About Addiction: Smoking, drinking and Heroin

Some great, informative articles about addiction, alcohol and smoking, as well as some about Heroin.  We also have some new sites with links listed here so give us your feedback on what you like!

Alcohol

Caron Chit Chat: According to a world renowned addiction treatment center, the female problem drinker in Dallas is most likely between the ages of 25-39, single, prefers wine and beer to hard liquor, drinks more with her girlfriends than on a date or with work colleagues and may not sleep well.

PhysOrg.com: Binge drinking can cause long lasting damage to an important area in the brains of adolescent monkeys, suggesting that binge drinking could have serious effects on memory formation in adolescents.

HealthDay: One in five college students admitted to drunk driving. Additionally, more than 40% of twenty year old adolescents rode in a car with an intoxicated driver.

Medical News Today: Young people in the two years after high school who are in romantic relationships are less likely than their peers to report heavy drinking and marijuana use. Marriage lowers the odds that people will get drunk frequently or smoke pot.

HealthDay: As teens become adults, their tendency toward impulsive behaviors decreases as well as the amount of alcohol they consume. Teenagers tend to mature as they get older as well as drink less alcohol.

SAMHSA: Around 508,000 adolescents aged 12-17 in the United States drink alcohol; 641,000 use illicit drugs; and more than 1 million smoke cigarettes on any average day. This data was conducted in a national survey sponsored by the Substance Abuse and Mental Health Services Administration.

Heroin

The Sydney Morning Herald: Heroin users regularly land in hospitals, and heroin use is often fatal. This study traced all hospital admissions of a group of heroin users over 10 years, to mid 2004.

REUTERS: According to the National Institute on  Drug Abuse, around 3.7 million people in the US have used heroin sometime in their lives. Prescription heroin may help addicts to stay off street drugs.

Smoking

PhysOrg.com: Increasing cigarette taxes could be an effective way to reduce smoking among alcohol or drug abusers or people with mental disorders. A ten percent increase in cigarette pricing resulted in an eighteen percent decline in smoking among alcohol or drug abusers or individuals with mental disorder.

REUTERS: Tobacco companies and retailers say in a lawsuit that anti-smoking signs in New York City showing a decaying tooth, diseased lungs and a damaged brain violate cigarette vendors’ free speech and should be removed.

More to cigarettes than nicotine

A recent talk I gave (click here), highlighted the fact that other aspects of smoking are very important for addiction to cigarettes. For some people, this isn’t news, especially if you’ve been reading our coverage about the importance of cues for smoking addiction. But that’s not all that makes cigarettes so hard to quit.

Cigarettes, chemicals, and addiction

Smoking addictions are very difficult  to quit

Thousands of chemicals are released when cigarettes are smoked, including the nicotine we’ve been hearing so much about as well as formaldehyde, benzene, and other nasty things. Some of the chemicals that are released have psychoactive effects, and a few, like acetaldehyde (the chemical that causes hangovers), and a group of monoamine oxidase inhibitors (yes, like old school MAOI antidepressants), apparently increase the effects of nicotine itself greatly, making it far more rewarding, and therefore theoretically addictive, than it would be without them.

The recent paper by a group at Duke University, suggests that there may be aspects of the smoke in cigarettes, even without nicotine, that are themselves rewarding. In the study, researchers gave people the option of taking nicotine by IV or smoking a de-nicotinzed cigarette – Overwhelmingly, participants chose to smoke the nicotine-free cigarettes.

Limitations and conclusions

Now granted, these were regular smokers, which meant that regardless of the effect, the act of smoking was so pre-programmmed for them as a rewarding one that overcoming it just for an experiment is a far-fetched notion. Still, given the hard time I’m having using nicotine as a reward, it seems likely that the other chemicals, as well as the experience of the smoke itself, play a very important role in addiction to cigarettes. Indeed, researchers years ago were very interested in discussing the role off the insula, a brain region important for bodily sensations (possibly involved in cravings and urges).

Another important limitation of this study was the fact that the “de-nicotinized” cigarettes actually had very  small amounts of nicotine in them. This little tidbit of  information is important because even small, “priming,” doses of a drug can cause very strong effects in terms of drug-seeking and drug-wanting. Maybe in the future there’d be some way of repeating this sort of study with cigarettes that actually contain no nicotine whatsoever.

Citation:

Rose, J.E., Salley, A., Behm, F.M., Bates, J.E.,  and Westman, E.C. (2010). Reinforcing effects of nicotine and non-nicotine components of cigarette smoke. Psychopharmacology, 210, 1-12.

About Addiction: Your brain, smoking, alcohol and drugs

Some new, different areas of addiction and some old favorites.  Read on to learn more!

Check out this USA Today story about President Obama’s public health fight and goals of reducing drug usage.  He said prevention and education are really what we need.

Your Brain and Addiction

Science Daily: A genetic variant of a receptor in the brain’s reward circuitry plays an important role in determining whether the neurotransmitter dopamine is released in the brain following alcohol intake.

Health Day: Children who experience psychological disorders such as depression and substance abuse appear to be headed for a financially depressed adulthood.

Science Daily: This article investigates separate and joint effects of alcohol and tobacco on the nucleus accumbens. A new study has found that alcohol abuse elevated the expression of a distinct set of genes in the NAC and VTA while nicotine blunted this effect in the VTA.

Alcohol

APP: This article talks about a new study on alcohol use of teens. The Partnership for a Drug Free America found in a study released in March an 11 percent increase among students in grades 9-12 who reported drinking alcohol in the past month, up to 39 percent in 2009, or 6.5 million students.

