RxPG News : Substance Abuse

Brain immune cells respond to alcohol

Thu, 29 Sep 2011 04:00:00 PST

( from http://www.rxpgnews.com ) New research from the University of Adelaide suggests that immune cells in your brain may contribute to response to alcohol.

It's amazing to think that despite 10,000 years of using alcohol, and several decades of investigation into the way that alcohol affects the nerve cells in our brain, we are still trying to figure out exactly how it works, says lead researcher Dr Mark Hutchinson from the University's School of Medical Sciences.

Although scientists know much about how alcohol affects nerve cells, there is also a growing body of evidence that alcohol triggers rapid changes in the immune system in the brain. This immune response lies behind some of the well-known alcohol-related behavioural changes, such as difficulty controlling the muscles involved in walking and talking.

In research published in the latest edition of the British Journal of Pharmacology, Dr Hutchinson's team gave a single shot of alcohol to laboratory mice and studied the effect of blocking Toll-like receptors, a particular element of the immune system, on the behavioural changes induced by alcohol. The researchers used drugs to block these receptors. They also studied the effects of giving alcohol to mice that had been genetically altered so that they were lacking the functions of selected receptors.

The results showed that blocking this part of the immune system, either with the drug or genetically, reduced the effects of alcohol. While the research was carried out on mice, Hutchinson's team believe that similar treatments could also work in humans.

Medications targeting Toll-like receptor 4 may prove beneficial in treating alcohol dependence and acute overdoses, says Dr Hutchinson.

This work has significant implications for our understanding of the way alcohol affects us, as it is both an immunological and neuronal response. Such a shift in mindset has significant implications for identifying individuals who may have bad outcomes after consuming alcohol, and it could lead to a way of detecting people who are at greater risk of developing brain damage after long-term drinking.

UCSF, UC Merced to study effectiveness of anti-tobacco programs

Wed, 07 Sep 2011 04:00:00 PST

( from http://www.rxpgnews.com ) Researchers with the University of California, San Francisco and the University of California, Merced will examine the effectiveness of state and local anti-smoking programs across the United States to ensure that health authorities are able to use their increasingly limited resources to support and defend the most effective approaches.

Stanton A. Glantz, PhD, UCSF professor of medicine; James Lightwood, PhD, UCSF assistant professor of clinical pharmacy; and Anna V. Song, PhD, UC Merced professor of psychology, have been awarded a five-year, $2.6 million grant from the National Institutes of Health to study which anti-smoking programs are working best and how the tobacco industry tries to prevent states from pursuing the most effective tobacco control policies and programs.

Tobacco use remains the leading preventable cause of death in California and the nation. Not all programs are equally effective in reducing smoking or bringing down health costs. Understanding which programs are best can help inform government policy decisions and make sure money is spent on effective programs, the researchers say.

California's tobacco control program has already saved California taxpayers and businesses well over $86 billion in direct health costs, Glantz said. With this research, we hope to inform policy makers and public health professionals how we can essentially eliminate tobacco as a public health problem in California in the next few years.

Glantz and Song will use qualitative and quantitative methods to accomplish three specific goals:

Document and analyze the variations in tobacco control policymaking and in how programs are run. The results will serve as the basis for recommendations to create the most effective and efficient tobacco control strategies and policies. Define the relationships between spending on state tobacco control programs, smoking, and health care expenditures, and then use these relationships to quantify the effects of program intensity and quality. Quantify the effects of tobacco control policies -- such as the clean indoor air laws California pioneered -- on smoking initiation, progression and cessation, and health disparities.

We are combining modern understanding of adolescent and young adult psychology with mathematical models to understand the spread and decline in tobacco use,'' Song said. It's similar to the way epidemiologists understand the spread of infectious diseases, with the tobacco companies playing the role of mosquitoes spreading disease.''

The field of tobacco control has remained dynamic with new legislation and advocacy programs. For example, the Family Smoking Prevention and Tobacco Control Act granted the U.S. Food and Drug Administration authority over tobacco products. It also repealed federal preemption of state and local actions to regulate the time, nature and place of tobacco advertising and promotion, creating new opportunities for state and local tobacco control policy making. California is also considering strengthening its own clean indoor air law to close loopholes that remain from the 1990s, when the current law was enacted.

Last year, the federal Centers for Disease Control and Prevention increased the visibility of tobacco control through several American Recovery and Reinvestment Act programs, including funding for tobacco control media campaigns in all states. It also has the Communities Putting Prevention to Work program, which is funding 21 state, local and tribal programs to implement policy-oriented tobacco control strategies.

Scientists show how gene variant linked to ADHD could operate

Tue, 16 Aug 2011 04:00:00 PST

( from http://www.rxpgnews.com ) A study using mice provides insight into how a specific receptor subtype in the brain could play a role in increasing a person's risk for attention-deficit hyperactivity disorder (ADHD). The research, conducted by the Intramural Research Program (IRP) at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, could also help explain how stimulants work to treat symptoms of ADHD.

Dysfunction of the dopamine D4 receptor subtype is linked to ADHD as well as other disorders characterized by decreased impulse control, including drug abuse. One subtype variant, D4.7, has been of particular interest because of its increased prevalence in those diagnosed with ADHD. However, the function of this particular variant in ADHD has been poorly understood.

In the study, published in today's Molecular Psychiatry, researchers inserted three variants of the dopamine D4 receptor into cells and into mice so that they could investigate differences in biological activities. The researchers found that the D4.7 variant, unlike its D4.2 and D4.4 counterparts, was not able to interact with the short version of the dopamine type 2 (D2S) receptor to reduce glutamate release in a brain region associated with impulsivity and symptoms of ADHD in humans.

Although previous studies have shown that dysfunctional dopamine D4 receptors are implicated in ADHD, this is the first study to show how this genetic difference might translate into functional deficits seen with this disorder, said NIDA Director Dr. Nora D. Volkow. Further research is needed to explore how this deficient interaction between receptors might be remedied, which could then lead to new medications for the treatment of ADHD.

Children with ADHD have trouble paying attention and controlling impulsive behaviors, and may be overly active, often resulting in poor school performance and social difficulties. They are also at increased risk for substance use disorders, particularly if their symptoms go untreated.

ADHD is the most commonly diagnosed neurobehavioral disorder of childhood, and the number of children diagnosed continues to rise. According to the Center for Disease Control's National Survey of Children's Health, the number of children aged 4-17 years that were identified by their parent as ever being diagnosed with ADHD increased by 21.8 percent from 2003-2007. By 2007, nearly one in 10 children aged 4-17 years were, at some point, diagnosed with ADHD. Among children with current ADHD diagnoses, 66.3 percent were taking medication for the disorder.

The most commonly used treatment for ADHD involves administering psychostimulant medications. Although these medications alleviate some of the symptoms of ADHD, it is unclear how these compounds act within the brain to do so.

Our results suggest that psychostimulants might reduce glutamate release by amplifying this D4/D2S interaction, said Dr. Sergi Ferre, primary author for the study. These results might also explain why these medications are less efficient in patients with the D4.7 variant.

Study: Graphic warning labels reduce demand for cigarettes

Mon, 08 Aug 2011 04:00:00 PST

( from http://www.rxpgnews.com ) Will graphic cigarette package warning labels significantly reduce demand? A new study suggests it will.

Current US policy requires that tobacco companies cover 50 percent of one side of a cigarette pack with a text warning. But the FDA recently unveiled nine new cigarette warning labels, which include graphic images of lung and mouth cancer, to be unveiled in September 2012.

A sample of 404 adult smokers from four states participated in an experimental auction on cigarette packs with four different kinds of warning labels. All packs carried the same message: smoking causes mouth cancer.

The first pack featured a text-only message on the side of the pack, the current US policy. The second had a text-only message that covered 50 percent of the lower half of the front, back and one side of the pack. A third had the same text message, but with a photo depicting mouth cancer. The fourth package had the same text and graphic photo, but was a mostly unbranded pack, meaning all color and symbolic brand elements were removed except for the brand's font, size and descriptors.

We found that the label with just the front text warning had little effect on consumers, says study co-author Matthew Rousu, professor of economics at Susquehanna University in Selinsgrove, Pa. However, demand was significantly lower for packs with grotesque images, with the lowest demand associated with the plain, unbranded pack.

The bids for cigarette packs that had a grotesque photo and no brand imagery received bids that were 17 percent lower than the bids for the package with the current US warning label.

Results from our study suggest that the new health warnings with graphic pictures will reduce demand for cigarettes, says Rousu, who conducted the study with James F. Thrasher, David Hammond, Ashley Navarro and Jay R. Corrigan.

Regulators should also consider health warnings with graphic pictures, but also plain packaging policies for tobacco products, he adds. Color and brand imagery can support false beliefs about reduced risks of some brands.

What their study can't address is how the new labels will affect non-smokers. One would assume that it would also have an impact on non-smokers, that some of those people will not start smoking because they are turned off by the images, says Rousu.

The study, Estimating the impact of pictorial health warnings and 'plain' cigarette packaging: Evidence form experimental auctions among adult smokers in the United States, appears in the September 2011 issue of the journal

BUSM/BMC researchers awarded $3.5 million grant from the NIDA

Thu, 21 Jul 2011 04:00:00 PST

( from http://www.rxpgnews.com ) (Boston) - Researchers from the Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) were recently awarded a $3.5 million grant from the National Institute on Drug Abuse (NIDA), to improve upon the seek, test, treat, and retain paradigm in Eastern Europe among HIV-infected Russian and Eastern European injection drug users (IDUs) in narcology (addiction) care. The project will be known as LINC, Linking Infectious and Narcology Care.

Russia and Eastern Europe have one of the fastest growing HIV epidemics in the world, with transmission risk primarily from injection drug use. Russia, Ukraine and other countries in the region have implemented routine HIV testing within established addiction treatment systems (narcology hospitals). The narcology system of care, however, works largely independent of other medical care systems and hence has not adopted strategies to link HIV-infected patients to HIV care.

The research will be conducted under the direction of Jeffrey H. Samet, MD, a professor of medicine and community health sciences at BUSM and BU School of Public Health and chief of the Section of General Internal Medicine at BMC. Samet was recently selected as a NIDA International Program 2011 Awards of Excellence winner.

According to the researchers, the narcology system of care works largely independent of other medical care systems and hence has not adopted strategies to link HIV-infected patients to HIV care. As in the United States in the 1990s, delayed or non-receipt of HIV medical care, particularly among IDUs, is common in Russia. According to Samet, the principal investigator of the study, this is a missed opportunity since up to 45 percent of Russian IDUs in narcology treatment are HIV infected, yet as few as 20 percent of those infected are in care.

The objective of this study is to implement and assess a behavioral and structural intervention in Russia designed to support and motivate HIV-infected heroin dependent narcology patients to engage in HIV medical care and ultimately improve their HIV outcomes, said Samet.

LINC is a clinical model designed to coordinate narcology and HIV systems of care using an intervention inclusive of staff from both systems and composed of elements shown to facilitate engagement in medical care: HIV case management and nurse home visits. The central hypothesis is that an intervention that involves coordination between the narcology and HIV systems will lead to increased engagement in HIV medical care. Coordination will involve HIV case management delivered by a peer to help motivate and reduce barriers to HIV care engagement and enhanced outpatient narcology treatment delivered by an addiction nurse with communication between these providers, added Samet.

The project will be undertaken by an international research team experienced in addressing HIV, substance use, and clinical interventions in Russia.

International AIDS Society to launch Virtual Media Centre in July to support opioid substitution therapy in Eastern Europe and Central Asia

Tue, 19 Jul 2011 04:00:00 PST

( from http://www.rxpgnews.com ) Tuesday, 19 July, 2011 (Rome, Italy) -- As a part of its new initiative, Expanding Access to Opioid Substitution Therapy (OST) for People Who Inject Drugs in Eastern Europe and Central Asia (EECA), the International AIDS Society (IAS) will launch a Virtual Knowledge Centre (VKC) in partnership with the Ukrainian Institute on Public Health Policy (UIPHP).

The announcement was made today at the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011), which runs from 17-20 July in Rome and is being attended by more than 5,000 researchers, clinicians and community leaders.

The VKC initiative is a scaling up of the commitment by IAS to drug policy which it adopted as one if its four key priority areas in late 2010. Provision of OST, a call for expanded access to antiretroviral therapy (ART) for injecting drug users living with HIV, campaigning against the criminalization of injecting drug users, and a special focus on the EECA region underpin the policy. (1)

The VKC will strive to contribute to improved knowledge and strengthened operations research capacity for scale up of HIV/OST programmes for people who inject drugs by creating an increased Russian-language evidence base around OST, harm reduction and HIV, as well as specialized documents and training modules relevant to professionals, public health experts, narcologists, students, parliamentarians, NGOs and any other interested and involved parties working in this field in EECA. (2)

The IAS believes that evidence-based interventions are the best way to implement HIV treatment scale-up and will continue to advocate for expanding access to Opioid substitution therapy, said IAS governing Council member Chris Beyrer, who is the Director of the Johns Hopkins Center for Public Health and Human Rights in Baltimore, USA. The science has been in since the very beginning of the AIDS epidemic 30 years ago - OST and clean needle exchange programs save lives.

Outside of sub-Saharan Africa, injecting drug use accounts for approximately one in three new cases of HIV. In some areas of rapid HIV spread, such as in Eastern Europe and Central Asia, injecting drug use is the primary cause of new HIV infections. Legal barriers to scientifically proven prevention services such as needle and syringe programs and OST mean hundreds of thousands of people become infected with HIV and Hepatitis C every year. In Russia for instance some 60 per cent of new HIV infections are linked to injecting drug use and some 80 per cent of the one million people living with HIV are estimated to be less than 30 years of age. OST is illegal in Russia.

OST is proven to be one of the most effective methods of intervention, prevention and care for people who inject drugs and hence prevent the transmission of HIV. However, globally, treatment with methadone and buprenorphine reaches only eight per cent of injecting drug users. In 2007, only 2 per cent of injecting drug users in developing countries with injection-driven HIV epidemics was accessing treatment for Opioid dependence.

Many countries in the EECA regions have been slow to adopt human rights based public health approaches to illicit drug policy, despite compelling evidence that a human rights based policy and decriminalization of drug use is the most effective approach to decreasing HIV transmission and improving treatment outcomes.

Another major challenge is the criminalization and drug policy laws that many governments have in place. Because drug use is illegal, many local police forces increase surveillance near needle exchange programs or drug treatment facilities. This increased surveillance causes fear amongst drug users and increases syringe sharing while decreasing the amount of individuals seeking health-care. For those who are arrested or caught for illegal drug use, punishment includes harassment, beatings, or detainment.

It really is time to switch from criminality to care and put an end to registries, put an end to compulsory drug detention and ended the imprisonment for drug use/possession for personal use, said Patrizia Carrieri, a researcher at the French National Institute for Health and Medical Research (INSERM U912). Governments need to stop portraying drug users as less than human and therefore less deserving of their human rights and access to proper treatment and care.

In the Ukraine up to 75 per cent of people living with HIV are dying from tuberculosis, and prisons are becoming incubators of MDR-TB filled with people convicted for minor possession. Irina Borushek , an activist with the All-Ukrainian Network of People Living with HIV/AIDS is patient pointed out that the recent implementation of a high quality drug dependency treatment programme on which she herself is a patient, should become the norm, not the exception.

.Unless we make radical changes in drug policy, ensure effective scale up of drug comprehensive drug treatment, first of all, substitution treatment, and prioritize healthcare principles over repressive drug policy - we will fail to overcome HIV epidemic, said Borushek.

Liudmyla Sulga from the International HIV/AIDS Alliance in Ukraine and a Senior Lecturer in the School of Public Health at the National University of Kyiv-Mohyla Academy in Kiev said that law reform was an essential step if treatment was to be expanded across the Ukraine.

Alliance Ukraine is the largest NGO in the field of AIDS in Ukraine providing HIV prevention programmes to more than 240,000 people. The organization was instrumental in starting and rolling out medically assisted treatment for people who inject drugs.

In recent months however Alliance Ukraine has been lobbying to stop the systematic obstructions to the legal substitution treatment programmes for people who use drugs. Interference of law enforcement bodies into treatment programmes has created an atmosphere of fear for both patients and medical staff and has resulted in the failure to meet the National AIDS programme targets.

Further treatment programme expansion in the Ukraine will only be possible if there is a revision on drugs administration, using liquid forms of methadone and making drug administration and control more flexible for medical institutions, concluded Shulga.

Alcohol drinking in the elderly: Risks and benefits

Mon, 27 Jun 2011 04:00:00 PST

( from http://www.rxpgnews.com ) The Royal College of Psychiatrists of London has published a report related primarily to problems of unrecognized alcohol misuse among the elderly. The report provides guidelines for psychiatrists and family physicians on how to find and how to treat elderly people with misuse of alcohol and drugs. Forum members consider it very important to identify abusive drinking among the elderly and this report provides specific and very reasonable recommendations to assist practitioners in both the identification and treatment of such problems.

There is no question that, on average, very elderly people may be more sensitive to the effects of alcohol (especially those individuals with chronic diseases, lower muscle mass, a poor diet, etc.) It should be made clear, however, that 65-year-olds are healthier than people of that age a generation ago - age-specific disability rates are decreasing, not increasing.

The report also recommends lower sensible limits for older people in comparison with younger people The International Forum on Alcohol Research scientific reviewers point out inherent difficulties in providing guidelines for a very non-homogenous group of individuals whose only criterion for inclusion, in this paper, is being above the age of 65 years Such a group includes individuals varying from marathon runners to very sick, frail people.

The report was conspicuously lacking in a discussion of the important role that moderate drinking can play in reducing the risk of coronary heart disease, ischemic stroke, diabetes, dementia, and osteoporosis. Advising healthy people aged 65 years or older who are moderate, responsible drinkers to stop drinking or to markedly reduce their intake would not be in their best health interests, especially in terms of their risk of cardiovascular diseases. Forum reviewers thought that advice to lower limits of drinking for everyone in this age group is not based on reliable research, and would certainly not apply to all in this age group. Of more importance, the absolute risk for cardiovascular diseases increases markedly with age, and therefore the beneficial or protective effect of light to moderate drinking on cardiovascular diseases is greater in the elderly than in younger people.

Evidence is also accumulating that shows that the risk of Alzheimer's disease and other types of dementia is lower among moderate drinkers than among abstainers. Neurodegenerative disorders are key causes of disability and death among elderly people. Epidemiological studies have suggested that moderate alcohol consumption, may reduce the incidence of certain age-related neurological disorders including Alzheimer's disease. Regular dietary intake of flavonoid-rich foods and/or beverages has been associated with 50% reduction in the risk of dementia, a preservation of cognitive performance with ageing,a delay in the onset of Alzheimer's disease and a reduction in the risk of developing Parkinson's disease.

Further, scientific data are consistent in demonstrating that quality of life is better and total mortality is lower among moderate drinkers than among abstainers. For example, analyses by Simons et al from a large population-based patient population in New South Wales demonstrated clearly that regular moderate alcohol consumption increases life span and quality of life for men up to 80 years of age and for women indefinitely.

In another paper, by Kirchner et al of almost 25,000 American adults over age 65 seen in primary care, those reporting between 8 and 14 drinks/week (A US drink is 14g, against 8g in the UK) did not differ significantly in their characteristics from drinkers consuming 1-7 drinks/week.. Heavier drinkers and binge drinkers did not do as well.

A particular interesting paper by White et al showed a direct dose-response relation between alcohol consumption and risk of death in women aged 16-54 and in men aged 16-34, whereas at older ages the relation is U shaped. These investigators used statistical models relating alcohol consumption to the risk of death from single causes to estimate the all-cause mortality risk for men and women of different ages. The authors state that their data suggest that women should INCREASE their intake to 3 units a day over age 75, and men rise from 3 units a day up to age 54 to 4 units a day up to age 84.

Since the absolute effects of moderate drinking on cardiovascular disease are much greater in older people than in younger adults, the current limitations to intake for the elderly may not be appropriate. Attempting to persuade elderly people who currently drink moderately to decrease their current intake may not be advisable. For healthy moderate and responsible drinkers, advice to reduce or stop all alcoholic beverage intake would not be in the best health interests of such individuals.

The association of alcohol drinking with migraine headache

Mon, 13 Jun 2011 04:00:00 PST

( from http://www.rxpgnews.com ) Migraine is a neurovascular disease that affects about 15% of the western population. Compounds in foods and beverages (chocolate, wine, citrus, etc) considered as migraine triggers include tyramine, phenylethylamine and possibly histamine and phenolic compounds. Avoiding those triggers may significantly reduce the frequency of migraines in some patients.

However, only a small percentage of patients in one study became headache-free simply by excluding those foods, epidemiological studies are pointing out that genetic factors may be an underlying cause. Discrepancies in the way people are reacting to wine intake, and whether or not it triggers migraine, may be potentially explained by genetic polymorphisms in specific enzymes related to metabolism Alcoholic drinks are a migraine trigger in about one third of patients with migraine in retrospective studies on trigger factors. Many population studies show that patients with migraine consume alcohol in a smaller percentage than the general population. Research has shown a decreased prevalence of headache with increasing number of alcohol units consumed. The classification criteria of alcohol-related headaches remain problematic.

An excellent paper from The Headache Center in Empoli, Italy by Panconesi A et al (Curr Pain Headache Rep (2011) )15:177-184 summarizes the scientific data relating to alcohol and migraine headaches. The factors that trigger an attack of migraine, or of other headaches as well, are poorly understood. While retrospective studies tend to include alcohol as a trigger for an attack, the authors describe that in a recent prospective study (in which information on the factors that could potentially trigger an attack were collected prior to the migraine attack), menstruation, stress, and fatigue were found most commonly to relate to a subsequent attack, In the present paper, the authors reviewed the role and mechanism of the action of alcohol or other components of alcoholic drinks in relation to alcohol-induced headache. They conclude from their review that reports overestimate the role of alcohol, as well as other foods, in the triggering of migraine.

International Scientific Forum on Alcohol Research members thought that this was a very balanced review of the subject, and that it provided straightforward and sensible advice. Although some individuals surely have the onset of a migraine or other type of headache after the consumption of wine or alcohol, the findings are not consistent (in this study, beer consumption on the previous day reduced the risk of a migraine attack). Forum members suggest that given that subjects reporting migraine headaches have been found to be at increased risk of cardiovascular disease, it would not be appropriate to advise all such sufferers to avoid alcohol. As suggested by the authors of this paper, it may be reasonable for migraine sufferers to drink small amounts of specific types of alcoholic beverages to see if each beverage is tolerated or not. After seeing the effects, and factoring in symptoms from other dietary or lifestyle elements (sleep, stress, dehydration), a reasonable discussion can be carried out with one's physician with respect to commencing or continued alcohol use.

Altruistic decision making focus of NIDA's Addiction Science Award

Fri, 13 May 2011 04:00:00 PST

( from http://www.rxpgnews.com ) A study of what influences decision making on issues whose consequences will only be felt by future generations won first prize in the annual Addiction Science Awards at this year's Intel International Science and Engineering Fair (ISEF) -- the world's largest science competition for high school students. The Intel ISEF Addiction Science Awards were presented at an awards ceremony Thursday night in Los Angeles. The awards were presented by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and Friends of NIDA, a coalition that supports NIDA's mission.

First place distinction went to Sarah Susie Pak, a 17-year-old senior at Roslyn High School in Roslyn Heights, N.Y., for her project Would You Do It for the Kids? Factors Involved in the Prediction of Intergenerational Preferences. The project was based on well-known phenomenon, called delayed discounting, in which people tend to discount the value of a reward that will be received at a later time vs. an immediate, but smaller, reward. Delayed discounting is abnormally high in people who are addicted to drugs and contributes to their impulsive risk taking behaviors, especially drug use. Pak's project identified generosity and patience as two key interacting factors that increase the likelihood that a person will make altruistic decisions that will primarily help future generations. The senior plans to attend Princeton in the fall.

Our first place winner took a fresh look at delayed discounting at the social and generational level, said NIDA Director Dr. Nora D. Volkow. Her studies illuminate aspects of neuroeconomics that are relevant not only to drug abuse and addiction, but that could have far reaching social, ethical, and public health policy implications.

Second place distinction in the Addiction Science Awards went to Darby Kathryn Schumacher, a 15-year-old freshman at the Girls Preparatory School in Chattanooga, Tenn. Her project, Making Heartbeats Go LOKO, investigated the effects of the alcoholic caffeinated beverage branded as Four Loko on the heart rate of the water flea (Daphnia). She chose to use this invertebrate model to test the effects of Four Loko not only because Daphnias show clear signs of intoxication when exposed to alcohol, but also because their heart rate can be easily monitored through their translucent bodies. She was able to demonstrate that alcohol, a depressant, and caffeine, a stimulant, can lower and boost Daphnia's heart rate, respectively. The caffeine content in Four Loko appears to have partially mitigated the depressant effect of the alcohol present in this beverage, supporting the notion that the caffeine in alcoholic energy drinks could mask some of alcohol's behavioral effects, making the user less aware of the true extent of their impairment.

Ms. Schumacher took a simple model of a nervous system that recreates some of the most basic features of human physiology to show how the combination of a stimulant and a depressant can affect heart function, said Dr. Susan Weiss, NIDA's head judge and acting director of the Office of Science Policy and Communications. She took a systematic and elegant approach to demonstrate why these drinks can be dangerous. The U.S. Food and Drug Administration issued warning notices to manufacturers of caffeinated alcoholic beverages in November 2010.

Third place went to 16-year-old Yamini T. Naidu, a student at Valley Catholic High School in Beaverton, Ore., for her entry, From Models to Medications: Identification of Medication Leads for Treating Methamphetamine Addiction. Using molecular modeling software that incorporated eye-catching 3D structural illustrations and vivid computer animations, Naidu discovered two potential sites in the methamphetamine binding TAA receptor. Her work predicted that these sites could have the ability to modulate the binding affinity of methamphetamine for this receptor. This work has resulted in the development of several lead compounds that are the subject of pending patents for possible novel medications for methamphetamine addiction. There are currently no medications approved for the treatment of methamphetamine addiction; thus, these lead compounds represent a potentially exciting new development in the addiction treatment field. The sophomore says she became interested in neuroscience after her uncle died of a stroke.

The non-profit organization, Friends of NIDA, partnered with NIDA to sponsor the awards as part of its ongoing support of NIDA research into the causes, consequences, and treatment of drug abuse and addiction.

We are delighted to see three young women win this year, and we hope these awards encourage them to continue their interest in addiction science, said Dr. William Dewey, Louis S. and Ruth S. Harris Professor and Chair, Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, and president and chair of the Executive Committee, Friends of NIDA. The awards were judged by Dr. Weiss, NIDA's Dr. Ruben Baler, and Dr. Walter Ling, a NIDA grantee at the University of California at Los Angeles, which hosted the fair.

Teenage alcohol consumption associated with computer use

Mon, 09 May 2011 04:00:00 PST

( from http://www.rxpgnews.com ) NEW YORK (May 9, 2011) -- Teenagers who drink alcohol spend more time on their computers for recreational use, including social networking and downloading and listening to music, compared with their peers who don't drink.

Results of an anonymous survey of 264 teenagers were reported in the online edition of the journal Addictive Behaviors in a study authored by Weill Cornell Medical College public health researcher Dr. Jennifer Epstein.

While the specific factors linking teenage drinking and computer use are not yet established, it seems likely that adolescents are experimenting with drinking and activities on the Internet. In turn, exposure to online material such as alcohol advertising or alcohol-using peers on social networking sites could reinforce teens' drinking, says Dr. Epstein, assistant professor of public health at Weill Cornell Medical College. Children are being exposed to computers and the Internet at younger ages. For this reason it's important that parents are actively involved in monitoring their children's computer usage, as well as alcohol use.

According to a national study conducted by the Pew Internet and American Life Project, more than half of parents of teenagers had filters installed on the computers their child uses to block content parents find objectionable, yet many parents do not use any form of parental monitoring, particularly for older teens, continues Dr. Epstein.

The Weill Cornell survey was completed by participants aged 13 to 17 and residing in the United States. Results showed that teens who reported drinking in the last month used a computer more hours per week excluding school work than those who did not; however, there was no demonstrated link between alcohol use and computer use for school work. Drinking was also linked to more frequent social networking and listening to and downloading music. There was no strong link between video games and drinking or online shopping and drinking.

Going forward, we would like to collect more detailed and longer-term data on adolescent alcohol and computer use, including the degree and duration of their drinking habit, says Dr. Epstein.

Teenagers typically first experiment with alcohol at age 12 or 13. Family risk factors include lax parental supervision and poor communication, family conflicts, inconsistent or harsh discipline and a family history of alcohol or drug abuse.

Parents may also need to reinforce their family ground rules on alcohol use and computer use, Dr. Epstein says.

This is an innovative study that is an important first step to understanding the potential impact that the Internet and new media may have on today's youth, says Dr. Gil Botvin, professor of public health and chief of the Division of Prevention and Health Behavior at Weill Cornell Medical College. The Internet offers a wealth of information and opportunities for intellectual and social enrichment. However, it is becoming clear that there may also be a downside to Internet use. More systematic research is needed to better understand to those potential dangers and how to combat them.

Alcohol, mood and me

Thu, 28 Apr 2011 04:00:00 PST

( from http://www.rxpgnews.com ) Thanks in part to studies that follow subjects for a long time, psychologists are learning more about differences between people. In a new article published in Current Directions in Psychological Science, a journal of the Association for Psychological Science, the author describes how psychologists can use their data to learn about the different ways that people's minds work.

Most psychology research is done by asking a big group of people the same questions at the same time. So we might get a bunch of Psych 101 undergrads, administer a survey, ask about how much they use alcohol and what their mood is, and just look and see, is there a relationship between those two variables, says Daniel J. Bauer of the University of North Carolina at Chapel Hill, the author of the article.

But a one-time survey of a bunch of college students can only get you so far. For example, it might find that sad people drink more, but it can't tell us whether people drink more at times when they are unhappy, whether the consequences of drinking instead result in a depressed mood, or whether the relationship between mood and alcohol use is stronger for some people than others.

One way psychologists have used to learn more about people is collecting data from people over a longer time period. For example, they might give each subject an electronic device to record blood pressure and stress several times a day, or ask them to log on to a website every night to answer a survey. In one case, Bauer's colleague, Andrea Hussong, asked adolescents to complete daily diaries with ratings of their mood and alcohol use over 21 days. The data showed that the relationship between mood and alcohol use is not the same for everyone. Adolescents with behavioral problems drink more in general, irrespective of mood, but only adolescents without behavioral problems drink more often when feeling depressed.

Analyzing this kind of data requires tougher math than the simple survey data, which is where quantitative psychologists like Bauer come in. I think even though a lot of researchers are starting to collect this data, I don't think they've taken full advantage of it, he says. In the new paper, Bauer points to other methods that can do a better job of showing how variables relate differently for different people.

The point of all of this is to help people, Bauer says. For example, if psychologists discover that certain kinds of people are more likely to drink when depressed, it would be possible to help those people early. Ultimately, the idea would be to identify people who might be more at risk and try to help them, he says.

Health-care alliance for tobacco dependence treatment launches training in the Middle East

Tue, 26 Apr 2011 04:00:00 PST

( from http://www.rxpgnews.com ) ROCHESTER, Minn. -- Global Bridges, a healthcare alliance for tobacco dependence treatment based at Mayo Clinic, and its regional partner, King Hussein Cancer Center (KHCC) in Amman, Jordan, announced today that they will start training health care providers in the Eastern Mediterranean Region (EMRO) on how to successfully treat tobacco users.

The first training, scheduled for April 27-28 at KHCC, will engage 15 health care professionals from Jordan. Feras Hawari, M.D., director of the Cancer Control Office at KHCC and regional director for Global Bridges, will conduct this workshop. In addition, KHCC will collaborate with other regional and international organizations to hold a four-day regional workshop in June.

Prevalence of tobacco use is high in most of the Eastern Mediterranean countries, and only a few countries have structured tobacco dependence services. By offering training, we are making a step towards addressing this epidemic, says Dr. Hawari, who is also chief of pulmonary and critical care service at KHCC.

Global Bridges -- a collaboration among Mayo Clinic's School for Continuous Professional Development and Mayo Clinic's Nicotine Dependence Center, the American Cancer Society and the University of Arizona -- was established in 2010 as a worldwide, science-based initiative to help health care providers unite to treat tobacco use and dependence while advocating for effective tobacco control policies. During its first year, Global Bridges has positively impacted 400,000 patients around the world through training over 5,400 health care providers in Mayo Clinic-led sessions on how to deliver culturally appropriate tobacco dependence treatment.

Global Bridges adapts to regional needs and enhances access to proven treatment methods throughout each of the World Health Organization's (WHO) six regions, says Richard Hurt, M.D., founder and director of the Mayo Clinic Nicotine Dependence Center and principal investigator of Global Bridges. The training that Dr. Hawari will lead is the first in a series of activities we are planning for WHO's Eastern Mediterranean region with our regional partner, King Hussein Cancer Center.

As a Global Bridges regional director, Dr. Hawari and his team will lead activities to grow the network and advance tobacco dependence treatment and tobacco control policies across the WHO Eastern Mediterranean Region that covers 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates and Yemen.

King Hussein Cancer Center is a dedicated medical center that focuses on providing state-of-the-art comprehensive cancer care in Jordan and the Middle East. KHCC is disease-specific accredited by the Joint Commission, making it the first in the region and the sixth worldwide.

KHCC has been a strong advocate for tobacco control in Jordan. KHCC is the first hospital in Jordan to declare its campus 100 percent smoke-free. The tobacco dependence treatment program was established in 2008 under the leadership of Dr. Hawari, and was then incorporated under the umbrella of the Cancer Control Office (CCO) established in 2010.

Prevalence of tobacco use is high in most EMRO countries. The Tobacco Atlas shows rates for men ranging from 82 percent in Afghanistan to 13.4 percent in Oman. For women, rates range from 57.1 percent in Lebanon to less than 1 percent in Oman. Among youngsters, WHO reports that between 1 in 3 and 1 in 4 boys smoke in EMRO countries. In Jordan, prevalence is at 28 percent among adults but is as high as 48 percent among adult males. Thirty-five percent of boys between 13 and 15 years are smokers, and prevalence among girls is on the rise.

Effects of a large reduction in alcohol prices on mortality in Finland

Fri, 08 Apr 2011 04:00:00 PST

( from http://www.rxpgnews.com ) Does a reduction in the price of alcohol result in an increase in deaths due to alcohol? This was the subject of a study following a significant reduction in taxes in Finland in 2004 (30% for spirits, 3% for wine).The abolition of import quotas by the EU in 2004 also made it possible to import from other member countries and this led to an increase of approximately 10% in alcohol consumption in Finland. This paper is particularly interesting as it not only reports the effects of reducing costs of alcohol on alcohol-related mortality, but it also reports the effects of such changes on cardiovascular and all-cause mortality.

The authors assessed the impact of a reduction in alcohol prices by analysing the monthly aggregations of deaths for the period 1996-2006.

Key results of paper: The key results of the analyses were that for subjects over the age of 50 years, the decrease in the cost of alcohol was associated with an increase in rates of alcohol-related mortality. For men aged 40-49 years and men and women aged 50-69 years, these increases in risk estimated 1.6 to 2.9 additional monthly deaths per 100,000 person-years. On the other hand, the trend was very different for cardiovascular and all-cause mortality rates. For men and women aged 40-49 years and those >69 years, there were clear decreases in mortality from cardiovascular disease, with estimated 19 fewer monthly deaths per 100,000 person-years for men and 25 for women. For ischemic heart disease deaths among subjects >69 years of age, many fewer deaths were estimated. These effects were not different when the investigators included numbers of coronary operations as a control series in the models.

