indicates high levels of delinquency and antisocial behaviour by daily users which may have become part of their 'lifestyle activities'. Of these teenagers, a quarter reported being in trouble with the police on more than 10 occasions and nearly one-fifth had been summoned to court during the twelve month period prior to the survey.


Dr McCrystal said: "The lifestyle activities of the high level users may provide valuable insights for education and prevention strategies for the future. The opportunity should be taken now to identify as many of these young people as possible and as early as we can. Our research provides examples of the type of information that is now needed to do this and to develop support strategies to meet their needs.


"Also, as we continue with our research into the lifestyles of these young people we may be able to determine more specifically the activities associated with their drug use, and in doing so also more fully understand how drug use is shaped by lifestyle, and conversely, how drug use reshapes lifestyle."


QUEEN'S UNIVERSITY, BELFAST

Communications Office, Lanyon North

Queen's University

Northern Ireland

Belfast

qub.ac

SAMHSA Announces FY 2011 Guidance For Submissions To National Registry Of Evidence-Based Programs And Practices

The Substance Abuse and Mental Health Services Administration (SAMHSA) today provided guidance for those interested in submitting programs and practices to its National Registry of Evidence-Based Programs and Practices (NREPP). The notice is published in the August 18, 2010 Federal Register.


NREPP is a voluntary rating and classification system designed to provide the public with reliable information on the scientific basis and practicality of interventions that prevent and/or treat mental and substance use disorders. Under NREPP, minimum review criteria require that interventions must: be evaluated using an experimental or quasi-experimental study design; demonstrate one or more positive change outcomes in mental health and/or substance use among individuals, communities or populations; have results that are published in a peer-reviewed publication or documented in a comprehensive evaluation report; and provide documentation, such as manuals, guides, or training materials, to facilitate broader public dissemination of the intervention.


Interested parties can review the complete Federal Register notice by going to the National Registry of Evidence-Based Programs and Practices web page on the SAMHSA home page.
? 


Source:

SAMHSA

Internet Addiction: A Novel Disease Or A Bad Habit?

It is impossible to deny the incredible significance of the internet and the effects its development has had on the world. Today the internet touches nearly every aspect of our daily lives; we shop online, we keep in touch through email, banking and credit can be taken care of through one click of a mouse, news from all over the world blinks up at us from the screen every time we log on, and communities of people from all over the planet are connected. Despite its obvious countless advantages, there is a rising concern regarding the overuse of the internet on a personal level. There are more and more people each day who feel a compulsive need to be connected to the internet, a need that some scientists and psychiatrists have begun to consider an addiction. This issue drew major media attention in March of this year when Dr. Jerald Block published an editorial in the American Journal of Psychiatry arguing that "Internet Addiction" should be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), a handbook published by the American Psychiatric Association of recognized psychological conditions. Block raised the question of whether this new phenomenon should be classified as a disease or written off as a bad habit.


The traditional view of addiction generally applies to substances like drugs or alcohol and is seen as a result of a combination of genetic and social influences. However, in recent years the definition of addiction has expanded to include different behaviors like gambling and over-eating. The question that remains to be seen is if there are enough similarities between traditional addiction and this so called internet addiction to warrant its acceptance as a disease by the mental health community. For now it is officially titled Internet Addictive Disorder (IAD) or Internet Overuse Syndrome (IOS) and not recognized by the American Psychiatric Association.


Block argues that Internet addiction is characterized by the same four factors as traditional addiction: excessive use, withdrawal, tolerance, and negative repercussions. He contends that users are on the internet for so much time that they are unaware of how many hours have gone by, and neglect other basic human desires, often forgetting to eat or use the bathroom. Users feel angry, depressed, and tense when access to the internet is limited and frequently need better tools and more time of use to experience the original satisfaction. Internet addicts also face such harmful consequences as social isolation and poor achievement. The statistics regarding the prevalence of internet addiction in the U.S. vary widely. A random telephone survey estimated 0.3-0.7% of Americans are afflicted, while Maressa Hecht Orzack of McLean Hospital in Massachusetts, estimates that nearly 10% of Americans have experienced some sort of internet dependency. Higher rates of addiction are seen mostly in Asian nations like South Korea and China where the popularity of internet cafes is high and the condition is easier to track because of its public nature. In fact, data from 2006 stated that approximately 210,000 South Korean children (2.1%) were afflicted with internet addiction with about 80% requiring treatment that included the use of psychotropic medication. Another interesting aspect of IAD is that most often individuals who suffer from it also are battling another mental illness. In particular, mood, anxiety, impulse control and substance abuse disorders are common in conjunction with internet overuse.















