Lindsay Lohan not drinking – cleared of false SCRAM bracelet alert

Here’s a little follow-up to last month’s post about Lindsay Lohan:

Lindsay Lohan’s SCRAM bracelet went off at an after party for the MTV Movie Awards on June 6, leading authorities to believe she had violated her probation and consumed alcohol.

Lindsay was ordered to come in at 10AM the next morning for a urine test. The results came back clean. She is still in full compliance with her probation and she continues to take court-ordered alcohol education classes. Linday’s next court hearing is scheduled for July 6th. Hopefully she can stay out of trouble until then. Violating her probation could land her up to 6 months in jail.

Addiction and the media – a stigma made in heaven

The sad truth is media outlets jump at the chance to make celebrities look bad. Celebrity addiction is usually brought up when someone gets arrested, checks into rehab, or overdoses. As a result, many people find it hard to believe that celebrities can stay sober. In the case of Lindsay Lohan, all sorts of rumors are flying around that she tampered with her SCRAM bracelet or that she paid off the testing lab.

Celebrities don’t always mess up. We just don’t get to see it when they succeed. To paint a more balanced picture of celebrity addiction, we will be featuring posts about famous individuals who have been able to overcome their addiction to drugs. Look for these in the weeks to come!

Contributing co-author: Andrew Chen

Understanding Blood Alcohol Content (BAC levels)

Contributing co-author: Andrew Chen

Blood Alcohol Content (BAC) is a measure of alcohol concentration in a person’s bloodstream. The more a person drinks, the higher their BAC and the more they experience alcohol-related impairments. The following table shows the behavioral, physical, and mental changes brought on by alcohol at various BAC levels:

Progressive Effects of Alcohol with rising BAC levels

Blood Alcohol
Concentration
Changes in Feelings
and Personality
Physical and Mental
Impairments
0.01 — 0.06 Relaxation
Sense of Well-being
Loss of Inhibition
Lowered Alertness
Joyous
Thought
Judgment
Coordination
Concentration
0.06 — 0.10 Blunted Feelings
Disinhibition
Extroversion
Impaired Sexual Pleasure
Reflexes Impaired
Reasoning
Depth Perception
Distance Acuity
Peripheral Vision
Glare Recovery
0.11 — 0.20 Over-Expression
Emotional Swings
Angry or Sad
Boisterous
Reaction Time
Gross Motor Control
Staggering
Slurred Speech
0.21 — 0.29 Stupor
Lose Understanding
Impaired Sensations
Severe Motor Impairment
Loss of Consciousness
Memory Blackout
0.30 — 0.39 Severe Depression
Unconsciousness
Death Possible
Bladder Function
Breathing
Heart Rate
=> 0.40 Unconsciousness
Death
Breathing
Heart Rate

BAC levels can be accurately measured through blood, breath, or urine tests. Currently, the legal limit to drive in the U.S. is .08 for individuals over the age of 21. That limit is similar to those used in other states, but there is some variation.

How many drinks for a BAC of .08?

The answer to this question is a little more complicated than it seems. Alcohol affects everyone differently. In general, smaller individuals reach higher BAC levels more quickly than larger individuals, fatter individuals reach higher levels more quickly than muscular individuals, and women reach higher levels more quickly than men. These factors are all related to the amount of water present in the body. The more water a person has in their body, the more diluted the alcohol will be in their blood. (smaller individuals have less water than bigger people, fatty tissue has less water than muscle, and women typically have a higher % of body fat than men).

Chronic drinkers can develop a tolerance to alcohol, allowing them to metabolize alcohol more quickly and giving them added resistance to the functional impairments of alcohol.

Furthermore, alcohol can affect the same person differently under different circumstances. Eating before drinking can delay alcohol absorption and reduce a person’s peak BAC levels by as much as 40%. Exhaustion, illness, and dehydration impair a person’s ability to metabolize alcohol, promoting higher BAC. Depressed mood and stress can also magnify the effects of alcohol. Finally, medications can react with alcohol, potentially causing serious health complications.

You’ve had too many – can you lower BAC?

Contrary to popular belief, there is no magic food or drink that can lower your BAC levels. Exercising and taking a cold shower will also do nothing to lower BAC. BAC levels will only decrease with time. On average, a person metabolizes alcohol at a rate of one drink (0.5 oz alcohol) per hour. Spacing out drinks is a good way to manage BAC levels as it gives your body time to metabolize alcohol while delaying further increases in BAC.