For all-cause mortality, the estimates implied 42 and 69 fewer monthly deaths in the oldest group. The lower all-cause mortality rates relate not only to decreases in CVD deaths but to fewer deaths from pulmonary disease, dementia, and diabetes; there were no changes in cancer death rates. The authors state: the negative, i.e., beneficial, point estimates found in the current study suggest that cheaper alcohol may . . . have fostered moderate consumption and its beneficial effects in at least some part of the population. They quote recent surveys showing that alcohol consumption in the 2000s has increased among persons aged >65 years and those aged 50-69 years, whose drinking is reported to be primarily low to moderate'.

Gambling problems are more common than drinking problems, according to first-of-its-kind study

Thu, 24 Mar 2011 04:00:00 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- After age 21, problem gambling is considerably more common among U.S. adults than alcohol dependence, even though alcohol dependence has received much more attention, according to researchers at the University at Buffalo's Research Institute on Addictions.

In results published this month in the Journal of Gambling Studies, John W. Welte, principal investigator on the study and a national expert on alcohol and gambling pathology, concluded that there is a distinct inconsistency between his research and much of the other research literature. Other research supports the proposition that problem gambling is more common among adolescents than among adults. Problem gambling has often been described as rare. Even the National Council on Problem Gambling describes it as rare but treatable.

Welte and colleagues conducted, then combined, results from two national surveys of gambling and alcohol -- one of youth ages 14-21 and the second of adults 18 and older -- to identify patterns of U.S. gambling and alcohol use across the lifespan. They found that gambling, frequent gambling and problem gambling increases in frequency during the teen years, reaches its highest level in the 20s and 30s and then fall off among those over 70.

No comparable analysis has been done previously and therefore none is available for a direct comparison of these results, Welte says. But, given what we found about the persistence of frequent and problem gambling through adulthood, increased prevention and intervention efforts are warranted.

Other results detailed in the article demonstrate that frequent gambling is twice as great among men (28 percent) as among women (13 percent). Men reach their highest rates of both any gambling and frequent gambling in the late teens, while females take longer to reach their highest rates.

The odds of any gambling in the past year are significantly higher for whites than for blacks or Asians, although the odds of frequent gambling are higher for blacks and Native Americans, the study found.

It is also notable that frequent and problem gambling become more common as socioeconomic status (SES) gets lower; gambling involvement tends to decline as SES rises. Welte speculated as early as 2004 that lower SES Americans may pursue gambling as a way to make money, leading to more difficulties than if their motivation were strictly recreational.

Welte's first telephone survey of adult gambling was conducted in 1999-2000 with 2,631 adults from 4,036 households nationwide. The second survey of youth gambling in 2005-2007 included 2,274 youth -- with parental permission -- from 4,467 households. Both surveys were conducted with residents drawn from all 50 states and the District of Columbia. Questions asked of those who agreed to participate ranged from frequency of drinking, quantity and type of alcoholic beverage to frequency of past-year gambling and type of gambling, such as raffles, cards, casinos, sports betting, horse or dog track, lottery involvement and games of skill.

Deep brain stimulation research expands at Barrow

Wed, 09 Mar 2011 05:00:00 PST

( from http://www.rxpgnews.com ) St. Joseph's Hospital and Medical Center's Barrow Neurological Institute has received a $10.1 million donation, the largest single gift in the organization's history and one of the biggest ever given to any Arizona hospital. The one-time cash donation from philanthropist Marian H. Rochelle to St. Joseph's Barrow Neurological Institute in Phoenix will be used to explore a new medical frontier for psychiatric and motor disorders by using novel treatments including advanced deep brain stimulation.

Deep brain stimulation (DBS) has previously been used almost exclusively for patients with movement disorders. The new Barrow center, called the Barrow Center for Neuromodulation, will expand its use, as well as the use of other technologies, to treat patients with a number of neurological and behavioral conditions such as depression, obsessive compulsive disorder, epilepsy, Tourette syndrome, addictions, autism and chronic pain.

I have grown to appreciate all that Barrow does for patients in Arizona and around the world. This is truly a gem among neuroscience centers, and I am proud to support it, says Rochelle, whose late husband was treated at Barrow for Alzheimer's disease. Each of us can play a role in making the new Barrow Center for Neuromodulation a beacon of hope for people with devastating neurological disorders. The doctors, nurses and scientists will give of their education, experience and skill, while we benefactors will give of the resources with which we are so richly blessed. I hope others will join me in supporting this amazing endeavor. Time is of the essence.

The new center will be located inside Barrow and will include neurosurgeons, neurologists, psychiatrists and clinical and basic researchers.

This donation will help insure that Barrow continues as a global leader in the neurosciences, says Barrow Director Robert Spetzler, MD. This gift will advance our understanding of the brain's pathways and their abnormal connections in patients who have movement and psychiatric disorders. There also exists the tantalizing prospect that with deep brain stimulators these abnormal pathways can be made to function in a more normal manner. This has the potential to make a dramatic difference in the lives of these patients. The Barrow Neurological Institute will be one of a small handful of medical institutions worldwide that are doing serious research to improve the lives of these patients with neuromodulation.

Deep brain stimulation involves the implantation of an electrode deep to a target area deep within the brain that is associated with a disorder. A pacemaker then sends electrical signals to the brain, alleviating symptoms. While DBS is the cornerstone of the new Barrow center, other neuromodulation therapies including transcranial magnetic stimulation and low frequency ultrasonic therapy will also be developed.

Since 1995 when DBS became available as a treatment for movement disorders, more than 80,000 people have been implanted with a deep brain stimulation device. Barrow currently conducts about 75 deep brain stimulation surgeries a year on Parkinson's patients. One of the early focuses of the new center will be use of DBS for patients with treatment-resistant depression. Barrow has already launched a research trial that will advance deep brain stimulation as a treatment for depression. (see attached sidebar)

Francisco Ponce, MD, is director of the center. A Barrow-trained neurosurgeon, Dr. Ponce received sub-specialty training in functional neurosurgery at the University of Toronto. Following his undergraduate studies at Harvard, he pursued graduate work in materials science at the University of Oxford before earning his medical degree from the University of Chicago in 2004.

This is one of the most exciting and promising areas of modern medicine. Through neuromodulation, we can improve and restore function in patients in a manner that is reversible, adjustable and safe, says Dr. Ponce. This center will combine the strengths of multiple disciplines, enabling our team to develop and implement new treatments for patients for whom current therapies fall short.

Study shows tobacco retail proximity to schools

Mon, 21 Feb 2011 05:00:00 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- For years the tobacco industry has argued that efforts to ban tobacco advertising near schools would constitute a total ban on tobacco advertising in urban areas.

But public health researchers at the University at Buffalo and Roswell Park Cancer Institute have presented research that shows this is not the case in Buffalo and Niagara Falls, N.Y. The UB and RPCI researchers presented their study results in a poster session on Feb. 18 at the annual meeting of the Society for Research on Nicotine and Tobacco held in Toronto.

They found that tobacco outlets in Buffalo and Niagara Falls are more concentrated around elementary and secondary schools; the outlets (convenience stores, groceries, delis, etc.) also are more densely concentrated in lower-income areas, which may be exacerbating tobacco-use disparities between socioeconomic groups.

According to the tobacco industry's argument, the area around schools in urban areas comprises a significant percentage of land area and population that would be off-limits to tobacco advertisements if an advertising ban were in place.

The tobacco industry has stated that a tobacco advertising ban within a 1,000-foot buffer zone near schools in urban areas would be equivalent to a total ban on advertising and would, therefore, be unconstitutional on First Amendment grounds, explains Andrea Licht, a doctoral candidate in the Department of Social and Preventive Medicine in the UB School of Public Health and Health Professions. Licht is first author on the study.

However, based on our analyses, a law banning tobacco advertising within 1,000 feet of schools would affect fewer than half of their outlets, she says. We also found that only about one-third of the population potentially lives within this 1,000-foot buffer zone, so such an advertising ban would not act like a 'de facto' ban, as industry has claimed.

During 2009-10, the years covered by the study, there were 350 tobacco retail outlets and 104 schools located in the City of Buffalo.

The study found that 17.3 percent of schools in Buffalo have a tobacco retail outlet located within 500 feet, while 49.9 percent have a tobacco retail outlet located within 1,000 feet and 71.2 percent of schools have a tobacco retail outlet located within 1,500 feet.

In the City of Niagara Falls, there were 65 tobacco retail outlets and 15 schools. Of those 15 schools, 13.3 percent have a tobacco retail outlet located within 500 feet, 33.3 percent have a tobacco retail outlet within 1,000 feet and 46.7 percent of schools have a tobacco retail outlet within 1,500 feet.

The proximity to schools is significant because smoking patterns are almost exclusively developed during the adolescent and teen years, Licht explains.

These outlets near the schools and in lower-income areas may be more likely to be frequented by adolescents, young adults and other disadvantaged populations, says Licht. Since availability, accessibility and the perception that smoking is normal are all associated with higher youth smoking rates, it is likely that advertising bans near schools may serve to reduce youth smoking initiation.

Moderate-to-heavy alcohol intake may increase risk of atrial fibrillation

Mon, 14 Feb 2011 05:00:00 PST

( from http://www.rxpgnews.com ) Atrial Fibrillation (AF) is the most common cardiac arrhythmia (abnormal heart rhythm). Its name comes from the fibrillating (i.e., quivering) of the heart muscles of the atria, instead of a coordinated contraction. The result is an irregular heartbeat, which may occur in episodes lasting from minutes to weeks, or it could occur all the time for years. Atrial fibrillation alone is not in itself generally life-threatening, but it may result in palpitations, fainting, chest pain, or congestive heart failure.

There is no doubt that heavy alcohol intake and binge drinking can lead to cardiac arrhythmias, with the Holiday Heart Syndrome being known for more than three decades. This syndrome often includes atrial fibrillation; the syndrome is usually not associated with long-standing heart disease and the arrhythmia tends to resolve when drinking stops.

Members of The international Scientific Forum on Alcohol Research comment 'This paper, Alcohol consumption and risk of atrial fibrillation. A meta-analysis. J Am Coll Cardiol 2011;57:427-436. analyzing the results of 14 papers suggests that even moderate drinking can lead to this syndrome, but others find no effect for moderate alcohol intake, only for heavy drinking. One of the best studies on alcohol consumption and risk of atrial fibrillation is a Danish cohort study (the Danish Diet, Cancer and Health Study) examining the issue among 22,528 men and 25,421 women followed over 6 years. The study included a large number of cases with atrial fibrillation, detailed information on potential confounding factors, and complete follow up through nationwide population-based registries. The results included a modest increase in risk of atrial fibrillation in men drinking more that 2 drinks/day and no association between alcohol consumption and risk of atrial fibrillation in women.

There is much evidence that heavy alcohol consumption is associated with an increased incidence of atrial fibrillation, among other health risks. The pattern of consumption (speed, time frame and without food), not often addressed, affects risk too - we know that binge drinking is associated with a greater incidence of arrhythmias, especially atrial fibrillation.

A weakness of this paper, and of essentially all meta-analyses, is that there were varying definitions for categories of alcohol consumption, and the highest category of alcohol intake included alcoholics and 6 or more drinks/day for some studies, while the highest category of alcohol intake was = 1-2 drinks/day in other studies.

The consistent message is that there is a difference between heavy and moderate use of alcohol, between binge drinking and a healthy pattern of drinking, and inherent health risk. The most important question would be: Does light to moderate drinking increase the risk of AF? The conclusion of the authors of this paper seems to be yes, while many other studies find little effect of such drinking'.

Overall, the scientific evidence from many studies suggests that heavy drinking may increase the risk of atrial fibrillation, although whether light-to-moderate intake increases the risk seems unlikely. Previous basic scientific data of mechanisms of atrial fibrillation have suggested that alcohol has little effect on this arrhythmia.

Simple feedback could be effective therapy for addictive behaviors

Mon, 07 Feb 2011 05:00:00 PST

( from http://www.rxpgnews.com ) As mental health care costs and problem gambling rates continue to rise, University of Missouri researchers are developing a personalized feedback tool that could serve as an effective and inexpensive way for people with addictive behavior-related problems to get the help they need.

Matthew Martens, associate professor of Educational, School and Counseling Psychology in the MU College of Education, and his team of researchers received a $172,500 grant from the Institute for Research on Gambling Disorders to expand a successful feedback based intervention program to study college student gambling. Martens and his team have been developing and testing this type of intervention for alcohol issues, and the new grant will build on that study.

Intensive therapy, such as counseling sessions or extensive rehabilitation, isn't always necessary, and in some cases may even be counterproductive, for many people who are experiencing problems associated with addictive behaviors like alcohol use and gambling, Martens said. If effective, the personalized feedback would give therapists an inexpensive tool to help people modify their behavior before it escalates.

In these interventions clients answer a series of targeted questions. After completion, the clients receive personalized responses designed to raise awareness about their current behaviors versus more desirable behaviors. For example, it is typical for heavy drinking college students to overestimate the amount of alcohol their peers drink. A client may think that drinking 20 drinks per week for a college student is normal, when actually, the nationwide average is much lower, Martens said.

With the rise of online gaming, more people are experiencing issues related to excessive gambling, such as missing appointments and classes or not meeting other responsibilities. However, most are not facing extreme issues, such as financial ruin, so intensive therapy, which can be very expensive, may not be necessary.

The gambling questionnaire will prompt clients to answer questions about how their gambling compares to national norms, the negative consequences they have experienced, and the myths about gambling they may hold that are not true, which will then be used to develop the personalized feedback, Martens said. To see all that feedback in one place can have a real positive effect.

In addition to the current alcohol and gambling questionnaires, Martens also is developing feedback based interventions that encourage physical activity in sedentary college students; alcohol interventions tailored to veterans returning from the Middle East; and a shorter, more focused alcohol intervention that includes a review of feedback and discussion with a clinician.

While similar questionnaires are available on the Internet, most of them are not associated with health care facilities. Martens believes that as research suggests that personalized feedback is an effective, low-cost intervention, more clinicians will adopt the practice.

Childhood self-control predicts adult health and wealth

Mon, 24 Jan 2011 05:00:00 PST

( from http://www.rxpgnews.com ) DURHAM, N.C. -- A long-term study has found that children who scored lower on measures of self-control as young as age 3 were more likely to have health problems, substance dependence, financial troubles and a criminal record by the time they reached age 32.

Self-control in the more than 1,000 New Zealand children who participated in the study was assessed by teachers, parents, observers and the children themselves. It included measures like low frustration tolerance, lacks persistence in reaching goals, difficulty sticking with a task, over-active, acts before thinking, has difficulty waiting turn, restless, not conscientious.

Fast-forward to adulthood, and the kids scoring lowest on those measures scored highest for things like breathing problems, gum disease, sexually transmitted disease, inflammation, overweight, and high cholesterol and blood pressure, according to an international research team led by Duke University psychologists Terrie Moffitt and Avshalom Caspi.

The impulsivity and relative inability to think about the long-term of the lower self-control individuals gave them more difficulty with finances, like savings, home ownership and credit card debt. They also were more likely to be single parents, have a criminal conviction record, and be dependent on alcohol, tobacco, cannabis and harder drugs.

These adult outcomes were predictable across the entire spectrum of self-control scores, from low to high, Moffitt said.

Yet study participants who somehow found a way to improve their self-control as they aged fared better in adulthood than their childhood scores would have predicted. Self-control is something that can be taught, the researchers say, and doing so could save taxpayers a pile of money on health care, criminal justice and substance abuse problems down the road.

To further corroborate the importance of self-control, Caspi and Moffitt ran the same analysis on a sample of 500 pairs of fraternal twins in Britain and found that the sibling with lower self-control scores at age 5 was more likely than their sibling to begin smoking, perform poorly in school and engage in antisocial behaviors at age 12. This shows that self-control is important by itself, apart from all other factors that siblings share, such as their parents and home life, Caspi said.

The New Zealand children with low-self control were more likely to make poor choices as adolescents, including taking up smoking, having unplanned pregnancies and dropping out of school. Naturally, this set them on a more difficult path. Even the low self-control individuals who finished high school as non-smokers without kids showed poorer outcomes at age 32.

And because of a greater likelihood of single-parent status and limited income, it's also apparent that one generation's low self-control puts the next generation at a disadvantage as well, Moffitt said.

The good news is that self-control can change. People can change, said Alexis Piquero, a professor of criminology at Florida State University who was not involved in the research.

Piquero, who studies the developmental roots of criminal behavior, said there are many time-tested approaches that give parents and teachers the tools to teach self-control. The successful programs practice decision-making, role-playing and learning the consequences of actions.

Identifying low self-control as early as possible and doing prevention and intervention is so much cheaper than dealing with prisons, drug programs and personal economic failures, Piquero said. If you're just making a dollars-and-cents decision, it's a no-brainer.

Research tackles drug use, HIV in South African youth

Mon, 13 Dec 2010 05:00:00 PST

( from http://www.rxpgnews.com ) Drug use, risky sexual behavior and violence among South African youth may be reduced thanks to Penn State researchers, who will look at expanding a leisure education and life skills program to 56 South African high schools. The researchers, led by Linda Caldwell, professor of recreation, park, and tourism management, and Edward Smith, associate director of the Penn State Prevention Research Center for the Promotion of Human Development, received a $2.8-million grant from the National Institute on Drug Abuse.

Caldwell and her colleagues will implement HealthWise, a curriculum they developed that teaches youth how to best utilize their free time, said Caldwell. HealthWise teaches adolescents to examine personal motivations and other factors leading to their decision-making, and it also provides information on safe sexual practices and how to avoid risky situations. In better understanding why they make decisions, youth can successfully prevent poor outcomes that result from risky decisions.

Recent studies show that nearly one-quarter of HIV-infected individuals in South Africa are under the age of 25, and AIDS is responsible for 71 percent of all deaths in the 15 to 49 year age group. One in eight South African high school students begins drinking alcohol before the age of 13. In grades 8 through 11, more than 10 percent of children have tried marijuana ,and about 30 percent of children have smoked cigarettes.

Caldwell and Smith first implemented HealthWise in the Cape Town Metro South Education District (MSED) in 2001 as a pilot program and later as a randomized trial involving nine schools and over 7,000 youth. Results from the trial indicated HealthWise was effective in reducing both substance use and sexual risk. Cigarette and alcohol use, for example, were significantly lower among those in the HealthWise schools. In addition, fewer males initiated sexual behavior and were less likely to push girls into unwanted sex. Importantly, from the perspective of reducing HIV risk, both males and females reported less use of substances at sexual encounters and were less likely to report having sex with someone they had recently met. There was also increased perception of condom availability, condom skills and conversations with partners surrounding condom use.

Following the success of the first trial, MSED administrators approached Caldwell and Smith requesting that they help with a large-scale implementation.

We saw great success in HealthWise over the past decade, said Caldwell. We hear constantly from teachers and district administrators of how good HealthWise is. The kids like it, too, because it's so positive. Now we're looking at what factors of success are important for a large-scale rollout of the program.

23% of young people get into fights when they go out at night

Thu, 11 Nov 2010 05:00:00 PST

( from http://www.rxpgnews.com ) Night-time violence among young Spaniards is becoming ever more common, according to a research study carried out by the European Institute of Studies on Prevention. The study shows that 5.2% of young people carry weapons when they go out at night, 11.6% have been attacked or threatened, and 23% have got into a fight at some time.

Reports about young people being attacked or injured in fights when they go out at night are becoming increasingly common, Amador Calafat, lead author of the study and a researcher at the European Institute of Studies on Prevention (IREFREA), which is at the forefront of studies into problems of childhood and adolescence and drug abuse, tells SINC.

The research, published in the latest issue of the Journal Psicothema, analyses the phenomenon of violence among young Spaniards (under the age of 25), in particular in terms of factors related to the night-time leisure context, among a selected sample of 440 participants in the Balearic Islands, Galicia and Valencia who regularly go out at night and consume alcohol or other substances.

Of this sample, 11.6% had been attacked or threatened at some time. This percentage rose to 23% for fights. The research goes further, finding that 5.2% of the young people studied carry weapons when they go out at night. Having been threatened or hurt with a weapon was associated with having frequent arguments related to the use of alcohol and drugs, Calafat explains.

The authors state that adolescence is a risk factor itself, since young people are more prone and vulnerable to this kind of behaviour. Some important aspects for preventing night-time violence relate to the way in which environmental conditions are managed. These include preventing crowds from building up, using soft music when bars and clubs close and bright lights when it is time to leave.

In order to prevent night-time violence, alcohol consumption among young people should be controlled by offering water and soft drinks at affordable prices, steering away from 'happy hour'-type alcohol offers, and strictly ensuring that alcohol is not sold to underage drinkers, the researcher concludes.

Violence among young tourists

Tourist destinations in southern Europe attract young people because of the good times and night-time action they promise. In another study, financed by the European Commission Daphne programme, the same research group studied the behaviour of young British and German tourists who chose to spend their 2009 holidays in Portugal, Spain, Italy, Greece and Cyprus.

The figures were impressive. Almost one-quarter of the study's participants (24%) visited bars and clubs every night during their holidays, and 95% consumed alcohol during their stay. More than two-thirds of the young respondents got drunk, and more than one in 10 took illegal drugs.

The 6,000 young tourists surveyed reported significant problems during their holidays. Almost 9% were sexually abused (7% of males and 10% of females), 6% suffered injuries and 4% were involved in cases of physical violence. More than half of the violent incidents (51%) took place in bars or nightclubs, while the rest (36%) took place on the street.

New NIH data show gains in COPD awareness

Tue, 09 Nov 2010 05:00:00 PST

( from http://www.rxpgnews.com ) The number of Americans who report being aware of chronic obstructive pulmonary disease, or COPD, increased by 4 percentage points between 2008 and 2010, but many people at risk are still unaware of the disease, according to mailed survey results released today by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.

Sixty-nine percent of adults said they are aware of COPD. However, up to 30 percent of Americans reported that they were unaware of the condition. Awareness increased steadily among current and former smokers as well as nonsmokers.

COPD kills more than 120,000 adults each year. That's one death every four minutes -- more than breast cancer and diabetes combined. Yet people go undiagnosed and untreated because they don't recognize the symptoms, said James P. Kiley, Ph.D., director of the NHLBI's Division of Lung Diseases. Through the NHLBI's COPD Learn More Breathe Better campaign, we are focusing on empowering people with knowledge that can bring greater quality of life.

To improve awareness of COPD symptoms, the NHLBI is launching a new public service announcement campaign that highlights common COPD signs and symptoms including: frequent shortness of breath, chronic cough, wheezing, and excessive phlegm production.

Individuals living with these symptoms often believe it is just a result of getting older or being out of shape, and may not think the symptoms warrant a doctor's visit. Not true. COPD is a serious lung disease that makes it difficult to breathe and can cause long-term disability. Sometimes referred to as emphysema or chronic bronchitis, COPD is now the fourth leading cause of death in the United States. More than 12 million people are currently diagnosed with COPD. And it is estimated that another 12 million may have COPD but not realize it.

For those who may be experiencing a recurrent cough or shortness of breath, particularly those who may have a history of smoking, awareness of the symptoms is not enough. They need to have their lungs tested, said Kiley. There is no cure for COPD -- but the good news is that we have come a long way in terms of improving how a person with COPD lives, and it only takes a few minutes in the doctor's office to get tested.

The NHLBI analyzed the results of the annual HealthStyles surveys of the public health attitudes, knowledge, practices, and lifestyle habits of consumers, conducted each year by Porter Novelli, communications contractor for the NHLBI's COPD Learn More Breathe Better campaign. The results represent a sample of 4,184 consumers through a mailed survey with a margin of error of plus or minus 1.5 percentage points. Both surveys were conducted in summer 2010.

The NHLBI initiated the COPD Learn More Breathe Better campaign, the first national awareness campaign on COPD, in 2007 to improve knowledge about COPD among those already diagnosed or at risk for COPD as well as health care providers, particularly those in a primary care setting.

2 studies present new data on effects of alcohol during pregnancy

Fri, 15 Oct 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Scientific data continue to indicate that higher intake of alcohol during pregnancy adversely affects the fetus, and could lead to very severe developmental or other problems in the child. However, most recent publications show little or no effects of occasional or light drinking by the mother during pregnancy. The studies also demonstrate how socio-economic, education, and other lifestyle factors of the mother may have large effects on the health of the fetus and child; these must be considered when evaluating the potential effects of alcohol during pregnancy.

A very large population-based observational study from the UK found that at the age of 5 years, the children of women who reported light (no more than 1-2 units of alcohol per week or per occasion) drinking did not show any evidence of impairment on testing for behavioral and emotional problems or cognitive ability. There was a tendency for the male children of women reporting heavy/binge drinking during pregnancy (7 or more units per week or 6 or more units per occasion) to have poorer behavioural scores, but the effects were less clear among female offspring.

A second study, published in Pediatrics, based on a population in Western Australia examined the associations between dose, pattern, and timing of prenatal alcohol exposure (PAE) and birth defects and found similar results, that there was no association between low or moderate prenatal alcohol exposure and birth defects.

Data from a randomly selected, population-based cohort of non- indigenous women who gave birth to a live infant in Western Australia (WA) between 1995 and 1997 (N = 4714) were linked to WA Midwives Notification System and WA Birth Defects Registry data. Information about maternal alcohol consumption was collected 3 months after birth for the 3 month period before pregnancy and for each trimester separately.

Low alcohol consumption was defined as less then 7 standard drinks (10g) a week, and no more than 2 drinks on any one day. Women who consumed more than 70g per week were classified as heavy drinkers and women consuming more than 140g were classified as very heavy drinkers.

The study results indicate that the prevalence of birth defects classified as ARBDs by the IOM was low. Compared with abstinence, heavy prenatal alcohol exposure in the first trimester was associated with increased odds of birth defects classified as ARBDs (adjusted odds ratio: 4.6 [95% confidence interval: 1.5-14.3]), with similar findings after validation through bootstrap analysis. There was no association between low or moderate prenatal alcohol exposure and birth defects.

Overall, current scientific data indicate that while drinking during pregnancy should not be encouraged, there is little evidence to suggest that an occasional drink or light drinking by the mother is associated with harm. Heavy drinking, however, is associated with serious developmental defects in the fetus.

Legalizing marijuana in California would not substantially cut cartel revenues, study finds

Tue, 12 Oct 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Legalizing marijuana in California will not dramatically reduce the drug revenues collected by Mexican drug trafficking organizations from sales to the United States, according to a new RAND Corporation study.

The only scenario where legalization in California could substantially reduce the revenue of the drug trafficking organizations is if high-potency, California-produced marijuana is smuggled to other U.S. states at prices that are lower than those of current Mexican supplies, according to the study from the RAND Drug Policy Research Center. RAND is a nonprofit research organization.

The study calculates that Mexican drug trafficking organizations generate only $1 billion to $2 billion annually from exporting marijuana to the United States and selling it to wholesalers, far below existing estimates by the government and other groups.

The RAND study also finds that the often-cited claim that marijuana accounts for 60 percent of gross drug export revenues of Mexican drug trafficking organizations is not credible. RAND's exploratory analysis on this point suggests that 15 percent to 26 percent is a more credible range. Given that California accounts for about 14 percent of the nation's marijuana use, this suggests that if marijuana legalization in California only influences the California market, it would have a small effect on drug trafficking organizations -- cutting total drug export revenues by perhaps 2 to 4 percent.

However, the impact of legalization on Mexican drug trafficking organizations' bottom line could be magnified if marijuana cultivated in California is smuggled into other states, according to the study. After legalization, if low-cost, high-quality marijuana produced in California dominates the U.S. marijuana market, then the Mexican drug trafficking organizations' revenue from exporting marijuana could decline by more than 65 percent and probably closer to 85 percent. In this scenario, results from the RAND study suggest the drug trafficking organizations would lose roughly 20 percent of their total drug export revenues.

Legalizing marijuana in California would not appreciably influence the Mexican drug trafficking organizations and the related violence unless exports from California drive Mexican marijuana out of the market in other states, said Beau Kilmer, the study's lead author and co-director of the RAND Drug Policy Research Center. If that happens, then legalization could reduce some of the Mexican drug violence in the long run. But even then, legalization may not have much impact in the short run.

In November, California voters will consider a ballot measure titled the Regulate, Control and Tax Cannabis Act of 2010 -- on the ballot as Proposition 19 -- that would authorize local jurisdictions to regulate and tax the commercial cultivation and sale of marijuana. Such activities would remain illegal in jurisdictions that do not opt in. In addition, the measure would make it legal for those aged 21 and older to cultivate marijuana on a 5-foot-by-5-foot plot and possess, process, share or transport up to one ounce of marijuana.

Some Proposition 19 supporters argue that legalizing marijuana could help curb drug violence in Mexico and frequently reference a 2006 U.S. government report suggesting that marijuana exports account for 60 percent of all Mexican drug trafficking organization revenue. The government has since retracted the 60 percent figure.

No publicly available source verifies or explains the mythical 60 percent figure and subsequent government analyses revealed great uncertainty about the estimate, said study co-author Jonathan P. Caulkins, the H. Guyford Stever Professor of Operations Research at Carnegie Mellon University's Heinz College and Qatar campus. Our analyses suggest that smuggling marijuana across the Southwest border accounts for 15 to 26 percent of the export revenues generated by Mexican drug trafficking organizations.

Researchers examined other examples of organized crime groups losing substantial revenues to assess how drug-related violence in Mexico might be affected.

Projections about the effect of a large revenue decrease on violence in Mexico are particularly uncertain, but there are some scenarios that suggest a large decline in revenues might provoke increased violence in the short run and a decline after some years, said study co-author Peter Reuter, a professor of public policy and criminology at the University of Maryland.

The RAND study employs replicable methods for estimating revenue earned by Mexican drug trafficking organizations for exporting marijuana and other drugs to the United States. Most estimates of international drug profits and supplies do not use methods that allow others to review the findings and reproduce the methods at a later date, researchers say.

The study does not calculate revenue from drug trafficking organization production and distribution within the United States, which -- apart from marijuana in California -- would not be affected by Proposition 19 and is extremely difficult to estimate with existing data, according to researchers.

Kilmer said the work underscores the need to develop better information about marijuana use and supplies to help guide public policy. For example, surveys asking the public about marijuana use should ask about the amount and type of marijuana used and how it is consumed -- key questions not asked today.

Unprecedented effort to seek, test and treat inmates with HIV

Thu, 23 Sep 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Twelve scientific teams in more than a dozen states will receive National Institutes of Health (NIH) grants to study effective ways to prevent and treat HIV/AIDS among people in the criminal justice system. The grants, announced today, will be awarded primarily by the National Institute on Drug Abuse (NIDA), with additional support from the National Institute of Mental Health (NIMH) and the National Institute of Allergy and Infectious Diseases (NIAID), all components of NIH. The research will take place over a five-year period.

These important and wide reaching research grants will focus on identifying individuals with HIV within the criminal justice system and linking them to highly active antiretroviral therapy (HAART) during periods of incarceration and after community re-entry, said NIDA Director Dr. Nora D. Volkow. We hope this effort will lead to decreased HIV/AIDS-related illness and death among those in the criminal justice system, as well as decrease HIV transmission in the community at-large, making an important impact on public health.

The seek, test and treat funding opportunity follows NIH-sponsored research conducted over the last few years which has indicated that identifying and offering treatment to all medically eligible HIV-positive individuals cannot only stop progression to AIDS and AIDS-related death, but can also help to prevent HIV transmission. These new grants will apply this strategy to the criminal justice system, where there is a high prevalence of HIV/AIDS and often poor access to treatment.

The newly funded research will compare different modalities of the seek, test, and treat strategy to identify, test, engage and retain HIV-positive offenders in treatment. Some of the projects will create and compare systems to better integrate and coordinate HIV management efforts within jails, prisons, health departments, universities, and community organizations. The grants will also support randomized controlled trials among large groups of HIV-positive parolees and probationers comparing varied approaches for linking them to screening, treatment and social services in their communities.

We are learning that treatment can be one of the most powerful forms of prevention, said NIMH Director Dr. Thomas Insel. But treatment of HIV-infected men and women during or after incarceration is a challenge, especially when many have co-occurring mental or substance abuse disorders. We know that patients will stay connected to HIV care if their mental health improves. NIMH's project involves intensive case management for African-American and Latino parolees in Oakland, California.

The grants will support research in a diverse group of jails and prison systems, including the Los Angeles County Jail; the Cook County Jail in Chicago; the Rikers Island correctional facility in New York City; jail facilities in Washington, D.C., as well as prison systems in Illinois, North Carolina, Texas, Wisconsin and Rhode Island. One of the grants will compare levels of care and adherence to HAART treatment among HIV-positive injection-drug using detainees in Hanoi, Vietnam, a city with a high rate of HIV infection related to drug use. Two of the projects will study the effectiveness of medication used to treat heroin addiction among HIV-positive injection drug users who are transitioning to home communities.

The strategy of providing widespread, voluntary testing for HIV infection, identifying individuals infected with the virus and better linking those patients to antiretroviral treatment and medical care is one that NIH is pursuing in a number of different populations, said NIAID Director Dr. Anthony S. Fauci. It is a potentially viable way to reduce HIV transmission and improve the health of those infected with the virus.

Currently, an estimated 1.1 million people in the United States are infected with HIV. Since the late 1990s, the number of new HIV infections has remained relatively stable with approximately 56,000 new infections reported annually. The funding opportunity, Seek, Test, and Treat: Addressing HIV in the Criminal Justice System, represents NIH's largest research initiative to date to aggressively identify and treat HIV-positive inmates, parolees and probationers and to help them continue care when they return to their communities. Close to $50 million dollars in grants over a five-year period are expected under this research initiative.

About four of every 10 AIDS deaths are related to drug abuse. Each year, an estimated one in seven individuals infected with HIV passes through a correctional facility suggesting that a disproportionate number of people in the criminal justice system are infected with the virus.

Could brain abnormalities cause antisocial behavior and drug abuse in boys?

Wed, 22 Sep 2010 04:00:00 PST

( from http://www.rxpgnews.com ) AURORA, Colo (Sept. 22, 2010) Antisocial boys who abuse drugs, break laws, and act recklessly are not just bad kids. Many of these boys may have malfunctioning brains, according to a new study by researchers at the University of Colorado School of Medicine.

Brain responses to everyday rewards and punishments gradually guide most youngsters' decisions to conform with society's rules. However, when these seriously troubled kids experience rewards and punishments, and make decisions, their brains apparently malfunction, said Thomas Crowley, MD, a professor of Psychiatry at the School of Medicine and lead author on the study. Our findings strongly suggest that brain malfunction underlies their frequent failure to conform to rules, to make wise decisions, and to avoid relapses back to drug use and antisocial acts.

The scientists, including collaborators at the University of Colorado at Boulder and the University of Maryland, studied 20 adolescent boys. On average they had been on probation 139 of the last 180 days; 19 of the 20 had the psychiatric diagnosis of conduct disorder, and all had diagnoses of substance use disorder. They had been abstinent, however, an average of about five weeks when studied. They were compared with 20 other boys who did not have serious antisocial or drug problems, but who were of similar age, ethnicity, and home neighborhoods.

All played a computerized risk-taking game that repeatedly presented a choice between a cautious and a risky behavior: press the left button and always win one cent, or press the right button and either win five cents or lose ten cents. The scientists examined brain activation with functional magnetic resonance imaging (fMRI) as the boys decided to press right or left, and then as they experienced wins or losses after right presses.

Brain activation differed dramatically in the two groups. The anterior cingulate cortex monitors changing rewards and punishments, and then sends that information to another brain region (dorsolateral prefrontal cortex), which regulates one's choices among possible behaviors. During decision-making, antisocial boys had significantly less brain activity than normals in both of those regions, and also in other decision-making areas (orbitofrontal cortex, amygdala, insula).