Research has traced other behavioral addictions like gambling and shopping to biological foundations; however the current research on internet addiction merely distinguishes it as a growing issue and draws parallels to other types of addictions. More studies need to be performed on this new phenomenon in order to properly characterize it as an addiction or as simply a destructive behavior.



While the internet may not officially be an addiction, there are still many individuals out there who would benefit from treatment. There are currently no proven forms of effective treatment and no available psychotropic medications for IAD. However, like with other addictive habits, cognitive behavioral therapy may be effective. Cognitive therapy is essentially a method that identifies and helps a person to correct specific errors in what he or she is thinking that produces negative or painful feelings. According to Dr. Allison Conner of Cognitive Therapy Associates, an internet addiction could be treated similarly to other addictions. She asserts that, "so many changes need to occur in the person's lifestyle (mental, emotional, physical, social), and support is crucial. A guide or coach is often essential to help ensure success, but most important is the willingness of the addicted person to get real with themselves and stay committed to the goal of recovery."



While we may not see Internet Addiction in the DSM-V handbook anytime soon, the issue is controversial and becoming ever more widespread. Ironically enough, you can even look up online resources if you feel you need help.



Written by Elizabeth Dillon, Cognitive Therapy Associates



Sources:


Block, Jerald J. (2008). Issues for DSM-V: Internet Addiction. The American Journal of
Psychiatry, 165, 306-307.


Goldsborough, Reid, (2008). Internet Addiction Afflicting a Growing Number of Web
Surfers. Community College Week, Vol. 20 Issue 11, 0, 22-22.


Shaw, Martha Black, Donald W. (2008). Internet Addiction. CNS Drugs, Vol. 22, Issue 5,
13, 353-365.



Dr. Allison Conner can be contacted through her
website. or at (212)-258-2577.


cognitive-therapy-associates/

Overeating Really Is An Addiction For Obese People

Obese people who eat huge amounts of food may be doing so because regions of their brain that control satiety (fullness) are also those that trigger cravings for drug addicts, say researchers from New York, USA. The scientists say that they now have a better understanding of how the brain and the stomach interact with emotions to cause overeating and obesity.


You can read about this study in Proceedings of the National Academy of Sciences.


The scientists scanned the brains of seven obese people, all of whom had had an implantable gastric stimulator (IGS) fitted for one to two years. An IGS is a device that sends signals to the vagus nerve, which sends the message on to the brain telling it that the person is full. The device has been shown to reduce the desire to eat.


Each volunteer underwent two positron emission tomography (PET) brain scans two weeks apart. One when the IGS was switched on and another when it was switched off. The volunteers were not told when the devices were switched on or off. Before the scans, they were injected with a a radioactively labeled form of glucose - so that the scanner could track brain metabolism.


The scans showed higher activity in the hippocampus. The hippocampus is an area of the brain linked to emotions, memory, learning and processing of sensory and motor impulses. The hippocampus has an important role in retaining memories related to prior drug experiences in drug addicts - it is likely that the memories of fullness in these obese volunteers might also be stimulated by hippocampal activation, say the scientists.


In other words, the scientists saw a similarity in these people's brain activity and that of drug addicts when they are craving for their drug. Identical parts of the brain became active in similar ways. This indicates, say the researchers, that is going on in the brain of an obese person who wants to eat is virtually identical to what goes on in a drug addict's brain when he/she wants his/her fix.


The researchers believe these brain circuits play a critical role in behaviors linked to calming negative emotions.


Lead author, Gene-Jack Wang, Brookhaven Lab's Center for Translational Neuroimaging, said "This study opens new territory in understanding how the body and brain connect to each other, and how this connection is tied to obesity. We were able to simulate the process that takes place when the stomach is full, and for the first time we could see the pathway from the stomach to the brain that turns 'off' the brain's desire to continue eating."


Click here to see the article in the Brookhaven National Laboratory's web site

Alcohol And Drugs 'Stifle Artistic Creativity'

The idea that alcohol and drugs can stimulate artists, writers and musicians to create great works of art is a "dangerous myth" and can actually stifle creativity, a psychiatrist has said.



Dr Iain Smith, a consultant in addiction psychiatry at Gartnavel Royal Hospital in Glasgow, was speaking at the International Congress of the Royal College of Psychiatrists in Edinburgh.



He said that while many artists and writers, such as the 19th century French poet Baudelaire and American writer Ernest Hemingway, were well known for their use of intoxicating substances (cannabis and alcohol respectively), most produced their greatest works when they were sober.