Understanding your body is the first step towards preventing dangerous BAC levels. Plan ahead make sure you don’t ruin your night or someone else’s by drinking more than you can handle.

Additional Resources:

BAC table for men

BAC table for women

Check out the Virtual Bar at www.b4udrink.org for a really fun way to learn about your own limits!

College students and binge drinking

Contributing co-author: Andrew Chen

The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as any pattern of alcohol consumption that brings an individual’s BAC (blood alcohol content) above .08 (the legal limit in most states). This equates to approximately 4-5 drinks for a man or 3-4 drinks for a woman within a 2 hour period.

In case some of you forgot, one drink is approximately a 1.5 oz shot OR 5 oz. of wine OR 12 oz. of beer.

College binge drinking norms

College students are one population in which binge drinking is prevalent. Prior to 18 years of age, students who end up not attending any college are most at risk for binge drinking. However, after 18 (the age when most people graduate from high school), students who attend a 4 year university become the population most at risk to binge.

So what is it about going to college that makes people want to drink more?

One important factor to consider is the way we portray college in the media. Television shows and movies often show binge drinking as the “normal” way college students consume alcohol (think beer bongs). This gives students unrealistic ideas of how much the average college students drinks. In fact, when asked how much most students drink in a typical drinking situation, students consistently overestimate how much their peers drink. This false norm creates an atmosphere where people are pressured to drink more than they normally would on their own.

The long-term consequences of binge drinking

Aside from the obvious impact of heavy drinking on health, binge drinking can lead to other very unpleasant outcomes. Among college students, students that drink heavily report higher incidences of regretted sex, sexual assault, riding with a drunk driver, loss of consciousness, and going to class hungover compared to those that drink moderately.

What can parents do?

Research has shown that parents continue to influence the choices their children make long after they leave for college. Parents can decrease the chances that their children will develop problematic drinking behaviors by doing two things: monitoring and modeling. Monitoring consists of asking a child where they are, what they are doing, and who they are interacting with. Modeling consists of setting a good example, communicating expectations, and transmitting values.

By remaining involved in their child’s life, parents may also indirectly influence who their child becomes friends with, which in turn influences their drinking behavior.

Citation:

Timberlake et. al (2007) Alcoholism: Clinical and Experimental Research

Abar. C, Turrisi, R. (2008) How important are parents during the college years? A longitudinal perspective of indirect influences parents yield on their college teens’ alcohol use

Facebook, E-mail, Games, and Porn – A glimpse at Computer addiction

Contributing co-author: Andrew Chen

Computer addiction, including social networking and porn  addiction, can lead to serious dysfunction in some peopleThe idea of the internet being addictive may draw a chuckle until you realize that compulsive video gaming has been responsible for some horrifying deaths across the world, including examples from China and South Korea of addicts playing for 50+ straight hours before going into extreme cardiac arrest.

With 1.5 billion Internet users around the world today, the Internet has become an integral part of our society. With the huge success of the Internet, researchers have become interested in the possibility of a new disorder, Computer addiction (or internet addiction disorder).

What is internet addiction?

Internet Addiction Disorder (IAD) is a controversial term being used to describe problematic use of the Internet. IAD is not a recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders. Many wonder if excessive Internet use really counts as an addiction. Excessive Internet use could just be a symptom of other underlying factors such as depression, anxiety, or occupational need. (1)

Those that believe excessive Internet use is a unique phenomenon have modified the criteria for diagnosing pathological gambling to diagnose IAD. For someone to have IAD, they must demonstrate five or more of the following:

1. Is preoccupied with the Internet (think about previous online activity or anticipate next online session).
2. Needs to use the Internet with increased amounts of time in order to achieve satisfaction.
3. Has made unsuccessful efforts to control, cut back, or stop Internet use.
4. Is restless, moody, depressed, or irritable when attempting to cut down or stop Internet use.
5. Has stayed online longer than originally intended.
6. Has jeopardized or risked the loss of a significant relationship, job, educational or career opportunity
because of the Internet.
7. Has lied to family members, therapist, or others to conceal the extent of involvement with the Internet.
8. Uses the Internet as a way of escaping from problems or of relieving a dysphoric mood (e. g., feelings of helplessness, guilt, anxiety, depression). (1)

Who gets computer addiction and to what?