Altogether, during decision-making about 6000 voxels (a voxel is a tiny cube in the brain) activated significantly less in antisocial boys than in comparison boys. No voxels activated more in antisocial boys. Such under-activity during decision-making could contribute to disinhibited antisocial and drug-using behaviors.

As predicted by others not associated with the study, the antisocial boys also had dysphoria, a chronic sad-anxious state, with reward insensitivity; in the game their brains responded less than the comparison boys' brains to wins. They also had punishment hypersensitivity, with greater brain response to losses than comparison boys.

Interestingly, the number of risky right presses was similar in the two groups. The scientists speculate that this occurred because the game forced the boys to deliberate for several seconds before pressing either button.

Gene-environmental interactions and MS progression is focus of new study

Tue, 21 Sep 2010 04:00:00 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- A $634,000 grant from the Department of Defense is allowing researchers at the University at Buffalo to investigate a trio of environmental factors and their influence on the progression of multiple sclerosis.

The two-year project, headed by Murali Ramanathan, PhD, tests the hypothesis that nicotine metabolism, the byproducts of vitamin D metabolism and increased levels of anti-Epstein-Barr virus (EBV) each interact with variations in specific genes to cause increased neurodegeneration and increased lesions in MS patients.

Ramanathan is a professor of pharmaceutical sciences and neurology in the School of Pharmacy and Pharmaceutical Sciences and the School of Medicine and Biomedical Sciences, respectively.

The study is a collaboration between the UB and investigators from Charles University in Prague, Czech Republic, and will be conducted on samples obtained at both universities' MS centers.

The research aims to identify gene-environmental interactions between key molecules in the vitamin D pathway, anti-Epstein-Barr virus antibodies, cigarette smoking and key genetic variants that are implicated in conversion of patients with clinically isolated syndrome (CIS) to definite MS.

They will assess the risk of developing clinically definite MS and the time to progression, as well as the neurodegeneration in the brain of MS patients, as measured by brain atrophy, and the extent of brain injury caused by lesions.

We will use a novel approach to measure the levels of vitamin D and its metabolites, EBV exposure and nicotine metabolites from cigarette smoking, says Ramanathan. We have developed sensitive and selective measurements for key metabolites in the vitamin D and nicotine metabolism pathways using mass spectrometry, a method that has not been used previously to study vitamin D metabolism.

The novel study design will include the genetic variations that were associated with the risk of developing MS, as well as genes that determine the levels and responses to environmental factors. MS patients will be divided into two equal groups: a training group that will be used to identify gene-environmental interactions, and a group that will be used to replicate the training group result.

Identifying gene-environmental interactions is critical for developing better strategies for slowing the progression of MS, because it could enable patients with preexisting genetic risk factors to reduce the rate of disease progression through lifestyle modification, Ramanathan says.

The study results will identify the gene-environment interactions that promote disease progression in MS and facilitate the development of preventive and therapeutic interventions for MS that disrupt these interactions, notes Ramanathan.

Latent HIV infection focus of NIDA's 2010 Avant-Garde Award

Mon, 13 Sep 2010 04:00:00 PST

( from http://www.rxpgnews.com ) The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, announced today that Dr. Eric M. Verdin of the J. David Gladstone Institutes in San Francisco, Calif., has been selected as the 2010 recipient of the NIDA Avant-Garde Award for HIV/AIDS Research for his proposal to study the mechanisms of latent HIV infection. NIDA's annual Avant-Garde award competition, now in its third year, is intended to stimulate high-impact research that may lead to groundbreaking opportunities for the prevention and treatment of HIV/AIDS in drug abusers. Awardees receive $500,000 per year for five years to support their research. Dr. Verdin is Senior Investigator and Associate Director of the Gladstone Institute of Virology and Immunology and Professor of Medicine at the University of California, San Francisco.

Highly active antiretroviral therapy (HAART) has been very successful in managing HIV. However, these medications do not rid the body of the virus, and patients can become symptomatic and more infective if their treatment is interrupted, said NIDA Director Dr. Nora D. Volkow, who announced the award. Dr. Verdin's innovative proposal seeks to identify the cellular proteins that control the latency process, which allows the virus to remain in a persistently dormant state, so that we can better understand how to completely eliminate the virus from the body.

The long-term persistence of HIV in a latent state in patients treated with HAART prevents the eradication of the disease, and forces patient to remain on HAART for their entire life. At this time, our understanding of how latent HIV infection occurs is basic. Dr. Verdin's project aims to develop a new single cell technology to examine how HIV latency is established, maintained, and how the virus becomes reactivated, in primary human lymphoid cells. By observing the fate of the virus in single cells, Dr. Verdin hopes to be able to devise novel strategies to eliminate latent HIV infection, or to restrict the latent pool to a size that can be controlled by the immune system.

Dr. Verdin was selected from 30 applicants whose proposals reflect diverse scientific disciplines and approaches to HIV/AIDS research. The Avant-Garde Awards are modeled after the NIH Pioneer Awards and are granted to scientists of exceptional creativity who propose high-impact research that will open new avenues for prevention and treatment of HIV/AIDS among drug abusers.

Drug abuse and its related behaviors, such as sharing drug injection equipment and/or engaging in risky sexual behavior while intoxicated, have been central to the spread of HIV/AIDS since the pandemic began more than 25 years ago. NIDA's HIV/AIDS research program supports a multidisciplinary portfolio that investigates the role of drug use and its related behaviors in the evolving dynamics of HIV/AIDS epidemiology, natural history, etiology, pathogenesis, treatment, and prevention.

Experimental treatments for cocaine addiction may prevent relapse

Thu, 26 Aug 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Doctors have used the drug disulfiram to help patients stay sober for several decades. It interferes with the body's ability to metabolize alcohol, giving a fierce hangover to someone who consumes even a small amount of alcohol.

More recently, disulfiram was shown to be effective in treating cocaine addiction as well, even though alcohol and cocaine affect the nervous system in different ways.

Now, researchers at Emory University School of Medicine have identified how disulfiram may exert its effects, and have shown that a newer drug with fewer side effects works by the same mechanism.

The results are published online this week by the journal Neuropsychopharmacology. Research assistant professor Jason Schroeder, PhD, and graduate student Debra Cooper are co-first authors of the paper, and the research also involved collaborations with P. Michael Iuvone, PhD, director of research at the Emory Eye Center, Gaylen Edwards, DVM, PhD, head of the department of physiology and pharmacology at the University of Georgia's College of Veterinary Medicine, and Philip Holmes, PhD, professor of psychology at the University of Georgia.

Disulfiram has several effects on the body: it interferes with alcohol metabolism, but it inhibits several other enzymes by sequestering copper, and can also damage the liver, says senior author David Weinshenker, PhD, associate professor of human genetics at Emory University School of Medicine. We wanted to figure out how disulfiram was working so we could come up with safer and potentially more effective treatments.

In treating cocaine addiction, there are several challenges: not only getting people to stop taking the drug, but also preventing relapse. Cocaine boosts the levels of several neurotransmitters, including dopamine and norepinephrine, at the junctions between nerve cells by blocking the machinery the brain uses to remove them.

Under normal conditions, dopamine is important for the sensation of pleasure produced by natural rewards such as food or sex, Weinshenker says. Cocaine hijacks the dopamine system, which plays a large role in addiction. Similarly, norepinephrine has a role in attention and arousal, but its overactivation can trigger stress responses and relapse, he says.

Weinshenker's team showed that disulfiram prevents rats from seeking cocaine after a break, a model for addicts tempted to relapse. At the same time, it doesn't stop them from taking cocaine when first exposed to it, or from enjoying their food.

Disulfiram appears to work by inhibiting dopamine beta-hydroxylase, an enzyme required for the production of norepinephrine. A dose of disulfiram that lowers the levels of norepinephrine in the brain by about 40 percent is effective, while doses that do not reduce norepinephrine have no effect on relapse-like behavior in rats.

To confirm that the beneficial effects of disulfiram were because of dopamine beta-hydroxylase inhibition, the researchers turned to a drug called nepicastat, which was originally developed for the treatment of congestive heart failure in the 1990s.

Nepicastat is a selective dopamine beta-hydroxylase inhibitor that does not sequester copper or impair a host of other enzymes like disulfiram, Weinshenker says. We reasoned that if disulfiram is really working through dopamine beta-hydroxylase, then nepicastat might be a better alternative.

Researchers at the University of Texas Medical Branch at Galveston have recently completed a Phase I safety trial studying nepicastat for the treatment of cocaine addiction in human subjects.

Study describes health effects of occupational exposures in Paducah Gaseous Diffusion Plant workers

Thu, 22 Jul 2010 04:00:00 PST

( from http://www.rxpgnews.com ) A five-year study into the causes of deaths of workers at Paducah Gaseous Diffusion Plant (PGDP) shows significantly lower death rates from all causes and cancer in general when compared to the overall United States population. This is known by occupational health researchers as the healthy worker effect. However, death from lymphatic and bone marrow cancers such as leukemia or multiple myeloma were slightly above national rates.

The study was conducted by faculty at the University of Louisville School of Public Health and Information Sciences and collaborators from the University of Cincinnati and the University of Kentucky. It was funded through the National Institute for Occupational Safety and Health, thanks to the effort of U.S. Senator Mitch McConnell, who was instrumental in getting the study off the ground.

This was an important study, because it addressed lingering concerns about the health of workers at the Paducah Gaseous Diffusion Plant, said David Tollerud, MD, MPH, professor of environmental and occupational health sciences at UofL's School of Public Health and Information Sciences. It is important for occupational health and public health research to attempt to answer pressing concerns of impacted populations, and we were able to report that we didn't find unexpectedly high rates of disease in this workforce.

Security workers had higher overall death rates than other employees, while chemical operators had higher death rates from leukemia and multiple myeloma than the rest of the workers.

The increased number of lymphatic and bone marrow cancer deaths is consistent with what we expected. Based on other studies, these forms of cancer have been linked to low levels of radiation exposure, Tollerud said.

The team compiled data on thousands of employees who worked at the plant for at least 30 days in different job classifications from 1952 through 2003. The data were used to assess exposure levels. Overall, 1,638 workers died out of the 6,759 in the study. This is less than the 2,253 deaths that would have been expected in the general public during the same time.

The team now plans to present its findings to PGDP workers and distribute a study fact sheet that summarizes the main findings and directs workers to resources that are available if they have concerns or questions.

The Paducah Gaseous Diffusion Plant, located in western Kentucky, is the only operating uranium enrichment facility in the United States, and the only one where a worker mortality study had not been conducted. The plant was commissioned in 1952 under the U.S. Department of Energy as part of a U.S. government program to produce enriched uranium to fuel military reactors and nuclear weapons. The plant's mission changed in the 1960s from enriching uranium for nuclear weapons to enriching uranium for use in commercial nuclear reactors to generate electricity.

New global report launched by the International AIDS Society recommends a new paradigm for treating injecting drug users: 'Seek, test, treat and retain'

Thu, 22 Jul 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Thursday, 22 July, 2010 (Vienna, Austria)-- Against the backdrop of some of the globe's fastest growing HIV epidemics in Eastern Europe and Central Asia, a report launched today at the XVIII International AIDS conference (AIDS 2010) in Vienna makes the case for a new model for scaling up treatment and prevention of HIV amongst Injecting Drug Users (IDUs).

The report, Prevention and Treatment of HIV/AIDS amongst Drug Using Populations: A Global Perspective, advocates a science based approach and stresses the urgent need to increase access and expand take up of highly active anti retroviral therapy (HAART) among drug using populations to improve health and reduce new infections. (1)

Increasing evidence supports the idea of expanding the implementation of outreach to high-risk, hard-to-reach drug using populations (seek), to encourage HIV testing (test), to link HIV+ individuals to care (treat), and to sustain these individuals in care (retain). The seek, test, treat, and retain model is also deliverable within the criminal justice system.

The evidence is in, individuals with and without a history of injection drug use derive similar survival benefit from HAART. There is an urgent need to treat drug users, not abuse them as much of the current drug policies do, said Dr Julio Montaner, President of the International AIDS Society. Sound public health policy demands that we increase access to HIV treatment and prevention for this population.

Two decades of experience have demonstrated that needle exchange programs are a proven way of preventing HIV infection amongst injecting drug users (IDUs). The report outlines how programs can increase this effectiveness by scaling up a comprehensive package of harm reduction interventions.

Offering Opioid Substitution Therapy (OST), such as methadone or buprenorphine, significantly decreases HIV acquisition and transmission and increases the chances of HIV positive people who inject drugs taking up and staying on highly active anti retroviral therapy (HAART), said Professor Dr Charles O'Brien, a researcher from the University of Pennsylvania and one of the contributors to the report. This in turn can lead to reductions in the community viral load and decrease new infections.

Wider uptake of HAART is associated with reduced community viral load and reduced transmission as well as individual survival. Not only does treatment offer health benefits for the individual, said Dr Montaner, but in diverse populations, we can now see that HAART is HIV prevention.

The selection of Vienna as the host city of the XVIII International AIDS Conference reflects the role the city has played in bridging Eastern and Western Europe. During the past week there has been a strong focus on Eastern Europe and Central Asia region, now home to what is the fastest growing HIV/AIDS epidemic in the world. Injecting drug use is the main driver of HIV infection in the region.

Some 65 per cent of HIV infections in Russia for instance, are through injecting drug use. The number of HIV infected people in Russia has increased tenfold in the past decade from an estimated 100,000 to one million. Eighty per cent of HIV positive people are under 30 years of age. Methadone is illegal in Russia.

The Russian government does not implement an evidence based approach to decision-making on public health, said Dasha Ocheret, spokesperson for the Eurasian Harm Reduction Network (EHRN). The prohibition of substitution treatment such as methadone is based on Soviet ideology and denies drug users the right to life saving treatment and prevention that exist in the vast majority of countries in the region. Methadone treatment began in Lithuania as far back as 1984.

Russian Government funds are used for policing rather than sound public health policy. All attempts by the Russian government over the past decade to control drug trafficking have been counterproductive and resulted in increased incarceration rates of people who use drugs and social exclusion and led to numerous deaths from overdoses and HIV and TB infections.

The report argues that it is now recognized that a punitive approach leads to the creation of incubators for HIV, HCV and TB in prisons.

We've been witness this week in Vienna to what is an all too familiar story: the unacceptable criminalisation and stigmatisation of a group of people, in this case, people who inject drugs, said Montaner. As a result of repressive drug policies and frankly, appalling public health policy in many parts of Eastern Europe, people who inject drugs are now shouldering the burden of an HIV epidemic that shows all the signs of moving into the wider community.

On the other hand we've also heard success stories in the region that give hope to scientists, researchers and policy makers who are committed to addressing HIV and injecting drug use based on sound scientific empiric evidence along the lines suggested in the report we have released today, concluded Montaner.

The report's recommendations include:

Individuals confess alcohol abuse to clergy

Wed, 14 Jul 2010 04:00:00 PST

( from http://www.rxpgnews.com ) ANN ARBOR, Mich.---Persons with alcohol problems are finding comfort in speaking about their situation to clergy, a new study shows.

Among 1,910 people with any alcohol-related problems, 14.7 percent said they used clergy services.The study, from researchers at the University of Michigan Health System and Saint Louis University, also indicates the majority of those who used services from clergy also used professional services at some point; only 0.5 percent used clergy services exclusively for their alcohol use-related problem.

Although professional services are used more commonly, these findings show that clergy services are an important part of the overall system of care for persons with alcohol problems.

Researchers sought to examine the prevalence of use of clergy services among those adults who received help for an alcohol use problem in the United States, as well as characteristics and correlates of individuals with alcohol-related problems who used clergy services compared to individuals who used other types of services. Researchers also examined the degree to which individuals who receive help from the clergy receive other types of services as well.

The factors that were associated with an increased likelihood of clergy service used included being Black, aged 35-54 years, a lifetime history of alcohol dependence, major depressive disorder and personality disorder, according to the data from the National Epidemiologic Survey on Alcohol and Related Conditions.

Individuals who met criteria for alcohol dependence were more likely to have used clergy services for alcohol use-related problems than individuals who never met criteria or who only met criteria for alcohol abuse.

This may in part reflect the fact that individuals who meet criteria for alcohol abuse by definition have experienced legal, occupational, and/or social problems due to their alcohol consumption, and may be more likely to enter treatment through the legal system, employee assistance programs, or social services, says lead author Amy Bohnert, Ph.D., M.H.S., assistant professor of psychiatry at the U-M Medical School and research investigator in the Department of Veterans' Affairs National Serious Mental Illness Treatment Resource and Evaluation Center.

What makes ministers, priests and rabbis ideal are they are involved in their communities, know their congregants well, and see them on a regular basis, researchers say.

Clergy are in a unique position to notice changes in behavior over time, says Brian Perron, assistant professor of social work at U-M. Their roles as senior leaders of churches, their embodiment of important tenants of their faiths, and their formal roles as caregivers of their congregations also lend clergy considerable credibility, particularly within African American communities. Clergy are often seen as being deeply committed to their congregants and willing to honor desires for confidentiality.

URI researcher: Teens drink more during summer before college

Wed, 07 Jul 2010 04:00:00 PST

( from http://www.rxpgnews.com ) KINGSTON, R.I. --July 7, 2010--Summertime and the living is easy. But not too easy for parents whose children will head to college in the fall.

University of Rhode Island Psychology Professor Mark Wood, a nationally recognized alcohol researcher, wants parents to be aware that this is a time when teens tend to increase their alcohol consumption.

The URI expert advises parents to monitor their children--know where they are, whom they are with and what they are doing.

This type of monitoring, particularly in combination with an emotionally supportive parenting style, is associated with less drinking and fewer alcohol-related problems across numerous studies, Wood said.

It is also important for parents to express clear disapproval of alcohol use and to provide clear and fair consequences associated with breaking the rules. Research shows this combination of factors decreases alcohol use and problems through adolescence and into college, continued Wood who helps create interventions to reduce alcohol related-harm, particularly among college-age students. Results of his recent study bear this out.

Is Wood advocating that parents become helicopter parents--ones who hover over their children and their problems or experiences, especially when they are in college?

We live in a era when students are texting and talking to parents, sometimes many times a day. Although the term helicopter parent does have a negative connotation, I think conversations about drinking are good whenever and wherever they occur, said the researcher.

But is it too late for parents to begin monitoring teenagers after they have already graduated from high school?

Most American teenagers begin to drink by age 15. By the time they go off to college, most have considerable drinking experience, explained Wood. Ideally, parents should be having conversations about alcohol throughout high school. But it's never too late to begin an ongoing dialogue about drinking with teens.

There is good reason to be concerned. It's estimated that more than 1,800 college students die each year in car accidents and more than 750,000 are involved in alcohol related physical or sexual assaults.

Summer before college, first semester

Adolescents tend to increase their alcohol use the summer before entering college and during their first semester at college. This is also true of children who have been consistently monitored and emotionally supported. However, these children don't increase consumption to the levels of kids who didn't have that kind of parental involvement in high school.

The protective effects that parents exert in high school continue to be influential into college even at a time when the kids have left the home. It's the internalization of those values, attitudes, expectations that seem to continue to exert an effect, said Wood.

Study Intervention

Wood and his team applied some of their research findings to an intervention to reduce the increases in drinking and the negative consequences that typically occur during matriculation and into college. Results of the study were published in the June 2010 issue of the

Legalizing marijuana in California would lower the price of the drug and increase use, study finds

Wed, 07 Jul 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Legalizing the production and distribution of marijuana in California could cut the price of the drug by as much as 80 percent and increase consumption, according to a new study by the nonprofit RAND Corporation that examines many issues raised by proposals to legalize marijuana in the state.

While the state Board of Equalization has estimated taxing legal marijuana could raise more than $1 billion in revenue, the RAND study cautions that any potential revenue could be dramatically higher or lower based on a number of factors, including the level of taxation, the amount of tax evasion and the response by the federal government.

Past research provides solid evidence that marijuana consumption goes up when prices go down, but the magnitude of the consumption increase cannot be predicted because prices will fall to levels below those ever studied, researchers say. Consumption also might rise because of non-price effects such as advertising or a reduction in stigma, researchers say.

In addition to uncertainty about the taxes levied and evaded, researchers do not know how users will respond to such a large drop in price. Even under a scenario with high taxes ($50 per ounce) and a moderate rate of tax evasion (25 percent), researchers cannot rule out consumption increases of 50 percent to 100 percent, and possibly even larger. If prevalence increased by 100 percent, marijuana use in California would be close to the prevalence levels recorded in the late 1970s.

The analysis, prepared by the RAND Drug Policy Research Center, was conducted in an effort to objectively outline the key issues that voters and legislators should consider as California weighs marijuana legalization.

There is considerable uncertainty about the impact that legalizing marijuana in California will have on consumption and public budgets, said Beau Kilmer, the study's lead author and a policy researcher at RAND. No government has legalized the production and distribution of marijuana for general use, so there is little evidence on which to base any predictions about how this might work in California,

The analysis also suggests that the annual cost of enforcing current marijuana laws is smaller than suggested by others. The RAND study estimates that the cost of enforcing the current laws probably totals less than $300 million.

It is critical that legislators and the public understand what is known and unknown as the state weighs this unprecedented step, said Rosalie Liccardo Pacula, a study co-author and co-director with Kilmer of the RAND Drug Policy Research Center.

Two proposals are pending that would legalize the production and sale of marijuana in California. Assembly Bill 2254 authored by Assemblyman Tom Ammiano (D-San Francisco) would legalize marijuana for those aged 21 and older and task the state Department of Alcoholic Beverage Control with regulating its possession, sale and cultivation. The bill would create a $50 per ounce excise tax and these funds would be used to fund drug education, awareness, and rehabilitation programs under the jurisdiction of the State Department of Alcohol and Drug Programs.

In November, California voters will consider a ballot measure titled the Regulate, Control and Tax Cannabis Act of 2010 that would make it legal for those aged 21 and older to cultivate marijuana on a 5-foot-by-5-foot plot, and possess, process, share or transport up to one ounce of marijuana. In addition, the initiative would authorize cities or counties to allow, regulate and tax the commercial cultivation and sales of marijuana. Such activities would remain illegal in jurisdictions that do not opt in.

In only two countries have there been changes in the criminal status of supplying marijuana. The Netherlands allows for sale of small amounts of marijuana (5 grams) in licensed coffee shops and in Australia four jurisdictions have reduced the penalties for cultivation of a small number of marijuana plants to confiscation and a fine. Neither has legalized larger-scale commercial cultivation of the sort California is considering.

In 1975, California was one of the first states to reduce the maximum penalty for possessing less than an ounce of marijuana from incarceration to a misdemeanor with a $100 fine. In 1996, California became the first state to allow marijuana to be grown and consumed for medical purposes.

RAND researchers say one effect of legalizing marijuana would be to dramatically drop the price as growers move from clandestine operations to legal production. Based on an analysis of known production costs and surveys of the current price of marijuana, researchers suggest the untaxed retail price of high-quality marijuana could drop to as low as $38 per ounce compared to about $375 per ounce today.

RAND researchers caution there are many factors that make it difficult to accurately estimate revenue that might be generated by any tax on legal marijuana. The higher the tax, the greater the incentives would be for a gray market in marijuana to develop, researchers say.

A fixed excise tax per ounce may give producers and users an incentive to shift to smaller quantities of higher-potency forms of marijuana, said study co-author Jonathan P. Caulkins, the H. Guyford Stever Professor of Operations Research at Carnegie Mellon University's Heinz College and Qatar campus. Such a shift is another factor that could lower revenues collected from marijuana taxes.

In addition, since the November ballot initiative leaves it to local governments to set tax rates, the size of any levy could vary broadly. A jurisdiction with a low tax rate might attract marijuana buyers from elsewhere in the state or even other states, further complicating efforts to predict government revenues from the sale of legal marijuana, according to researchers.

The RAND report also investigates some of the costs to the state and society in general, such as drug treatment and other health expenses, that may change if marijuana is legalized in California.

It's unclear whether legalizing marijuana may increase or decrease drug treatment costs, according to the study. More than half of the 32,000 admissions for treatment of marijuana abuse in California during in 2009 resulted from criminal justice referrals, which could drop if legalization is approved. However, an increase in marijuana use could cause a spike in those who voluntarily seek treatment for marijuana abuse, researchers say.

Ignoring stress leads recovering addicts to more cravings

Wed, 23 Jun 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Recovering addicts who avoid coping with stress succumb easily to substance use cravings, making them more likely to relapse during recovery, according to behavioral researchers.

Cravings are a strong predictor of relapse, said H. Harrington Cleveland, associate professor of human development, Penn State. The goal of this study is to predict the variation in substance craving in a person on a within-day basis. Because recovery must be maintained 'one day at a time,' researchers have to understand it on the same daily level.

Cleveland and his colleague Kitty S. Harris, director, Center for the Study of Addiction and Recovery, Texas Tech University, used data from a daily diary study of college students who are recovering addicts to identify the processes that trigger cravings and prevent some addicts from building a sustained recovery.

The researchers found that how addicts cope with stress -- either by working through a problem or avoiding it -- is a strong predictor of whether they will experience cravings when faced with stress and negative mood.

Whether you avoid problems or analyze problems not only makes a big difference in your life but also has a powerful impact on someone who has worked hard to stay away from alcohol and other drugs, explained Cleveland. When faced with stress, addicts who have more adaptive coping skills appear to have a better chance of staying in recovery. The findings appeared in a recent issue of Addictive Behaviors.

Researchers supplied Palm Pilots to 55 college students who were in recovery from substance abuse ranging from alcohol to cocaine and club drugs. The students were asked to record the their daily cravings for alcohol and other drugs, as well as the intensity of negative social experiences -- hostility, insensitivity, interference, and ridicule -- and their general strategies for coping with stress.

We looked at variations in the number of cravings across days and found that these variations are predicted by stressful experiences, said Cleveland. More importantly, we found that the strength of the daily link between experiencing stress and the level of cravings experienced is related to the participants' reliance on avoidance coping.

Statistical analyses of the survey data suggests that the magnitude of the link between having a stressful day and experiencing substance use cravings doubles for recovering addicts who cope with stress by avoiding it.

We found that addicts who deal with stress by avoiding it have twice the number of cravings in a stressful day compared to persons who use problem solving strategies to understand and deal with the stress, explained Cleveland. Avoidance coping appears to undercut a person's ability to deal with stress and exposes that person to variations in craving that could impact recovery from addiction.

According to Cleveland, the findings suggest the impulse to avoid stress is never going to help recovering addicts because stressful experiences cannot be avoided.

If your basic life strategy is to avoid stress, then your problems will probably end up multiplying and causing you more problems, he added.

Violence, not overdose, the likely method of suicide in veterans with substance use disorders

Mon, 21 Jun 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Veterans with substance use disorders who die by suicide are more likely to use violent means (such as a firearm) rather than nonviolent means (such as a drug overdose), new research suggests.

In a study of more than 5,000 Veterans Affairs (VA) patients with substance use disorders, researchers found that, despite having access to potentially lethal substances, 70% of those who died by suicide used violent means. The study was reported in the July issue of the Journal of Studies on Alcohol and Drugs.

This research is the largest known study of risk factors for suicide in individuals with alcohol or drug problems and one of the first to examine risk factors for suicide based on method of attempt. To perform the study, the researchers looked at two distinct groups. They identified 854 VA patients who died by suicide and had substance use disorders, as well as a control group of 4,228 VA patients with substance use disorders who did not die by suicide.

The researchers found that the people who committed suicide by overdose had more -- and more severe -- mental disorders such as depression or posttraumatic stress disorder than people who used violent means.

What's troubling about these findings is that some of the predictors that we typically think of as good indicators of suicide risk were not as closely related to violent suicide as nonviolent suicide, although violent suicide was the most common type of suicide, said lead researcher Dr. Mark Ilgen, a psychologist at the Ann Arbor VA Health Care System and an assistant professor in the psychiatry department at the University of Michigan in Ann Arbor. It's potentially scary if there's a group of patients that is somewhat large in number that we might be missing by paying attention only to psychiatric problems.

The researchers say the findings highlight the importance of suicide prevention in people with substance use disorders. Previous research has found that people with substance use disorders are about 10 to 14 times more likely to die by suicide than people without these problems.

Ilgen said that substance use disorders and suicide are probably linked in several ways: First, people who develop a drug or alcohol addiction may already be at higher risk for suicide. Second, having a substance use disorder can cause problems at work and in relationships, which may increase suicide risk. Third, being under the influence of alcohol or drug can make someone more likely to engage in impulsive behaviors -- such as a suicide attempt.

Care providers should be aware of the high risk of suicide in this group and do an initial screening for current suicidal thoughts and plans, said Ilgen. It's easy to wait to think about suicide prevention until someone is depressed, but it's really a conversation worth having with someone who has a substance use disorder, since they're already at risk.

Anxiety/panic disorder most frequent disabling comorbid disorder in TS patients, study finds

Thu, 17 Jun 2010 04:00:00 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- An assessment of patients with adult Tourette syndrome (TS) to identify clinical factors that contribute to psychosocial and occupational disabilities resulting from the vocal or motor tics that define TS found that anxiety/panic disorder may be the most disabling psychiatric condition associated with the disorder. The results of the study, based on the Global Assessment of Functioning (GAF) scale, will be used to identify patients who are more likely to have or develop significant disabilities related either to the severity of their tics, or to the psychiatric disorders associated with TS, such as obsessive-compulsive disorder, mood disorders and drug or alcohol abuse.

Results were presented today (June 17) at the 14th International Congress on Parkinson's Disease and Movement Disorders, being held in Buenos Aires, Argentina, June 14-17.

David G. Lichter, MD, professor of clinical neurology in the University at Buffalo's School of Medicine and Biomedical Sciences, is first author.

Our study identified the most significant predictors of disability, says Lichter. Now having identified these at-risk patients, we can follow them more closely and begin appropriate interventions as early as possible.

Lichter also noted that the finding of anxiety/panic disorder as the most-disabling psychiatric disorder associated with TS was unexpected.

The main surprise was that depression was not a major predictor of psychosocial or occupational disability in these patients, says Lichter. Depression has been identified as an important predictor of quality of life in TS.

Tics, both motor and vocal, are the primary symptoms of Tourette syndrome. Vocal tics are involuntary sounds, such as whistles, hums, or throat clearing. Complex vocal tics can be repeating words or phrases or involuntary swearing. Motor tics are muscle spasms, such as involuntary eye blinks, shoulder shrugs, repetitive kicking, head jerks, eye darts and nose twitches.

In most patients, tics wane after mid-to-late adolescence. However, the study data indicates that in those patients whose tics persist into adulthood, tic severity remains the primary factor contributing to global psychosocial and occupational disability, according to Lichter.

In many TS adults, motor tics remain more enduring and prominent than vocal tics and, in our study, motor tics were more severe overall than vocal tics and were more closely correlated with GAF scale score, says Lichter.

The study involved 66 patients -- 45 male and 21 female -- who had been followed for an average of 8.2 years at a UB-based TS clinic. They ranged in age from 20 to 80.

Results showed that nearly 32 percent were diagnosed with obsessive-compulsive disorder (OCD), while 62 percent showed OCD behavior. Nearly 29 percent had anxiety/panic disorder with another 21 percent exhibiting anxiety symptoms.

Prevalence of other TS-associated conditions were depression (16.7 percent), depressed mood (12.1 percent), bipolar disorder (12.1 percent), rage attacks and severe self-injury behavior (4.5 percent), childhood ADHD history (33.3 percent), adult ADD (18.2 percent), substance-use disorder (22.7 percent) and psychosis and restless legs syndrome (1.5 percent).

In the future Lichter and colleagues plan to collect prospective data on both quality of life and psychosocial and occupational functioning in TS patients.

We will look more closely at the interactions of tic severity, mood disorders, substance abuse and social support systems and determine how these issues relate to personal and social/occupational adjustment, Lichter says.

We hope this information will help us improve the lives of our TS patients, especially those who are at highest risk for a poor outcome.

NIDA announces 2010 Addiction Science Award winners at Intel ISEF

Fri, 14 May 2010 04:00:00 PST

( from http://www.rxpgnews.com ) A project using cutting edge computer modeling to identify potential new medications for nicotine addiction won first place distinction at the annual Addiction Science Awards at this year's Intel International Science and Engineering Fair (ISEF) --- the world's largest science competition for high school students. The Intel ISEF Addiction Science Awards were presented at an awards ceremony last night in San Jose, Calif., by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and Friends of NIDA, a coalition that supports NIDA's mission.

First place distinction for the special Addiction Science Awards went to Ameya Ashish Deshmukh, a 16-year-old junior at Upper Arlington High School in Upper Arlington, Ohio. His winning project was titled Rational Drug Design Methods for the Identification of a Novel Negative Allosteric Modulator of a4b2 Nicotinic Receptors. Because identifying a molecule that will effectively bind to nicotine receptors can be like finding a needle in a haystack, Mr. Deshmukh used what is known as rational drug design. He first selected candidate molecules based on previous research. He then used computerized molecular models to narrow the list of potential compounds. Finally, he tested these on human cells to identify which compounds show promise for treating nicotine addiction.

Our first place winner realized the potential of rational drug design to address the need for more effective medications for treating nicotine addiction, said NIDA Director Dr. Nora Volkow. The result of this project, if developed further, has the potential to dramatically improve our smoking cessation strategies.

Second place distinction in the Addiction Science Awards went to Improving ADHD Treatment: A Comparison of Stimulant Medication Treatment for Children with ADHD, Computerized Cognitive Training of Attention and Working Memory, and the Combination of the Two. Seventeen-year-old Kevin Michael Knight, a junior at Collegiate High School at Northwest Florida State College in Niceville, Fla. submitted the entry. As a student diagnosed with ADHD who had difficulties with the side effects of stimulant medication, Knight wanted to identify other ways to treat the attention and memory problems ADHD causes. He asked whether it is possible to use specialized computer programs to re-train the brains of students with ADHD, either as an alternative or as a complement to the stimulant medications typically prescribed to treat ADHD. The results of his pilot study suggest that some cognitive games could be useful as an adjunct to currently available ADHD medication.

Third place went to Joseph Hunter Yagoda, a 17-year-old student at the William A. Shine Great Neck High School in Great Neck, N.Y. for his analysis of the thought process that goes into a teenager's decision to cut classes at school. For Risky Business: What Cognitive Factors Influence Risk Taking in the Academic Setting? the risk of class cutting was modeled by an innovative simulation mimicking a prototypical classroom. Following the risk scenario, he measured his subjects' perceptions of the risks of skipping class. His project concluded that schools should increase the benefits of attending class, have clear enforcement of consequences, and minimize the perception that everyone cuts class.

Our second and third place winners showed enormous enthusiasm for using a sound scientific process to solve problems that they or their friends contend with, said Dr. Cindy Miner, NIDA's chief ISEF judge and deputy director of NIDA's Office of Science Policy and Communications. These are important issues since we know that succeeding in school is crucial for future achievement, and is also a preventive factor for drug abuse and related health problems. We were thrilled that these brilliant young people already understand how science is key to solving these kinds of challenging social and health issues.

This year, more than 1,500 students from more than 50 countries participated in the ISEF competition, coordinated by the Society for Science and the Public, at the San Jose Convention Center. The nonprofit organization Society for Science and the Public partners with Intel - along with dozens of other corporate, academic, government and science-focused sponsors to provide support and awards for the Intel ISEF each year.

Winners of the Addiction Science Award received cash awards provided by Friends of NIDA in a ceremony Thursday night, with a $2,500 scholarship for the first-place honoree. NIDA has developed a special section on its website, which includes other resources on addiction science, to help science fair entrants understand the criteria for the awards:

Keeping kids away from R-rated movies may prevent early drinking

Mon, 26 Apr 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Middle-school children whose parents restrict access to R-rated movies are substantially less likely to start drinking than their peers who are allowed to see such films, a new study suggests.