Dr Smith said: "The reason that this myth is so powerful is the allure of the substances, and the fact many artists need drugs to cope with their emotions. Artists are, in general, more emotional people and the use of substances to deal with their emotions is more likely to happen."



He added that drugs and alcohol are social substances and many creative people, such as Ernest Hemingway and the French artist Degas, spent a lot of time in Parisian cafes exchanging ideas and imbibing large quantities of absinthe and other types of alcohol.



Dr Smith said that American writers Tennessee Williams and Hemingway were both addicted to alcohol. He said poets Coleridge and Keats favoured opiates, as did writers Proust and Edgar Allan Poe, while Vincent van Gogh drank absinthe. American writers F. Scott Fitzgerald, Eugene O'Neill and William Faulkner were all recipients of the Nobel Prize for Literature, and all were alcoholics.



Dr Smith told the Congress that the American writer Hunter S. Thompson once wrote: "I'd hate to advocate drugs, alcohol or insanity to anyone - but they've always worked for me". Baudelaire also urged fellow poets "to be drunk always".



But from reviewing the evidence, Dr Smith claims that many of these artists were most productive during times of sobriety. He said: "The idea that drugs and alcohol give artists unique insights and powerful experiences is an illusion. When you try and capture the experiences [triggered by drugs or alcohol], they are often nonsense."



For example, the strong visual experiences triggered by hallucinogenic drugs, such as LSD, can be captured on canvas - but this is unlikely to happen in other fields such as music and writing. Dr Smith said: "These drugs often wipe your memory, so it's hard to remember how you were in that state of mind."



References:


International Congress of the Royal College of Psychiatrists, Edinburgh, 21-24 June 2010.


Source:
Royal College of Psychiatrists

UCSF Study Shows That Cocaine Addiction Is Linked To Voluntary Drug Use And Cellular Memory

Rats that voluntarily use cocaine show a persistent cellular memory in the brain's reward center even after several months of abstinence from the drug, while their involuntary counterparts had no such memory, according to a new study by researchers at the University of California, San Francisco.



The researchers conclude that the pharmacologic effects of cocaine alone are not enough to cause long-lasting cellular memories in the brain's reward circuit. The discovery by neuroscientists at UCSF's Ernest Gallo Clinic and Research Center appears in the July 31 issue of the journal Neuron.



The study opens a window onto the significance of active choice in using cocaine and extends our understanding that addiction is caused by more than the pharmacological effects of a given drug, according to Antonello Bonci, MD, senior author of the paper, UCSF associate professor of neurology, Howard J. Weinberger Chair in Addiction Research and principal investigator at the Gallo Center.



"We know that environmental cues are significant in many addictions, including tobacco and alcohol, and contribute to relapses," Bonci said. "This study identifies the specific neuronal process involved and helps explain relapse even after rehabilitative therapy or long-term abstinence."



The researchers trained rats to self-administer cocaine, food or sucrose using a lever-pressing procedure. A separate group of rats also received passive researcher-administered cocaine. Neural activity was compared in brain tissue samples from the four groups and with samples from rats that had not experienced any rewards or training.



The study found that rats that learned to self-administer cocaine showed an increase in communication to dopamine neurons, which form the brain's key natural reward and motivational circuit, known as the ventral tegmental area (VTA).



In rats that self-administered cocaine, the increase in neuronal communication - called long-term synaptic potentiation (LTP) - was similar to those that had self-administered food or sucrose, but with a critical distinction. The increase in LTP due to cocaine persisted for up to three months of abstinence, but the increase in response to natural rewards dissipated after only three weeks. One striking finding, according to the research team, was that rats given passive cocaine infusions did not show LTP in the VTA dopamine neurons.



One subset of rats in the active group also underwent behavioral extinction. In extinction training, depression of the lever was no longer accompanied by cocaine leading to the cessation of drug-seeking behavior. Despite the absence of the behavior, LTP remained just as high as in rats that had not received the extinction training, indicating that the cellular memory produced by cocaine-seeking behavior remained intact, according to Billy T. Chen, PhD, a postdoctoral fellow at the Gallo Center and lead author of the study.



"These potentiated synapses are persistent, regardless of what your new behavior is, and because the memory is still maintained, it could trigger relapse when the conditions are repeated," Chen said. "This is a clear validation that drug addiction is a life-long disease. Three months for a rat could equal several years in a human. Although drug-taking behaviors may be absent, the 'memory' makes relapse not only possible, but likely."







In 2006, six million Americans age 12 and older had abused cocaine in any form, according to the National Institute on Drug Abuse (NIDA). There are currently no medications for cocaine addiction, therefore standard treatments typically rely on behavioral interventions and relapse after treatment is common.