Despite early beliefs that Internet addiction was most prevalent among introverted young males, new studies have shown that Internet addiction can affect people of any gender, age, and socioeconomic status (1).

People are most likely to develop unhealthy Internet habits using online social applications such as e-mail, instant messaging, and networking sites (e.g. Facebook, Myspace). Chat rooms and MMORPGs (Massively Multiplayer Online Role Playing Games) are especially addicting as they allow a user to instantly communicate with hundreds if not thousands of other users (2).

Online social interactions may help a person fulfill unmet real life social needs and thereby reinforce prolonged Internet use.

It should be noted that most studies of Internet use rely on self-report measures. This method undoubtedly leads to an underreporting of Internet pornography use. According to the AVN Media Network, people in the United States alone spend around three billion dollars on online porn. Aside from social applications, online porn certainly plays a significant role in Internet addiction.

So, does excessive Internet use truly characterize an addiction? That debate is not likely to end anytime soon. Either way, the Internet is here to stay and many individuals who have problems controlling their Internet use could benefit greatly from help, especially if their use involves a financial cost.

Citations:

1. Beard, K.W., Wolf, E.M. (2001) Modification in the proposed diagnostic criteria for internet addiction, Cyberpsychology & Behavior, 4(3)
2. Young, K.S., (1996) Internet addiction: Emergence of a new clinical disorder, Cyberpsychology & Behavior, 1(3)

The Prescription drug use problem: Unethical marketing strategies for Oxycontin

080727-oxycontin-vmed-4p.widecIn 1996, Purdue Pharma L.C. introduced Oxycontin to the drug market. Oxycontin is a sustained-release oxycodone preparation used in treating chronic pain. Purdue put together an aggressive marketing plan to promote the sale of the drug. In it’s first year, Purdue sold $48 million dollars of Oxycontin. By 2000, Purdue was making a staggering 1.1 billion dollars a year from Oxycontin.
The enormous commercial success of Oxycontin would not have been surprising if it had been a revolutionary drug. However, numerous studies have shown many other opioid medications to be just as safe and effective as Oxycontin. So how did Purdue get so many people to buy Oxycontin? Below are some of the tactics Purdue Pharma used to increase it’s sales:
– From 1996-2001, Purdue put on more than 40 national pain-management and speaker-training conferences. More than 5000 physicians, nurses, and pharmacists attended these all-expenses-paid conferences where they were trained for Purdue’s national speaker bureau. Although many physicians deny it, research has shown that attending these types of conferences influences physician’s prescribing tendencies.
-Purdue implemented a bonus system to encourage their sales representatives to increase sales of Oxycontin in their territory. In 2001 alone, Purdue paid approximately $40 million dollars in incentive bonuses.
-Purdue used marketing data which allowed them to see nationwide statistics on physicians prescribing patterns. Purdue used this data to aim their marketing campaign at physicians with the highest rates of opioid prescription. While in theory this strategy targets physicians with the most chronic pain patients, it also ends up targeting physicians with loose standards for prescribing drugs.
– Purdue gave out coupons for a free prescription good for one 7-30 day supply of Oxycontin. By the time the offer ended, 34,000 coupons had been claimed.
-Purdue claimed that the risk of addiction to Oxycontin was less than one percent. Long term studies of opioid treatment for chronic pain patients have shown the risk of addiction to range from 0% to 50%. In 2007, Purdue Frederick Company Inc (an affiliate of Purdue Pharma) and three company executives pled guilty to misbranding the risk of addiction for Oxycontin and will pay $646 million dollars in fines.
Together these strategies helped shoot Oxycontin sales through the roof. In 2001, Oxycontin became the most frequently prescribed opioid in the United States for treating moderate to sever pain.
The problem is not that Purdue made a lot of money. The problem is that in the process of making money, Purdue created a huge drug problem. Between 1997-1999, the state of Maine experienced a 460% increase of people treated for opioid abuse. In southwest Virginia, the number of deaths related to prescription opioids increased 830% from 23 deaths in 1997 to 215 deaths in 2003. In eastern Kentucky, there was a 500% percent increase in the number of patients entering methadone maintenance treatment programs. In each case, these increases were correlated with increases in Oxycontin availability in those regions.
Currently the FDA is in charge of ensuring that prescription all drug advertising is honest and truthfully communicated. Aggressive marketing strategies like those used by Purdue end up making prescription drugs easier to obtain and easier to abuse. Tougher FDA restrictions on acceptable marketing practices would make the pharmaceutical industry more like honest evidence-based medicine and less like a car sale.