In a study of nearly 3,600 New England middle school students, researchers found that among kids who said their parents never allowed them to watch R movies, few took up drinking over the next couple years.

Of that group, 3 percent said they had started drinking when questioned 13 to 26 months after the initial survey. That compared with 19 percent of their peers who'd said their parents sometimes let them see R-rated films, and one-quarter of students who'd said their parents allowed such movies all the time.

The researchers say the findings, reported in the May issue of the Journal of Studies on Alcohol and Drugs, underscore the importance of parents paying close attention to their children's media exposure.

We think this is a very important aspect of parenting, and one that is often overlooked, said Dr. James D. Sargent, a professor of pediatrics at Dartmouth Medical School in Hanover, New Hampshire.

The current findings build on evidence linking children's exposure to R-rated movies and onscreen adult content in general not only to early drinking but also to early smoking and kids' likelihood of having sex or behaving violently.

The research to date suggests that keeping kids from R-rated movies can help keep them from drinking, smoking and doing a lot of other things that parents don't want them to do, Sargent said.

He pointed out that it could be argued that parents who restrict access to R movies are simply more careful in general -- keeping tabs on their children's friends or making sure their kids have no access to alcohol at home, for instance. However, Sargent and his colleagues accounted for this in the current study by asking students questions that gauge authoritative parenting -- which gauges the adolescent's perception of parental responsiveness (ability to respond to the adolescent's point of view) and demandingness (ability to set and enforce limits).

The researchers found that, even with such factors considered, exposure to R-rated movies was still linked to the likelihood of early drinking.

Ninety percent of R-rated films have depictions of drinking, and that may be one reason that middle-schoolers who see the films are more vulnerable to early drinking. But Sargent said that the R-rated movie effect goes beyond that. Other research suggests that children who see R-rated movies become more prone to sensation seeking and risk taking. We think seeing the adult content actually changes their personality, Sargent said.

The bottom line, according to the researcher, is that parents should restrict their kids from seeing R-rated films. But he also pointed out that PG-13 movies, as well as many TV shows, often portray drinking and other adult situations -- and that supports limiting children's media time in general.

The American Academy of Pediatrics currently recommends that children watch no more than one to two hours of quality media, including movies, TV and videos, each day.

Proteins may point to alcohol use test

Tue, 23 Mar 2010 04:00:00 PST

( from http://www.rxpgnews.com ) Measuring a set of protein changes in the blood linked to alcohol use may potentially lead to a more accurate diagnostic test than those currently available, according to Penn State College of Medicine researchers.

The challenge in alcohol abuse as opposed to substance abuse -- things like cocaine or heroin or PCP -- is that alcohol is a perfectly legal substance for those over 21, said Willard M. Freeman, Ph.D., department of pharmacology and lead investigator. Unlike routine testing for illicit drugs, you can't just look for a trace of alcohol because many people enjoy a drink in a responsible manner and alcohol is very quickly metabolized. Discriminating between excessive and responsible levels of drinking makes this a greater challenge.

Penn State Hershey researchers, working for two-and-a-half years in cooperation with Kathleen A. Grant, Ph.D., at the Oregon National Primate Research Center, identified a set of 17 proteins in the blood that accurately predicted alcohol usage 90 percent of the time in non-human primates. Researchers were able to separate usage into three categories -- no alcohol use, drinking up to two drinks per day and drinking at least six drinks per day.

Protein levels rose and declined depending on alcohol consumption.

We observed that the levels of some proteins increased or decreased with as little as one or two drinks a day, Freeman said. These same changes occurred with heavier levels of drinking. We also found other proteins that responded only to heavy levels of drinking. Combined, these proteins allow us to classify subjects into non-drinking, alcohol-using, and alcohol-abusing groups.

The researchers are continuing their work, first by determining whether the changes measured return to normal levels with cessation of drinking. Second, they are looking for additional proteins to both increase accuracy and provide alternates if some of the initial 17 do not work in humans.

Working with groups around the world, Penn State Hershey researchers -- led by Freeman and Kent Vrana, chair, department of pharmacology -- plan to collect blood from people undergoing inpatient treatment for alcohol abuse.

We'll collect blood throughout their stay to see if the patients' protein pattern reverts from an excessive drinking pattern to a pattern that's indicative of alcohol abstinence, Freeman said.

The goal is to create a diagnostic test for alcohol consumption that may be used in areas of public safety like aviation or national security, for parole conditions and for helping physicians determine if a patient may have an alcohol abuse problem. Currently there are tests that try to address this issue, but Freeman said these tests are not sensitive and specific enough to serve as diagnostics.

Many of these tests rely on just one protein, he said. The limitation to this approach is that these tests often look at proteins produced by the liver. While these proteins increase with excessive alcohol intake, they also increase with any type of injury to the liver. For example, a lot of prescription drugs are hard on the liver. These tests let us know that the liver is being stressed but can't discriminate between excessive drinking and other conditions, which therefore reduces the utility of these tests.

That's where we see the promise in this panel of proteins. The proteins are produced by a number of organs including the liver, the muscle, and the brain. This unique fingerprint that is indicative of alcohol abuse is less likely to be produced by unrelated conditions.

Freeman stresses, a diagnostic test would not be testing for alcoholism, but rather, alcohol intake.

In a strictest use of the words, alcoholism is a psychological diagnosis as opposed to a level of drinking, he said. The Diagnostic and Statistical Manual really classifies alcohol abuse and alcoholism based on how alcohol is interfering with your life. Obviously we can't use a blood test to say yes, your drinking is interfering with your home life. But the amount of drinking and the amount of problems it causes in your life are tightly correlated.

We envision, a number of years down the line if this becomes a diagnostic test, that if the test indicates that you're drinking a lot, it would prompt a referral to a specialist in alcohol abuse and alcoholism. This test could provide an objective indicator to help people begin addressing what may really be a problem in their lives.

Are bees also addicted to caffeine and nicotine?

Wed, 10 Feb 2010 05:00:00 PST

( from http://www.rxpgnews.com ) *A study carried out at the University of Haifa has found that bees prefer nectar with a small concentration of caffeine and nicotine over nectar that does not comprise these substances at all. This could be an evolutionary trait intended to make the bee addicted, the researchers say.*

Bees prefer nectar with small amounts of nicotine and caffeine over nectar that does not comprise these substances at all, a study from the University of Haifa reveals. This could be an evolutionary development intended, as in humans, to make the bee addicted, states Prof. Ido Izhaki, one of the researchers who conducted the study.

Flower nectar is primarily comprised of sugars, which provide energy for the potential pollinators. But the floral nectar of some plant species also includes small quantities of substances known to be toxic, such as caffeine and nicotine. The present study, carried out by researchers at the Department of Environmental and Evolutionary Biology and the Department of Science Education at the University of Haifa-Oranim, headed by Prof. Ido Izhaki along with Prof. Gidi Ne'eman, Prof. Moshe Inbar and Dr. Natarajan Singaravelan, examined whether these substances are intended to entice the bees or whether they are byproducts that are not necessarily linked to any such objective.

Nicotine is found naturally in floral nectar at a concentration of up to 2.5 milligrams per liter, primarily in various types of tobacco tree (Nicotiana glauca). Caffeine is found at concentration levels of 11-17.5 milligrams per liter, mostly in citrus flowers. In the nectar of grapefruit flowers, however, caffeine is present in much higher concentrations, reaching 94.2 milligrams per liter. In order to examine whether bees prefer the nectar containing caffeine and nicotine, the researchers offered artificial nectar that comprised various natural sugar levels and various levels of caffeine and nicotine, alongside clean nectar that comprised sugar alone. The caffeine and nicotine concentrations ranged from the natural levels in floral nectar up to much higher concentrations than found in nature.

The results showed that bees clearly prefer nectar containing nicotine and caffeine over the clean nectar. The preferred nicotine concentration was 1 milligram per liter, similar to that found in nature. Given a choice of higher levels of nicotine versus clean nectar, the bees preferred the latter.

According to the researchers, it is difficult to determine for sure whether the addictive substances in the nectar became present in an evolutionary process in order to make pollination more efficient. It can be assumed, however, based on the results of the study, that the plants that survived natural selection are those that developed correct levels of these addictive substances, enabling them to attract and not repel bees, thereby giving them a significant advantage over other plants. The researchers emphasized that this study has proved a preference, not addiction, and they are currently examining whether the bees do indeed become addicted to nicotine and caffeine.

Undergrad researchers lay groundwork for drug addiction remedy

Tue, 08 Dec 2009 05:00:00 PST

( from http://www.rxpgnews.com ) DURHAM, N.C. -- Sarah Steele and Langtian Ren Yuan were both self-admittedly inexperienced Duke freshmen in the spring of 2006. But then they followed helpful directions of an assistant chemistry professor, added their own patience and ingenuity, and ended up identifying compounds that might allay the powerful cravings of methamphetamine and cocaine addiction.

The two women, now seniors, have since moved on to other things. But their earlier accomplishment was recently celebrated by a research paper in a British journal. It also helped bring the professor, Jiyong Hong, a $390,000 stimulus grant from the National Institutes of Health and the American Recovery and Investment Act to do follow-up research.

I think this is a kind of showcase for something that Duke is very strong in -- undergraduate research, Hong said. And, socioeconomically, it deals with drugs of abuse that are huge problems.

Hong, whose research group investigates the synthesis of natural products for drug design as well as small molecules' roles in biological processes, got interested in finding small molecules that could inhibit the good feelings induced by meth and coke after reading a 2006 paper in the journal Science.

That study implicated a derivative of an enzyme called protein kinase C zeta (abbreviated PKCzeta) in brain chemistry changes involved in memory and learning.

When people take methamphetamines and cocaine, that gets engraved in their memories, Hong said. So the hypothesis was that by inhibiting a specific enzyme, in this case PKCzeta, we might be able to delete those memories.

The problem was that researchers had never identified a PKCzeta inhibitor, he added. PKCzeta is one of the least studied members of the PKC family. In other words, his quest would be like searching for needles in a haystack.

Enter the two undergraduates. Steele, an intended biology major, showed up in Hong's lab to do an independent study tied to a freshman chemistry research seminar class. I hadn't taken organic chemistry, but he explained everything to me so I was sure of what I was doing, she said.

Following Hong's elaborate instructions, Steele began the task of canvassing about 1,200 different small molecules looking for candidate PKCzeta blockers. It was repetitive work, but once we learned the concept it was easy to continue, she recalled.

The work involved placing each candidate inhibitor into one of 96 tiny wells on a sample plate, along with PKCzeta and an energy-providing chemical called adenosine triphosphate (ATP), plus a light-emitting enzyme called luciferase.

If a candidate compound was ineffectual, then the ATP in the well would be used by PKCzeta's activity. But if a compound did interfere with the PKCzeta, then the energy of the ATP would instead cause the luciferase to light up. The better the blocking action, the brighter the glow.

Yuan, originally a premed student planning to triple major in biomedical engineering, economics and public policy, had also approached Hong seeking freshman work as a lab assistant, though not as part of a class.

Originally I was asked to try to find an inhibitor for something other than PKCzeta, she said. But when Steele entered a different summer research program after the spring semester, I kind of picked up where Sarah stopped.

I was doing similar things as she, but really trying to pinpoint which specific compounds worked as inhibitors, Yuan recalled. We were almost out of molecules to test by then. But, in the last batch, there were a series that were similar that all lit up really well.

The work required lots of transferring chemicals with the aid of a pipette, and then incubating them at different temperatures and at different concentrations. That was a lot of hours, she said. I was working almost full time during the summer. But I'm glad it paid off.

Other researchers from Duke's Chemistry Department and Medical Center, as well as a separate group from Korea, filled in gaps in the research. Their results were published online on May 8, 2009 in

Depression as deadly as smoking

Tue, 17 Nov 2009 05:00:00 PST

( from http://www.rxpgnews.com ) A study by researchers at the University of Bergen, Norway, and the Institute of Psychiatry (IoP) at King's College London has found that depression is as much of a risk factor for mortality as smoking.

Utilising a unique link between a survey of over 60,000 people and a comprehensive mortality database, the researchers found that over the four years following the survey, the mortality risk was increased to a similar extent in people who were depressed as in people who were smokers.

Dr Robert Stewart, who led the research team at the IoP, explains the possible reasons that may underlie these surprising findings: 'Unlike smoking, we don't know how causal the association with depression is but it does suggest that more attention should be paid to this link because the association persisted after adjusting for many other factors.'

The study also shows that patients with depression face an overall increased risk of mortality, while a combination of depression and anxiety in patients lowers mortality compared with depression alone. Dr Stewart explains: 'One of the main messages from this research is that 'a little anxiety may be good for you'.

'It appears that we're talking about two risk groups here. People with very high levels of anxiety symptoms may be naturally more vulnerable due to stress, for example through the effects stress has on cardiovascular outcomes. On the other hand, people who score very low on anxiety measures, i.e. those who deny any symptoms at all, may be people who also tend not to seek help for physical conditions, or they may be people who tend to take risks. This would explain the higher mortality.'

In terms of the relationship between mortality and anxiety with depression as a risk factor, the research suggests that help-seeking behaviour may explain the pattern of outcomes. People with depression may not seek help or may fail to receive help when they do seek it, whereas the opposite may be true for people with anxiety.

Dr Stewart comments: 'It would certainly not surprise me at all to find that doctors are less likely to investigate physical symptoms in people with depression because they think that depression is the explanation, but may be more likely to investigate if someone is anxious because they think it will reassure them. These are conjectures but they would fit with the data.'

The researchers point out that the results should be considered in conjunction with other evidence suggesting a variety of adverse physical health outcomes and poor health associated with mental disorders such as depression and psychotic disorders.

In light of the findings, Dr Stewart makes suggestions on the focus of future developments in the treatment of depression and anxiety: 'The physical health of people with current or previous mental disorder needs a lot more attention than it gets at the moment.

'This applies to primary care, secondary mental health care and general hospital care in the sense that there should be more active screening for physical disorders and risk factors, such as blood pressure, cholesterol, adverse diet, smoking, lack of exercise, in people with mental disorders. This should be done in addition to more active treatment of disorders when present, and more effective general health promotion.'

Smoking bans reduce the risk of heart attacks associated with secondhand smoke

Thu, 15 Oct 2009 04:00:00 PST

( from http://www.rxpgnews.com ) WASHINGTON -- Smoking bans are effective at reducing the risk of heart attacks and heart disease associated with exposure to secondhand smoke, says a new report from the Institute of Medicine. The report also confirms there is sufficient evidence that breathing secondhand smoke boosts nonsmokers' risk for heart problems, adding that indirect evidence indicating that even relatively brief exposures could lead to a heart attack is compelling.

It's clear that smoking bans work, said Lynn Goldman, professor of environmental health sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, and chair of the committee of experts that wrote the report. Bans reduce the risks of heart attack in nonsmokers as well as smokers. Further research could explain in greater detail how great the effect is for each of these groups and how secondhand smoke produces its toxic effects. However, there is no question that smoking bans have a positive health effect.

About 43 percent of nonsmoking children and 37 percent of nonsmoking adults are exposed to secondhand smoke in the United States, according to public health data. Despite significant reductions in the percentages of Americans breathing environmental tobacco smoke over the past several years, roughly 126 million nonsmokers were still being exposed in 2000.

A 2006 report from the U.S. Surgeon General's office, THE HEALTH CONSEQUENCES OF INVOLUNTARY EXPOSURE TO TOBACCO SMOKE, concluded that exposure to secondhand smoke causes heart disease and indicated that smoke-free policies are the most economical and effective way to reduce exposure. However, the effectiveness of smoking bans in reducing heart problems has continued to be a source of debate.

The IOM committee conducted a comprehensive review of published and unpublished data and testimony on the relationship between secondhand smoke and short-term and long-term heart problems. Eleven key studies that evaluated the effects of smoking bans on heart attack rates informed the committee's conclusions about the positive effects of smoke-free policies. The studies calculated that reductions in the incidence of heart attacks range from 6 percent to 47 percent. Given the variations in how the studies were conducted and what they measured, the committee could not determine more precisely how great the effect is. Only two of the studies distinguished between reductions in heart attacks suffered by smokers versus nonsmokers. However, the repeated finding of decreased heart attack rates overall after bans were implemented conclusively demonstrates that smoke-free policies help protect people from the cardiovascular effects of tobacco smoke, the committee said.

The report also provides a detailed discussion of the evidence from animal research and epidemiological studies showing a cause-and-effect relationship between secondhand smoke exposure and heart problems. The committee was not able to determine the exact magnitude of the increased risk presented by breathing environmental tobacco smoke, but noted that studies consistently indicate it increases the risks by 25 percent to 30 percent. Although there is no direct evidence that a relatively brief exposure to secondhand smoke could precipitate a heart attack, the committee found the indirect evidence compelling. Data on particulate matter in smoke from other pollution sources suggest that a relatively brief exposure to such substances can initiate a heart attack, and particulate matter is a major component of secondhand smoke.

Young age at first drink may affect genes and risk for alcoholism

Fri, 18 Sep 2009 04:00:00 PST

( from http://www.rxpgnews.com ) The age at which a person takes a first drink may influence genes linked to alcoholism, making the youngest drinkers the most susceptible to severe problems.

A team of researchers, led by scientists at Washington University School of Medicine in St. Louis, studied 6,257 adult twins from Australia. They wanted to learn whether twins who start drinking at an early age are more likely to develop a more heritable form of alcohol dependence than those who begin drinking later in life. The researchers found that the younger an individual was at first drink, the greater the risk for alcohol dependence and the more prominent the role played by genetic factors.

There seemed to be a greater genetic influence in those who took their first full drink at a younger age, says first author Arpana Agrawal, Ph.D. That's very consistent with what has been predicted in the literature and in the classification of types of alcohol dependence, but we present a unique test of the hypothesis.

Agrawal and her colleagues examined previously collected data from identical and fraternal, male and female twins, using statistical methods to measure the extent to which age at first drink changed the role of heritable influences on symptoms of alcohol dependence. Using the twin model, they were able to tease out genetic influences, shared environmental influences and non-shared environmental factors.

Agrawal's team found that when twins started drinking early, genetic factors contributed greatly to risk for alcohol dependence, at rates as high as 90 percent in the youngest drinkers. For those who started drinking at older ages, genes explained much less, and environmental factors that make twins different from each other, such as unique life events, gained prominence.

The twins in the study were 24 to 36 years old when they were interviewed, but some reported taking their first drink as young as age 5 or 6. The researchers found that those who were 15 or younger when they started drinking tended to have a greater genetic risk for alcohol dependence. Some who were 16 or older before they took their first drink later became alcohol dependent, but their dependence was related more to environmental factors.

We don't have actual gene expression data in this study, but we could hypothesize that exposure to early-onset drinking somehow modifies the developing brain, Agrawal says. Particularly frequent or heavy early drinking may influence gene expression and contribute to more severe outcomes. Our research cannot prove that, but it's something that neuro-imaging and gene expression studies certainly should investigate.

Another possibility is that early drinking exposes adolescents to certain environment influences, such as their peer groups, that somehow enhance genetic influences that contribute to risk for alcohol dependence.

Something about starting to drink at an early age puts young people at risk for later problems associated with drinking, Agrawal says. We continue to investigate the mechanisms, but encouraging youth to delay their drinking debut may help.

Longitudinal study investigates cocaine's impact on adolescent development

Wed, 19 Aug 2009 04:00:00 PST

( from http://www.rxpgnews.com ) Teen years are filled with experimenting. Sometimes that means trying some risky behaviors.

Nearly 400 teens, half of which were prenatally exposed to cocaine, will be studied in their adolescent years. Researchers will look at the youths' choices when it comes to using drugs, having sex or engaging in delinquent behaviors, and see if there is an association with prenatal cocaine exposure. The study will also closely follow the cognitive development and mental health behavior of the young people.

Sonia Minnes, an assistant professor from the Mandel School of Applied Social Sciences at Case Western Reserve University and now the lead researcher in phase four of a long-term study of cocaine exposed children, has received a five-year, nearly $5 million grant from the National Institute on Drug Abuse (NIDA).

This latest funding will help us to continue to tell the story of what happens in the development of prenatally cocaine-exposed children, says Minnes.

With the inception of this new study, Prenatal Cocaine Exposure in Adolescence, Minnes and her co-investigators will follow the children through age 18.

The study began with 415 infant-mother (or caretaker) pairs recruited at the infant's birth. Over the years, the children's development has been followed, as well as the mental health and substance abuse by the mother or caregiver. In three previous phases of NIDA funding, the researchers found that prenatal cocaine exposure negatively affects attention, language development, behavior and the ability to process visual information.

Most people know that mothers should not use drugs during pregnancy, says Minnes. This study over time will tell us what risks are associated with a specific prenatal drug exposure and how environmental influences shape developmental outcomes.

She adds that they have found important environmental factors such as elevated blood lead, maternal mental health and vocabulary level and the type of caregiver placement, are important to consider in evaluating prenatal cocaine exposure's effect on developmental outcome. The study will help us understand what interventions are needed at different developmental stages in their lives.

The study has been underway since 1994, when Lynn Singer, deputy provost and professor of pediatrics in the school of medicine, questioned what happens to prenatally cocaine-exposed children as they grow older. Minnes, who worked as the project coordinator since its beginning, became the study's principal investigator in 2007.

Her recent appointment to the Mandel School of Applied Social Science, where she earned her doctorate in social work, comes at a pivotal point in the study's progress as the focus shifts towards social behavior issues traditionally studied in the realm of social work, says Minnes. She will draw from the expertise of colleagues at MSASS who can provide additional insight regarding the effects of neighborhood and family violence, parental substance use, and placement issues on the development of prenatally cocaine-exposed adolescents.

Findings from the study will provide important information to early intervention specialists and child policy experts who can then develop targeted therapeutic interventions.

New reagents for genomic engineering of mouse models to understand human disease

Wed, 19 Aug 2009 04:00:00 PST

( from http://www.rxpgnews.com ) The ability to specifically target and modify genes in the mouse allows researchers to use this small rodent to study how certain genes contribute to human disease. A common method used to make genetic changes in mice and cells is called site-specific recombination, where two DNA strands are exchanged. The two strands may contain very different sequences, but are designated at their ends by specific target sequences that are not commonly found elsewhere in the genome. A protein, called a recombinase, cuts the DNA at its target sites and rearranges it. Scientists use this technique to exchange a naturally occurring DNA sequence for an altered or deleted gene to gain insight into the gene's normal function or how it contributes to disease.

Currently there are a few systems available to create genetic mutations in mice, including the recombinases FLP and Cre. These proteins are very efficient genetic modifiers and specifically target their appropriate sequences. They can also be turned on or off at precise times, or within specific tissues, to make carefully reegulated genetic changes. However, the small number of available methods that can be used together to mutate genes limits the complexity of the modifications that can be produced. For example, it would be informative to independently regulate the temporal and tissue-specific expression of genes with overlapping functions to understand their individual and combined effects.

Scientists now report that a new recombinase, Dre, induces controlled genetic changes in mice. Dre works similarly to the currently popular recombinase Cre, with an important exception: Dre recognizes a distinct target sequence and only recombines DNA around its target sequence, even if the target sequence for Cre is present. The ability of the related proteins, Cre and Dre to distinguish their own target sequences indicates that Dre can be used in combination with Cre, and other recombinases, to produce more sophisticated mouse models. This should facilitate the analysis of complex gene interactions and how they function in disease.

This technological advance also highlights the progress that might be made through open reagent sharing within the scientific community. The discovery of Dre recombinase was originally reported by Sauer and McDermott at the Stowers Institute for Medical Research. The Institute holds an intellectual patent for the system that allows it to be shared openly for non-commercial purposes and evaluates requests on a case-by-case basis for its use by for-profit institutions. Thus, the authors of the new DMM report do not have any proprietary claims to the system that they used to create this valuable mouse model. This is the first of a series of Resource Articles that will appear in

New study uses wastewater to map large-scale patterns of illicit drug use

Fri, 17 Jul 2009 04:00:00 PST

( from http://www.rxpgnews.com ) A team of researchers has mapped patterns of illicit drug use across the US state of Oregon using a method of sampling municipal wastewater before it is treated.

Their findings provide a one-day snapshot of drug excretion that can be used to better understand patterns of drug use in multiple municipalities over time. Municipal water treatment facilities across Oregon volunteered for the study to help further the development of this methodology as a proactive tool for health officials.

Applying analytical methods advanced at Oregon State University (OSU), researchers from the University of Washington, McGill University and OSU collected single-day samples from 96 municipalities across Oregon and tested the samples for evidence of methamphetamine, cocaine, and ecstasy or MDMA.

This work is the first to demonstrate the use of wastewater samples for spatial analyses, a relatively simple and cost-effective approach to measuring community drug use, said Caleb Banta-Green, lead author of the paper and epidemiologist at the University of Washington Alcohol and Drug Abuse Institute. Current measures of the true prevalence of drug use are severely limited both by cost and methodological issues. We believe these data have great utility as a population measure of drug use and provide further evidence of the validity of this methodology.

Municipalities across the state generously volunteered to help us test our methods by collecting samples more or less simultaneously, providing us with 24-hour composite influent samples from one day - March 4, 2008, said OSU's Jennifer Field, who led the laboratory analyses of the samples.

Using these samples from 96 municipalities, the researchers calculated the presence, measured as index loads, of three stimulant drugs: methamphetamine, ecstasy, and benzoylecgonine (BZE, a cocaine metabolite).

They found that the index loads of BZE were significantly higher in urban areas and below the level of detection in some rural areas. Methamphetamine was present in all municipalities, rural and urban. MDMA or ecstasy was at quantifiable levels in less than half of the communities, with a significant trend toward higher index loads in more urban areas.

Researchers said the study validates wastewater drug testing methodology that could serve as a tool for public health officials. Officials could, for example, use the methodology to identify patterns of drug abuse across multiple municipalities over time.

The research team said data used for this study are inadequate as a complete measure of drug excretion for a community or entire state. The team looked at a single day, mid-week sample, for instance. Results might be altered depending on the day or time of year the sample was gathered.

We believe this methodology can dramatically improve measurement of the true level and distribution of a range of illicit drugs, said Banta-Green. By measuring a community's drug index load, public health officials will have information applicable to a much larger proportion of the total population than existing measures can provide.

Currently, Field and Banta-Green are working on a project funded by the National Institutes of Health to determine the best method for collecting data in order to get a reliable annual estimate of drug excretion for a community.

DOD, VA should take stronger steps to combat tobacco use in military, veteran populations

Fri, 26 Jun 2009 04:00:00 PST

( from http://www.rxpgnews.com ) WASHINGTON -- Because tobacco use impairs military readiness, harms the health of soldiers and veterans, and imposes a substantial financial burden on the departments of Defense and Veterans Affairs, these agencies should implement a comprehensive strategy to achieve the Defense Department's stated goal of a tobacco-free military, says a new report from the Institute of Medicine. DOD should gradually phase in a ban on tobacco use in the military, starting at military academies and officer training programs and among new recruits, the report says. DOD should also stop selling tobacco products in Army and Air Force commissaries -- Navy and Marine Corps commissaries already do not sell them -- and should stop selling them at a discount in military exchanges and other stores. In addition, Congress should allow VA to establish tobacco-free medical centers.

The report was requested by DOD and VA, who asked the Institute of Medicine to identify policies and practices that could lower rates of smoking and help soldiers and veterans quit.

Tobacco use reduces soldiers' physical fitness and endurance and is linked to higher rates of absenteeism and lost productivity, the report says. In 2005, 32 percent of active-duty personnel and 22 percent of veterans were smokers; rates among active-duty personnel have recently increased, possibly because of growing tobacco use by deployed troops.

We found that the adverse effects of tobacco use on military readiness, the health of both smokers and nonsmokers, and the financial cost of the medical care of smoking-related illness in military and veteran populations are a sound basis for moving systematically toward a tobacco-free military, said Stuart Bondurant, professor of medicine and dean emeritus of the School of Medicine at the University of North Carolina, Chapel Hill, and chair of the committee that wrote the report. The state of the art in tobacco control is such that with well-managed programs, DOD and VA could eventually be tobacco free with minimal disruption, and with substantial benefit to military personnel and veterans.

DOD and VA should ensure that all personnel have quick and easy access to comprehensive, evidence-based tobacco-cessation services, the report says. All DOD and VA health care providers should be able to provide brief counseling and nicotine-replacement therapy to patients. In addition, the committee recommended that VA and DOD develop toll-free quitlines to provide military personnel and veterans with counseling on quitting tobacco. Quitline counselors should be trained to deal with issues related to these populations, such as post-traumatic stress disorder.

The Defense Department should set a date by which the military will be tobacco-free and require each of the four services to develop and enforce a timeline for achieving this goal, the report says. Recognizing that immediately banning tobacco use in deployed personnel is not realistic, the committee urged an incremental strategy, starting with closing the pipeline of new tobacco users entering the military. Smoking should be banned at military academies, and the current ban on tobacco use during basic training should be extended to include subseqent technical training. That ban could eventually be extended to all new enlistees, who would be informed during recruitment that they would be expected to remain tobacco-free during their entire military careers.

Eventually, all military installations and active-duty personnel should be required to be tobacco-free -- a goal that could realistically be achieved in 20 years or even sooner, if the plan's initial phase for military academies and new recruits starts within a year, the report says.

Only with assistance from DOD and VA will tobacco use be stopped, the report says, and ideally DOD should not sell tobacco products as they inhibit military readiness. As a first step, DOD should prohibit tobacco sales in Army and Air Force commissaries and stop selling tobacco products at a discount in other military stores. Congress should direct DOD to sell any tobacco products in military exchanges at prices equal to those in the civilian sector, and preferably higher.

Congressional action is also necessary to allow VA to implement tobacco-free medical facilities. The VA's efforts to do so have been hampered by the language of the Veterans Health Care Act of 1992, which requires them to maintain smoking areas for veterans and employees. This act should be repealed, the report says.

Brain protein BDNF might get you hooked on drugs, alcohol

Wed, 17 Jun 2009 14:23:59 PST

( from http://www.rxpgnews.com ) A brain protein can practically hook you on to drugs and alcohol by hijacking the normal functioning of its reward circuitry.

Researchers investigating this addiction 'switch' have now implicated a naturally occurring protein, a dose of which allowed them to get rats hooked with no drugs at all.

Chronic drug users, as noted by previous research, can experience an increase in this protein called BDNF - in the brain's reward circuitry.

Researchers noted that a single injection of BDNF made rats behave as though they were dependent on opiates -.

Though rats instinctively prefer certain smells, lighting and texture, these rats left their comfort zone in search of a fix.

'If we can understand how the brain's circuitry changes in association with drug abuse, it could potentially suggest ways to medically counteract the effects of dependency,' said Scott Steffensen, neuroscientist at Brigham Young University -.

He co-authored the study with two of his undergraduate students, one of his graduate students, and a team of researchers at the University of Toronto, said a BYU release.

'This work may reveal a mechanism that underlies drug addiction,' said study co-author Hector Vargas-Perez, a Toronto neurobiologist.

The study was published in Science.

Report on US tobacco control policies and use finds stark contrasts in progress among states

Wed, 10 Jun 2009 04:00:00 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- The United States is becoming a nation of haves and have-nots when it comes to tobacco control, according to a comprehensive publication on cigarette smoking prevalence and policies in the U.S. that was released today.

The new report, Cigarette Smoking Prevalence and Policies in the 50 States: An Era of Change -- the Robert Wood Johnson Foundation ImpacTeen Tobacco Chart Book, was presented today at the National Conference on Tobacco or Health meeting in Phoenix.

It was prepared for the Robert Wood Johnson Foundation by researchers in the University at Buffalo Department of Health Behavior in UB's School of Public Health and Health Professions and at the Roswell Park Cancer Institute. Researchers from eight other institutions also contributed, including the University of Illinois at Chicago, the National Cancer Institute and the Robert Wood Johnson Foundation.

The report includes individualized data on smoking behaviors for all 50 states as well as a discussion of national trends revealed by the data.

States can reduce death and disease by reducing smoking prevalence, said Gary G. Giovino, Ph.D., professor and chair of the Department of Health Behavior in the UB School of Public Health and Health Professions and principal investigator on the report. It's that simple.

States should feel morally obligated to use a higher proportion of the revenues they receive from cigarette excise taxes and settlement payments to prevent smoking initiation, protect nonsmokers and help people who smoke to quit. Strong tobacco control programs save lives, he added.

The report points out that even after four decades of tobacco control efforts, one-fifth of American adults still smoke and prevalence is especially high among populations with lower levels of education and income, Native Americans and those with psychiatric and substance abuse problems.

While much progress has been made in reducing cigarette smoking in the United States, there still is much work to do, said Giovino, who has long studied the epidemiology of tobacco use among youth and adults and how it is affected by public health policies; he was previously chief of the Epidemiology Branch in the Office on Smoking and Health of the U.S. Centers for Disease Control and Prevention.

According to the report, serious disparities remain in the use of tobacco and access to effective policies and treatments that curtail it.

There is wide variation in cigarette smoking prevalence across states and a clear relationship between smoking prevalence and the rate of mortality that can be attributed to smoking, Giovino said.

For example, among 18-29 year olds, smoking prevalence was 2.5 times higher in Kentucky (36.2 percent) than in California (14.4 percent). And in 2006-07, 66 percent of adults aged 30 or older in New Hampshire who had ever smoked said they had quit, while in West Virginia for the same age group, only 45 percent of smokers said they had quit.

The report also presents state-level analyses showing that in states with the lowest prevalence of smoking, the remaining smokers are less likely to show indicators of dependence and more likely to want to quit, compared to smokers in high prevalence states.

The same programs and policies that lower prevalence also reduce the number of cigarettes smoked each day and motivate quitting, Giovino stated.

He said that while a combination of outreach programs, legislation, cigarette price increases and coverage for and access to stop-smoking treatments has been proven to work, the report nevertheless reveals that most states are not fully implementing these approaches to reduce smoking rates and protect nonsmokers.

According to the report, in 2006, approximately 27 percent of adult Medicaid recipients were smokers, significantly higher than the 17 percent rate among adults with private insurance. But in 2006, Medicaid programs in a dozen states still did not provide coverage for proven tobacco treatment to their clients who smoked.

The report also reveals that increases in excise taxes on cigarettes have consistently been proven to be effective in both preventing smoking and causing people to quit, but these taxes range from a high of $3.46 in Rhode Island to a low of just 7 cents in South Carolina.

Even considering the recent 61-cent federal excise tax increase, state and federal excise taxes still accounted for a smaller percentage of the retail price of a pack of cigarettes in 2009 (40 percent) than they did in 1970 (49 percent).

The percentage of resources available to states from cigarette excise taxes and settlement payments that is dedicated to tobacco prevention and cessation is dwindling, said Giovino. This is a tragic development.

According to the report, the increase in state programs and policies designed to reduce both smoking prevalence and exposure to tobacco smoke pollution has resulted in numerous positive outcomes from 1992-93 to 2006-07, including:

'Happy hour' gene discovery suggests cancer drugs might treat alcoholism

Thu, 21 May 2009 04:00:00 PST

( from http://www.rxpgnews.com ) A class of drugs already approved as cancer treatments might also help to beat alcohol addiction. That's the conclusion of a discovery in flies of a gene, dubbed happyhour, that has an important and previously unknown role in controlling the insects' response to alcohol.