Co-authors on the paper include M. Scott Bowers, PhD; Miguel Martin, PhD; F. Woodward Hopf, PhD; Anitra M. Guillory, PhD; Jonathan K. Chou, all from the UCSF Gallo Center; and Regina M. Carelli, PhD, from University of North Carolina, in Chapel Hill.



This study was funded by NIDA, part of the National Institutes of Health.



UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. For further information, please visit ucsf/.



Source: Kristen Bole


University of California - San Francisco

Alcohol Influence In Films - Can Predispose Younger Teens To Experiment With Alcohol

Seeing movies that feature characters drinking alcohol can predispose young adolescents to experiment with alcohol at an early age, concludes a study led by Dartmouth Medical School (DMS) researchers. It is the first research study to measure the influence of alcohol use in movies and, using data from more than 600 films and 5,000 students, found that movies play a significant role in an adolescent's decision to drink at a young age.


The regional study was published in the January issue of the Journal of Studies on Alcohol and the authors cite previous research that identified early initiation of alcohol use (before the age of 14) as one risk factor for problems with alcohol later in life.


"Each year that kids delay experimenting with alcohol can help them avoid some of the serious consequences that drinking at a young age can contribute to, including drinking and driving and alcohol dependence," said the lead author of the study Dr. James Sargent, professor of pediatrics at DMS. "This study is aimed at the prevention of early alcohol use and our hope is that parents of young children become more aware that drinking in films is common and that seeing these depictions can lead to early experimentation with drinking."


In his previous studies, Sargent found that images and scenarios depicted in movies are among the strongest influences on young children, rivaling several other factors such as drinking by parents and peers. In his current study, his research team found that 92% of the films in a sample of 601 contemporary movies depicted the use of alcohol. Broken down by ratings, they found that alcohol was used in 52% of G-rated films, 89% for PG, 93% for PG-13 and 95% for R.


The researchers surveyed more than 5,000 students ages 10 to 14 years old in Vermont and New Hampshire schools, to assess the amount of movies they watch and whether they had tried drinking before. Other factors, including the adolescents' class performance, gender and personality characteristics were also taken into account. The researchers then followed up with the "never drinkers" two years after the initial assessment and found that kids who with higher exposure to movie alcohol use at the initial assessment were more likely to start drinking during the follow up period. Thus, high exposure predicted future use of alcohol.


Overall, researchers calculated that the typical child who took part in the survey was exposed to about 8 hours of alcohol use through movies. "If you think about how many 30 second beer commercials one can fit into eight hours, it's a staggering number--over 1000" said Sargent.


A practicing pediatrician at Dartmouth-Hitchcock Medical Center, he notes that the vast majority of movie scenarios depict alcohol in a positive light, often showing people drinking at parties or bars, unwinding with a drink after work, or leading up to a romantic scene. He believes that parents could improve their kids' health later in life by limiting their "diet" of movies that portray adult-oriented behavior. "Parents shouldn't let their kids overeat and they shouldn't let their kids overindulge in movies," he said. "One movie per week for a child 10-14 years old should be sufficient, but it's clear from this research that kids are watching much more than that."


This study was sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and grants from the National Cancer Institute, and the National Institute on Drug Abuse. Co-authors of the study include Dr. Thomas Wills (Albert Einstein College of Medicine), Dr. Mike Stoolmiller (University of Oregon), Dr. Fredrick Gibbons (Iowa State University), and Jennifer Gibson (Norris Cotton Cancer Center).


Andy Nordhoff

mednewsdartmouth

Dartmouth Medical School

dartmouth

fpa Response To 'Sex, Drugs, Alcohol And Young People' Report, UK

Responding to the publication of the Independent Advisory Group (IAG) on Sexual Health and HIV seminar report 'Sex, Drugs, Alcohol and Young People' Anne Weyman, Chief Executive fpa said:



"fpa welcomes this report and supports all findings of the review. We have to recognise that drugs and alcohol influence some young people's sexual behaviour consequently putting them at risk. This is why we need a national strategy relevant to young people's experiences. It would also connect the work of different organisations that are currently operating in isolation from each other.



"As this report shows, young people receive messages and behavioural cues not just from family and friends but from different sources including advertising and the media. We know from the community based work fpa does with young people that this can affect decision-making. For the first time fpa will be including information about sex, drugs and alcohol in our campaign information for Sexual Health Week[1].



