Youth who have their first drink during puberty have higher levels of later drinking

May 18, 2013

Science Daily/Alcoholism: Clinical & Experimental Research

Research shows that the earlier the age at which youth take their first alcoholic drink, the greater the risk of developing alcohol problems. Thus, age at first drink (AFD) is generally considered a powerful predictor of progression to alcohol-related harm. A new study shows that individuals who have their first drink during puberty subsequently have higher drinking levels than do individuals with a post-pubertal drinking onset.

Results will be published in the October 2013 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Most teenagers have their first alcoholic drink during puberty, however, most research on the risks of early-onset alcohol use up to now has not focused on the pubertal stage during which the first alcoholic drink is consumed," said Miriam Schneider, leader of the Research Group Developmental Neuropsychopharmacology at the Central Institute of Mental Health, University of Heidelberg, as well as corresponding author for the study. "Common thinking in alcohol research was that the earlier adolescents begin, the more deleterious become their drinking habits. However, a closer look at the statistics revealed a peak risk of alcohol use disorders for those beginning at 12 to 14 years of age, while even earlier beginners seemed to have a slightly lower risk. Since timing of puberty is not a simple function of chronological age, and also greatly differs between the sexes, the pubertal phase at first drink may therefore represent a stronger and better indicator for subsequent alcohol-related problems than simply the age."

"Usually this type of research has to be done retrospectively, and those studies are not very reliable," added Rainer Spanagel, head of the Institute of Psychopharmacology at the University of Heidelberg. "Prospective longitudinal studies like the one here … are able to provide reliable conclusions on such a clinically and highly relevant research question. Alternatively, animal studies can be very informative -- and which the researchers have also provided."

"Adolescents have their first drink at very different ages," explained Schneider. "It would be unethical to make adolescents have their first drink in the course of a study, so this variable requires a longitudinal epidemiological study or experimental animal research to assess drinking behavior. Also, the determination of the pubertal stage at AFD is not trivial; even our study had to rely on estimations. Third, it takes longitudinal studies to assess drinking data in early adulthood. Fourth, both drinking behavior and pubertal development can be traced back to common factors such as psychosocial adversity. Finally, while puberty and adolescence are overlapping time periods, with puberty being a part of adolescence, the terms cannot be used interchangeably. 'Puberty' refers to the time period during which sexual maturity is achieved. 'Adolescence' refers to the gradual period of behavioral and cognitive transition from childhood to adulthood, where adult behavioral abilities are acquired, and the boundaries of this period are not precisely defined. Girls complete puberty much earlier than boys, indicating a difference in timing of neurodevelopmental processes."

Schneider and her colleagues determined pubertal age at first drink in 283 young adults (152 females, 131 males) that were part of a larger epidemiological study. In addition, the participants' drinking behavior -- number of drinking days, amount of alcohol consumed, and hazardous drinking -- was assessed at ages 19, 22, and 23 years via interviews and questionnaires. Furthermore, a rodent study concurrently examined the effects of mid-puberty or adult alcohol exposure on voluntary alcohol consumption in later life by 20 male Wistar rats.

"Both studies revealed that those individuals that initiated alcohol consumption during puberty tended to drink more and also more frequently than those starting after puberty," said Schneider.

"In other words," said Spanagel, "this study indicates that the period of puberty might serve as a risk window for AFD. Results also show a higher Alcohol Use Disorders Identification Test (AUDIT) score later in life in those individuals who had their AFD in puberty. A higher AUDIT score is indicative of a high likelihood of hazardous or harmful alcohol consumption. This information is of great relevance for intervention programs. Even more interesting, neither pre-pubertal nor post-pubertal periods seem to serve as risk-time windows. Therefore, intervention programs should be directed selectively towards young people in puberty."

Both Schneider and Spanagel noted the influence of a high degree of brain development that occurs during puberty.

"Numerous neurodevelopmental alterations are taking place during puberty, such as maturational processes in cortical and limbic regions, which are characterized by both progressive and regressive changes such as myelination and synaptic pruning," said Schneider. "Typically, an overproduction of axons and synapses can be found during early puberty, followed by rapid pruning during later puberty, indicating that connections and communication between subcortical and cortical regions are in a highly transitional state during this period."

"Puberty is a phase in which the brain reward system undergoes major functional changes," said Spanagel. "For example, the endocannabinoid and dopamine systems are at their peak and these major neurobiological changes are reflected on the behavioral level; reward sensitivity is highest during puberty. Therefore, during puberty the brain is in a highly vulnerable state for any kind of reward, and drug rewards in particular. This high vulnerability might also affect reward seeking, or in this particular case, alcohol seeking and drinking behavior later in life."

"In summary," said Schneider, "puberty is a very critical developmental period due to ongoing neurodevelopmental processes in the brain. It is exactly during puberty that substances like drugs of abuse -- alcohol, cannabis, etc. -- may induce the most destructive and also persistent effects on the still developing brain, which may in some cases even result in neuropsychiatric disorders, such as schizophrenia or addictive disorders. Prevention work therefore needs to increase awareness of specific risks and vulnerability related to puberty."

https://www.sciencedaily.com/releases/2013/05/130518153740.htm

Drug use trends remain stable or decline among teens

2015 survey shows long term decline in illicit drug use, prescription opioid abuse, cigarette and alcohol use among the nation's youth

December 16, 2015

Science Daily/NIH/National Institute on Drug Abuse

The 2015 Monitoring the Future survey (MTF) shows decreasing use of a number of substances, including cigarettes, alcohol, prescription opioid pain relievers, and synthetic cannabinoids ("synthetic marijuana"). Other drug use remains stable, including marijuana, with continued high rates of daily use reported among 12th graders, and ongoing declines in perception of its harms.