Contributing co-author: Andrew Chen080727-oxycontin-vmed-4p.widec

If you’ve read our Hellish Heroin story, you know how addictive Oxycontin can be for some people, especially when used recreationally, and not to treat severe pain. This article will talk about some of the unethical practices used to market that drug.

The story of oxycontin

In 1996, Purdue Pharma L.C. introduced Oxycontin to the drug market. Oxycontin is a sustained-release oxycodone preparation used in treating chronic pain. Purdue Pharma put together an aggressive marketing plan to promote the sale of the drug. In it’s first year, Purdue sold $48 million dollars of Oxycontin. By 2000, Purdue was making a staggering 1.1 billion dollars a year from Oxycontin.

The enormous commercial success of Oxycontin would not have been surprising if it had been a revolutionary drug. However, numerous studies have shown many other opioid medications to be just as safe and effective as Oxycontin. So how did Purdue get so many people to buy Oxycontin? Below are some of the tactics Purdue Pharma used to increase it’s sales:

  • From 1996-2001, Purdue put on more than 40 national pain-management and speaker-training conferences. More than 5000 physicians, nurses, and pharmacists attended these all-expenses-paid conferences where they were trained for Purdue’s national speaker bureau. Although many physicians deny it, research has shown that attending these types of conferences influences physician’s prescribing tendencies.
  • Purdue implemented a bonus system to encourage their sales representatives to increase sales of Oxycontin in their territory. In 2001 alone, Purdue paid approximately $40 million dollars in incentive bonuses.
  • Purdue used marketing data which allowed them to see nationwide statistics on physicians prescribing patterns. Purdue used this data to aim their marketing campaign at physicians with the highest rates of opioid prescription. While in theory this strategy targets physicians with the most chronic pain patients, it also ends up targeting physicians with loose standards for prescribing drugs.
  • Purdue gave out coupons for a free prescription good for one 7-30 day supply of Oxycontin. By the time the offer ended, 34,000 coupons had been claimed.
  • Purdue claimed that the risk of addiction to Oxycontin was less than one percent. Long term studies of opioid treatment for chronic pain patients have shown the risk of addiction to range widely, from 0% to 50%. In 2007, Purdue Frederick Company Inc (an affiliate of Purdue Pharma) and three company executives plead guilty to misbranding the risk of addiction for Oxycontin and will pay $646 million dollars in fines.

Together these strategies helped shoot Oxycontin sales through the roof. In 2001, Oxycontin became the most frequently prescribed opioid in the United States for treating moderate to severe pain.

Improper prescription marketing

The problem is not that Purdue made a lot of money. The problem is that in the process of making money, Purdue created a huge drug problem. Between 1997-1999, the state of Maine experienced a 460% increase of people treated for opioid abuse. In southwest Virginia, the number of deaths related to prescription opioids increased 830% from 23 deaths in 1997 to 215 deaths in 2003. In eastern Kentucky, there was a 500% percent increase in the number of patients entering methadone maintenance treatment programs. In each case, these increases were correlated with increases in Oxycontin availability in those regions.

Currently the FDA is in charge of ensuring that all prescription drug advertising is honest and truthfully communicated. Unfortunately, in it’s current state, this department of the FDA is understaffed and underfunded so the review of promotional materials is both slow and lax. Aggressive marketing strategies like those used by Purdue end up making prescription drugs easier to obtain and easier to abuse. Tougher FDA restrictions on acceptable marketing practices would make the pharmaceutical industry more like honest evidence-based medicine and less like a car sale.

Citation:
Zee, A.V. (2009) The promotion and marketing of OxyContin: Commercial triumo, public health tragedy. American Journal of Public Health. 99(2)

Take Charge of your Life: Another adolescent substance abuse prevention program that doesn’t work.