"Yet again fpa calls on the Government to introduce comprehensive Personal Social and Health Education in schools for all pupils to give them the information and skills they need to make informed decisions about their lives."



fpa (Family Planning Association) is the only registered charity working to improve the sexual health and reproductive rights of all people throughout the UK


1] Pillow Talk : taking the embarrassment out of talking about condoms is the theme of Sexual Health Week 6th- 12th August 2007.


fpa

Brain Imaging And Genetic Studies Link Thinking Patterns To Addiction

Scientists have for the first time identified brain sites that fire up more when people make impulsive decisions. In a study comparing brain activity of sober alcoholics and non-addicted people making financial decisions, the group of sober alcoholics showed significantly more "impulsive" neural activity.


The researchers also discovered that a specific gene mutation boosted activity in these brain regions when people made impulsive choices. The mutation was already known to reduce brain levels of the neurotransmitter dopamine. The newly found link involving the gene, impulsive behavior and brain activity suggests that raising dopamine levels may be an effective treatment for addiction, the scientists say.


The research is reported in the Dec. 26, 2007 issue of the "Journal of Neuroscience."


Lead scientist is Charlotte Boettiger, PhD, assistant professor of psychology at the University of North Carolina at Chapel Hill. Boettiger led the research as a scientist at UCSF's Ernest Gallo Clinic and Research Center. Senior author is Howard Fields, MD, PhD, a UCSF professor of neurology and an investigator in the Gallo Center. He also serves as director of the UCSF Wheeler Center for the Neurobiology of Addiction.


"Our data suggest there may be a cognitive difference in people with addictions," Boettiger said. "Their brains may not fully process the long-term consequences of their choices. They may compute information less efficiently."


"What's exciting about this study is that it suggests a new approach to therapy. We might prescribe medications, such as those used to treat Parkinson's or early Alzheimer's disease, or tailor cognitive therapy to improve executive function" she added.


"I am very excited about these results because of their clinical implications," Fields said. "The genetic findings raise the hopeful possibility that treatments aimed at raising dopamine levels could be effective treatments for some individuals with addictive disorders."


The scientists used functional magnetic resonance imaging, or fMRI, to image brain activity while subjects were faced with a hypothetical scenario: choose less money now, or more money later.


Boettiger recruited 24 subjects:19 provided fMRI data, 9 were recovering alcoholics in abstinence and 10 had no history of substance abuse. Another five were included in the genotyping analysis.


At the fMRI research facility at the University of California, Berkeley, financial decision tasks measured rational thinking and impulsivity. Sober alcoholics chose the "now" reward almost three times more often than the control group, reflecting more impulsive behavior.


While decisions were being made, the imaging detected activity in the posterior parietal cortex, the dorsal prefrontal cortex, the anterior temporal lobe and the orbital frontal cortex. People who sustain damage to the orbital frontal cortex generally suffer impaired judgment, manage money poorly and act impulsively, the scientists noted.















The study revealed reduced activity in the orbital frontal cortex in the brains of subjects who preferred "now" over "later," most of whom had a history of alcoholism.


The orbital frontal cortex activity may be a neural equivalent of long-term consequences, Fields said.


"Think of the orbital frontal cortex as the brakes," Boettiger explained. "With the brakes on, people choose for the future. Without the brakes they choose for the short-term gain."


The dorsal prefrontal cortex and the parietal cortex often form cooperative circuits, and this study found that high activity in both is associated with a bias toward choosing immediate rewards.


The frontal and parietal cortexes are also involved in working memory - being able to hold data in mind over a short delay. When asked to choose between $18 now or $20 in a month, the subjects had to calculate how much that $18 (or what it could buy now) would be worth in a month and then compare it to $20 and decide whether it would be worth the wait.


The parietal cortex and the dorsal prefrontal cortex were much more active in people unwilling to wait. This could mean, Boettiger said, that the area is working less efficiently in those people.


The researchers also focused on a variant of a gene called COMT. The mutation is associated with lower dopamine levels, and the study showed that people with two copies of this allele (resulting in the lowest dopamine levels) had significantly higher frontal and parietal activity and chose "now" over "later" significantly more often.


"We have a lot to learn," Boettiger said. "But the data takes a significant step toward being able to identify subtypes of alcoholics, which could help tailor treatments, and may provide earlier intervention for people who are at risk for developing addictions."


The bigger picture, she added, is that her study provides more evidence that addiction is a disease, something even some of her peers don't yet believe.


"It's not unlike chronic diseases, such as diabetes," she said. "There are underlying genetic and other biological factors, but the disease is triggered by the choices people make."


"It wasn't that long ago that we believed schizophrenia was caused by bad mothers and depression wasn't a disease. Hopefully, in 10 years, we'll look back and it will seem silly that we didn't think addiction was a disease, too."