The MTF survey measures drug use and attitudes among eighth, 10th, and 12th graders, and is funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. The survey has been conducted by researchers at the University of Michigan at Ann Arbor since 1975.

For the first time, daily marijuana use exceeds daily tobacco cigarette use among 12th graders. Daily marijuana use for this group remained relatively stable at 6 percent, compared to 5.5 percent reporting daily cigarette smoking (down from 6.7 percent in 2014).

"We are heartened to see that most illicit drug use is not increasing, non-medical use of prescription opioids is decreasing, and there is improvement in alcohol and cigarette use rates," said Nora D. Volkow, M.D., director of NIDA. "However, continued areas of concern are the high rate of daily marijuana smoking seen among high school students, because of marijuana's potential deleterious effects on the developing brains of teenagers, and the high rates of overall tobacco products and nicotine containing e-cigarettes usage."

"This year's Monitoring the Future data continue the promising trends from last year with declining rates of adolescent substance use, and support the value of evidence-based prevention, treatment, and recovery," said National Drug Control Policy Director Michael Botticelli. "Efforts to prevent drug use from ever starting are particularly important as we work to reduce the rising number of drug overdoses across the country. I encourage parents, teachers, coaches, and mentors to have a conversation with the young people in their lives about making the healthy decisions that will keep them on a path toward a successful future."

"We are very encouraged by the continued decline in underage drinking illustrated in these data," said George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism. "However, the percent of underage individuals drinking still remains unacceptably high. For example, approximately 40 percent of 12th graders have reported being drunk in the past year and binge drinking remains a significant problem."

Other highlights from the 2015 survey:

Drugs

·     Use of many illicit drugs has trended down. Among high school seniors, 23.6 percent report using an illicit drug in the past month, with 7.6 percent reporting they used an illicit drug other than marijuana.

·     Perception of marijuana use as risky continues to decline, with 31.9 percent of seniors saying regular use could be harmful, compared to 36.1 percent last year.

·     Past year use of synthetic cannabinoids ("synthetic marijuana") is at 5.2 percent for 12th graders, down significantly from 11.4 in 2011, the first year it was measured in the survey.

·     Past year use of heroin, typically very low among teens, is at an all-time low at 0.3 percent for eighth graders, and 0.5 for 10th and 12th graders.

·     Use of MDMA (also known as Ecstasy or Molly), inhalants, and LSD are generally stable or down. In 2015, 3.6 percent of seniors reported past year use of MDMA, compared to 5 percent in 2014.

·     Non-medical use of the prescription amphetamine Adderall, typically given for ADHD, remains high at 7.5 percent among 12th graders.

·     Use of prescription opioids continues its downward trend, with 4.4 percent of high school seniors reporting non-medical use of Vicodin (hydrocodone and acetaminophen), down from a peak of 10.5 percent in 2003.

·     Most teens abusing prescription opioids report getting them from friends or family members. However, one-third report getting them from their own prescriptions, underscoring the need to monitor teens taking opioids and evaluate prescribing practices.

Tobacco

·     Cigarette smoking rates have greatly declined among teens in recent years. For example, among 10th graders, there has been a 54.9 percent drop in daily smoking in just five years, reported at just 3 percent this year compared to 6.6 percent five years ago.

·     However, rates of use of other tobacco products, while not significantly changed from 2014, remain high with 12th graders, reporting rates of past year use of hookah and small cigars of 19.8 percent and 15.9 percent, respectively.

·     More than 75 percent of high school seniors view smoking a pack or more a day as harmful, compared to 51.3 percent in 1975, first year of the survey.

·     As e-cigarettes are currently unregulated, there is limited data on what chemicals teens are actually smoking. However, when asked what they inhaled the last time they used an e-cigarette, only about 20 percent said they were using nicotine. Most say they inhaled flavoring alone and many admitted they were unsure what they inhaled. In fact, about 13 percent of eighth graders who use e-cigarettes said they did not know what was in the device they used. Furthermore, some products labeled nicotine-free may actually contain nicotine.

·     Roughly twice as many boys as girls report using e-cigarettes (21.5 percent to 10.9 percent).

Alcohol

·     Alcohol use continues its gradual downward trend among teens, with significant changes seen in the past five years in nearly all measures.

·     Binge drinking (described as having five or more drinks in a row within the past two weeks) is 17.2 percent among seniors, down from 19.4 percent last year and down from peak rates in 1998 at 31.5 percent.

·     37.7 percent of 12th graders say they have been drunk in the past year, compared to 41.4 percent in 2014 and 53.2 percent in 2001, when rates were highest for that group.

·     High school seniors see a distinction in potential harmfulness between one or two drinks nearly every day (21.5 percent) versus four to five drinks nearly every day (59.1 percent).

Overall, 44,892 students from 382 public and private schools participated in this year's MTF survey. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th graders nationwide. Eighth and 10th graders were added to the survey in 1991. Survey participants generally report their drug use behaviors across three time periods: lifetime, past year, and past month. Questions are also asked about daily cigarette and marijuana use. NIDA has provided funding for the survey since its inception by a team of investigators at the University of Michigan at Ann Arbor, led by Drs. Lloyd Johnston and Richard Miech. MTF is funded under grant number DA001411. Additional information on the MTF Survey, as well as comments from Dr. Volkow, can be found at http://www.drugabuse.gov/drugpages/MTF.html.

https://www.sciencedaily.com/releases/2015/12/151216115801.htm