Animals with a mutant version of the gene grow increasingly resistant to alcohol's sedative effects, the research shows. The researchers report further evidence that the gene normally does its work by blocking the so-called Epidermal Growth Factor (EGF) pathway. That EGF pathway is best known for its role in cancer, and drugs designed to inhibit the EGF receptor, including erlotinib (trade name Tarceva) and gefitinib (trade name Iressa), are FDA-approved for the treatment of non-small cell lung cancer.

Now, the researchers show that flies and mice treated with erlotinib also grow more sensitive to alcohol. What's more, rats given the cancer-fighting drug spontaneously consumed less alcohol when it was freely available to them. Their taste for another rewarding beverage -- sugar water -- was unaffected.

This is a very powerful example of how simple model organisms -- and the little fruit fly in particular -- can be used to move quickly from an unknown gene to a potential therapy for drug addiction, said Ulrike Heberlein of the University of California, San Francisco, noting that erlotinib and gefitinib, along with other EGFR inhibitors, not only cross the blood-brain barrier in humans, but they are also well-tolerated in general.

Alcohol is one of the most popular and abused drugs in the world, the researchers said. Therefore, a better understanding of the genetic and environmental factors that lead to its addiction would have considerable benefit for those who suffer its consequences and for society at large. Despite the well-known effects of alcohol consumption on behavior and cognition, the underlying basis for those effects on the nervous system are still rather incomplete.

Human studies have pointed to a strong genetic component to alcoholism, but identifying the specific genes responsible has proved difficult. Studies have also indicated that an individual's sensitivity to alcohol intoxication acts as a predictor of future alcoholism, with a link between lower initial response and increased risk of addiction. Therefore, Heberlein's team explained, genes and pathways involved in the acute response to alcohol can yield insight into the genetic factors contributing to the more complex process of addiction.

Earlier studies have shown that fruit flies are a useful tool for unraveling the basis for the effects of alcohol. Several genes previously identified as playing a role in fruit flies' alcohol response hold similar roles in mammals.

In search of more in the new study, the researchers screened mutant flies for those less sensitive to ethanol. That screen led them to happyhour, a gene closely related to mammalian enzymes known as the Ste20-family kinases of the GCK-1 subfamily.

Heberlein said they still don't know exactly how alcohol exerts its influence on the EGFR pathway or how that leads to the telltale changes in behavior that come with alcohol intoxication. Those questions will be the subject of future investigation. Her team is also exploring other new gene candidates that turned up in the fly screens. She says that several of those appear to be tied to the EGFR pathway in different ways.

It's not yet clear how it all fits together, she said. But the fact that we've come, in an unbiased way, to molecules in the same pathway is telling us this is really, really important.

Mind over muscle

Fri, 24 Apr 2009 04:00:00 PST

( from http://www.rxpgnews.com ) One in five women between the ages of 18 and 24 are smokers, and most say they keep lighting up for fear of gaining weight. But researchers at Temple University have found that when it comes to quitting, a little bit of dialogue and support can be more effective than an exercise plan in helping women not only keep off the weight, but also stay smoke-free.

A lot of college--age women report smoking to keep their weight down and for body image reasons, and we think that by providing them with the tools to make them feel better about themselves, it alleviates some of those stressors, said Melissa Napolitano, a clinical psychologist at Temple's Center for Obesity Research and Education.

In a two-phased study, Napolitano and a team of researchers looked at the smoking habits and weight gain of women aged 18-24. The first phase collected data from focus groups who stated that stress, peer pressure and weight management were the main reasons why they smoked. Participants also felt that group-based programs that provide ongoing social support would be instrumental in helping them quit.

Those results laid the groundwork for the project's next phase, dubbed Fit to Quit, a small pilot study of 24 women who were randomly assigned to either a supervised group exercise program or body image group counseling sessions. All women were provided with a nicotine patch as well.

After eight weeks, the body image counseling group showed a rate of smoking cessation that was more than double that of the exercise group (18 percent vs. 8 percent). In addition, the body image group lost more than three times the weight of their exercise counterparts (3.3 pounds vs. less than a pound). These findings were presented this week at the Society for Behavioral Medicine's annual meeting.

Smoking has psychological and psychosocial implications, especially for young women, said Napolitano, an associate professor of kinesiology and public health in the College of Health Professions. We wanted to design a program that would not only address the physical addiction by providing a nicotine patch, but would also address those social and behavioral aspects as well.

Another aspect of the program relied on technology to reach their population of smokers. Text message and email were used to stay in contact with participants, more so than phone calls, because those were the preferred methods of communication among the young women in the study.

A lot of times, we would try to call participants to remind them of different sessions, and they would respond back via text or e-mail, so we took that message and used avenues like text messaging and the Internet not just as a means of getting information out, but for support as well.

Napolitano says that the results derived from this study have laid the groundwork for larger future studies at Temple and nationwide that focus on smoking cessation in college age women. The hope is to see if the results continue to hold true in studies with larger numbers of participants.

Temple's Student Health Services supported the Fit to Quit program, and Napolitano says it has the potential to be permanently offered as part of the menu of health promotion services on campus.

Our hope is to make programs like Fit to Quit sustainable on other college campuses, because we know that if we can give young people the tools they need to make better health decisions, it helps them not only improve their health but it also helps them do better academically.

Adolescent risk-taking has major consequences when it comes to marriage

Wed, 22 Apr 2009 04:00:00 PST

( from http://www.rxpgnews.com ) BUFFALO, N. Y. -- A national study of data collected over 12 years finds that delinquent teens marry earlier than their peers, while substance-abusing teens -- especially girls who abuse marijuana -- marry later than peers, if at all.

The Influence of Risk-Taking Behaviors on the Transition into Marriage: An Examination of the Long-Term Consequences of Adolescent Behavior by University at Buffalo sociologist Sampson Lee Blair, Ph.D., is a rare look at the long-term effects of teen delinquency and drug abuse on adult role attainment.

Delinquency was defined as anti-social behavior, including frequency of running away, arrests, physical fights and behavioral problems in school.

The study analyzed data from a U.S. Department of Education survey collected from a nationally representative sample of 9,813 young adults from 1988 to 2000. The results were presented at the March conference of the Eastern Sociological Society in Baltimore, Md.

The results are significant, says Blair, associate professor of sociology at UB, because in the U.S. marriage is commonly regarded as offering substantial economic, social and health advantages for individuals. The vast majority of high school girls -- much more so than boys -- tend to view marriage as extremely important to them.

But adolescent substance abuse and delinquent behaviors, he says, clearly have far-reaching consequences for the marital status of young adults, particularly girls.

Most previous studies have focused on the relatively short-term effects of adolescent substance use and delinquency, he says, but here we find good evidence that, for both sexes, delinquent behavior is linked to an increase in the likelihood of marriage and a lower age at first marriage. On the other hand, adolescents with relatively high levels of abuse of alcohol and marijuana have a lower likelihood of marriage even by their late 20s.

The likelihood of marriage by that age is substantially lower among female adolescent substance abusers, particularly if the substance abused is marijuana.

He says the results suggest that delinquency and substance abuse may influence adolescents' orientation toward other adult roles as well.

The analyses employed data from 5,331 females and 4,482 males participants in the National Educational Longitudinal Study (NELS), a nationally representative sample of high school students that collected information from respondents over a 12-year period.

NELS, conducted by the U.S. Department of Education, collected data from surveys of students, parents, teachers and school administrators in 1988, 1990, 1992, 1994 and 2000, at which time most of the students in the sample were in their mid- to late-20s, had completed their educational goals and had already entered into marriage.

Adolescent respondents were asked about the frequency of their alcohol use and marijuana use; delinquent and anti-social behavior, including frequency of running away, arrests, physical fights and school problems (cutting classes, skipping school, getting into trouble for violating rules, suspension or probation, transfer for disciplinary reasons).

The study also assessed data relative to family income, parental expectations about college attendance and the importance peers placed on various activities like going to parties, drinking alcohol, having sex and using drugs. Control measures for the race/ethnicity of respondents were used as well.

It is certainly the case that many of these variables had an effect on the timing of the participants' marital experience, Blair says.

Nevertheless, this analysis clearly suggests that even when all of them are considered, adolescent substance abuse and delinquent behaviors have far-reaching consequences for the marital status of young adults, he says.

Additional research is needed to learn how developmental processes of adolescence are affected by delinquent behavior and substance abuse and the relative influences of these sex-based differences on other forms of adult status attainment.

Drawing enhances emotional verbalization among children under the shadow of drug-addicted fathers

Thu, 12 Mar 2009 04:00:00 PST

( from http://www.rxpgnews.com ) Research at the new School of Creative Arts Therapies at the University of Haifa: Drawing enhances emotional verbalization among children who live under the shadow of drug-addicted fathers

*The use of art seems to help with verbalizing trauma. It is usually difficult to express the trauma through speech, yet the body remembers it, said Prof. Rachel Lev-Wiesel, Head of the Graduate School of Creative Arts Therapies who carried out the study.*

Drawing helps children whose fathers are drug addicts to express their feelings, concludes a new study carried out at the School of Creative Arts Therapies at the University of Haifa. It is difficult to verbally describe a trauma, yet the body remembers it, said Head of the school Prof. Rachel Lev-Wiesel, who carried out the study alongside Revital Liraz of the Hosen Center in Beer Sheba.

People who have experienced trauma often find it difficult to describe their feelings and experiences in words. Art therapy enables the client to expose these feelings first through non-verbal symbols, and then narrate them. The Graduate School of Creative Arts Therapies at the University of Haifa is the first Israeli academic track that grants an MA degree in creative arts therapies to its graduates. There are three courses of study in the school: Plastic Art Therapy, Movement Therapy, and Drama Therapy. The importance of therapy through the arts has increased over the past years, and as with every other discipline of therapy, much weight ought to be placed on basing therapist training on research, said Prof. Lev-Wiesel.

Participating in this study were 60 children, aged nine to fourteen, who were arbitrarily divided into two groups. The children in the first group were asked to draw their life in the shadow of a drug-addicted father and then to describe their experiences to a social worker who interviewed them. The second group was asked to describe life with a drug-addicted father without use of drawings. It was observed that already while drawing the first group of children spoke freely about their lives.

An analysis of the narratives provided by the two groups revealed that the descriptions given by those children who had been asked to draw first included more feelings and sensations, were longer, and expressed optimism for the future. The children in the second group, however, were more reluctant to talk. Their narratives were shorter, without feeling, and less coherent. Emotional-verbal ability is crucial for growth and for social skills, so enabling a child to increase ability of expression and sharing by means of drawing pictures is beneficial in contributing to the efficiency and effectiveness of therapy, Prof. Lev-Wiesel concluded.

Therapy through art is a relatively new field, she said, there is still a lack of empirical studies. One of the goals of the new school is to expand the pool of researchers in the field.

UCSF Gallo team reports hormone disorder drug could help drinkers stay sober

Mon, 23 Feb 2009 05:00:00 PST

( from http://www.rxpgnews.com ) A drug prescribed for male and female infertility and menstrual disorders could hold the key to a more effective treatment for alcoholism, according to a study by researchers at the UCSF-affiliated Ernest Gallo Clinic and Research Center.

The study showed that alcoholic rodents, when injected with the drug cabergoline, decreased their alcohol consumption and alcohol-seeking behavior and were less likely to relapse.

Cabergoline, which is marketed under the trade name Dostinex, is approved by the Food and Drug Administration in pill form to treat conditions caused by excess of the hormone prolactin.

The study, led by Dorit Ron, PhD, a principal investigator at the Gallo Center and associate professor of neurology at UCSF, is now on line (February 20, 2009), in the journal Biological Psychiatry. (See end of news release for link to paper.)

Notably, cabergoline did not impact the rats' consumption of sucrose and, in a subgroup of binge-drinking mice, the drug did not appear to significantly affect intake of water or saccharin.

This is encouraging, says Ron, because it demonstrates that cabergoline is specific for alcohol, but does not affect general reward or pleasure. One of the problems with some existing drugs to treat alcoholism is a side effect that decreases pleasure, making compliance an obstacle to sobriety.

The research builds on an earlier, provocative finding by Ron and her colleagues regarding the protein GDNF (glial cell line-derived neurotrophic factor), which they had injected into rats' VTA (ventral tegmental area) brain region, associated with drug-seeking behavior.

In this earlier study, the scientists had trained rats to consume alcohol. Some, like humans, drank in moderation, while others binged. But when GDNF was administered, both heavy and light drinkers lost at least some of their craving for alcohol. This effect became apparent within 10 minutes and lasted at least 24 hours, the scientists discovered. Importantly, administration of GDNF into the brain prevented the rats from relapsing after a period of abstinence.

While the discovery broke new ground, the scientists knew that GDNF could not be used to treat alcoholic humans because its molecule is too large to cross the blood-brain barrier. So, in the present study, Ron and her colleagues looked at cabergoline, a compound that has been shown in cells to increase the expression of GDNF.

After establishing that cabergoline treatment resulted in an increase of the level of GDNF and activation of the GDNF pathway in the rats' VTA, the researchers sought to test its impact on rodents' drinking habits.

Rats underwent a two-month training program in which they learned to press a lever to obtain alcohol. Researchers found that when rats were injected with cabergoline, they were less likely to press the lever. The higher the dose of cabergoline, the lower the number of lever presses reported. The researchers also found that binge-drinking mice consumed less alcohol after cabergoline administration.

In further study, the researchers found that cabergoline was effective in reducing both craving for alcohol and relapse to drinking. Relapse is a critical issue for alcoholic patients trying to stay abstinent.

As further evidence of the interplay between cabergoline and GDNF, alcohol intake was tested on mice that had been genetically engineered to have a single copy of the GDNF gene, and therefore less GDNF in the brain. As expected, the scientists found that the drinking habits of these genetically modified mice were not affected by cabergoline.

Although the results of the study offer fresh hope to problem drinkers, Ron cautions that human clinical trials are needed before cabergoline can be safely prescribed. Higher doses of cabergoline have been used to treat Parkinson's disease and have been linked to heart valve problems.

However, notes Ron, we show that in mice and rats, a low dose of the drug is enough to reduce excessive alcohol consumption, alcohol seeking and relapse. The dose is similar to what is given to humans for the treatment of hyperprolactinemia.

Cabergoline may eventually be prescribed for other addictions. A pilot study conducted on cocaine addicts, cited in Ron's paper, reported a substantial reduction in cocaine use.

In the United States, 17.6 million people -- approximately one in every 12 adults -- abuses alcohol or is alcohol-dependent, according to the National Institutes of Health. But there are just three medications approved to treat alcohol dependence -- disulfiram (Antabuse), naltrexone (Depade, ReVia), and acamprosate (Campral).

Virtual studies answer real questions

Sat, 14 Feb 2009 05:00:00 PST

( from http://www.rxpgnews.com ) Are online games just for male teenagers?

About 80 percent of Ever Quest II players are male, but the hardcore players are women. And, almost all players are adults.

The women play more intensely than the guys do, Williams says. They're less likely to quit, and they're happier playing.

They also buy into the males-only stereotypes of technology use: women under-reported their playing time much more than men. Williams believes that female players may lie about their playing habits out of a sense of shame.

But female players spent an average of 29 hours a week in-world, versus 25 for males.

Can game researchers trust players to self-report their playing time?

No. As the first researcher with the ability to compare survey responses to server data, Williams found a large discrepancy, with most players systematically underestimating by 3-4 hours per week. This potentially calls into question 30 years of game research based on self-reported data.

Why don't we do anything together anymore?

Server data doesn't lie: in the online game EverQuest II, men in committed heterosexual relationships prefer to play alone, while women prefer to play with their partner. Follow-up surveys confirm that what's good for the goose is not good for the gander, Williams says.

Men are happier when playing without their partner. Women are happier when they play with them, says Williams, a sociologist and assistant professor in the USC Annenberg School for Communication. He will report findings at AAAS from his upcoming study of gender differences.

If I'm a head case, will role-playing make it worse?

Not necessarily, says Williams: We found it to be, surprisingly, a pretty healthy thing.

Only a small number of players adopt a character other than their real self, Williams explains. Those that do tend to have more mental health problems than average.

Every psychological indicator is worse for them: drug use, ADD, depression, substance abuse, Williams says.

However, Williams found that online play provided a valuable outlet.

They're very aware of the pitfalls of doing it for the wrong reasons or in the wrong way, and most of them see it as a release. It's people who feel they can't express themselves offline.

Williams was the first game researcher to be granted access to a major online world's database. As a result, he was able to match hard data about in-world behavior with survey responses. Nearly 7,000 players of EverQuest II agreed to participate in exchange for an in-world prize, The Great Staff of the Sun Serpent.

The symposium Analyzing Virtual Worlds: Next Step in the Evolution of Social Science Research, will start at 8:30 a.m. on Feb. 14 in the Columbus GH room of the Hyatt Regency Hotel.

The symposium organizers are Jaideep Srivastava of the University of Minnesota, Noshir Contractor of Northwestern University, and Scott Poole of the University of Illinois at Urbana-Champaign. Each will present on a different aspect of virtual world research.

Smokers putting their loved ones at risk of heart attacks

Wed, 11 Feb 2009 05:00:00 PST

( from http://www.rxpgnews.com ) Researchers at University College London and St George's, University of London measured recent exposure to tobacco smoke in non-smoking middle-aged men taking part in the British Regional Heart Study by measuring the levels of cotinine - a compound carried in the blood - at two time points 20 years apart. A blood cotinine level above 0.7ng/mL is associated with a 40% increase in the risk of a heart attack (2), and other studies have suggested that even a level of 0.2ng/mL may increase the risk (3). The researchers found that while in 1978-80, 73% of men had a cotinine level above 0.7ng/mL, by 1998-2000 that proportion had fallen to 17%.

However, despite the number of non-smoking men at risk having fallen, half of those who still had a high cotinine level (above 0.7 ng/ml) in 1998-2000 lived with a partner who smoked. Non-smoking men who had a partner who smoked had average cotinine levels of 1.39ng/mL, almost twice the level associated with an increased risk of a heart attack. Their cotinine levels were nearly eight times higher than the cotinine levels of men whose partner did not smoke.

During the period the study looked at, national data shows that the prevalence of smoking amongst adults across the UK declined from 40% to 27% and the number of cigarettes consumed by smokers fell from 114 to 97 per week. Restrictions on smoking in public spaces and workplaces were also introduced, although the study period was before the national legislative bans on smoking in public places introduced between 2006 and 2007.

Dr Barbara Jefferis, from University College London who led the research, said: The decline in smoking together with restrictions on smoking in public places has created an environment where people are exposed to far less tobacco smoke. This has resulted in the dramatic fall in the number of non-smokers at an increased risk of a heart attack.

However, we can clearly see that living with someone who smokes puts you at a heightened risk. If we are going to reduce people's exposure to tobacco smoke further then we will need to focus efforts on reducing smoking in the home.

Professor Peter Weissberg, Medical Director at the BHF, said: This research shows that a great deal of progress has been made in reducing exposure to potentially damaging environmental tobacco smoke over the past 20 years. Importantly, it also shows that people are now more at risk of exposure in their own homes than in public places.

We cannot stop people smoking in their own home, but we would urge smokers to think of the risk they're exposing their non smoking friends and relatives to when they have a cigarette in the house.

The BHF are calling for a proper plan to reduce the harm from smoking including measures in the NHS Bill that will put an end to point of sale displays and prohibit cigarette vending machines, which are disproportionately used by underage smokers.

Methamphetamine use cost the US about $23 billion in 2005, RAND study estimates

Wed, 04 Feb 2009 05:00:00 PST

( from http://www.rxpgnews.com ) The economic cost of methamphetamine use in the United States reached $23.4 billion in 2005, including the burden of addiction, premature death, drug treatment and many other aspects of the drug, according to a new RAND Corporation study.

The RAND study is the first effort to construct a comprehensive national assessment of the costs of the methamphetamine problem in the United States.

Our findings show that the economic burden of methamphetamine abuse is substantial, said Nancy Nicosia, the study's lead author and an economist at RAND, a nonprofit research organization.

Although methamphetamine causes some unique harms, the study finds that many of the primary issues that account for the burden of methamphetamine use are similar to those identified in economic assessments of other illicit drugs.

Given the uncertainty in estimating the costs of methamphetamine use, researchers created a range of estimates. The lowest estimate for the cost of methamphetamine use in 2005 was $16.2 billion, while $48.3 billion was the highest estimate. Researchers' best estimate of the overall economic burden of methamphetamine use is $23.4 billion

The study was sponsored by the Meth Project Foundation, a nonprofit group dedicated to reducing first-time methamphetamine use. Additional support was provided by the National Institute on Drug Abuse.

We commissioned this study to provide decision makers with the best possible estimate of the financial burden that methamphetamine use places on the American public, said Tom Siebel, founder and chairman of the Meth Project. This is the first comprehensive economic impact study ever to be conducted with the rigor of a traditional cost of illness study, applied specifically to methamphetamine. It provides a conservative estimate of the total cost of meth, and it reinforces the need to invest in serious prevention programs that work.

The RAND analysis found that nearly two-thirds of the economic costs caused by methamphetamine use resulted from the burden of addiction and an estimated 900 premature deaths among users in 2005. The burden of addiction was measured by quantifying the impact of the lower quality of life experienced by those addicted to the drug.

Crime and criminal justice expenses account for the second-largest category of economic costs, according to researchers. These costs include the burden of arresting and incarcerating drug offenders, as well as the costs of additional non-drug crimes caused by methamphetamine use, such as thefts committed to support a drug habit.

Other costs that significantly contribute to the RAND estimate include lost productivity, the expense of removing children from their parents' homes because of methamphetamine use and spending for drug treatment.

One new category of cost captured in the analysis is the expense associated with the production of methamphetamine. Producing methamphetamine requires toxic chemicals that can result in fire, explosions and other events. The resulting costs include the injuries suffered by emergency personnel and other victims, and efforts to clean up the hazardous waste generated by the production process.

Researchers caution that their estimates are in some cases based on an emerging understanding of methamphetamine's role in these harms and should be further refined as understanding of these issues matures. The RAND report also identifies costs that cannot yet be adequately quantified.

Estimates of the economic costs of illicit drug use can highlight the consequences of illegal drug use on our society and focus attention on the primary drivers of those costs, Nicosia said. But more work is needed to identify areas where interventions to reduce these harms could prove most effective.

Methamphetamine is a highly addictive substance that can be taken orally, injected, snorted or smoked. While national surveys suggest that methamphetamine use is far from common, there is evidence that the harms of methamphetamine may be concentrated in certain regions. One indicator of the problem locally is treatment admissions. Methamphetamine was the primary drug of abuse in 59 percent of the treatment admissions in Hawaii in 2004 and accounted for 38 percent of such admissions in Arizona in 2004.

Genetics may increase propensity for alcoholism

Tue, 03 Feb 2009 23:21:01 PST

( from http://www.rxpgnews.com ) In Poland, alcohol dependence (AD) affects about four percent of the population, causing about 10,000 deaths per year. While a number of biological markers have been linked to a predisposition for developing AD, a new study has found a link between the Val66Met (rs6265) polymorphism in the brain-derived neurotrophic factor (BDNF) gene and risk for post-treatment relapse among AD patients.

Results will be published in the April issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Some people are simply more likely than others to become dependent on alcohol," explained Marcin Wojnar, associate professor of psychiatry at the Medical University of Warsaw and adjunct researcher at the University of Michigan. "Clearly, cultural, social, and psychological factors are involved. AD also runs in families, so there is an inherited component to it. Once AD has developed, certain people are more likely to relapse after treatment than others. Some studies show that a family history of alcoholism can lead to a more severe illness that is harder to treat, which is why our group and others are looking at genetic factors."

"Although some biological predictors of the re-emergence of AD have been described," said Lance Bauer, professor of psychiatry at the University of Connecticut School of Medicine, "biological measures can be affected by many variables, such as the time of day; the patient's gender, age, or medical background; or medications that have been prescribed. Most genetic differences are not complicated by these same variables. Accordingly, this study by Wojnar and colleagues points us toward a new and promising approach."

"We selected genetic polymorphisms that were, one, related to serotonin or dopamine function; and two, associated with suicidality and/or impulsivity," said Wojnar, who is the study's first author. "Serotonin's decreased functioning has consistently been reported to be associated with both impulsivity and suicidal behaviors. Regarding dopamine, most researchers agree that it plays an essential role in addiction, either by causing pleasure from taking drugs or by telling the brain to associate that pleasure with certain cues in the environment."

The researchers examined 154 patients (117 males, 37 females) from addiction-treatment programs in Poland who met Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition criteria for AD. All were assessed for demographics, severity of alcohol use, suicidality, impulsivity, depression, hopelessness, and severity of alcohol use at baseline; 123 patients were followed for approximately one year to evaluate treatment outcomes. In addition, patients were tested for genetic polymorphisms in several genes as predictors of relapse – defined as "any drinking during follow-up" – which were: rs1386483 in the tryptophan hydroxylase type 2 gene, C102T (rs6313) in the serotonin receptor 2A gene, 5-HTT gene-linked polymorphic region in locus SLC6A4, C(-1019)G (rs6295) in the serotonin receptor 1A gene, Val158Met (rs4680) in the catechol-O-methyl transferase gene, and the Val66Met (rs6265) in the BDNF gene.

"Our study indicated that some patients may have inherited a tendency to return to drinking even after intensive treatment," said Wojnar, "and [may be] more treatment-resistant than other patients. Specifically, we found that a particular type or variant of the gene that codes for BDNF was associated with an increased risk for relapse in alcoholic patients, particularly those with a family history of AD." BDNF is a protein found in the brain that helps nerve cells survive and connect to one another.

"These findings provide further support for the assertion that alcoholic patients are not all alike," said Bauer. "Some possess genetic propensities which … may motivate or promote risk for alcoholism as well as risk for treatment failure."

"These patients may have special difficulty in responding well to currently available treatments because of their biological makeup," added Wojnar, "and therefore may need newly constructed intensive programs of therapy that are preferably individualized. This might be a step forward towards 'personalized medicine.'"

Bauer agreed. "During the past 10 years, several new treatments have become available," he said. "However, 'how does one decide among the options?' Genetic differences may eventually help us make the decision. For example, individuals possessing the high-risk-for-relapse variant of the BDNF gene might warrant assignment to the most intensive – and usually most expensive – treatment. Individuals with the low-risk variant might not require this level of treatment to have a good outcome."

Monthly shot for holiday drinkers on wagon

Wed, 17 Dec 2008 05:00:00 PST

( from http://www.rxpgnews.com ) ALCOHOLICS struggling to keep off shots of the hard stuff over the festive season may want to consider an alternative shot: a monthly injection that keeps them off the booze.

For people battling alcoholism, holidays pose a strong danger of relapse. When you interview patients about triggers for drinking, they often say holidays and family events, says David Rosenbloom, a specialist in substance abuse at Boston University School of Public Health. For some it's the stress of being lonely, for others it's the stress of being with people. Over Christmas and New Year, social pressure and opportunities to drink add to the intoxicating mix.

Some people take pills containing naltrexone, a substance that reduces the desire to drink by blocking the receptors in the brain responsible for the high that drinking brings. But during the holiday season, pressures often drive alcoholics to stop taking the tablets. With a pill, they have to make a decision every day, says Sandra Lapham at the Behavioral Health Research Center of the Southwest in Albuquerque, New Mexico.

In 2006, the US Food and Drug Administration approved a slow-release formulation of naltrexone, in which the drug is stored in microscopic spheres made of a biodegradable polymer and injected into muscle once a month. Lapham wondered if this might help people who stop taking naltrexone pills during holidays. Working with the company that manufactures the formulation - Alkermes, based in Cambridge, Massachusetts - she reanalysed data from a previous clinical trial, focusing on the drug's performance during 10 US holidays and celebrations.

The study was small - just 28 patients received full-dose naltrexone shots, compared with another 28 given placebos. The shots reduced the frequency of drinking days, the number of drinks and the percentage of days classed as heavy drinking sessions - five or more drinks a day for men, and four for women. Crucially, the drug was just as effective during the holidays as it was for the rest of the year (Journal of Substance Abuse Treatment, vol 36, p 1).

The results have impressed Rosenbloom, who describes their significance for public health as huge. Lapham warns that naltrexone injections must be given with care, because they can cause abscesses if the drug is deposited into fatty tissue.

The treatment might also reduce deaths from drink-driving: in the US, 40 per cent of road deaths over Christmas and the New Year involve at least one driver impaired by alcohol, compared with about 28 per cent for the rest of December. Rosenbloom would like to see courts offer naltrexone shots to repeat drink-driving offenders.

Up to 2 drinks per day not linked with higher risk of irregular heart beat for women

Tue, 02 Dec 2008 05:00:00 PST

( from http://www.rxpgnews.com ) Women who have up to two alcoholic drinks per day do not appear to be at increased risk of atrial fibrillation (irregular heart beat), but drinking more than that amount is associated with a higher risk, according to a study in the December 3 issue of JAMA.

Studies assessing the effects of regular alcohol consumption on the risk of atrial fibrillation have provided inconsistent results, with several studies finding significant associations between moderate to high amounts of alcohol intake and increased risks of atrial fibrillation among men, but not among women. However, these studies were not of adequate size to detect significant associations among women, according to background information in the article.

David Conen, M.D., M.P.H., of Brigham and Women's Hospital, Harvard Medical School, Boston, and University Hospital, Basel, Switzerland, and colleagues analyzed data from a completed randomized controlled trial involving 34,715 women participating in the Women's Health Study, to assess the effects of regular alcohol consumption on the risk of atrial fibrillation. The participants were older than 45 years and had no atrial fibrillation at the start of the study and underwent follow-up from 1993 to October 2006. Alcohol consumption was assessed via questionnaires at the beginning of the trial and at 48 months of follow-up and was grouped into 4 categories: 0 drinks per day, greater than 0 and less than 1, 1 or more and less than 2, and 2 or more drinks per day. Atrial fibrillation was self-reported on the yearly questionnaires and subsequently confirmed by electrocardiogram and medical record review.

During a median (midpoint) follow-up of 12.4 years, there were 653 confirmed cases of new atrial fibrillation. Among women consuming no alcohol (n = 15,370), there were 294 events (1.9 percent); for women consuming more than 0 and less than 1 drink per day (n = 15,758), there were 284 events (1.8 percent); for 1 to 2 drinks per day (n = 2,228), there were 35 events (1.6 percent); and for women consuming 2 or more drinks per day (n = 1,359), there were 40 atrial fibrillation events (2.9 percent).

In the present study, alcohol consumption of up to 2 drinks per day was not associated with an increased risk of incident atrial fibrillation among initially healthy, middle-aged women. In contrast, the small group of women who consumed 2 or more alcoholic beverages per day had a 1.6-fold greater risk for atrial fibrillation relative to nondrinking women. While this finding needs to be interpreted with some caution because of the small number of women in some subgroups, it supports a possible threshold effect in the relationship between alcohol consumption and risk of atrial fibrillation among women, the authors write.

3 esophageal, stomach cancer subtypes linked to smoking; 1 associated with alcohol use

Mon, 17 Nov 2008 05:00:00 PST

( from http://www.rxpgnews.com ) WASHINGTON, D.C. - Researchers who have been following the health of more than 120,000 residents of the Netherlands for more than two decades have found that smoking is associated with two forms of esophageal cancer as well as a form of stomach cancer, and that drinking alcohol is strongly linked to one form of esophageal cancer.

Researchers say that while their findings, presented at the American Association for Cancer Research's Seventh Annual International Conference on Frontiers in Cancer Prevention Research, confirm risk factors previously associated with these cancers, they don't explain the rising incidence of these tumors, especially esophageal adenocarcinoma (EAC) and gastric cardia adenocarcinoma (GCA), a cancer of the upper stomach area, where it joins the esophagus.

The results of this study again confirm recommendations for a healthy lifestyle, namely not to smoke and to drink alcohol in moderation, said study author, Jessie Steevens, M.Sc., of the Department of Epidemiology at Maastricht University, in Maastricht. But it also suggests that there must be other risk factors for EAC and GCA, she said. Smoking is a risk factor for both cancers, but since a decreasing part of the population smokes, this cannot explain why the incidence is rising so rapidly for both cancers in Western countries in recent decades.

Other factors that might be associated with the risk of these cancers include obesity, diet and nutrition, exercise, occupational exposures, medical factors and so forth, which we are beginning to study, Steevens said.

Their findings are from one of the first large cohort studies to investigate risk factors in esophageal adenocarcinoma and gastric cardia adenocarcinoma, as well as in esophageal squamous cell carcinoma (ESCC), which resembles head and neck cancer.

ESCC, which can occur anywhere along the esophagus, was at one time responsible for more than 90 percent of all esophageal cancers, but now EAC, which is typically found in the lower esophagus, makes up more than half of this cancer type. Esophageal cancer, in general, had been linked to alcohol and tobacco use, but this study sought to refine that risk between different cancer subtypes.

Researchers in the Netherlands Cohort Study, which began in 1986, administered lifestyle questionnaires to participants, who were healthy when they enrolled, and then followed the group to see who developed cancer. After 16 years, investigators identified 120 ESCC cases, 168 EAC cases, and 187 GCA cases among the group of 120,852 enrollees.

For esophageal squamous cell carcinoma, they found a dose-response relationship between alcohol use and cancer development. For example, a person drinking four glasses of alcohol had five times the risk of developing the cancer compared to a person who does not drink alcohol, Steevens said.

Another way to explain this is that a person's lifetime risk of developing ESCC is one in 250 if that person doesn't drink alcohol and the lifetime risk would be about one in 50 if the person drinks four glasses of alcohol per day, she said.

Former and current smoking was associated with an increased risk of all three cancers, although the risks of ESCC were higher than those of EAC and GCA.

It appeared that current smokers have the highest risks, and former smokers have an intermediate risk compared with never smokers. This was true for ESCC, EAC and GCA. These are the results when no other aspects of smoking were considered, such as the amount of cigarettes smoked per day and the number of years a person smoked, Steevens said. When we took into account the smoking duration and frequency, it appeared that the difference in risk between former smokers and current smokers could partly be explained by these other aspects of smoking. This is also logical, because a former smoker, for example, has usually smoked fewer years than a current smoker.

Brisk walk could help chocoholics stop snacking

Tue, 11 Nov 2008 05:00:00 PST

( from http://www.rxpgnews.com ) Researchers at the University of Exeter have found that a walk of just fifteen minutes can reduce chocolate cravings. The benefits of exercise in helping people manage dependencies on nicotine and other drugs have previously been recognised. Now, for the first time, newly-published research shows that the same may be true for food cravings.

Following three days of abstinence, 25 regular chocolate eaters were asked to either complete a 15-minute brisk walk or rest, in a random order. They then engaged in tasks that would normally induce chocolate cravings, including a mental challenge and opening a chocolate bar.

After exercise participants reported lower cravings than after rest. Cravings were not only reduced during the walk, but for at least ten minutes afterwards. The exercise also limited increases in cravings in response to the two tasks.

Professor Adrian Taylor comments: Our ongoing work consistently shows that brief bouts of physical activity reduce cigarette cravings, but this is the first study to link exercise to reduced chocolate cravings. Neuroscientists have suggested common processes in the reward centres of the brain between drug and food addictions, and it may be that exercise effects brain chemicals that help to regulate mood and cravings. This could be good news for people who struggle to manage their cravings for sugary snacks and want to lose weight.

Previous research has suggested that 97% of women and 68% of men experience food cravings. Craved foods tend to be calorie-dense, fatty or sugary foods, with chocolate being the most commonly reported. Chocolate has a number of biologically active constituents that temporarily enhance our mood with a result that eating it can become a habit, particularly when we are under stress and when it is readily available, and perhaps when we are least active.

Professor Taylor concludes: While enjoying the occasional chocolate bar is fine, in time, regular eating may lead to stronger cravings during stress and when it is readily available. Recognising what causes us to eat high energy snacks, even if we have plans to not do so, can be helpful.