Co-authors on the paper are: Jennifer Mitchell, Vanessa Tavares, Margaret Roberston and Geoff Joslyn at the Gallo Center, and Mark D'Esposito at the University of California, Berkeley.


The research was supported by the U.S. Department of Defense and the UCSF Wheeler Center for the Neurobiology of Addiction.


UCSF is a leading university dedicated to defining health worldwide through advanced biomedical research, graduate level education in the life sciences and health professions, and excellence in patient care.


UCSF's Gallo Clinic and Research Center is a preeminent academic center for the study of the biological basis of alcohol and substance abuse. More information is available at galloresearch/site/gallo


Written by - Wallace Ravven

University of California - San Francisco

Effects On Drinking Differ By Gender: Study On Drinking By Hispanics Along The Texas-Mexico Border

Acculturation in the Texas-Mexico border region: effects on drinking differ by gender



* Immigrant groups that acculturate to mainstream America tend to have more alcohol-related problems.


* A new study on drinking by Hispanics along the Texas-Mexico border shows that acculturation can have very different effects on men and women.



Previous research has shown that immigrant groups that acculturate to mainstream American culture tend to have more alcohol-related problems. Most of this research, however, has been conducted among Hispanic populations living in U.S. metropolitan areas. A study of Hispanic populations along the Texas-Mexico border has found that acculturation appears to have different effects on drinking by men and women.



Results are published in the February issue of Alcoholism: Clinical & Experimental Research.



"As immigrant groups acculturate to mainstream America, at least in the case of alcohol, because U.S. norms regulating alcohol use are more liberal than those of other countries, especially regarding drinking by women, as women acculturate they drink more," explained Raul Caetano, professor of epidemiology and regional dean (Dallas) at The University of Texas School of Public Health as well as the study's corresponding author. "With men it may be the fact that acculturated men have higher incomes and may have more disposable income to buy alcohol."



Although the factor of acculturation may be different, the consequences are all too familiar: problems with family, work, drinking and driving, alcohol dependence, etc.



Caetano and his colleagues chose to focus on the Texas-Mexico border for several reasons. "Texas has the largest part of the border, and most of the population living on the border," he said. "Also, the previous research was fragmented and not very conclusive."



"The border is a unique, complex and rich environment," added Hector Balcazar, regional dean of the El Paso Regional Campus, University of Texas School of Public Health, "both regarding acculturation, and the role that acculturation plays in affecting drinking behavior. This is also the first study of this nature in the border area."



Researchers analyzed data gathered from a 2002-2003 survey conducted in El Paso, the Rio Grande Valley, and an unspecified number of colonias (border settlements, often poverty stricken). Of the 1,200 face-to-face interviews that were conducted, a total of 472 male and 484 female Hispanic adults were included in an analysis to investigate their degree of acculturation, drinking patterns, and applicability of diagnostic criteria for alcohol abuse and dependence. Respondents were coded into four acculturation categories: very Mexican oriented, bicultural-Mexican, bicultural-Anglo, or very Anglo/Anglicized.



"There is a clear differential effect of acculturation by gender," said Caetano. "While this was shown in previous research, the effects on the border seem to be more accentuated. Men drank less as they acculturated, and had a lower prevalence of alcohol-use disorders. Women drank more with acculturation, but this did not seem to lead to a higher rate of alcohol use disorders."
















Caetano said these findings help to clarify that the border population of mostly Mexican Americans and their alcohol use is different from that of the rest of the country. "It is not possible to assume that acculturation will have the same effect on drinking across gender, age or ethnic groups in the United States," he said. "Furthermore, readers should understand that drinking is a product of personality characteristics and the environment. As these change, drinking will change as well."



Balcazar recommended that future research develop methods to better understand biculturalism, as well as the environment and ecology of the border region. This study, he said, has helped to highlight the phenomenon of acculturation, especially in places like El Paso-Juarez, where two cultures can come together to interact in many different ways.







Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Acculturation, Drinking and Alcohol Abuse and Dependence among Hispanics in the Texas-Mexico Border," were: Suhasini Ramisetty-Mikler and Christine McGrath of the University of Texas School of Public Health, Dallas Regional Campus; and Lynn S. Wallisch and Richard T. Spence of the School of Social Work at the University of Texas at Austin. The study was funded by the National Institute of Drug Abuse.



Source:



Raul Caetano, M.D., M.P.H., Ph.D.

The University of Texas School of Public Health


Hector Balcazar, Ph.D.