In a previous post we talked about the ineffectiveness of the school-based substance abuse prevention program called D.A.R.E. (Drug Abuse Resistance Education). We reported data from a meta-analysis of 11 studies which showed no significant effect of D.A.R.E. in reducing drug use. A recently published study examined the effectiveness of another school-based program called Take Charge of Your Life (TCYL)
TCYL was developed in 1999 as part of the Adolescent Substance Abuse Prevention Study (ASAPS). The ASAPS was a response to the criticism D.A.R.E. was receiving at the time. The goal of the study was to create a more effective program that could utilize D.A.R.E. funding and resources.
The TCYL curriculum consists of 10 lessons in the seventh grade and 7 lessons in the ninth grade which are all taught by trained D.A.R.E. Officers. The TCYL lessons inform students of the personal, social, and legal risks involved with drug use and provide accurate statistical data on drug use. The general philosophy of TCYL is to actively engage students and allow them to make a choice to not use drugs. Like D.A.R.E., the TCYL courses teach communication, decision-making, assertiveness, and refusal skills.
To determine the effectiveness of TCYL, 20,000 seventh graders were enrolled in the study and followed through the ninth grade. Roughly half of these students received the TCYL curriculum while the other half did not.
The results from the study show a negative effect, where TCYL actually increased alcohol and cigarette use among baseline nonusers, compared to students who did not receive TCYL. Clearly, this is not what the developers of TCYL were hoping to see. However, what is equally interesting from the results is a positive effect, where TCYL decreased marijuana use among students who were already using marijuana when the study began. This finding reinforces the idea that people can be affected by the same program differently.
Perhaps the lesson to be learned from the mixed results of TCYL is that prevention programs need to be designed to take into account people’s individual differences. The traditional “one size fits all” approach to prevention may not be the most effective
*D.A.R.E. has not adopted the TCYL curriculum and will continue to teach the relatively new “keepin’ it REAL” curriculum, whose effectiveness has yet to be determined.

Teen smoke

Contributing co-author: Andrew Chen

In a previous post we talked about the ineffectiveness of the school-based substance abuse prevention program called D.A.R.E. (Drug Abuse Resistance Education). We reported data from a meta-analysis of 11 studies which showed no significant effect of D.A.R.E. in reducing drug use. A recently published study examined the effectiveness of another school-based program called Take Charge of Your Life (TCYL).

TCYL was developed in 1999 as part of the Adolescent Substance Abuse Prevention Study (ASAPS). The ASAPS was a response to the criticism D.A.R.E. was receiving at the time. The goal of the study was to create a more effective program that could utilize D.A.R.E. funding and resources.

The TCYL curriculum consists of 10 lessons in the seventh grade and 7 lessons in the ninth grade which are all taught by trained D.A.R.E. Officers. The TCYL lessons inform students of the personal, social, and legal risks involved with drug use and provide accurate statistical data on drug use. The general philosophy of TCYL is to actively engage students and allow them to make a choice to not use drugs. Like D.A.R.E., the TCYL courses teach communication, decision-making, assertiveness, and refusal skills.

To determine the effectiveness of TCYL, 20,000 seventh graders were enrolled in the study and followed through the ninth grade. Roughly half of these students received the TCYL curriculum while the other half did not.

The results from the study show a negative effect, where TCYL actually increased alcohol and cigarette use among baseline nonusers, compared to students who did not receive TCYL. Clearly, this is not what the developers of TCYL were hoping to see. However, what is equally interesting from the results is a positive effect, where TCYL decreased marijuana use among students who were already using marijuana when the study began. This finding reinforces the idea that people can be affected by the same program differently.

Perhaps the lesson to be learned from the mixed results of TCYL is that prevention programs need to be designed to take into account people’s individual differences. In addition to previous drug use, developers need to understand how race, gender, personality, and other individual variables affect the success or failure of their program. Without this understanding, “one size fits all” programs like D.A.R.E. and TCYL can easily end up causing more harm than good.

*D.A.R.E. has not adopted the TCYL curriculum and continues to teach the relatively new “keepin’ it REAL” curriculum, whose effectiveness has yet to be determined.

Citation:

Sloboda, Z., Stephens, R.C. , Grey, S.S., Teasdale, B, Hawthorne, R.D., Williams, J., and Marquette, J.F. (2009) The adolescent substance abuse prevention study: A randomized field trial of a universal substance abuse prevention program. Drug and Alcohol Dependence. 102(1-3)