Science Daily: This article suggests that frequent alcohol use is linked to faster HIV disease progression. According to the article, HIV disease tends to progress at a faster rate in infected individuals who consume two or more alcoholic drinks a day.

Associated Press: This is a link to a short text which states that the World Health Organization endorsed a global strategy to reduce alcohol abuse. This text calls alcohol use one of the leading causes of sickness and death.

Smoking

Physorg.com: In a new study was found that treatment for smoking dependence is as effective among people with severe mental illnesses as it is for the general population.

Cesar Fax: This  states that cigarette excise tax increased in fifteen states in 2009. Four states have not increased cigarette taxes in more than a decade.

Other Drugs

Reuters: Prescription drug use of US children has risen. Children were the leading growth demographic for the pharmaceutical industry in 2009, with the increase of prescription drug use among youngsters nearly four times higher than in the overall population.

Medical News Today: There are significant changes in substance use treatment admissions patterns that have occurred over the past decade. The co-abuse of alcohol and drugs has declined gradually yet significantly.

About Addiction: Smoking, Drugs, Drinking and Cancer

New links for interesting articles about addiction. Check them out!

Tobacco, nicotine, and Smoking

Medical News Today: According to a recent study in China there is a new effective strategy for treating tobacco addiction.  Researchers have developed a novel tea filter that seems to help with cigarette addiction. (Note: this link doesn’t give direct access to the article so we’re basing the summary on the article itself)

SAMHSA: According to a new nationwide study, adolescent smoking may be influenced by mothers’ smoking or depression. The study states that adolescents living with mothers who smoke are 25.6% more likely to smoke. It’s frightening to think that 1.4 million 11-17 year old kids started smoking in the past 12 months!

Science Daily: Exposure to prenatal smoking may lead to psychiatric problems. According to new research, exposure to prenatal smoking can increase the need for psychotropic medications in childhood and young adulthood.

Hard drugs

Science Daily:  A newly developed and tested modified enzyme has been shown to break down cocaine into inactive products nearly 1000 times faster than the human body. The article states further that cocaine toxicity due to drug overdose results in more than half a million emergency room visits annually. This new enzyme could help prevent OD deaths by breaking down the drug.

Fox News: The number of soldiers seeking opiate abuse treatment has been increasing, going up from 89 in 2004 to 529 last year.

Addiction Inbox: A study that uses the Stroop test (have to name the colors of words and not the words themselves) seems to be a good predictor for addiction treatment effectiveness and drop out rates. Pretty cool stuff!

Alcohol

Join Together: This is a short article summarizing research which shows that rare childhood leukemia is tied to drinking during pregnancy. According to this research, children whose mothers are drinking during pregnancy are 56 percent more likely to develop a rear form of leukemia called AML.

Addiction Tomorrow: Britain is considering raising the prices of their very low-end alcohols most likely in an attempt to damper the young adults that binge drink and of alcoholics since they are most often the ones that drink the low-end alcohol.

The context of my addiction – Environmental effect on drug use???

When most people think about addiction, they imagine a person completely unable to control their cravings, always wanting the thing they’re addicted to. That was certainly my experience throughout most of my addiction.

So what happens when you just can’t have it? What happens when drug use is just not allowed? What happens if your life depended on it?

In a way, this question was at least partially answered recently in an article by a number of psychologists at the University of Tel Aviv. What the authors did was simple: They asked a group of heavy Orthodox smokersQuitting is smoking is difficult, at least in some contexts. about their cravings, irritability, and difficulty avoiding smoking on a regular workday, and random day in which they were not allowed to smoke, and the Sabbath (the Jewish day of rest), during which they’re not allowed to smoke for religious reasons. The simple finding was that the participants craved smoking a lot less, were less irritable, and found it a lot easier to avoid smoking on the Sabbath than on any of the other two day.

The moral of the story? Smoking may be really addictive, but when the choice is a cigarette or eternal damnation, it’s a pretty easy one to make…

In the future, I’ll talk about how this idea of addiction within specific contexts has been shown to also exist for the effect of the drug (or behavior) itself!

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)

Drug use and abuse following terrrorism: Lessons from addiction research

A recent addiction research article combined findings from 31 different studies to assess the impact of large terrorism events on rates of alcohol, cigarettes, and drug use. The researchers noted that most of the studies occurred after the World Trade bombing of September 11th, 2001.

  • After controlling for the level of exposure, type of event, and length since exposure, the evidence suggests that somewhere between 7%-14% of the population affected by the terrorism will show an increase in their rates of alcohol use.
  • For cigarettes smoking, the average is somewhere between 7%-10%.
  • Drug use, including narcotics and prescription medication, increased an average of 16% to as high as 50% or more. There’s no doubt that a large portion of that increase is due to increased prescription drug use, most likely anti-anxiety medication, antidepressants, etc.

Overall, the findings certainly show that a large-scale terrorism event affects the daily life of citizens, especially in terms of their coping using drugs and alcohol. Hindsight is 20/20, but hopefully next time, we’ll be ready to help people deal with such catastrophes while helping them steer away from possible dependence on drugs down the line.

Citation:

DiMaggio, Charles; Galea, Sandro; Li, Guohua (2009) Substance use and misuse in the aftermath of terrorism. A Bayesian meta-analysis. Addiction, Volume 104, 894-904.

Substance use and misuse in the aftermath of terrorism. A Bayesian meta-analysis