The University of Texas School of Public Health



The University of Texas School of Public Health
Alcoholism: Clinical & Experimental Research

Common chemicals morphing into potential toxins in Arctic

Compounds used to protect carpets and fabrics may be travelling to remote regions of the planet and undergoing chemical reactions before building up in the food chain, says a new study from the University of Toronto.


Until now, scientists had no idea why the persistent chemicals - perfluorinated carboxylic acids (PFCAs) - were present in remote areas such as the Canadian Arctic, says U of T postdoctoral research fellow Jonathan Martin, a study co-author in the lab of chemistry professor Scott Mabury. "We've shown that fluorotelomer alcohols - chemicals used to prevent stains on textiles and in the electronics manufacturing industry - appear to last for up to 20 days in the atmosphere and are capable of delivering PFCAs to remote environments," he says. The study was published in the June 15 issue of Environmental Science and Technology.


Chemists at U of T, the Ford Motor Company and the University of Copenhagen used a smog chamber to simulate how the alcohols degrade in the atmosphere and discovered a previously unknown reaction that produced PFCAs. Martin says the team also found the compounds in polar bear liver tissue samples. Other studies are examining exposure levels in humans living in the far north.


"It does appear to be an issue that's going to affect Arctic food webs and Arctic people who depend on them. We don't know toxicologically how much of these chemicals an animal can withstand before it might start to cause problems," says Martin, noting that previous studies have suggested that a form of PFCAs in a mother's blood may pose developmental risks.


The study was funded by Natural Sciences and Engineering Research Council of Canada and the Danish Research Council.


CONTACT:


Scott Mabury, Department of Chemistry, 416-978-3566, smaburychem.utoronto.ca.

Jonathan Martin, Department of Chemistry, 416-978-3596, jmartinchem.utoronto.ca.

Nicolle Wahl, U of T public affairs, 416-978-6974, nicolle.wahlutoronto.ca.


Contact: Jonathan Martin

416-978-3596

University of Toronto

Glucose Metabolism And Recidivism Of Severe Violent Crimes In Alcohol Intoxications

It is commonly known that alcoholism and alcohol intoxications are connected with severe violent crimes such as homicides. For instance, in Finland even 80 per cent of these crimes happen in alcohol intoxications. It has not, however, been clear why only a minority of alcoholics in intoxications become irritated and impulsively aggressive or even commit severe violent crimes.



A Finnish study now finds that low glycogen level - which means non-oxidative glucose metabolism - predicts forthcoming violent offending among antisocial violent offender males in a prospective 8-year follow-up study. "Usually, the new violent crimes happened already during 1-2 years after the release from prisons and with the new starting problems of alcoholism", says Professor Matti Virkkunen, the corresponding author for the study.



Results of the study have been published in the June issue of the journal Psychiatry Research.



Glucose metabolism was measured using the insulin clamp / calorimetry method among 49 impulsive, violent, antisocial male offenders during a forensic psychiatric examination. Those 17 offenders who committed at least one new violent crime during the follow-up had mean NOG of 1.4 standard deviations lower than non-recidivistic offenders. Glycogen levels did not differ among nonrecidivists and 40 normal male controls. All offenders and normal male controls were in normal weight and did not differ in the age or in the basal metabolic index (BMI). Only the basal insulin level was higher among residivistic violent offenders. In logistic regression analysis NOG alone explained 27% of the variation in the recidivistic offending and so clearly better than other variables in the international violence research.



Possibly by means of hypoglycemic states the new violent crimes happen among these persons in alcohol intoxications when they have very low glycogen stores in the liver. The low activity of the enzyme glycogen synthesis is the probable reason for the finding. This might suggest that substances increasing glycogen formation and decreasing the risk of hypoglycemia might be potential treatments for impulsive violent behavior. Of course, also regular eating habits while drinking are important in the prevention of new violent crimes.



Source:
Professor Matti Virkkunen


University of Helsinki

Long-Term Narcotics Use For Back Pain May Be Ineffective And Lead To Abuse

Narcotic drugs (opioids) are commonly prescribed for short-term relief of chronic back pain, but their effectiveness long-term has been questioned in a review article by researchers at Yale School of Medicine, who also found that behaviors consistent with opioid abuse was reported in 24 percent of cases.



"Patients with chronic back pain commonly request pain medication, and opioid medications are used despite the concerns clinicians have with patients developing an addiction to these medications," said first author Bridget Martell, M.D., assistant clinical professor of general internal medicine at Yale School of Medicine. "Our findings suggest that clinicians should consider other treatments with similar benefits but fewer long-term adverse effects."