Short bouts of physical activity can help to regulate how energised and pleasant we feel, and with a sedentary lifestyle we may naturally turn to mood regulating behaviours such as eating chocolate. Accumulating 30 minutes of daily physical activity, with two 15 minute brisk walks, for example, not only provides general physical and mental health benefits but also may help to regulate our energy intake. This research furthers our understanding of the complex physical, psychological and emotional relationship we have with food.

The research is now published online in the journal

Gene mutation in worms key to alcohol tolerance

Sun, 02 Nov 2008 14:46:33 PST

( from http://www.rxpgnews.com ) London, Oct 23 - Liverpool University reseachers, picking up from a study by the Oregon Health and Science University on the linkage between gene mutation and tolerance to alchohol in mice, investigated it in worms.

This gene specifies the ways in which amino acids arrange themselves into a protein called UNC-18 - or Munc18-1 - in humans, an essential component of the nervous system.

Researchers found that a naturally occurring change in this gene can result in a change in the nature of one of the amino acids, which then alters communication between cells in the nervous system.

Consequently, with these changes the nervous system becomes less sensitive to the effects of alcohol, allowing the body to consume more, according to a Liverpool University release.

Bob Burgoyne, the head of the university's School of Biomedical Sciences, explained, 'Alcohol consumption can affect the nervous system in a number of ways. Low concentrations of alcohol can make the body more alert, but high concentrations can also reduce its activity, resulting in motor dysfunction and a lack of coordination.'

'Some people, however, are more susceptible to these effects than others, but it has never been fully understood why this is.

'We used the nematode worm as a model to look at the role genes play in alcohol tolerance because all of the worm's genome has been characterised and we can therefore identify its genes easily,' he said.

'The gene we looked at corresponds to a gene in humans that performs the same function in the nervous system. Mutations in genes can occur naturally without any known cause and will persist if they are not particularly harmful,' Burgoyne concluded.

Jeff Barclay, co-author of the research, added, 'We investigated alterations in amino acids in two genetically identical worms. One carried a mutation that was exactly the same as the genetic change our American colleagues found in mice and the other carried a different change within the same gene.'

'Both these mutations altered the way communicate occurs between cells in the nervous system. The mutations reduce the negative behavioural effects of alcohol and so more can be consumed before the body starts to react badly to it.

'Now that we have shown the link between the gene and alcohol tolerance in worms, it is possible to search the human gene to see if there are any spontaneous changes that could help identify individuals with a predisposition to alcoholism,' he said.

The research is published in the journal Molecular Biology of the Cell.

Physicians lack smoking cessation training

Mon, 27 Oct 2008 04:00:00 PST

( from http://www.rxpgnews.com ) Physicians and other health-care providers may advise their patients to quit smoking, but few providers have the adequate training to follow their patients through the cessation process. New research presented at CHEST 2008, the 74th annual international scientific assembly of the American College of Chest Physicians (ACCP), shows that 87 percent of physicians and other medical professionals receive less than 5 hours of training on tobacco dependence and less than 6 percent knew Agency for Healthcare Research and Quality (AHRQ) treatment guidelines for tobacco dependence, including the signs of nicotine withdrawal. Researchers speculate that this lack of knowledge related to tobacco dependence treatment may, in turn, affect quit rates among smokers.

If health-care providers are unaware of the AHRQ guidelines for tobacco dependence, and consequently unsure of how to treat their patients who are tobacco-dependent, they are less likely to do more than ask and advise their patients to quit, said the study's lead researcher, Virginia Reichert, NP, who conducted her research while at the North Shore-LIJ Health System Center for Tobacco Control, Great Neck, NY.

Researchers from the North Shore-LIJ Center for Tobacco Control surveyed 600 health-care providers, of which 322 were considered prescribers (physicians, nurse practitioners, or physician assistants), and the remaining 278 participants were considered nonprescribers (pharmacists, registered nurses, social workers, counselors, respiratory therapists, and students). Survey questions regarding tobacco control issues were related to prevalence of smoking, tobacco treatment guidelines, cessation pharmacotherapy, interaction of nicotine with other drugs, and symptoms and implications of nicotine withdrawal.

Results showed that a significant number of health-care providers lack general knowledge related to tobacco dependence treatment. Of those surveyed, 87 percent of prescribers and 93 percent of nonprescribers received less than 5 hours of tobacco-dependence training. In addition, only 6 percent of prescribers and 5 percent of nonprescribers knew the AHRQ treatment guidelines for tobacco dependence.

Without appropriate training in tobacco dependence treatment, health-care providers may lack the knowledge and confidence to help their patients quit smoking, said Ms. Reichert. Furthermore, providers may not recognize that tobacco dependence is a chronic relapsing condition and become frustrated when patients do not quit when advised to do so. Research indicates that approximately 70 percent of smokers report a desire to quit but believe it will be too difficult without assistance. Research also indicates that smokers are 30 percent more likely to quit with assistance from their health-care provider.

In relation to cessation pharmacotherapy, 16 percent of prescribers and 8 percent of nonprescribers knew which FDA-approved medications were over-the-counter and which required a prescription. The majority of prescribers and nonprescribers also failed to recognize select contraindications and changes to medication dosages in patients undergoing smoking cessation. In addition, only 1 percent of prescribers and 3 percent of nonprescribers correctly identified the signs of nicotine withdrawal.

If clinicians are unaware of the contraindications related to cessation medications, this could lead to adverse reactions for the patient and, consequently, a failure to quit, said study author Patricia Folan, RN, acting director of the North Shore-LIJ's Center for Tobacco Control. In addition, if clinicians are unaware of withdrawal symptoms, they may not encourage their patients to use the cessation medications. Without the cessation medications, patients experience the discomfort of withdrawal symptoms and are less likely to sustain their quit attempt.

Patients who are advised to quit smoking, but who are not given the tools and resources to help them, will be less likely to quit, said James A. L. Mathers, Jr., MD, FCCP, President of the American College of Chest Physicians. Health-care providers must be educated about the smoking cessation process and available resources in order to provide comprehensive guidance to patients who wish to stop smoking.

UCLA issues new report on Prop. 36

Tue, 14 Oct 2008 04:00:00 PST

( from http://www.rxpgnews.com ) The effectiveness of Proposition 36, a ballot measure approved by California voters in 2000 that offers treatment instead of incarceration for nonviolent drug offenders is being undermined by inadequate funding, participants dropping out of treatment, and increased arrests for drug and property crimes.

The good news, however, is that the initiative has saved taxpayers millions of dollars, several promising new programs have the potential to improve Proposition 36's results, and violent crime arrests have decreased more in California than nationally since the proposition's implementation.

These are some of the key findings from UCLA's latest report on Proposition 36, also known as the Substance Abuse and Crime Prevention Act (SACPA) of 2000. The measure, which went into effect in July 2001, allows nonviolent adult drug offenders to receive substance-abuse treatment with supervision as an alternative to incarceration or supervision without treatment. The law also calls for an independent evaluation of the program, which is being conducted by UCLA's Integrated Substance Abuse Programs at the Semel Institute for Neuroscience and Human Behavior.

According to the report, under Proposition 36, more than 30,000 drug offenders enter treatment each year and about half of them are being treated for the first time. Most receive outpatient care, which is less expensive than residential treatment but is also less effective for heavy drug users. Although the number of available residential treatment beds has increased since the measure's enactment, the increases have not been able to meet the rising need. Stakeholders interviewed in focus groups indicated that this was due to limited funding and infrastructure.

The report also found that drug and property crime arrests were higher among Proposition 36 participants than among a comparison group of pre-Proposition 36 drug offenders, the latter having spent more days in custody and fewer days on the street during which they could get arrested. However, despite early concerns by critics of SACPA that the law would result in an increase in violent crime, the rate of violent crime dropped more in California (12 percent between 2001 and 2005) than nationally (9 percent over the same period).

While the Proposition 36 group was more likely to be rearrested, the measure has been a much less expensive alternative to jail or prison time. By reducing incarceration, Proposition 36 has helped save taxpayers about $2 for every $1 invested in the program. To improve Proposition 36's implementation, the report calls for greater use of narcotics-treatment programs, employment assistance and residential treatment, as well as graduated sanctions, ranging from more drug-test requirements to short jail stays, for those participants who fail to comply with the program's provisions.

Study highlights risky behavior, lack of care among HIV-infected crack users

Mon, 04 Aug 2008 04:00:00 PST

( from http://www.rxpgnews.com ) Doctors who treat HIV-infected crack users refer to them as the forgotten population. A study being presented at this week's International AIDS Conference in Mexico City reveals that these patients frequently lack outpatient health care, do not receive life-saving antiretroviral therapy and continue to engage in risky sexual behavior that likely contributes to HIV transmission.

Researchers interviewed 190 HIV-infected crack-using patients at Grady Memorial Hospital in Atlanta and Jackson Memorial Hospital in Miami over 14 months as part of an NIH/National Institute on Drug Abuse funded study.

One fourth of the group reported having unprotected sex in the last six months, half had not seen an HIV specialist in the last six months, and more than three fourths were not getting antiretroviral therapy, according to the interviews.

The five-year HOPE study (Hospital visit is an Opportunity for Prevention and Engagement) is a collaboration between the NIH funded Center for AIDS Research at Emory University School of Medicine and the NIH funded Developmental Center for AIDS Research at the University of Miami School of Medicine.

At a time when life-saving medications are available to treat persons living with HIV, there continues to be a population of HIV-positive people who have fallen through the cracks, says Lisa Metsch, PhD, associate professor of epidemiology and public health at University of Miami School of Medicine. Frequently, their only contact with the healthcare system is during a hospitalization.

Metsch is director of the University of Miami CFAR's behavior, social sciences and community outreach core and principal investigator for the HOPE study.

Previous studies of crack users in urban hospitals found that their drug use bars them from getting HIV-related care. Drug treatment experts say the short, intense nature of the crack high and lack of a methadone equivalent make crack users a unique group, on top of the chaotic lives they share with other drug users.

In addition, the study's interviews found that, compared with males, female HIV-infected crack users were more likely to report lack of HIV-related care (almost twice as likely) and recent unprotected sex (three times as likely), as well as annual income less than $5,000 and homelessness.

We know that not being engaged in care and prevention services is not only bad for the individuals but is also bad for society, in that a substantial fraction of HIV-infected crack users engage in behavior that transmits the virus to others, says Carlos Del Rio, MD, professor of medicine and chief of medical services at Grady Memorial Hospital, co-director of the Emory Center for AIDS Research and co-principal investigator for the HOPE study.

The Emory and University of Miami researchers are testing the effectiveness of an eight-session intervention program that helps participants get into HIV care, teaches them about reducing risky sex practices and helps them into drug treatment if they are ready.

Del Rio says that the findings from this intervention study may be used to establish future interventions targeted to HIV-infected crack users to get them into care, keep them in care and allow them to benefit from care and prevention services available in HIV outpatient clinics.

Hospitals like Grady and Jackson are doing the best they can in the face of a persistent problem, with limited resources, Del Rio says. More needs to be done to address substance abuse and mental health in this population.

Research says fat friends and poor education helps people think thin

Thu, 24 Jul 2008 04:00:00 PST

( from http://www.rxpgnews.com ) Research by economists at the University of Warwick, Dartmouth College, and the University of Leuven, finds that people are powerfully but subconsciously influenced by the weight of those around them. Without being aware of it, the researchers believe, human beings keep up with the weight of the Joneses. For a whole society, this can lead to a spiral of imitative obesity. The researchers will present their results on Friday July 25th at a National Bureau of Economic Research conference in Cambridge Massachusetts in a paper entitled Imitative Obesity and Relative Utility at the NBER Summer Institute on Health Economics.

Using data on 27,000 Europeans from 29 countries, the researchers find that nearly half of European women feel overweight. Less than a third of males feel overweight.

The authors suggest that whether for reasons of job promotions or finding a mate it is someone's weight relative to others that matters. They show that overweight perceptions and dieting decisions are influenced by people's comparisons with others of the same age and gender.

Highly educated Europeans hold themselves to a particularly tough standard, the research shows. For any given level of Body Mass Index (BMI), somebody with a university degree feels much fatter than someone with low educational qualifications.

Overall, the researchers believe that a person's utility (an economic term roughly meaning satisfaction levels) depends on their own weight relative to the weight of those around them. They suggest that it is easier to be fat in a society that is fat.

However, the authors also found a significant gender split. Females were much more prone, for any given BMI value, to feel overweight. For European women, weight dissatisfaction and overweight perceptions depended crucially upon not just their own absolute BMI, but also upon their BMI relative to other women of exactly the same age in their country. Conversely, being overweight tended not to be a significant issue for men if many of those around them were as overweight as they were.

Professor Andrew Oswald at the University of Warwick, one of the researchers, said Consumption of calories has gone up but that does not tell us why people are eating more. Some have argued that obesity has been produced by cheaper food, but if fatness is a response to greater purchasing power, why do we routinely observe that rich people are thinner than poor people?

He said: A lot of research into obesity, which has emphasized sedentary lifestyles or human biology or fast-food, has missed the key point. Rising obesity needs to be thought of as a sociological phenomenon not a physiological one. People are influenced by relative comparisons, and norms have changed and are still changing.

However, the authors found a significant gender split. Females were much more prone, for any given BMI value, to feel overweight. For European women, weight dissatisfaction and overweight perceptions depended crucially upon not just their own absolute BMI, but also upon their BMI relative to other women of exactly the same age in their country.

Energy drinks linked to risk-taking behaviors among college students

Thu, 24 Jul 2008 04:00:00 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- Over the last decade, energy drinks -- such as Red Bull, Monster and Rockstar -- have become nearly ubiquitous on college campuses. The global market for these types of drinks currently exceeds $3 billion a year and new products are introduced annually.

Although few researchers have examined energy drink consumption, a researcher at the University at Buffalo's Research Institute on Addictions (RIA) has been investigating links between energy drinks and public health concerns like substance abuse and risky behaviors.

Two new research reports by RIA Research Scientist Kathleen E. Miller, Ph.D., examine the relationships between energy drink consumption and risk-taking in college students as well as toxic jock identity -- characterized by hyper-masculinity and risk-taking behaviors among college-age athletes.

Miller's research validates and expands upon existing concerns about energy drink consumption: The principal target demographic for energy drinks is young adults ages 18-25, but they're nearly as common among younger teens, she explains. This is a concern because energy drinks typically contain three times the caffeine of a soft drink, and in some cases, up to 10 times as much. They also include ingredients with potential interactions such as taurine and other amino acids, massive doses of vitamins, and plant and herbal extracts.

Miller is a sociologist and an adjunct research assistant professor in the Department of Sociology in UB's College of Arts and Sciences. The research was funded by a $471,000 grant by the National Institute on Drug Abuse.

In the first set of results published online in June in the Journal of Adolescent Health, Miller identified links between energy drink consumption, risky substance use and sexual risk-taking.

Frequent energy drink consumers (six or more days a month), according to Miller's findings, were approximately three times as likely than less-frequent energy drink consumers or non-consumers to have smoked cigarettes, abused prescription drugs and been in a serious physical fight in the year prior to the survey. They reported drinking alcohol, having alcohol-related problems and using marijuana about twice as often as non-consumers. They were also more likely to engage in other forms of risk-taking, including unsafe sex, not using a seatbelt, participating in an extreme sport and doing something dangerous on a dare. The associations with smoking, drinking, alcohol problems and illicit prescription use were found for white but not African-American students.

A total of 795 Western New York male and female undergraduate students participated in the study and 39 percent reported consuming at least one energy drink in the previous month. There was significantly higher consumption by men (46 percent) than by women (31 percent) and higher consumption by whites (40 percent) than by blacks (25 percent). Eighty-seven percent of the students in the study were white; 52 percent were male.

Two-thirds of the energy drink consumers in Miller's study had used energy drinks as mixers with alcoholic beverages. The growing popularity of this practice further heightens concern, Miller says.

It is widely, but incorrectly, believed that the caffeine in energy drinks counteracts the effects of alcohol, so students will have the energy to party all night without getting as drunk, she explains. While the combination may reduce perceptions of intoxication, it does not reduce alcohol-induced impairments of reaction time or judgment.

According to Miller, these findings suggest that frequent energy drink consumption may serve as a useful screening indicator to identify students at risk for what scientists call problem behavior syndrome.

Energy drink consumption is correlated with substance use, unsafe sexual activity and several other forms of risk-taking, Miller notes. For parents and college officials, frequent energy drink consumption may be a red flag or warning sign for identifying a young person at higher risk for health-compromising behavior.

Although energy drink consumption can be used to predict other problem behaviors, it does not necessarily follow that drinking these substances is a gateway to more serious health-compromising activities, Miller cautions. It is entirely possible that a common factor, such as a sensation-seeking personality or involvement in risk-oriented peer sub-cultures, contributes to both. More investigation is needed to study these relationships further, over longer periods of time.

In the second set of results, published in the March/April issue of the Journal of American College Health, Miller looked at energy drink consumption and toxic jock identity.

For many people, being an athlete is an important part of who they are, Miller explains. Some go a step farther, though, and come to see themselves as 'jocks.' For them, sport is wrapped up in a larger identity that also emphasizes hyper-masculinity and a willingness to take excessive risks. Unlike an athlete identity, a jock identity can be considered toxic, according to Miller, because it's associated with a wide range of risky or problem behaviors, including problem drinking, sexual risk-taking, interpersonal violence, academic misconduct, delinquency and even suicide attempts.

Miller's research found that undergraduates who consumed energy drinks more often were also more likely to develop a jock identity and to engage in risk-taking behaviors. Ultimately, she says, undergraduates' frequent use of Red Bull and other energy drinks should be seen by peers, parents and college officials as a potential predictor of 'toxic jock identity.'

In the wake of several recent deaths linked to energy drinks, a number of countries have instituted restrictions on their use. Some, like France, Turkey, Denmark, Norway, Uruguay and Iceland ban high-caffeine/taurine energy drinks altogether, Miller notes. Sweden only permits them to be sold in pharmacies as medicinal products. Canada, which banned these drinks until 2004, now requires warning labels cautioning against use by children or pregnant women, use in large quantities or use with alcohol. However, energy drink consumption remains unregulated in the United States.

Miller says she hopes to develop future research into the influence of personality traits, peer norms and other factors that may influence the relationships among energy drink consumption, race, gender and risk-taking. Better understanding of these relationships, she argues, may be useful in developing programs for preventing substance use and other health-compromising behaviors.

Claims linking health problems and the strength of cannabis may be exaggerated

Tue, 17 Jun 2008 04:00:00 PST

( from http://www.rxpgnews.com ) Claims that a large increase in the strength of cannabis over the last decade is driving the occurrence of mental health and other problems for users are not borne out by a study of the worldwide literature, say researchers at the National Drug and Alcohol Research Centre (NDARC) and the National Drug Research Institute (NDRI), both from Australia.

Their conclusions, published in this month's issue of ADDICTION, are that increased potency has been observed in some countries, but there is enormous variation between samples, meaning that cannabis users may be exposed to greater variation in the strength of the cannabis they use in a single year than over years or decades.

Cannabis samples tested in the United States, the Netherlands, the United Kingdom and Italy have shown increases in potency over the last decade, but no significant growth in other European countries or in New Zealand has been found during the same period.

THC is the active ingredient in cannabis, which produces the strongest psychoactive effect. In the United States, the level of THC in confiscated cannabis was 8.5% in 2006, up from 4.5% in 1997. Recent Dutch data show that the THC of cannabis sold in coffee shops more than doubled between 2000 and 2004, but has since levelled off.

THC content varies according to the part of the plant that is used, the method of storage, and cultivation techniques. Popular belief is that hydroponic or other methods of indoor cultivation produce higher concentrations of THC than occur naturally, but the jury is still out on this issue.

The ability to control the indoor environment means that plants can reach their full potential, which includes reaching the maximum level of THC. The increase in market share of indoor-grown cannabis seen in Australia as well as North America and Europe may have led to a more consistent product which could explain the potency increases reported in some countries.

While some public debate has linked large increases in cannabis potency to increased mental health problems, there are currently insufficient data to justify this claim, and care ought to be taken when considering policy decisions on this basis. Importantly, further research is required to understand whether cannabis users can, or do, alter their intake in response to a change in potency.

In their discussion of potential health risks, the authors point to studies that observe that some cannabis smokers, when faced with a 'strong' product, act rather like tobacco smokers and adjust their dose by increasing the interval between puffs, or holding smoke in their lungs for a shorter period of time. This behaviour may reduce possible harms caused by increased potency.

Drink and drugs fuel Scottish suicide and homicide rates

Mon, 16 Jun 2008 04:00:00 PST

( from http://www.rxpgnews.com ) Alcohol and drug misuse mean Scots are almost twice as likely to kill or take their own life compared to people living in England and Wales, research published today (Monday, June 16) reveals.

The findings by The University of Manchester's National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCI) also show that the number of mental health patients committing homicide or suicide was proportionately much higher in Scotland.

The 'Lessons for Mental Health Care in Scotland' report, commissioned by the Scottish Government, blames these higher death rates north of the border on alcohol and drug consumption, both in the general population and among mental health patients.

The NCI examined all suicides and homicides in the general population in Scotland, as well as those committed by people who had sought help from mental health services, and compared them to its findings for England and Wales.

Suicide rates in Scotland equated to 18.7 per 100,000 of the population, compared to 10.2 per 100,000 in England and Wales, while homicide rates north of the border were 2.12 per 100,000 people compared to 1.23 per 100,000 in England and Wales. The north-south divide was highest among teenagers, the report found.

Memory loss linked to common sleep disorder

Wed, 11 Jun 2008 04:00:00 PST

( from http://www.rxpgnews.com ) For the first time, UCLA researchers have discovered that people with sleep apnea show tissue loss in brain regions that help store memory. Reported in the June 27 edition of the journal Neuroscience Letters, the findings emphasize the importance of early detection of the disorder, which afflicts an estimated 20 million Americans.

Sleep apnea occurs when a blocked airway repeatedly halts the sleeper's breathing, resulting in loud bursts of snoring and chronic daytime fatigue. Memory loss and difficulty focusing are also common complaints. Prior studies have linked the disorder to a higher risk of stroke, heart disease and diabetes.

Our findings demonstrate that impaired breathing during sleep can lead to a serious brain injury that disrupts memory and thinking, said principal investigator Ronald Harper, a distinguished professor of neurobiology at the David Geffen School of Medicine at UCLA.

The study focused on structures called mammillary bodies, so named because they resemble small breasts, on the underside of the brain.

The UCLA team scanned the brains of 43 sleep apnea patients, using magnetic resonance imaging (MRI) to collect high-resolution images of the entire brain, including slices of the mammillary bodies.

The structures' small size and proximity to bone and fluid make them difficult to measure by conventional MRI. So the researchers manually traced the mammillary bodies from the high-resolution scans and calculated their volumes from the hand-drawn outlines.

When they compared the results to images of 66 control subjects matched for age and gender, the scientists discovered that the sleep apnea patients' mammillary bodies were nearly 20 percent smaller, particularly on the left side.

The findings are important because patients suffering memory loss from other syndromes, such as alcoholism or Alzheimer disease, also show shrunken mammillary bodies, said lead author Rajesh Kumar, a UCLA assistant researcher in neurobiology.

Physicians treat memory loss in alcoholic patients with massive amounts of thiamine, or vitamin B1, he added. We suspect that the dose helps dying cells to recover, enabling the brain to use them again.

The scientists' next step is to determine how sleep apnea causes tissue loss in the mammillary bodies.

Harper hypothesizes that repeated drops in oxygen lead to the brain injury. During an apnea episode, the brain's blood vessels constrict, starving its tissue of oxygen and causing cellular death. The process also incites inflammation, which further damages the tissue.

The reduced size of the mammillary bodies suggests that they've suffered a harmful event resulting in sizable cell loss, Harper said. The fact that patients' memory problems continue despite treatment for their sleep disorder implies a long-lasting brain injury.

In a future study, Harper and Kumar will explore whether taking supplemental vitamin B1 helps restore sleep apnea patients' memory. The vitamin helps move glucose into the cells, preventing their death from oxygen starvation.

UCLA researchers used sophisticated imaging technology to identify brain lesions associated with impaired memory in individuals with obstructive sleep apnea, said Elizabeth G. Nabel, director of the National Heart, Lung and Blood Institute, which funded the study. These results underscore the importance of early diagnosis and treatment of sleep-disordered breathing, which can have long-term effects on patients' health and well-being.

Obstructive sleep apnea occurs when the muscles in the throat, soft palate and tongue relax during sleep and sag, narrowing the airway. The tongue slides to the back of the mouth, blocking the windpipe and cutting off oxygen to the lungs.

The sleeper wakes up, gasping for air, and falls back into a fitful sleep. The cycle can repeat itself hundreds of times per night.

Excessive drinking and relapse rapidly cut in new approach

Mon, 09 Jun 2008 04:00:00 PST

( from http://www.rxpgnews.com ) Boosting the level of a specific brain protein quickly cut excessive drinkingof alcohol in a new animal study, and also prevented relapse -- the common tendency found in sober alcoholics to easily return to heavy drinking after just one glass.

In addition, the treatment did not block other pleasure-seeking behaviors -- in this case, craving sweets. Interference with these normal behaviors has been a problem with drugs developed for alcoholism treatment. Nor did the brain chemical boost appear to carry any side effects, the study researchers report.

The findings are being published June 9 in The Proceedings of the National Academy of Sciences.

The research by scientists at theUCSF-affiliatedErnest Gallo Clinic and Research Center builds on their earlier work. In 2005, they reported the first hints that increased levels of this brain protein, known as GDNF, cut down alcohol consumption. The new study established how quickly the effect kicks in, and shows for the first time that the chemical blocks relapse and does not interfere with normal cravings. The research also pinpointed the brain site where GDNF acts to control drinking.

Alcoholism is a devastating and costly psychiatric disease with enormous socioeconomic impact, said Dorit Ron, PhD, senior author on the paper and principal investigator at the Gallo Center. There is a tremendous need for therapies to treat alcohol abuse.

Unfortunately, only three drugs are currently approved to treat excessive drinking, and all have serious limitations. Our findings open the door to a promising new strategy to combat alcohol abuse, addiction and especially relapse. Ron is also associate professor of neurology at UCSF.

GDNF, or glial cell-derived neurotrophic factor, is already a focus of strong interest for treating Parkinson's disease. A new orally-delivered, experimentaldrug has been shown to raise brain GDNF levels in rats, suggesting its promise against Parkinson's. Research by Ron and her colleagues suggests such a drug might also treat alcoholism.

The Gallo Center scientists set out to test the actions of GDNF in a brain site known as the Ventral Tegmental Area, or VTA, a region of the brain thought to be strongly involved in drug-seeking behavior. The first part of the study was designed to model both human social and excessive drinking. Researchers first trained rats to seek alcohol for two months. GDNF was then injected into the VTA brain region, and their motivation to drink in both models dropped significantly within as little as 10 minutes. The effect lasted at least three hours, the scientists reported.

In a second part of the study, rats had access to sugar water, and the scientists showed that after GDNF treatment, the animals still sought sugar -- convincing evidence that increased GDNF did not decrease other, related pleasure-seeking behaviors.

Repeated methamphetamine use causes long-term adaptations in brains of mice, researchers find

Wed, 09 Apr 2008 04:00:00 PST

( from http://www.rxpgnews.com ) Repeatedly stimulating the mouse brain with methamphetamine depresses important areas of the brain, and those changes can only be undone by re-introducing the drug, according to research at the University of Washington and other institutions. The study, which appears in the April 10 issue of the journal Neuron, provides one of the most in-depth views of the mechanisms of methamphetamine addiction, and suggests that withdrawal from the drug may not undo the changes the stimulant can cause in the brain.

The researchers set out to determine what sort of changes happen in the brain because of repeated use of the stimulant methamphetamine, and to better understand addiction-related behaviors like drug craving and relapse. Methamphetamine, also known as simply meth, is one of the most popular illegal drugs in the United States, and abuse of the drug can cause severe addiction.

Scientists have believed that abuse of drugs like meth can cause changes to the neurons in the brain and the synapses and terminals that control transmission of information in the brain. In this project, researchers focused on the mouse brain, and how it was affected by methamphetamine over 10 days, which is the mouse equivalent of chronic use in humans.

They found that the long administration and withdrawal of the drug depressed the neural terminals controlling the flow of signals between two areas of the brain, the cortex and striatum. Even a long period of withdrawal -- the equivalent of years in humans -- did not return the terminals to normal activity level. Re-introducing the drug, however, reversed the changes in the brain.

The areas affected by the drug are called pre-synaptic terminals, and are related to the flow of information from the cortex to the striatum. When a person sees something new in their environment, the scientists explained, she focuses attention on that item. At the neuron level, that process stimulates the release of dopamine, a chemical involved in transmitting signals in the brain. As the person sees the new item over and over again, the dopamine response drops, and synapses in the brain adapt to the no-longer-new item.

What happens with methamphetamine use is that the drug makes the nervous system release dopamine, which helps a user focus a lot of attention on a particular goal. Scientists believe that meth allows dopamine in the striatum to filter information coming from the cortex through the pre-synaptic terminals. The filtering of some of the terminals would help someone ignore other things and focus on that one goal or task.

After chronic use of methamphetamine, the filtering process eventually becomes a permanent depression in the activity of those terminals in the brain, the scientists found. And the only thing that can help the pre-synaptic terminals recover in mice, they found, was re-administering the drug.

What we found is that the repeated use of methamphetamine causes adaptations in the brain, and that only re-introducing the drug can reverse that, said Dr. Nigel Bamford, UW assistant professor of neurology and pediatrics and a physician at Seattle Children's Hospital. We think these changes in the brain may account for at least some of the physiological components of meth addiction.

If the mechanism turns out to be similar in people, Bamford said, this could have big effects on the treatment and management of methamphetamine addiction. One treatment for drug addiction is to give people smaller and smaller amounts of the drug to wean them from it and reduce the effects of withdrawal. Unfortunately, that method would not affect the adaptation of the neural terminals in the brain.

Now that we have some understanding of the mechanism through which meth addiction occurs, we may be able to develop other approaches to treating addiction, explained Bamford. We might be able to target some of the chemical receptors in the brain to reset the system and get rid of this depressed state in the pre-synaptic terminals.

Though scientists believe that other stimulants, like methylphenidate, may have similar effects on the brain, they caution against applying these findings to other situations. These synaptic changes may not occur in patients with underlying conditions that require treatment with stimulants, the scientists said.

Brain DNA 'remodeled' in alcoholism

Tue, 01 Apr 2008 04:00:00 PST

( from http://www.rxpgnews.com ) Reshaping of the DNA scaffolding that supports and controls the expression of genes in the brain may play a major role in the alcohol withdrawal symptoms, particularly anxiety, that make it so difficult for alcoholics to stop using alcohol.

The finding is reported by researchers at the University of Illinois at Chicago and the Jesse Brown VA Medical Center in the April 2 issue of the Journal of Neuroscience.

DNA can undergo changes in function without any changes in inheritance or coded sequence. These epigenetic changes are minor chemical modifications of chromatin -- dense bundles of DNA and proteins called histones.

This is the first time anyone has looked for epigenetic changes related to chromatin remodeling in the brain during alcohol addiction, said Dr. Subhash C. Pandey, professor and director of neuroscience alcoholism research at the UIC College of Medicine and the Jesse Brown VA Medical Center in Chicago, the lead author of the study.

Chemical modification of histones can change the way DNA and histones are wound up together. Histone acetyltransferases (HATs) are enzymes that add acetyl groups to histones and loosen the packing, promoting gene expression. On the other hand, histone deacetylases (HDACs) remove acetyl groups from histones, causing them to wrap with DNA more tightly, decreasing gene expression.

The UIC researchers had previously shown in an animal model that levels of neuropeptide Y in the amygdala modulate anxiety and alcohol-drinking behavior. In the new study, they looked at the HDAC activity, acetylation of histones, and expression of the genes for NPY in the amygdala and the anxiety-like behaviors associated with withdrawal from chronic alcohol use.

Pandey and his colleagues found that acute exposure to alcohol decreases HDAC activity; increases the acetylation histones; increases levels of NPY -- and reduced anxiety in the animals.

Conversely, anxiety-like behaviors during withdrawal in animals with chronic alcohol exposure was associated with an increase in HDAC activity and decrease in histones acetylation and NPY levels.

Importantly, blocking the observed increase in HDAC activity using an HDAC inhibitor during alcohol withdrawal brought up histone acetylation and NPY expression levels in the amygdala and prevented the development of anxiety-like behaviors.

Our findings suggest that HDAC inhibitors may have potential as therapeutic agents in treating alcoholism, Pandey said.

The researchers also found that levels of a protein known as CREB binding protein, which has HAT enzymatic activity, were increased by acute alcohol but were decreased during ethanol withdrawal.

They concluded that the enzymes that are involved in remodeling of chromatin play an important role in the anxiety that accompanies alcohol withdrawal as well as in the anti-anxiety effects of acute alcohol use.

We need new strategies to treat alcoholism that are directed toward the prevention of withdrawal symptoms, Pandey said. Anxiety associated with withdrawal from alcohol abuse is a key factor in the maintenance of alcohol addiction.

Adolescent girls with ADHD are at increased risk for eating disorders, study shows

Fri, 14 Mar 2008 04:00:00 PST

( from http://www.rxpgnews.com ) Girls with attention deficit hyperactivity disorder stand a substantially greater risk of developing eating disorders in adolescence than girls without ADHD, a new study has found.

Adolescent girls with ADHD frequently develop body-image dissatisfaction and may go through repeating cycles of binge eating and purging behaviors that are common in bulimia nervosa, said University of Virginia psychologist Amori Yee Mikami, who led the study.

The findings appear in the current issue of the Journal of Abnormal Psychology.

ADHD is a disorder that affects about 5 percent of school-age children, and three times more boys than girls. Symptoms include a short attention span, poor organization, excessive talking, disruptive and aggressive behavior, restlessness and irritability. Many children with ADHD suffer through a range of problems, from poor grades to poor relations with parents and teachers, and more than half have serious problems making friends.

Because the disorder is far more common in boys, researchers are still learning its long-term effects on girls.

Our finding suggests that girls may develop a broader range of problems in adolescence than their male counterparts, Mikami said. They may be at risk for eating problems, which are a female-relevant domain of impairment. We know that eating disorders occur 10 times more often in girls than boys.

Additionally, Mikami noted that because ADHD is more common in boys, many girls with the disorder may go undiagnosed and untreated.

Girls with ADHD may be more at risk of developing eating problems as adolescents because they already have impulsive behaviors that can set them apart from their peers, Mikami said. As they get older, their impulsivity may make it difficult for them to maintain healthy eating and a healthy weight, resulting in self-consciousness about their body image and the binging and purging symptoms.

The study was conducted with an ethnically diverse sample of 228 girls in the San Francisco Bay area; 140 who had been diagnosed with ADHD and 88 matched comparison girls without ADHD. They were first assessed between the ages of 6 and 12 and again five years later.

Girls with the combined type of ADHD (those with both inattention and hyperactivity/impulsivity) were most likely to have adolescent bulimia nervosa symptoms, relative to girls with the inattentive type of ADHD (those with inattention only) and girls without ADHD. Girls with both types of ADHD were more likely to be overweight, to have experienced harsh/critical parenting in childhood, and to have been peer-rejected than girls without ADHD. Mikami said she believes these factors could contribute to the bulimia nervosa symptoms.

An additional concern is that stimulant medications used to treat ADHD have a side effect of appetite suppression, creating a risk that overweight girls could abuse these medicines to encourage weight loss, though we have not yet investigated that possibility, Mikami said.

She warned parents and teachers to be aware that adolescent girls with ADHD may develop an array of female-relevant symptoms beyond the standard ADHD symptoms, to include eating disorders, depression and anxiety.

