Prenatal cocaine exposure increases risk of higher teen drug use

May 3, 2017

Science Daily/Case Western Reserve University

While the crack cocaine epidemic peaked in the late 1980's, its effects are still causing harm to an estimated 3 million teenagers and young adults exposed to the stimulant in the womb.

They are twice as likely to use tobacco and marijuana at age 15 and develop a substance use disorder at 17 than teens who weren't exposed to the drug in utero, according to researchers at Case Western Reserve University.

They are also more likely to handle stress in negative ways, especially if mistreated as a child, using fewer problem-solving skills and having less control over their emotions. They're also more likely to become distracted or disengaged.

These poor coping strategies are typically associated with acting out behaviors: Teens in the study were likely to break rules, fight, show aggression, steal and use drugs, tobacco and alcohol.

At 15 years old, more than 36 percent of these teens had used a drug within the past month; at 17, it was 43 percent, significantly higher than their peers who were not exposed to cocaine in utero.

"Children exposed to cocaine in the womb are more susceptible to addiction themselves because they are more likely to have trouble controlling their behaviors and emotions, which can lead to using substances more often and at earlier ages," said Sonia Minnes, an associate professor at the Jack, Joseph and Morton Mandel School of Applied Social Sciences at Case Western Reserve.

As lead researcher of Project Newborn, a National Institutes of Health (NIH)-funded study that began in 1994, Minnes and her research team have followed babies with prenatal cocaine-exposure from birth into emerging adulthood.

While researchers are in the midst of a four-year, $2.5 million NIH grant to report on the group at age 21, the latest results come from two studies published in Drug and Alcohol Dependence that focus on the children at ages 15 and 17.

Cocaine, in any form, is toxic to a fetal brain, by restricting blood flow and altering the expression of genes, which can affect executive functioning, language and other types of development.

Many of the teens in the study were raised in chaotic caregiving environments; more than 30 percent reported maltreatment, including physical and emotional abuse and neglect.

These teens were more likely to use denial as a coping strategy and less likely to override initial impulses to calm themselves down, redirect thoughts positively or forego gratification when they also experienced childhood maltreatment.

"Prenatal cocaine exposure may predispose children to a lower threshold for activating 'stress circuits' and may increase their vulnerability to the harmful effects of environmental stress such as childhood maltreatment," said Meeyoung O. Min, a research associate professor at the Mandel School and a researcher with Project Newborn.

Many of the mothers in the study also used other substances during pregnancy including tobacco, alcohol and marijuana.

"Given the many challenges presented to these children, they are doing better than expected as they enter adulthood," Minnes said. "They are a testament to the benefits of providing a positive environment for a child who was put at higher risk due to drug exposure."

Project Newborn data suggests that specialized drug use prevention programs could benefit such high-risk children as they develop. In addition, the project's findings may provide insights into addressing similar public health crises, such as prenatal exposure to opiates.

"You want to prevent the next generation from using drugs while pregnant, and this is powerful data that helps make this case," Minnes said. "This project helps us better understand the many factors and pitfalls facing children whose mothers used drugs."

https://www.sciencedaily.com/releases/2017/05/170503080213.htm

Early age of drinking leads to neurocognitive and neuropsychological damage

October 30, 2017

Science Daily/Research Society on Alcoholism

Although drinking by U.S. adolescents has decreased during the last decade, more than 20 percent of U.S. high-school students continue to drink alcohol before the age of 14 years. This can have adverse effects on their neurodevelopment. Little is known about how the age of alcohol-use onset influences brain development. This is the first study to assess the association between age of adolescent drinking onset and neurocognitive performance, taking into account pre-existing cognitive function.

The researchers examined data from a longitudinal study on the neurocognitive effects of substance use in adolescents: 215 adolescents (127 boys, 88 girls) with minimal alcohol use experience were administered a neuropsychological test battery, which was repeated an average of 6.8 years later. Analyses examined whether earlier ages of onset for first and weekly alcohol use adversely affected neurocognition, controlling for substance-use severity, and familial and social environment factors.

Results showed that an earlier onset of drinking increases the risk for alcohol-related neurocognitive vulnerabilities, and that the initiation of any or weekly alcohol use at younger ages is a risk factor for poorer, subsequent neuropsychological functioning. More specifically, an earlier age of onset of first drinking predicted poorer performance in the domains of psychomotor speed and visual attention, and an earlier age of onset of weekly drinking predicted poorer performances on tests of cognitive inhibition and working memory. The authors suggested that these findings have important implications for public policies related to the legal drinking age and prevention strategies and further research on these effects is warranted.

https://www.sciencedaily.com/releases/2017/10/171030131607.htm

Large declines seen in teen substance abuse, delinquency

Surveys over a decade indicate positive behavioral shifts

October 25, 2017

Science Daily/Washington University School of Medicine

In recent years, teens have become far less likely to abuse alcohol, nicotine and illicit drugs, according to researchers. Teens also are less likely to engage in behaviors like fighting and stealing, and the researchers believe the declines in substance use and delinquency are connected.

More than a decade of data indicates teens have become far less likely to abuse alcohol, nicotine and illicit drugs, and they also are less likely to engage in delinquent behaviors, such as fighting and stealing, according to results of a national survey analyzed by researchers at Washington University School of Medicine in St. Louis.

The data come from the National Survey on Drug Use and Health, an annual survey of 12- to 17-year-olds from all 50 states that is sponsored by the Substance Abuse and Mental Health Administration, an agency of the U.S. Department of Health and Human Services. The data include information from 2003 through 2014, the last year for which survey numbers are available. A total of 210,599 teens -- 13,000 to 18,500 each year -- were part of the study.

The findings are reported Oct. 25 in the journal Psychological Medicine.

The researchers found that the number of substance-use disorders among 12- to 17-year olds had declined by 49 percent over the 12-year span, along with a simultaneous 34 percent decline in delinquent behaviors, such as fighting, assault, stealing, selling drugs or carrying a handgun.

The drop in substance abuse among teens parallels findings in other recent surveys, but until now no one has looked at how the drop-off may be linked to other behavioral issues.

"We've known that teens overall are becoming less likely to engage in risky behaviors, and that's good news," said first author Richard A. Grucza, PhD, a professor of psychiatry. "But what we learned in this study is that the declines in substance abuse are connected to declines in delinquency. This suggests the changes have been driven more by changes in adolescents themselves more than by policies to reduce substance abuse or delinquent behavior."

Other researchers have found that teens are delaying sex and using seat belts more often than their parents and grandparents. Grucza's team focused on substance-use disorders -- involving alcohol, nicotine, marijuana, opioids and the abuse of other prescription drugs or nonprescription drugs -- and delinquent behaviors.

"It's not clear what is driving the parallel declines," Grucza said. "New policies -- including things like higher cigarette taxes and stricter anti-bullying policies -- certainly have a positive effect. But seeing these trends across multiple behaviors suggests that larger environmental factors are at work. These might include reductions in childhood lead exposure, lower rates of child abuse and neglect, and better mental health care for children."

Although heroin and opioid abuse have become epidemic in many areas of the United States, the use among teens has fallen, according to the survey data.

"Opioid problems continue to increase among adults," he said. "But among the 12- to 17-year-old population, we saw a drop of nearly 50 percent."

Based on the survey data, Grucza and his team estimated that in 2014 there were nearly 700,000 fewer adolescents with substance-use disorders than in 2003. And because it's possible for a person to be addicted to nicotine while abusing alcohol or marijuana, the researchers estimate the total number of substance-use disorders among adolescents declined by about 2 million.

https://www.sciencedaily.com/releases/2017/10/171025090515.htm