Published in the January 16 Annals of Internal Medicine, Martell and co-authors conducted a systematic literature review and meta-analysis that addressed the prevalence and effectiveness of opioid prescriptions for patients with chronic back pain, and the incidence of substance abuse disorders among patients receiving opioid medications for chronic back pain.



The study populations consisted of non-obstetric patients over age 18 with non-malignant chronic back pain lasting for at least three months. The research focused on efficacy of oral, transdermal, or topical opioids, where there was no pre-existing diagnosis of opioid dependence.
According to the report, opioids may be effective for the short-term (less than four months) treatment of chronic low back pain, but long-term effectiveness was not conclusive.



"Our results also demonstrate that the quality of the literature on these topics is generally weak and more studies need to be done before firm conclusions can be made," said Martell.



Notes:



In addition to Martell and corresponding author David Fiellin, M.D., associate professor of general internal medicine at Yale, other authors on the study included Patrick G. O'Connor, M.D., Robert D. Kerns, William C. Becker, M.D., Knashawn H. Morales and Thomas R. Kosten, M.D.



Citation: Annals of Internal Medicine, Vol. 146, No. 2 (January 16, 2007)
What are Opioids?
For more information on what opioids are, and opioid-induced constipation (OIC), please see:
All About Opioids and Opioid-Induced Constipation (OIC)


Yale News Releases are available via the World Wide Web at yale/opa

For further information please go to:
Yale University

Cannabis Study Finds 'A Double-Edged Sword'

A new neurobiological study has found that a synthetic form of THC, the active ingredient in cannabis, is an effective anti-depressant at low doses. However, at higher doses, the effect reverses itself and can actually worsen depression and other psychiatric conditions like psychosis.



The study, published in the October 24 issue of The Journal of Neuroscience, was led by Dr. Gabriella Gobbi of McGill University and Le Centre de Recherche Fernand Seguin of H??pital Louis-H. Lafontaine, affiliated with l'Universit?© de Montr?©al. First author is Dr. Gobbi's McGill PhD student Francis Bambico, along with Noam Katz and the late Dr. Guy Debonnel* of McGill's Department of Psychiatry.



It has been known for many years that depletion of the neurotransmitter serotonin in the brain leads to depression, so SSRI-class anti-depressants like Prozac and Celexa work by enhancing the available concentration of serotonin in the brain. However, this study offers the first evidence that cannabis can also increase serotonin, at least at lower doses.



Laboratory animals were injected with the synthetic cannabinoid WIN55,212-2 and then tested with the Forced Swim test -- a test to measure "depression" in animals; the researchers observed an antidepressant effect of cannabinoids paralleled by an increased activity in the neurons that produce serotonin. However, increasing the cannabinoid dose beyond a set point completely undid the benefits, said Dr. Gobbi.



"Low doses had a potent anti-depressant effect, but when we increased the dose, the serotonin in the rats' brains actually dropped below the level of those in the control group. So we actually demonstrated a double effect: At low doses it increases serotonin, but at higher doses the effect is devastating, completely reversed."



The anti-depressant and intoxicating effects of cannabis are due to its chemical similarity to natural substances in the brain known as "endo-cannabinoids," which are released under conditions of high stress or pain, explained Dr. Gobbi. They interact with the brain through structures called cannabinoid CB1 receptors. This study demonstrates for the first time that these receptors have a direct effect on the cells producing serotonin, which is a neurotransmitter that regulates the mood.



Dr. Gobbi and her colleagues were prompted to explore cannabis' potential as an anti-depressant through anecdotal clinical evidence, she said. "As a psychiatrist, I noticed that several of my patients suffering from depression used to smoke cannabis. And in the scientific literature, we had some evidence that people treated with cannabis for multiple sclerosis or AIDS showed a big improvement in mood disorders. But there were no laboratory studies demonstrating the anti-depressant mechanism of action of cannabis."



Because controlling the dosage of natural cannabis is difficult -- particularly when it is smoked in the form of marijuana joints -- there are perils associated with using it directly as an anti-depressant.



"Excessive cannabis use in people with depression poses high risk of psychosis," said Dr. Gobbi. Instead, she and her colleagues are focusing their research on a new class of drugs which enhance the effects of the brain's natural endo-cannabinoids.



"We know that it's entirely possible to produce drugs which will enhance endo-cannabinoids for the treatment of pain, depression and anxiety," she said.







*Dr. Guy Debonnel, a highly respected depression researcher who had been at McGill University since 1988, passed away unexpectedly at the age of 57 in November, 2006.



Source: Mark Shainblum


McGill University




View drug information on Celexa; Prozac Weekly.