Brain chemistry ties anxiety and alcoholism

Tue, 04 Mar 2008 05:00:00 PST

( from http://www.rxpgnews.com ) Doctors may one day be able to control alcohol addiction by manipulating the molecular events in the brain that underlie anxiety associated with alcohol withdrawal, researchers at the University of Illinois at Chicago College of Medicine and the Jesse Brown VA Medical Center report in the March 5 issue of the Journal of Neuroscience.

The association of anxiety with increased alcohol use is a key factor in the initiation and maintenance of alcohol addition, says Dr. Subhash Pandey, UIC professor of psychiatry and director of neuroscience alcoholism research, the lead author of the study.

Previous research has shown that people with inherently high levels of anxiety are at an increased risk of becoming alcoholics. In addition, withdrawal of alcohol in chronic users is often accompanied by extreme anxiety.

Alcoholics may feel a need to continue to drink alcohol in an attempt to self-medicate to reduce their anxiety and other unpleasant withdrawal symptoms, said Pandey.

Pandey and his colleagues have discovered the molecular basis for the link between anxiety and alcohol addiction, which may help in identifying new therapeutic strategies for the treatment of alcohol addiction.

The researchers found that a protein within neurons in the amygdala -- the area of the brain associated with emotion and anxiety -- controls the development of alcohol withdrawal symptoms and drinking behaviors in laboratory animals by changing the shape of the neurons. This change in shape affects the communication between neurons, leading to changes in behavior.

Neurons communicate by sending signals through branches called dendritic spines. The researchers found that short-term alcohol exposure increased the number of dendritic spines in certain regions of the amygdala, producing anti-anxiety effects. Alcohol-dependent animals eventually developed a tolerance to the anxiety-lowering effects of alcohol.

The researchers traced the anti-anxiety effect to the production of a particular protein, Arc, in response to a nerve growth factor called BDNF that is stimulated by alcohol exposure. BDNF is vital in the functioning and maintenance of neurons.

When alcohol was withheld from animals that had been chronically exposed, they developed high anxiety. Levels of BDNF and Arc -- and the number of dendritic spines -- were decreased in the amygdala. But the researchers were able to eliminate the anxiety in the alcohol-dependent animals by restoring BDNF and Arc to normal levels.

Pandey suggested that an initial easing of anxiety may encourage people to begin to use alcohol, while for chronic users, a lack of alcohol provokes high anxiety, creating a need to continue drinking to feel normal.

The researchers blocked Arc production in normal rats by injecting a complementary sequence to Arc gene DNA into the central amygdala. They found that when levels of Arc in the central amygdala were lowered, the spines decreased and anxiety and alcohol consumption increased. When levels of Arc were returned to normal three days post-injection, anxiety and alcohol consumption also returned to normal. In a previous study, researchers found that lowering BDNF in amygdala promoted anxiety and alcohol drinking.

This is the first direct evidence of the molecular processes occurring in the neurons that is responsible for the co-morbidity of anxiety and alcoholism, which we believe plays a major role in the addictive nature of alcohol, said Pandey.

This offers the possibility of new therapeutic target -- BDNF-Arc signaling and associated dendritic spines in the amygdala -- or new drug development.

These observations by Dr. Pandey's research group provide an insight into the link between alcohol and anxiety and could be used to identify new targets for developing medications that alleviate withdrawal-induced anxiety and potentially modify a motivation for drinking, said Antonio Noronha, director of neuroscience and behavior research at the National Institute on Alcohol Abuse and Alcoholism.

Cocaine's effects on brain metabolism may contribute to abuse

Mon, 18 Feb 2008 05:00:00 PST

( from http://www.rxpgnews.com ) UPTON, NY - Many studies on cocaine addiction - and attempts to block its addictiveness - have focused on dopamine transporters, proteins that reabsorb the brain's reward chemical once its signal is sent. Since cocaine blocks dopamine transporters from doing their recycling job, it leaves the feel-good chemical around to keep sending the pleasure signal. Now a new study conducted at the U.S. Department of Energy's Brookhaven National Laboratory suggests that cocaine's effects go beyond the dopamine system. In the study, cocaine had significant effects on brain metabolism, even in mice that lack the gene for dopamine transporters.

In dopamine-transporter-deficient mice, these effects on metabolism are clearly independent of cocaine's effects on dopamine, said Brookhaven neuroscientist Panayotis (Peter) Thanos, who led the research. These metabolic factors may be a strong regulator of cocaine use and abuse, and may also suggest new avenues for addiction treatments. The study will appear in the May 2008 issue of the journal Synapse, and will be available online on Monday, February 18, 2008.

The scientists used positron emission tomography, or PET scanning, to measure brain metabolism in dopamine-transporter deficient mice (known as DAT knockouts) and in littermates that had normal dopamine transporter levels. In this technique, the scientists administer a radioactively labeled form of sugar (glucose) - the brain's main fuel - and use the PET scanner to track its site-specific concentrations in various brain regions. They tested the mice before and after cocaine administration, and compared the results to mice treated with saline instead of the drug.

Before any treatment, mice lacking dopamine transporters had significantly higher metabolism in the thalamus and cerebellum compared with normal mice. This elevated metabolism may be linked to chronically high levels of dopamine in the DAT knockout mice. It also suggests that dopamine levels may play an important role in modulating glucose levels in these brain areas, which play important roles integrating sensory information, learning, and motor function.

Interestingly, DAT knockout mice have been suggested as an animal model for attention-deficit hyperactivity disorder (ADHD). Elevated metabolism due to persistent elevated dopamine levels may be a factor contributing to the symptoms of ADHD, Thanos said.

After the scientists administered cocaine, whole brain metabolism decreased in both groups of mice, but more significantly in normal mice than in DAT knockouts. The scientists were able to detect this reduction in metabolism in a wide range of brain regions in the normal mice, suggesting that these decreases in metabolism are somehow associated with the blockade of dopamine transporters by cocaine.

The scientists also observed a reduction in metabolism in the thalamus region in the DAT knockout mice. This effect may likely be due to the effect of cocaine on other neurotransmitter systems, for example, norepinepherine or serotonin.

In summary, cocaine exposure has an effect on regional brain activity, which is mostly driven by dopamine action and to a secondary degree norepinephrine or serotonin. These results also support the idea that the thalamus and the cerebellum play key roles in cocaine's mechanism of effect on sensory input, learning, and motor function. This is particularly of interest in better understanding the mechanism of cocaine addiction as well as the neurobiology of ADHD.

UTMB wins $3.4 million federal grant to study addiction-recovery drugs

Thu, 07 Feb 2008 05:00:00 PST

( from http://www.rxpgnews.com ) GALVESTON, Texas -- The National Institute on Drug Abuse has awarded University of Texas Medical Branch at Galveston researchers a four-year, $3.4 million grant to develop what may become the first effective drugs to help people conquer cocaine addiction.

The researchers believe this ambitious program may ultimately benefit compulsive overeaters as well.

Led by the director of UTMB's Center for Addiction Research, Kathryn A. Cunningham, the effort centers on components of the brain's electrochemical signaling system that laboratory research suggests are crucially linked to success or failure in recovering from cocaine addiction. The scientists will focus on two types of molecules on the surfaces of nerve cells in the brain that respond to serotonin, a chemical that carries messages across the tiny gaps between the cells. Stimulation of these receptor molecules prompts a nerve cell to generate an electrical pulse that travels from one end of the nerve to the other, where the signal launches still more chemical messengers to be picked up by receptors on other nerve cells.

UTMB scientists have discovered that chemicals that increase the activity of one of the two kinds of serotonin receptors under study -- designated the 5-HT2C receptor -- dramatically reduce cocaine-induced behavior in rats, including the animals' tendency to press a lever to dose themselves intravenously with the drug.

Chemicals that block the activity of the other serotonin receptor, called the 5-HT2A receptor, suppress a characteristic seen in humans with a history of addiction: the sudden craving for a drug long associated with certain stimuli, like the desire for a cigarette some smokers get when having a drink in a bar.

In the laboratory, scientists have found that when rats were trained to associate lights and sound with pressing a lever to self-administer cocaine and then denied the drug for a time, they relapsed by pressing the lever for the drug when again exposed to the same sounds and lights. When the scientists activated the 5-HT2C receptor or blocked the 5-HT2A receptor, the rats were significantly less likely to initiate such relapses.

Changes in serotonin signaling have also been implicated in such disorders as depression, anxiety and anorexia, Cunningham said. Recent experiments have led the UTMB investigators to believe that drugs affecting the 5-HT2A and 5-HT2C receptors may also curb compulsive overeating and obesity.

Our ongoing research strongly suggests that drug therapies aimed at the 5-HT2A and 5-HT2C receptors could be potent weapons against both cocaine addiction and obesity, two of the most significant public health problems facing the U.S., Cunningham said. We hope this research will bring us closer to developing treatments for substance abuse and addiction that are as effective as those used for such other conditions as high blood pressure, asthma and diabetes.

The new program is divided into three parts.

A clinical research component, directed by Professor F. Gerard Moeller of the University of Texas Health Science Center at Houston, will investigate the responses of cocaine addicts to two antidepressants that increase the concentration of serotonin in nerve cell synapses.

A neurobiology project, headed by Cunningham, will use laboratory rat experiments to study the effects of new compounds specifically targeted at the 5-HT2A and 5-HT2C receptors (two of 14 known serotonin receptor subtypes).

Finally, a drug-design project led by UTMB chemical biologist Scott Gilbertson will seek to produce new molecules that could become powerful anti-addiction drugs themselves.

The entire effort will be supported by a cellular and molecular biology core lab directed by UTMB biochemistry and molecular biology professor Cheryl Watson, enabling the researchers to perform genetic analyses of serotonin function in individuals, along with cell-culture studies of new compounds aimed at the 5-HT2A and 5-HT2C receptors.

We believe that recovery in the brain's serotonin signaling systems can lead to recovery from cocaine addiction, Cunningham said. Our new research may jump-start a new generation of discovery for anti-addiction, and, potentially, anti-obesity therapies.

Video games activate reward regions of brain in men more than women, Stanford study finds

Mon, 04 Feb 2008 05:00:00 PST

( from http://www.rxpgnews.com ) STANFORD, Calif. - Allan Reiss, MD, and his colleagues have a pretty good idea why your husband or boyfriend can't put down the Halo 3. In a first-of-its-kind imaging study, the Stanford University School of Medicine researchers have shown that the part of the brain that generates rewarding feelings is more activated in men than women during video-game play.

These gender differences may help explain why males are more attracted to, and more likely to become 'hooked' on video games than females, the researchers wrote in their paper, which was recently published online in the Journal of Psychiatric Research.

More than 230 million video and computer games were sold in 2005, and polls show that 40 percent of Americans play games on a computer or a console. According to a 2007 Harris Interactive survey, young males are two to three times more likely than females to feel addicted to video games, such as the Halo series so popular in recent years.

Despite the popularity of video and computer games, little is known about the neural processes that occur as people play these games. And no research had been done on gender-specific differences in the brain's response to video games.

Reiss, senior author of the study and the Howard C. Robbins Professor of Psychiatry and Behavioral Sciences, has long been interested in studying gender differences; in 2005, he published a study showing that men and women process humor differently. He and his colleagues became interested in exploring the concept of territoriality, and they determined the best way to do so was with a simple computer game.

The researchers designed a game involving a vertical line (the wall) in the middle of a computer screen. When the game begins, 10 balls appear to the right of the wall and travel left toward the wall. Each time a ball is clicked, it disappears from the screen. If the balls are kept a certain distance from the wall, the wall moves to the right and the player gains territory, or space, on the screen. If a ball hits the wall before it's clicked, the line moves to the left and the player loses territory on the screen.

During this study, 22 young adults (11 men and 11 women) played numerous 24-second intervals of the game while being hooked up to a functional magnetic resonance imaging, or fMRI, machine. fMRI is designed to produce a dynamic image showing which parts of the brain are working during a given activity.

Study participants were instructed to click as many balls as possible; they weren't told that they could gain or lose territory depending on what they did with the balls. Reiss said all participants quickly learned the point of the game, and the male and female participants wound up clicking on the same number of balls. The men, however, wound up gaining a significantly greater amount of space than the women. That's because the men identified which balls - the ones closest to the wall - would help them acquire the most space if clicked.

The females 'got' the game, and they moved the wall in the direction you would expect, said Reiss, who is director of the Center for Interdisciplinary Brain Sciences Research. They appeared motivated to succeed at the game. The males were just a lot more motivated to succeed.

After analyzing the imaging data for the entire group, the researchers found that the participants showed activation in the brain's mesocorticolimbic center, the region typically associated with reward and addiction. Male brains, however, showed much greater activation, and the amount of activation was correlated with how much territory they gained. (This wasn't the case with women.) Three structures within the reward circuit - the nucleus accumbens, amygdala and orbitofrontal cortex - were also shown to influence each other much more in men than in women. And the better connected this circuit was, the better males performed in the game.

The findings indicate, the researchers said, that successfully acquiring territory in a computer game format is more rewarding for men than for women. And Reiss, for one, isn't surprised. I think it's fair to say that males tend to be more intrinsically territorial, he said. It doesn't take a genius to figure out who historically are the conquerors and tyrants of our species-they're the males.

Reiss said this research also suggests that males have neural circuitry that makes them more liable than women to feel rewarded by a computer game with a territorial component and then more motivated to continue game-playing behavior. Based on this, he said, it makes sense that males are more prone to getting hooked on video games than females.

Most of the computer games that are really popular with males are territory- and aggression-type games, he pointed out.

Reiss said the team's findings may apply to other types of video and computer games. This is a fairly representative, generic computer game, he said, adding that he and his colleagues are planning further work in this area.

Daily alcohol use causes changes in sexual behavior, new study reveals

Wed, 02 Jan 2008 05:00:00 PST

( from http://www.rxpgnews.com ) A team of researchers at Penn Sate has used an animal model to reveal, for the first time, a physiological basis for the effect of alcohol on male sexual behavior, including increased sexual arousal and decreased sexual inhibition. The research, which will be published on 2 January 2008 in the scientific journal PLoS ONE, resulted in four novel findings with broad importance for further addiction research. It is the first study to characterize the effects of chronic alcohol exposure in fruit flies. Physiological evidence supporting various theories about the effect of alcoholic drinks has been lacking, so our now having a suitable animal model makes it possible to conduct much-needed laboratory research on this issue, explains research-team-leader Kyung-An Han, associate professor of biology and a neuroscientist at Penn State. Information from this research can serve as a baseline for similar studies in other animals, including humans.

In contrast to previous studies in other labs, which subjected fruit flies to short-term doses of ethanol -- the intoxicating ingredient in alcoholic drinks -- Han's team administered to fruit flies a daily dose of ethanol to more closely mimic the drinking habits of alcoholics and chronic alcohol abusers. The team investigated several factors that influence the physiological effects of ethanol, including genetic and cellular components, age, and prior experience.

Among the team's discoveries is that male fruit flies, which typically court females, also actively court males when they are given a daily dose of ethanol. We identified three molecules that are crucial for ethanol-induced courtship disinhibition, Han said. In one of the team's experiments, Han and her students generated transgenic flies whose brain activities regulated by the neurotransmitter dopamine could be turned off temporarily by changing the temperature to 32-degrees C. Without a temperature change, the transgenic males showed conspicuous inter-male courtship under the influence of ethanol; however, they exhibited negligible inter-male courtship when we changed the temperature to block the transmission of dopamine neurons in the brain, Han said. This result suggests that dopamine is a key mediator of ethanol-induced inter-male courtship.

A second discovery is that repeated exposure to ethanol causes male flies to engage in more inter-male courtship, a phenomenon known as behavioral sensitization. If a behavior like alcohol consumption becomes more pleasurable the more often you do it, you are more likely to keep doing it, Han explained. Because the researchers suspect that behavioral sensitization results from adaptive changes in the brain's cells and molecules induced by chronic alcohol consumption, they plan to use behavioral sensitization as a model for further physiological studies of alcohol-associated behavior and addiction. This part of our study demonstrates that sexual behavior is not determined only during an organism's development, but it also can be influenced by a post-developmental environmental factor; in this case, recurring exposure to ethanol, Han said. These findings represent the first demonstration of enduring behavioral changes induced by recurring ethanol exposure in a fly model.

A third achievement of the team's research is its demonstration that daily ethanol exposure induces chronic tolerance to the sedative effect of ethanol in flies, as it does in other animals. Han and her students also made a fourth discovery -- that ethanol-induced intermale courtship is affected by aging. As flies get older, their cognitive capacities decline, making them more susceptible to the negative effect of ethanol on cognition, Han reports. The research revealed that, under the influence of ethanol, middle-aged and old male flies (2- to 4-weeks old) have a higher propensity for uninhibited inter-male courtship compared to fully mature male flies (4-days old).

As a result of our research with the fruit fly, we are now just beginning to discover the molecular and cellular mechanisms underlying neural changes in the brain that result from the chronic use of alcohol and that result in alcohol addiction and other behavior changes in our fly model, Han said. Taken together, the studies described by Han's team provide novel insights into the physiological effects of chronic ethanol exposure on sexual behavior and adaptive physiological changes within the brain, plus a foundation for future research on the effect of alcohol consumption on sexual behavior in mammals and other species.

Cognitive, genetic clues identified in imaging study of alcohol addiction

Tue, 25 Dec 2007 05:00:00 PST

( from http://www.rxpgnews.com ) People with clinical addictions know first-hand the ravages the disease can take on almost every aspect of their lives. So why do they continue addictive behaviors, even after a period of peaceable abstinence

Some answers appear rooted in regions of the brain active during decision making.

It's perhaps not just that people are slaves to pleasure, but that they have trouble thinking through a decision, said Charlotte Boettiger, an assistant professor of psychology at the University of North Carolina at Chapel Hill, and lead author of a study in the December issue of the Journal of Neuroscience that took a novel tack in addiction imaging research.

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.

The study also found that a variant of the COMT gene, which controls the level of the neurotransmitter dopamine in the cortex, was associated with a tendency to make impulsive decisions and with high activity in certain brain areas during decision making.

Current medications for addictions are not universally effective; many either mimic the addictive substance to help people get through withdrawal periods or block the substance to prevent its effects. For stimulants, such as methamphetamines, there are no therapies yet, Boettiger said.

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, said Boettiger, who led the study as scientist at the University of California, San Francisco's Gallo Clinic and Research Center.

I am very excited about these results because of their clinical implications, said Dr. Howard Fields, a professor of neurology at UCSF and an investigator in the Gallo Center.

The genetic findings raise the hopeful possibility that treatments aimed at raising dopamine levels could be effective treatments for some individuals with addictive disorders, said Fields, who is senior author of the study.

Most addiction imaging studies have focused on the brain response to drug-related stimuli.

Boettiger used functional magnetic resonance imaging (fMRI), which shows brain activity while a subject performs a function, to see what happened inside their heads when sober alcoholics and people in a non-alcoholic control group made decisions between immediate and delayed rewards.

Boettiger recruited 24 subjects; 19 provided fMRI data, nine 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, the subjects were asked to decide between receiving a small monetary award immediately or wait for a larger payoff. The scenarios were hypothetical, but the 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 the predicted individual choice in regions associated with decision making -- 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; they manage money poorly and act impulsively. Boettiger's study revealed reduced activity in the orbital frontal cortex in the brains of subjects who preferred nowover later, most of whom had a history of alcoholism.

The orbital frontal cortex activity may be a neural equivalent of long-term consequences. Think of the orbital frontal cortex as the brakes, Boettiger said. 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 cortex 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 COMT gene has two common variants with a single amino acid difference at position 158; valine (Val) or methionine. The Val form of the gene is associated with lower dopamine levels, and Boettiger's study showed that people with two copies of the Val 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 take a significant step toward being able to identify subtypes of alcoholics, which could help tailor treatments, and may people who are at risk for developing addictions and provide earlier intervention.

The bigger picture, Boettiger said, is that her study provides more evidence that addiction is a disease, something even some of her peers do not 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.

Research reveals secrets of alcohol's effect on brain cells

Fri, 07 Dec 2007 05:00:00 PST

( from http://www.rxpgnews.com ) NEW YORK (Dec. 7, 2007) -- Alcohol triggers the activation of a variety of genes that can influence the health and activity of brain cells, and new research from Weill Cornell Medical College in New York City sheds light on how that process occurs.

The findings, published in the Nov. 21 issue of The Journal of Neuroscience, may also edge scientists closer to understanding alcohol-linked disorders such as the brain damage associated with chronic alcoholism, and the abnormal brain development seen in the fetal alcohol syndrome (FAS).

If you are going to understand the biological effects of alcohol on genes within cells, you have to understand the molecular machinery driving the transcription, or activation, of the genes in question. That's what we believe we have done here, says the study's senior author Dr. Neil L. Harrison, professor of pharmacology and pharmacology in anesthesiology at Weill Cornell.

In research conducted in cell cultures and in mouse neurons in vivo, his team found that alcohol stimulates a ubiquitous, stress-linked biochemical cascade -- called the heat shock pathway -- to send a molecule called heat shock factor 1 (HSF1) into the neuron's nucleus. HSF1 then stimulates the transcription of many of the genes known to be activated by alcohol.

The fact that alcohol triggers the activation of genes in the brain is not new and has long been the subject of intense research.

One gene in particular, called Gabra4, is closely linked to the function (or dysfunction) of receptors for GABA, an important neurotransmitter.

We knew that levels of expression of Gabra4 fluctuated rapidly in the presence of alcohol, and so we wondered if we could find out how this happens, says lead author Dr. Leonardo Pignataro, instructor in pharmacology in anesthesiology at Weill Cornell.

At the same time, research in Korea with the C. elegans worm (a common tool for genomics research) had discovered that alcohol worked on a particular bit of DNA to trigger activity in the heat shock pathway, finding the same piece of DNA in the Gabra4 gene of mice and humans. This was all very intriguing, because the heat shock pathway is a biochemical mechanism found in almost all cells and all organisms, says Dr. Harrison. Scientists believe it helps cells deal with stressors -- including excessive heat or environmental toxins -- substances such as alcohol.

Working with mouse cells in the lab, the researchers used microarray technologies to search for genes other than Gabra4 that might be activated when the heat shock pathway was exposed to alcohol. They found many others.

The big question that remains is how does this activation occur The current theory holds that, under conditions of stress, heat shock proteins break away from a key molecule, HSF1. HSF1 then makes its way to the cell nucleus, where it helps stimulate the transcription and activation of a variety of genes that enable the cell to survive stress. We think this may happen with alcohol exposure, Dr. Harrison explains.

This finding, observed in vitro in the cell cultures, was replicated in in vivo experiments in mice, conducted in the lab of Dr. Daniel Herrera, assistant professor of psychiatry at Weill Cornell and an attending psychiatrist at NewYork-Presbyterian/Weill Cornell.

It was really exciting to see this mechanism work itself out in an animal model, suggesting that this same pathway may mediate at least some of the effects of alcohol on human brain cells, Dr. Herrera says.

Exactly what those effects might mean clinically remains in the realm of speculation for now, the researchers stress.

Alcohol can have bad effects -- the well-known effects of alcoholism, such as liver or brain damage, for example -- but moderate alcohol use also has more benign effects, such as the improvement in cardiovascular health observed in drinkers of red wine compared with tee-totallers, Dr. Pignataro points out.

One theory holds that alcohol-mediated stimulation of the heat shock pathway might trigger genes that help mop up mis-folded proteins that can damage cells. This would be a beneficial effect.

But it might also be possible that inappropriate activity of this pathway -- either during fetal brain development or in the adult brain -- is harmful. We just don't know, Dr. Harrison says. We'd certainly like to explore these issues going forward, and this research will give us some tools to answer these questions.

New research review shows that your family doctor may be the key to quitting smoking

Mon, 26 Nov 2007 05:00:00 PST

( from http://www.rxpgnews.com ) Scientists at the Centre for Addiction and Mental Health (CAMH) are defining the most effective ways to treat tobacco dependence, and in an article released in the November issue of the Canadian Medical Association Journal (CMAJ) they highlight the surprisingly significant role that the health practitioner can play in helping people quit smoking. Many people's attempts to quit are unsuccessful, so effective interventions are critical for the 4.5 million smokers in Canada alone.

Advising patients to quit, even just once, helps to double quit rates, write CAMH researchers Dr. Bernard Le Foll and Dr. Tony George. Their article Treatment of tobacco dependence: integrating recent progress into practice is a comprehensive summary of tobacco use, causes of nicotine dependence, and advances in treatment and intervention.To initiate as many cessation attempts as possible, practitioners should advise all of their patients who smoke to quit.

Research shows that since an estimated 70% of smokers visit a physician each year, family doctors have a substantial opportunity to influence smoking behaviour. Even a short intervention (three minutes or less) can increase a person's motivation to quit and can significantly increase abstinence rates, the authors write. They provide an algorithm topped by the simple question Are you smoking to help physicians integrate a patient's smoking status and his or her readiness to quit, taking a comprehensive approach that combines assessment, behavioural interventions and pharmacologic treatment of tobacco dependence.

The article also showed that smokers with moderate to severe tobacco dependence have been found to respond best to three types of pharmacotherapy -- nicotine replacement therapy, bupropion and varenicline -- but there is no clear threshold that can help clinicians decide whether a particular patient will benefit from a particular pharmacotherapy, and there is no consensus on which one should be used first. The authors' provide physicians with a clear comparative table of these three first-line pharmacologic treatments, as well as advice on whether to combine these pharmotherapies, or to consider nortriptyline and clonidine as second-line medications.

Epidemiologic studies have indicated that the majority of successful attempts to quit smoking occur without direct medical assistance or without pharmacotherapy. The use of nonpharmacologic methods (such as counseling) should be encouraged, especially for people for whom medication use is problematic, say the authors. The goal is to motivate the patient to try to quit smoking. Moreover, pharmacological interventions are clearly effective and allow doctors to double or triple the odds of success.

NSF grant funds research on risky decision-making in pre-teens

Mon, 26 Nov 2007 05:00:00 PST

( from http://www.rxpgnews.com ) Researchers at the University of Iowa have secured a $396,000 grant from the National Science Foundation (NSF) to study risky decision-making among pre-teens.

We hope to identify characteristics of kids who become risk-takers, such as lack of attention to risk levels or unwillingness to factor in long-term consequences, said Irwin Levin, principal investigator for the project and a UI professor with joint appointments in psychology in the College of Liberal Arts and Sciences and marketing in the Henry B. Tippie College of Business. If we can do that, future research could identify ways to proactively intervene and help those kids before they engage in risky behaviors like smoking or drinking, having unprotected sex, or disregarding traffic laws.

In the first phase of the study, funded by a $262,000 National Science Foundation grant, Levin tested children between the ages of 6 and 11 to gauge their ability to weigh risks. In a computer game, the subjects chose between two arrays of cups. Their options were to play it safe, selecting the cups guaranteed to contain one coin, or to take a chance, choosing the cups that sometimes had several coins and sometimes had none. The youngest children made the riskiest choices, while the older children varied their choices depending on the level of risk and whether the risk involved potential gains or potential losses.

Levin is conducting the second phase of the study with co-principal investigator Joshua Weller, who earned a doctorate in psychology from the UI in May and is now working for Decision Research in Eugene, Ore. The researchers plan to track changes in children's decision-making competence.

At age 10, children will complete surveys about the perceived risk of real-life scenarios, such as riding a bike without a helmet, being in the sun without sunscreen, riding in a vehicle without a seat belt, eating too much junk food, or playing violent video games. They will report the extent to which they engage in such risks, the extent to which they consider the behaviors risky, and how they think their peers would respond. The two-part survey will also include questions to assess each child's personality and grasp of probability. Parents will be surveyed on what they think their children are doing or would do in each scenario.

The same group will be surveyed again when the children reach age 13 or 14, this time including questions on some of the temptations they may be beginning to face, such as smoking, experimenting with drugs or alcohol, or sex.

Levin hopes to enroll 100 children and 100 parents in the study.

We expect steady increases in decision-making competence over a three-year period, and we should be able to identify profiles of at-risk children and track how their decision-making deficits affect choices in their everyday lives, Levin said. If we can define deficits in terms of some children not understanding the concept of risk very well, we can reach out to these potential risk-takers and help them better understand the possible consequences of some of these risks.

Cocaine abuse blunts sensitivity to monetary reward

Wed, 07 Nov 2007 05:00:00 PST

( from http://www.rxpgnews.com ) SAN DIEGO, CA - New measurements of brain activity in individuals addicted to cocaine confirm that addicted individuals have compromised sensitivity to monetary rewards.

This altered sensitivity to reward may help explain why some drug-addicted individuals are unable to modify their drug-taking behavior, even in the face of well-understood negative consequences and/or positive incentives for behavioral change, said Rita Goldstein, who runs the neuropsychoimaging lab at the U.S. Department of Energy's Brookhaven National Laboratory where the work was done. Muhammad A. Parvaz, a Stony Brook University graduate student working with Goldstein, will present the findings at the Society for Neuroscience annual meeting in San Diego on Wednesday, November 7, 2007.

The researchers studied 18 current cocaine users and 18 age-matched control subjects. They outfitted each subject with a cap of electrodes to measure brain activity after instructing the subjects to press or not press a button in response to certain visual prompts. During the task, subjects were told they could earn various amounts of money for fast and accurate performance.

The scientists were specifically interested in the P300 component of the brain waves time locked to the task (known as Event-Related Potentials). The P300, a positive voltage potential occurring at a latency of 300 milliseconds after presentation of a novel or meaningful stimulus, has been shown to be blunted in individuals addicted to alcohol and their offspring. The current study demonstrates, for the first time, a blunted P300 response to a commonly occurring and generalized abstract reward - money - in cocaine-addicted individuals with recent cocaine use.

The findings: In healthy control subjects, the P300 response was significantly higher and both accuracy and speed of performance were significantly better and faster, respectively, when a monetary reward was offered compared with when the reward was absent (45 vs. 0 cents). These responses to money in both brain and behavioral measures - and their interdependence - were reduced in cocaine-addicted individuals. In addition, those who had used cocaine most frequently during the year preceding the study were the least able to improve their behavioral performance in response to monetary rewards.

Interestingly, these results could not be attributed to decreased task engagement in the cocaine users, who instead reported being more interested in the task than the control subjects. It is possible that this heightened interest could be attributed to recent cocaine use, which was documented in all cocaine-using subjects in this study by positive urine screening tests.

So despite greater self-reported interest, cocaine users did not respond faster or more accurately and their brain activity did not change in response to monetary reward to the same degree as in the healthy control subjects, Parvaz said.

These results confirm findings from earlier studies conducted in Goldstein's lab that used functional magnetic resonance imaging (fMRI) to demonstrate a similar compromise in neural sensitivity to monetary reward in cocaine addiction.

Individuals with such blunted neural and behavioral sensitivity to rewards may have a particularly difficult time responding to abstract incentives designed to motivate behavioral changes - especially when outside of a structured treatment environment or when rewards are not readily available or clearly contingent on behavior, Goldstein said.

It would be interesting to see if there are any differences between the cocaine users studied here, who were not seeking treatment, and those in treatment or abstinent for longer periods of time, Parvaz suggested. Such a comparison would allow the researchers to determine whether recovery of sensitivity to reward can be expected, and assess the time frame for such recovery. The researchers may also extend the study to see if their findings can be generalized to negative reinforcement, such as the loss of money.

D-cycloserine reduces cocaine-seeking behavior in 'addicted' mice

Tue, 06 Nov 2007 05:00:00 PST

( from http://www.rxpgnews.com ) SAN DIEGO, CA - Scientists at the U.S. Department of Energy's Brookhaven National Laboratory provide further evidence that a drug known as D-cycloserine could play a role in helping to extinguish the craving behaviors associated with drug addiction. Their study found that mice treated with D-cycloserine were less likely to spend time in an environment where they had previously been trained to expect cocaine than mice treated with a placebo.

Since the association between drugs and the places where they are used can trigger craving and/or relapse in humans, a medication that could aid in the reduction or even extinction of such responses could be a powerful tool in the treatment of addiction, said Carlos Bermeo, a Stony Brook University graduate student working under the direction of Brookhaven Lab neuroscientist Panayotis (Peter) Thanos. Bermeo will present these results in a talk at the Society for Neuroscience annual meeting in San Diego on Tuesday, November 6, 2007, at 11 a.m.

D-cycloserine was originally developed as an antibiotic. But it has also been shown to extinguish conditioned fear in pre-clinical (animal) studies, and has been successfully tested in human clinical trials for the treatment of acrophobia (fear of heights). This finding led several researchers to wonder whether D-cycloserine could extinguish drug-seeking behaviors as well.

In 2006, a group of scientists not affiliated with Brookhaven Lab tested this hypothesis in rats. They found that D-cycloserine facilitated the extinction of cocaine conditioned place preference - the tendency for the animals to spend more time in a chamber where they had been trained to expect cocaine than in a chamber where they had no access to the drug.

The Brookhaven study builds on the previous work and adds information on the drug dose effect, the lasting properties of the treatment, and the locomotor effects of this compound.

Bermeo and Thanos' group worked with C57bL/c mice. Animals were first trained to receive cocaine in a particular environment. Once conditioned place preference was established (that is, animals willingly spent more time in a cocaine-paired environment than in a neutral environment), the mice were treated with either D-cycloserine or saline and allowed to spend forty minutes in either the previously cocaine-paired environment (with the drug no longer available) or the neutral environment.

This paradigm would be analogous to a clinical approach where the addict is returned to the environment that previously was the place of drug use (e.g., the neighborhood or home), but this time with no drug available, said Thanos. Reduced seeking of the drug in the same environment - that is extinction behavior - is a great indicator of future success in treatment and reduced chance of relapse, he added.

Mice treated with D-cycloserine showed less preference for the cocaine-paired environment and did this more rapidly than mice treated with saline. The low dose (15 milligrams D-cycloserine per kilogram of body weight, given intraperitonially) showed a 10 percent decrease in time spent in the previously cocaine-paired environment, and the high dose (30 mg/kg i.p.) showed a 17 percent decrease in the time spent in the previously cocaine-paired environment. The high dose produced a more pronounced and consistent extinction than the lower dose.

Interestingly, animals treated with the high dose of D-cycloserine exhibited lower locomotor activity compared to both the low-dose D-cycloserine group and the saline-treated animals. These two groups exhibited similar levels of locomotor activity. This indicates that dosing may have to be fine tuned to achieve optimal efficacy with minimum side effects.

It's important to remember that these are very preliminary results from a small animal study, Thanos cautions. Much further research will be required before testing this drug in humans. But it is inspiring to know that this drug may show promise in treating cocaine addiction, which continues to take a toll on society and for which no pharmacological treatment currently exists.

Hold your horses

Thu, 25 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) For those who suffer with the debilitating symptoms of Parkinson's disease, Deep Brain Stimulation offers relief from the tremors and rigidity that can't be controlled by medicine. A particularly troublesome downside, though, is that these patients often exhibit compulsive behaviors that healthy people, and even those taking medication for Parkinson's, can easily manage.

Michael Frank, an assistant professor of psychology and director of the Laboratory for Neural Computation and Cognition at The University of Arizona, and his research colleagues have shed some light on how DBS interferes with the brain's innate ability to deliberate on complicated decisions. Their results are published in the current (Oct. 26) issue of the journal Science.

DBS implants affect the region of the brain called the subthalamic nucleus (STN), which also modulates decision-making.

This particular area of the brain is needed for what's called a 'hold-your-horses' signal, Frank said. When you're making a difficult choice, with a conflict between two or more options, an adaptive response for your system to do is to say 'Hold on for a second. I need to take a little more time to figure out which is the best option.'

The STN, he said, detects conflict between two or more choices and reacts by sending a neural signal to temporarily prevent the selection of any response. It's this response that DBS seems to interrupt. DBS acts much like a lesion on the subthalamic nucleus. Frank's hypothesis predicted that DBS would negate the hold-your-horses response to high-conflict choices. Surprisingly, it actually sped up the decision-making process, a signature, he said, indicated of impulsive decision making.

The tendency toward impulsive behavior in Parkinson's patients is well-documented but only dimly understood. How is the STN involved in decision-making and why should things go awry when you stimulate it

For those taking them, medications did not slow down decision-making conflict. Regardless of whether these patients are on or off medication, for the purposes of the experiment they looked like healthy people or people who are off DBS.

But what Frank found was that medications prevent people from learning from negative outcomes of their choices. That could be one explanation for why patients develop gambling habits. If you learn from the positive outcomes instead of the negative, it could cause you to become a gambler.

Whereas the DBS had no effect on positive v. negative learning, but it had an effect on your ability to 'hold your horses,' so it was a dissociation between two treatments which we think reveal different mechanisms of the circuit of the brain that we're interested in.

Frank said the results of his experiments are a test of a basic science mechanism for how the brain makes adaptive decisions. The same basal ganglia is involved in other disorders. People who are addicts, for example, are more likely to make impulsive choices, and DBS and medication used to treat Parkinson's have been shown to cause pathological gambling to some degree.

We may be able to use this to understand that from this more basic sciences perspective. Maybe the same circuits are involved in gamblers who don't have Parkinson's, Frank said.

He also hinted that the study might also offer clues to consumer behavior.

I think that you can have the opposite effect, where the hold-your-horses signal is too strong in responding to decision conflict. One thing that has been shown in healthy people who have been presented with too many options exhibit is a kind of 'decision paralysis,' he said.

For example, if shoppers are exposed to two dozen varieties of essentially the same product, research shows very few will actually make a purchase. Employees faced with too many options for 401k plans are less likely to invest in any of them, even though their employer is going to match their contributions.

Frank is interested in whether impulsive decision making can be prevented in DBS patients. One long-range goal, he said, is to be able to test the STN during the implant surgery, avoiding the decision-making areas and target only the brain's motor function.

We hope that in the operating room we can actually when they record this brain area, we can determine selective parts of it that respond to this conflict-based decision-making and use that as a potential way of avoiding stimulating that area and have it be selective to just the pure motor function.

Decision-makers seek internal balance, not balanced alternatives

Thu, 25 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) A researcher at the University of California, San Diego (UCSD) School of Medicine suggests that psychiatrists may need to approach the treatment of psychiatric patients from a new direction � by understanding that such individuals� behavior and decision-making are based on an attempt to reach an inner equilibrium.

In a special section in the October 26 issue of the journal Science, Martin Paulus, M.D., professor in UCSD�s Department of Psychiatry, has compiled a body of growing evidence that human decision-making is inextricably linked to an individuals� need to maintain a homeostatic balance.

�This is a state of dynamic equilibrium, much like controlling body temperature,� said Paulus. �How humans select a particular course of action may be in response to raising or lowering that �set point� back to their individual comfort zone. In people with psychiatric disorders or addictions, the thermostat may be broken.�

Up to now, according to Paulus, psychiatrists and others have looked at the decision-making process as a considered series of options and values.

�What has never been considered closely, but should be, is the state of the decision-maker,� Paulus said. According to the researcher, this homeostatic state � the tendency to maintain internal stability, due to the mind and body�s coordinated responses to any stimulus that disturbs the normal condition � is altered in individuals with addictions and psychiatric disorders such as schizophrenia or anxiety. �This disturbance of homeostatic balance leads to dysfunctions in decision-making � which helps explain why such patients make seemingly bad choices,� he said.

Recent neuroimaging research shows strong support for the homeostatic nature of decision making, according to Paulus. �For example, interoceptive information � which is related to the body�s internal state or sense of balance � is integrated in a particular part of the brain called the anterior insular cortex,� he said. The same brain structures implicated in the urge to take drugs are involved in other biological urges, Paulus added, suggesting that a homeostatic approach could have a broad impact on treatments that seek to control addictions or psychiatric disorders, and will lay the groundwork for new areas of research.

The question addressed in part by this paper are whether changes in decision-making behavior and associated brain functions are a result of pre-existing characteristics � which may predispose individuals to use drugs � or as a consequence of long-term use.

�Decision-making dysfunctions and resultant altered neural processing could provide a biomarker to identify those at high-risk for addictive behaviors,� said Paulus, who added that much additional research is needed before scientists could begin to use such an approach.

In an upcoming paper in the journal �Dialogues in Clinical Neuroscience,� Paulus cites the complex affective, cognitive and behavioral phenomena that come into play during decision-making. �The interoceptive system is able to connect with various physiological systems in the brain to orchestrate a complex set of responses,� he said, adding that craving and urges are among the most notable responses that play important functions in maintaining homeostasis. Insights into how pleasure and urge are integrated in the brain and how this process is modulated can play an important role in the understanding of � and possible future treatment of � drug addiction, according to Paulus.

Gauging parent knowledge about teens' substance use

Wed, 24 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- New research results from the University at Buffalo�s Research Institute on Addictions (RIA) suggest that most parents are aware of and accurately evaluate the extent of their teenager�s cigarette smoking, marijuana use, drinking and overall substance use.

Researchers also found that in cases where parents provided lower estimates of substance use, parents were nearly twice as likely to underestimate frequency of marijuana use and quantity of alcohol use. Parents also were less likely to be aware of extent of use by younger teens and of their children�s use if they themselves had personal problems or were using alcohol more frequently.

What is novel about these findings is that for the first time, detailed statistics are available about parental knowledge of teen substance use for families in which the teen�s substance use is causing the parent stress, but the teen is not necessarily in treatment. Previous studies have been restricted to families with a teen in substance-buse treatment or families with no current substance use issues.

For a six-month reporting period, 82 percent of parents accurately evaluated the presence of teen cigarette smoking; the parents� reports corresponded with the teens� reports of their own smoking. Eighty-six percent of parents accurately evaluated the presence of teen alcohol use, and 86 percent accurately reported the presence of teen marijuana use. However, only 72 percent of the parents in the RIA study accurately reported the presence of illicit drug use (other than marijuana) by teens.

According to lead researcher Neil B. McGillicuddy, Ph.D., �This study begins to dispel the notion that parents don�t know the extent to which their teens are using cigarettes, alcohol and illicit drugs. It seems that, despite a few exceptions, many parents do know the extent of their teenager�s substance use. Parents can use this knowledge to help themselves cope with teenage substance use and the resulting stress on the family, as well as to begin conversations with their teen about making changes.�

McGillicuddy is a research scientist at RIA with extensive background in treatment interventions for parents of substance-abusing adolescents, interventions for partners of addicted persons and treatment for alcohol and drug-abusing adolescents.

This research was funded by the National Institute on Drug Abuse and published in the most recent issue of the Journal of Child and Adolescent Substance Abuse.

For this study, 75 parents and their teenagers were interviewed separately about the teens� recent use of cigarettes, alcohol, marijuana and other illicit drugs. Parent-participants were, on average, female (85 percent), 39 years of age with 13 years of education. Teen-participants were, on average, male (61 percent), 16 years of age and not receiving substance abuse treatment (76 percent).

When parents� and teens� reports were discrepant, parents provided lower estimates of substance use than teens. That is, teens tended to report greater frequency and amount of substance use. Although some of these discrepancies were small (for instance regarding how often teens drank alcohol), others were substantial (parents were nearly twice as likely to underestimate the frequency of marijuana use and the quantity of alcohol use).

In addition, McGillicuddy and colleagues set out to find factors that might explain the discrepancies in parent-teen reports of teen substance use. Parents were less aware of the extent of the teen�s substance use if the teen was younger (about 14 or 15), and if the parents did less monitoring of what their teens were doing after school, during the evening and on weekends. Together, these findings suggest that parents need to consider increasing their monitoring of how teens spend their time and begin thinking about substance use at a significantly younger age.

Lastly, parents who are caught up in their own issues or problems, whether stressed, feeling depressed or using alcohol more frequently, also made less accurate reports.

�What we would hope that people come away with from this study, is that parents can be more aware of their teen�s substance use,� McGillicuddy explained, �by reducing their own alcohol use, giving more attention to what their teen is doing 24/7, particularly if the teen is younger, and taking steps to reduce their own psychological distress. Participation in parenting programs, especially those geared toward coping with an adolescent�s substance use, can give the parent important skills to deal with teen behavior and have been found to reduce the parent�s distress.�

Age affects motivation for quitting smoking

Mon, 22 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) (Chicago, IL, October 22, 2007) � A new study shows that obstacles to smoking cessation and motives for quitting smoking vary with age. The study presented at CHEST 2007, the 73rd annual international scientific assembly of the American College of Chest Physicians (ACCP), found that smokers over age 65 reported quitting smoking due to physician pressure and stress due to a major health problem, while smokers under age 65 reported cigarette cost and tobacco odor as reasons for quitting.

�The current common perception among the medical community is that if smokers age 65 and older haven�t quit by now, they can�t or won�t quit � a perception which may lead physicians to focus less on their older patients� smoking habit,� said lead study author Virginia Reichert, NP, Center for Tobacco Control, North Shore-LIJ Health System, Great Neck, New York. �Our results show that older smokers are motivated to quit smoking by very different factors compared with younger smokers. If these factors are addressed, we may see cessation rates improve for both age groups.�

Ms. Reichert and colleagues from the Center for Tobacco Control at North Shore-LIJ compared health status and motives and obstacles for quitting smoking between 1,909 smokers under age 65 (younger smokers) and 143 smokers over age 65 (older smokers) who were attending a 6-week comprehensive cessation program. Older smokers were more likely than younger smokers to have a recent hospitalization (23% vs 13%), comorbid cardiac disease (78% vs 38%), cancer (20% vs 7%), and/or chronic obstructive lung disease/asthma (37% vs 23%). Regarding motivation, older smokers cited pressure by their physician and stress of a major health problem as main reasons for quitting. Younger smokers attributed their reasons for quitting to the cost of cigarettes, tobacco odor, and general health concerns.

�If the cost of cigarettes hasn�t made the older smoker quit by now, they are not as likely to be affected by the rising costs as much as younger smokers may be,� said Ms. Reichert. �On the other hand, younger smokers may not have experienced health effects from their smoking, but they may have felt the impact of the cost of cigarettes/cigars.�

Obstacles to smoking cessation also varied by age group. Younger smokers were more likely than older smokers to report concerns of weight gain (30% vs 15%), stress management (59% vs 45%), fear of failure (15% vs 8%), handling social situations (24% vs 7%), and cravings (44% vs 36%) as obstacles to quitting smoking. Furthermore, 54% of older smokers and 69% of younger smokers reported not wanting to give up their first cigarette in the morning as an obstacle to quitting smoking. Young smokers also believe that trying to quit �cold turkey� is best, when in reality, only 7% of smokers achieve long-term abstinence without professional help.

�To be most effective, treatment plans and education should be relevant to each group�s concerns,� said Ms. Reichert. She suggests that health-care providers offer weight management programs and stress management strategies as part of the treatment and relapse prevention programs for younger smokers, while older smokers may be more successful with physician encouragement and knowledge of how smoking is influencing their current health conditions.

�Tobacco-related diseases are major causes of death in the United States,� said Alvin V. Thomas, Jr., MD, FCCP, President of the American College of Chest Physicians. �The more we know about what motivates smokers to quit their habit and what personal obstacles they face in doing so, the more we can tailor smoking cessation programs to fit the individual needs of our patients.�

Carbon monoxide test helps doctors determine patients' smoking status

Mon, 22 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) (Chicago, IL, October 22, 2007) � Pulse cooximeters have long been used to identify and measure the levels of carbon monoxide (CO) in the blood of patients or firefighters. But new research, presented at CHEST 2007, the 73rd annual international scientific assembly of the American College of Chest Physicians (ACCP), indicates that the device has another use� it can quickly, inexpensively, and noninvasively identify a person who smokes. The study argues that if smokers know their blood CO levels, they may be more prone to quit or more likely to never start in the first place.

�By using this device in the office, the poisoning of the hemoglobin or blood with carbon monoxide can be detected and shown to the patient before they actually develop a clinical disease such as emphysema or cancer,� said study author Sridhar P. Reddy, MD, MPH, FCCP, St. Clair Pulmonary and Critical Care, St. Clair, MI. �In our practice, when the carboxyhemoglobin is 10%, it�s easy to tell a patient that 10% of his or her blood is poisoned and unable to carry oxygen. By doing this, we catch the patient�s attention right away and can begin smoking cessation counseling.�

The study originated as a high school science project. Carried out by Dr. Reddy�s son. At each outpatient visit, Dr. Reddy measured patients� carboxyhemoglobin, blood poisoned by CO, and methhemoglobin, blood transformed by other substances, such as nitrogen dioxide, with a pulse cooximeter. And, as part of his project, his son, who was a sophomore at Detroit Country Day School, developed and distributed questionnaires regarding the patients� smoking status.

�When I was searching for a science project, I realized that the question of how much carboxyhemoglobin is needed to suggest smoking seemed unanswered,� said coauthor and son Ashray Reddy. �I thought that by trying to answer this question, I could help people quit smoking.�

Researchers used the pulse cooximeter, a device that is clipped to the patient�s finger and reads the percentages of poisoned blood through a light that is shined through the nail bed. A total of 476 patients who visited the clinic participated. Patients were identified as a smoker, based on a combination of their questionnaire responses and if they�re CO levels exceeded 6% of their blood. Researchers were also able to identify secondhand smokers based on slight changes found in their levels, as well. Results showed that 98 patients were smokers, 72 were secondhand smokers, and 306 were nonsmokers.

�For the first time, the entire smoking cessation story can be quickly and noninvasively played out from beginning to end�detection, revealing the effect, and intervention, all while being respectful of available resources,� said Dr. Reddy. �Using this device, we can deliver the whole package, and based on our data, we believe it should be routinely used in any program geared toward smoking cessation.�

Researchers conclude that pulse cooximetery is a quick, inexpensive, and noninvasive way to detect patients� smoking status, and that the outpatient clinic is an ideal setting for its use. They also suggest its use for screening smoking status in multiple settings and populations, such as smoking cessation programs, high schools, hospitals, and the workplace.

�Physicians need to be able to identify a patient�s smoking status in order to effectively counsel them about smoking cessation,� said Alvin V. Thomas, Jr., MD, FCCP, President of the American College of Chest Physicians. �A method or device that could help physicians do this, and potentially reduce the number of people who smoke, is a method that is worth further exploration.�

Insulin's brain impact links drugs and diabetes

Tue, 16 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) Insulin, long known as an important regulator of blood glucose levels, now has a newly appreciated role in the brain.

Vanderbilt University Medical Center researchers, working with colleagues in Texas, have found that insulin levels affect the brain�s dopamine systems, which are involved in drug addiction and many neuropsychiatric conditions.

In addition to suggesting potential new targets for treating drug abuse, the findings raise questions as to whether improper control of insulin levels � as in diabetes � may impact risk for attention deficit hyperactivity disorder (ADHD) or influence the effectiveness of current ADHD medications.

The study, led by Aurelio Galli, Ph.D., in the Center for Molecular Neuroscience and Calum Avison, Ph.D., in the Institute of Imaging Science (VUIIS), appears online this week in the Public Library of Science Biology (PLoS Biology).

The psychostimulant drugs amphetamine and cocaine, as well as related medications for ADHD, block the reuptake of the neurotransmitter dopamine by dopamine transporters (DATs) and increase the level of dopamine signaling. Some of these compounds, including amphetamine, also cause a massive outpouring of dopamine through DATs.

The resulting surge of synaptic dopamine alters attention, increases motor activity and plays an important role in the addictive properties of psychostimulants.

But the link between insulin status and dopaminergic function is not readily apparent.

�In the 1970s, there were articles showing that, in animals with type 1 diabetes, psychostimulants like amphetamine would not increase locomotor behavior,� said Galli, associate professor of Molecular Physiology and Biophysics. �We didn�t have a clear understanding of why that was happening.�

This sparked Galli and colleagues to investigate the link between insulin signaling and amphetamine action.

Using a rat model of type 1 � or juvenile � diabetes in which insulin levels are depleted, Galli�s group assessed the function of the dopaminergic pathway in the striatum, an area of the brain rich in dopamine.

In the absence of insulin, amphetamine-induced dopamine signaling was disrupted, they found. Dopamine release in the striatum was severely impaired and expression of DAT on the surface of the nerve terminal � where it normally acts to inactivate dopamine � was significantly reduced.

The lack of the protein on the plasma membrane prevents the amphetamine-induced increase in extracellular dopamine, and in turn, amphetamine fails to activate the dopamine pathways that stimulate reward, attention and movement, Galli noted.

The researchers then restored insulin by pulsing the hormone back into the brain of the diabetic animals and found that the system returns to normal, indicating that the lack of insulin in the striatum directly affected amphetamine action.

To connect the physiological findings to activity in the intact brain, collaborators in the VUIIS, led by Avison, developed a probe for brain DAT activity using functional magnetic resonance imaging (fMRI).

�You can do molecular dissection in very well defined model systems and break the system down into its constituents,� said Avison, professor of Radiology and Radiological Sciences, and professor of Pharmacology. �But the question is: how does that relate to the intact brain? What�s the relevance to overall functioning in the intact system?�

Working with Galli and Avison, Jason Williams, Ph.D., used fMRI to demonstrate that in normal, healthy rats with plenty of insulin, amphetamine increased neural activity in the striatum. But in diabetic animals, activity in the striatum was suppressed.

�This finding is in vivo evidence that, in the intact diabetic rat, loss of insulin has compromised DAT trafficking to the plasma membrane,� Avison said. �These experiments show that there is likely a strong interplay between these important dopamine neurotransmitter systems and insulin signaling mechanisms, which we know are altered in diabetes�

The results are some of the first to link insulin status and dopaminergic brain function and hold several implications for human health and disease.

�This is really the first mechanistic connection in vivo between diabetes and amphetamine action,� Galli said. �This offers a completely new perspective on the influence of this disease (diabetes) on brain function, as well as diseases with altered dopamine signaling, such as schizophrenia and ADHD.�

The findings suggest that ADHD risk may have an insulin-dependent component and that control of insulin levels and response to the hormone may be an important determinant of amphetamine efficacy in patients with ADHD, Galli noted.

�We have described a novel mechanism by which diabetes may affect brain function.�

Why it is impossible for some to 'just say no'

Wed, 10 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) Drug abuse, crime and obesity are but a few of the problems our nation faces, but they all have one thing in common�people�s failure to control their behavior in the face of temptation. While the ability to control and restrain our impulses is one of the defining features of the human animal, its failure is one of the central problems of human society. So, why do we so often lack this crucial ability

As human beings, we have limited resources to control ourselves, and all acts of control draw from this same source. Therefore, when using this resource in one domain, for example, keeping to a diet, we are more likely to run out of this resource in a different domain, like studying hard. Once these resources are exhausted, our ability to control ourselves is diminished. In this depleted state, the dieter is more likely to eat chocolate, the student to watch TV, and the politician to accept a bribe.

In a recent study, Michael Inzlicht of the University of Toronto Scarborough and colleague Jennifer N. Gutsell offer an account of what is happening in the brain when our vices get the better of us.

Inzlicht and Gutsell asked participants to suppress their emotions while watching an upsetting movie. The idea was to deplete their resources for self-control. The participants reported their ability to suppress their feelings on a scale from one to nine. Then, they completed a Stroop task, which involves naming the color of printed words (i.e. saying red when reading the word �green� in red font), yet another task that requires a significant amount of self-control.

The researchers found that those who suppressed their emotions performed worse on the Stroop task, indicating that they had used up their resources for self-control while holding back their tears during the film.

An EEG, performed during the Stroop task, confirmed these results. Normally, when a person deviates from their goals (in this case, wanting to read the word, not the color of the font), increased brain activity occurs in a part of the frontal lobe called the anterior cingulate cortex, which alerts the person that they are off-track. The researchers found weaker activity occurring in this brain region during the Stroop task in those who had suppressed their feelings. In other words, after engaging in one act of self-control this brain system seems to fail during the next act.

These results, which appear in the November issue of Psychological Science, a journal of the Association for Psychological Science, have significant implications for future interventions aiming to help people change their behavior. Most notably, it suggests that if people, even temporarily, do not realize that they have lost control, they will be unable to stop or change their behavior on their own.

The 'arms' race: Adult steroid users seek muscles, not medals

Wed, 10 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) The majority of non-medical anabolic-androgenic steroid (AAS) users are not cheating athletes or risk-taking teenagers. According to a recent survey, containing the largest sample to date and published in the online open access publication, Journal of the International Society of Sports Nutrition, the typical male user is about 30 years old, well-educated, and earning an above-average income in a white-collar occupation. The majority did not use steroids during adolescence and were not motivated by athletic competition or sports performance.

The study, conducted by a collaboration of researchers from around the country coordinated by Jason Cohen, Psy.D. candidate, used a web-based survey of nearly 2,000 US males. Whereas athletes are tempted to take anabolic steroids to improve sports performance, the study suggests that physical self-improvement motivates the unrecognized majority of non-medical AAS users who particularly want to increase muscle mass, strength, and physical attractiveness. Other significant but less highly ranked factors included increased confidence, decreased fat, improved mood and attraction of sexual partners.

Although often considered similar to abusers of narcotics and other illicit drugs (e.g., heroin or cocaine), non-medical AAS users are remarkably different. These users follow carefully planned drug regimens in conjunction with a healthy diet, ancillary drugs and exercise. As opposed to the spontaneous and haphazard approach seen in abusers of psychotropic drugs, everything is strategically planned to maximize benefits and minimize harm. This is simply not a style or pattern of use we typically see when we examine substance abuse said Jack Darkes, Ph.D., one of the authors. The notions of spontaneous drug seeking and loss of control do not apply to the vast majority of AAS users, added co-author Daniel Gwartney, M.D.

These findings question commonly held views of typical AAS users and their underlying motivations, said Rick Collins, one of the study's authors. The focus on 'cheating' athletes and at risk youth has led to irrelevant policy as it relates to the predominant group of non-medical AAS users. The vast majority of AAS users are not athletes and hence, are not likely to view themselves as cheaters. The targeting of athletes through drug testing and other adolescent or sports-based interventions has no bearing on non-competitive adult users.The study concludes that these AAS users are a driven and ambitious group dedicated to gym attendance, diet, occupational goals and educational attainment. The users we surveyed consider that they are using directed drug technology as one part of a strategy for physical self-improvement within a health-centered lifestyle, said Collins. Effective public policy should begin by accurately identifying who's using steroids and why. We hope our research - the largest adult survey of non-medical AAS use we know of - is a significant step forward in that direction.

Vanderbilt nets brain gene research center

Tue, 02 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) Neuroscientists at Vanderbilt University are stepping into the national limelight with the establishment of a Silvio O. Conte Center for Neuroscience Research.

The new center, funded by a $10 million grant from the National Institute of Mental Health (NIMH), will support interdisciplinary studies aimed at understanding the gene networks that control serotonin systems in the brain.

The neurotransmitter serotonin is central to brain biology: it participates in systems that control sleep, aggression, sexual drive, satiety, reward and mood. Serotonin has been implicated in a range of disorders including depression, obsessive-compulsive disorder, schizophrenia and autism, and medications that affect serotonin signaling, such as the SSRI (selective serotonin reuptake inhibitor) antidepressants, are widely prescribed.

The Vanderbilt Conte Center investigators are focusing their efforts on the raphe nuclei, a cluster of serotonin neurons that reside in the brain stem and receive input from and send messages to neurons throughout the rest of the brain.

�This is one of the most medically important cell groups in the nervous system, and the genes that control these neurons and their output are particularly key to our understanding of mental illness risk,� said Randy Blakely, Ph.D., director of the new Conte Center.

�Dr. Blakely has assembled the right team for the job of understanding how genetic variability affects neurotransmitter systems in the developing brain,� said Thomas Insel, M.D., director of the NIMH. �The new Center holds promise for hastening the day when discoveries in the lab will be translated into improved treatments for people with mental illnesses, from mood disorders to autism.�

Conte Centers for Neuroscience Research are a centerpiece of NIMH funding, said Beth-Anne Sieber, Ph.D., chief of the Developmental Biology Program at NIMH. �With these centers, NIMH is looking to the investigators to push their hypotheses forward, create new hypotheses, and find answers relevant to mental health.�

�The Vanderbilt center is the epitome of a Conte Center,� she said. �It really captures the spirit of integration and synergy between investigators.�

The centers are named for the late U.S. Rep. Silvio O. Conte, a longtime advocate for scientific research and organizer of the 1990s �Decade of the Brain� efforts. There are approximately 10 Conte Centers for Neuroscience Research and 10 Conte Centers for the Neuroscience of Mental Disorders � centers with a translational-clinical research emphasis.Blakely said the new center reflects Vanderbilt�s commitment to and investments in neuroscience programming, evident in the growth in research and education here over the last decade.

�This is a defining moment for the neurosciences at Vanderbilt,� said Jeffrey Balser, M.D., Ph.D., associate vice chancellor for Research. �Over the last few years, we have received several forms of external validation that affirm neuroscience at Vanderbilt has become absolutely top tier. An NIH Conte award makes that excellence even more visible to the national and international research community, and at the same time will provide crucial resources for making fundamental progress in mental health research.�

The Vanderbilt Conte Center includes scientists from the School of Medicine and the College of Arts and Science as well as researchers at other institutions. The center investigators will probe the workings of serotonin neurons in the raphe complex from their earliest stages of development to their function in mature animals. The operating hypothesis of the group, Blakely said, is that a rich network of genes establishes and maintains serotonin signaling in the brain and that deficits in the formation or stability of this network in humans underlies risk for mental illness.

The projects make extensive use of specialized mouse models, including mice in which serotonin neurons have been specifically tagged with fluorescent marker proteins or have had selective changes to their serotonin signaling molecules.

�We know that serotonin networks � broadly, all the genes that cooperate to control serotonin assembly and signaling � can be identified and manipulated in the mouse,� Blakely said, �and we feel strongly that the conservation of these networks in humans will allow us to formulate new hypotheses regarding disease-associated genetic variation.�

The Conte Center will also support multiple core facilities that �rest upon the significant technological framework that has been established at Vanderbilt through its shared resources program,� Blakely added.

In addition to its core facilities that will benefit the wider Vanderbilt research community, the Conte Center will administer a pilot grant program targeted to young investigators or established investigators who wish to enter the field of serotonin biology. The center will also host an annual symposium centered on the themes of the Conte program, and Conte Center members will participate in outreach activities that convey to a broader audience the �why� behind the research.

Vanderbilt Conte Center projects and leaders:

On-screen smoking in movies linked to young adult smoking behavior

Tue, 02 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) New study findings show that exposure to on-screen smoking in movies has a strong correlation with beginning to smoke or becoming established smokers among young adults 18-25, a critical age group for lifelong smoking behavior.

The research was conducted by a team from the University of California, San Francisco. Previous studies from around the world found that viewing on-screen smoking was linked to recruitment of adolescent smokers, but this is the first time that smoking among young adults has been associated with their exposure to smoking scenes on screen, said senior author Stanton Glantz, PhD, professor of medicine and director of the UCSF Center for Tobacco Control Research and Education.

�Ages 18 to 25 are critical years, when one-third of smokers start and others who began smoking as adolescents either stop smoking or become regular smokers,� he said.

The research team found a �dose-response relationship� between exposure to smoking on screen and the likelihood of having smoked in the past 30 days in a sample of 1,528 young adults. The study findings are published in the November issue of the �American Journal of Preventive Medicine.�

Young adults who saw the most smoking on screen have a 77 percent greater chance of having smoked at least once in the last 30 days (a measure of smoking initiation) and an 86 percent increased chance of being regular established smokers compared to young adults who saw little smoking in movies, the study showed. �Established smokers� are defined as those who have smoked 100 cigarettes or more and currently smoke.

Participants in the study reflected a cross-section of the U.S. population for the age group, and they took part through a web-based survey. Of the study group, 24.7 were smokers, comparable to estimates of the Centers for Disease Control and Prevention of 25.3 percent for this population. The survey format was similar to the studies of adolescents, with participants receiving a list of 60 motion pictures, selected at random from the top grossing 500 movies released during 2000-2004, and asked to identify the movies they had seen. Each participant was then placed in a quartile of exposure based on the sum of tobacco occurrences that had been viewed.

The results showed a direct effect between exposure and current smoking. The researchers found that two factors mediated the association between exposure to film smoking and established smoking: positive expectations about smoking and exposure to friends and relatives who smoke.

�The main effect is to recruit new smokers from among young adults,� Glantz noted. �Movies encourage them to experiment, and once they start experimenting with cigarettes other factors take hold. Movies create the expectation that smoking will turn out okay.�

The effect demonstrated in young adults is smaller than effects shown in adolescents, but comparable to other environmental risk factors for smoking initiation in young adults, he emphasized.

For example, in the 18-25 age group, researchers estimate that exposure to tobacco promotions in clubs and bars and at campus social events boosts the odds of 30-day smoking by a factor of 1.75, close to the risk of 1.77 posed by exposure to smoking on screen.

It has been estimated that awarding R-ratings on future tobacco imagery to eliminate smoking from youth-rated films would reduce teen exposure to the imagery by half and prevent about 200,000 youth a year from starting to smoke, Glantz said. The results of the new study indicate that young adults are also being recruited to smoke through their exposure to movie smoking, and a substantial reduction in smoking content has the potential to avert even more tobacco deaths, he added.

Scripps research study reveals mechanism behind nicotine dependency

Mon, 01 Oct 2007 04:00:00 PST

( from http://www.rxpgnews.com ) The research is being published the week of October 1, 2007, in an advance, online issue of the journal Proceedings of the National Academy of Sciences (PNAS).

The new study reveals that, in rats, chronic nicotine use recruits a major brain stress system, the extrahypothalamic corticotropin releasing factor (CRF) system, which contributes to continued tobacco use by exacerbating anxiety and craving upon withdrawal. The researchers found that administering a compound that blocked the receptors involved in this stress system alleviated withdrawal symptoms.

�We reduced the need to take nicotine by blocking CRF-1 receptors in the brain,� says Olivier George, a research associate in the Scripps Research Koob lab who conducted the study with Sandy Ghozland and other colleagues. �We were surprised by the compound�s dramatic effectiveness. We don�t know yet if the same mechanism is involved in humans with tobacco dependence, but it is very promising.�

Tobacco addiction is the leading avoidable cause of disease and premature death in the United States, responsible for more than 438,000 deaths annually, according to the Centers for Disease Control and Prevention. Nicotine, the main psychoactive ingredient in tobacco, is a tough drug, with smokers continuing to crave it long after they�ve started withdrawal. Most smoking-cessation medication is based on nicotine replacement therapy, using nicotine gum or patches, that substitutes one source of nicotine for another. Roughly 80 percent of smokers who try to quit relapse within a year.

While nicotine can produce mildly pleasurable effects, the Scripps Research scientists believe a more important factor in the difficulty in quitting is the brain�s adaptation to that reward, which produces an intense discomfort upon withdrawal.

�The key in nicotine addiction is that the positive pleasurable effects of nicotine are instantaneous and short lasting, while the negative effects are delayed and long lasting,� George says. �Even if nicotine may transiently induce a relief from a negative emotional state, its long-term consequences are disastrous.�

For years, scientists have wanted to know what changes in the brain occur in the transition from nicotine use to nicotine dependence. In the current study, the researchers set out to see if nicotine dependence is linked to changes in the CRF system in the amygdala, an area of the brain that plays a primary role in the processing and memory of emotional reactions. The CRF system is activated by CRF-1, an essential protein for coping with stressful events.

When the researchers induced nicotine withdrawal in rats, the nicotine-deprived group exhibited severe anxiety-like behavioral symptoms of withdrawal-such as burying and �freezing� (becoming motionless)-compared with controls. In addition, withdrawal whetted the rats� appetite for even greater quantities of the drug, a result the researchers call the �nicotine deprivation effect.�

�Rats exhibited drug-loading behavior following a cycle of abstinence, attaining an amount of nicotine in roughly six hours that previously took 12 hours,� George says. �This is like the light smoker becoming a chain smoker after trying to quit.�

Measurements showed this behavior was indeed matched by hyperactivity in the CRF system, and that these withdrawal effects lasted a surprisingly long time. In addicted rats, these effects developed in under a week and maintained a hold for at least two months.

�That�s a long time for a rat, considering its life expectancy is two years,� says George. �These results suggest long-lasting neuroadaptations of the CRF system, possibly through gene regulation, that may help explain why many cigarette smokers relapse even after a long abstinence from smoking.�

Importantly, the researchers were able to moderate the effects of nicotine deprivation. When addicted rats were injected with a CRF receptor antagonist, the injected rats showed less anxiety-like behavior during withdrawal and self-administered less nicotine compared with an addicted controls.

The Scripps Research scientists hope their work will lead to new nicotine-free pharmacological treatments, as well as shedding light on questions such as what makes some people more likely than others to become addicted in the first place.

Mixing large doses of both acetaminophen painkiller and caffeine may increase risk of liver damage

Wed, 26 Sep 2007 04:00:00 PST

( from http://www.rxpgnews.com ) WASHINGTON, Sept. 26 2007 -- Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS� Chemical Research in Toxicology, a monthly journal. The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.

Health experts have warned for years that consuming excess alcohol while taking acetaminophen can trigger toxic interactions and cause liver damage and even death. However, this is the first time scientists have reported a potentially harmful interaction while taking the painkiller with caffeine, the researchers say.

While the studies are preliminary findings conducted in bacteria and laboratory animals, they suggest that consumers may want to limit caffeine intake -- including energy drinks and strong coffee -- while taking acetaminophen.

Chemist Sid Nelson, Ph.D., and colleagues, of the University of Washington in Seattle, tested the effects of acetaminophen and caffeine on E. coli bacteria genetically engineered to express a key human enzyme in the liver that detoxifies many prescription and nonprescription drugs. The researchers found that caffeine triples the amount of a toxic byproduct, N-acetyl-p-benzoquinone imine (NAPQI), that the enzyme produces while breaking down acetaminophen. This same toxin is responsible for liver damage and failure in toxic alcohol-acetaminophen interactions, they say.

In previous studies, the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage, thus supporting the current finding.

�People should be informed about this potentially harmful interaction,� Nelson says. �The bottom line is that you don�t have to stop taking acetaminophen or stop taking caffeine products, but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol.�

Nelson points out that the bacteria used in the study were exposed to �megadoses� of both acetaminophen and caffeine, much higher than most individuals would normally consume on a daily basis. Most people would similarly need to consume unusually high levels of these compounds together to have a dangerous effect, but the toxic threshold has not yet been determined, he says.

Certain groups may be more vulnerable to the potentially toxic interaction than others, Nelson says. This includes people who take certain anti-epileptic medications, including carbamazepine and phenobarbital, and those who take St. John�s Wort, a popular herbal supplement. These products have been shown to boost levels of the enzyme that produces the toxic liver metabolite NAPQI, an effect that will likely be heightened when taking both acetaminophen and caffeine together, he says.

Likewise, people who drink a lot of alcohol may be at increased risk for the toxic interaction, Nelson says. That�s because alcohol can trigger the production of yet another liver enzyme that produces the liver toxin NAPQI. The risks are also higher for those who take large amounts of medications that combine both acetaminophen and caffeine, which are often used together as a remedy for migraine headaches, arthritis and other conditions.

The researchers are currently studying the mechanism by which this toxic interaction occurs and are considering human studies in the future, they say. The National Institutes of Health funded the initial animal and bacterial studies.