Use of alcohol, cigarettes, number of illicit drugs declines among U.S. teens

December 16, 2014

Science Daily/University of Michigan

A national survey of students in U.S. middle schools and high schools shows some important improvements in levels of substance use.

Both alcohol and cigarette use in 2014 are at their lowest points since the study began in 1975. Use of a number of illicit drugs also show declines this year.

These findings come from the University of Michigan's Monitoring the Future study, which tracks trends in substance use among students in 8th, 10th and 12th grades. Each year the national study, now in its 40th year, surveys 40,000 to 50,000 students in about 400 secondary schools throughout the United States.

ALCOHOL

Alcohol use by the nation's teens continued its long-term decline in 2014. All three grades showed a decline in the proportion of students reporting any alcohol use in the 12 months prior to the survey; the three grades combined dropped from 43 percent to 41 percent, a statistically significant change.

"Since the recent peak rate of 61 percent in 1997, there has been a fairly steady downward march in alcohol use among adolescents," said Lloyd Johnston, the study's principal investigator. "The proportion of teens reporting any alcohol use in the prior year has fallen by about a third."

Of perhaps greater importance, the proportion of teens who report "binge drinking"—that is, consuming five or more drinks in a row at least once in the two weeks preceding the survey—fell significantly again this year to 12 percent for the three grades combined. This statistic is down from a recent high point of 22 percent in 1997. While this is an important improvement, say the investigators, still roughly one in five (19 percent) 12-graders report binge drinking at least once in the prior two weeks.

Some 12th-graders drink even more heavily, reporting having 10 or more, or 15 or more, drinks in a row on at least one occasion in the prior two weeks. Since 2005 (the first year that this "extreme binge drinking" was measured), these measures also have declined, from 11 percent to 7 percent in 2014 for 10 or more drinks, and from 6 percent to 4 percent for 15 or more drinks.

Peer disapproval of binge drinking has been rising since 2000 among teens. Declines in availability may be another contributing factor to the drops in teen drinking. In recent years, there has been a fair decline in all three grades in the proportion saying that alcohol is easy for them to get.

CIGARETTES

Cigarette smoking also reached historical lows among teens in 2014 in all three grades. For the three grades combined, 28 percent reported any smoking in the prior month in 1997, the recent peak year, but that rate was down to 8 percent in 2014.

"The importance of this major decline in smoking for the health and longevity of this generation of young people cannot be overstated," Johnston said.

As with alcohol, there has been a substantial reduction in the proportion of students who say cigarettes are easy for them to get, and this decline continued into 2014. Increasing disapproval of smoking also has accompanied the decline in use, as well as an increased perception that smoking carries a "great risk" for the user. However, there were only modest further increases in these factors in 2014.

ILLICIT DRUGS

A number of measures of illicit drug use showed declines in use this year. The greatest decline was in students' use of synthetic marijuana—a particularly dangerous class of abusable substances.

Synthetic marijuana (K-2, "Spice"), sold over the counter in many states—particularly in gas stations, convenience stores and head shops—has synthetic chemical components of marijuana sprayed onto shredded plant material that is then smoked. It is manufactured and sold in an unregulated system—often being imported from overseas—and it can be very potent and unpredictable in its effects. Side effects are many and are reported to be as severe as acute psychosis and heart attacks.

"Most students still do not recognize synthetic marijuana as a dangerous class of drugs, although the proportion of 12th-graders reporting it as dangerous to use did rise significantly in 2014," Johnston said. "Efforts at the federal and state levels to close down the sale of these substances may be having an effect."

The proportion of 12th-graders reporting use of synthetic marijuana in the prior 12 months has fallen by nearly half. It was 11 percent when first included in the survey in 2011 and was down to 6 percent in 2014.

"Bath Salts," another class of synthetic drugs sold over-the-counter and of particular concern a few years ago, also have declined in use, with the percentages of students in all three grades now down to less than 1 percent.

"Fortunately, students have come to see these synthetic stimulants as more dangerous, which they are, and that appears to have limited their use," Johnston said.

Substantial efforts to make them illegal probably have reduced their availability, but the availability of this drug is not measured in the study. 

Marijuana use, after five years of increasing among teens, actually declined slightly in 2014, with use in the prior 12 months declining from 26 percent to 24 percent for the three grades combined.

"The belief that regular marijuana use harms the user, however, continues to fall among youth, so changes in this belief do not seem to explain the change in use this year, as it has done over most of the life of the study," Johnston said.

Personal disapproval of use is also down some in 8th and 12th grades. Reported availability, on the other hand, is down significantly since 2013 in the two lower grades (and unchanged in 12th grade), which may help to explain the modest decline in use this year.

Current daily or near-daily marijuana use—defined as use on 20 or more occasions in the prior 30 days—also declined some in 2014; nonetheless, it remains quite high. About one in every 17 high school seniors in 2014 (5.8 percent) is a current daily or near-daily marijuana user, which is down from 6.5 percent in 2013.

An index of using any illicit drug other than marijuana in the prior 12 months declined by 1.9 percent (not a statistically significant change) to 15.9 percent in 12th grade; but in 8th and 10th grades the prevalence was virtually unchanged and stood at 6.4 percent and 11.2 percent, respectively.

Ecstasy (MDMA) use showed a statistically significant decline in 2014. For the three grades combined use in the prior 12 months dropped from 2.8 percent in 2013 to 2.2 percent in 2014. In 2001, the peak year of use, the rate had reached 6 percent.

Salvia, another drug used for its hallucinogenic properties, has fallen to quite low levels of use, and it continued to fall significantly in 2014. For example, it was used in the prior 12 months by 5.7 percent of the 12th-graders in 2009 but by less than 2 percent in 2014.

Use of hallucinogens other than LSD, which for the most part involves the ingestion of hallucinogenic mushrooms (Psilocybin or "shrooms"), is continuing a longer-term decline. Availability of these drugs has been falling since 2001 and continued to decline in 2014.

Any prescription drug misuse includes use of narcotics, sedatives, tranquilizers, and/or amphetamines without medical supervision. It has been of considerable public health concern in recent years, because most of these drugs showed a substantial increase in use in the 1990s, which then continued into the first decade of the 2000s, when many of the illegal drugs already were in decline.

Only 12th-graders report on their use of all of these drugs; they show a statistically significant decline between 2013 and 2014, from 16 percent to 14 percent, saying that they used one or more of these prescription drugs in the 12 months prior to the survey. The gradual turnaround began after 2005, when 17 percent indicated misuse of any of these drugs.

"It's not as much progress as we might like to see, but at least the number of students using these dangerous prescription drugs is finally declining," Johnston said.

Narcotic drugs other than heroin—among the most dangerous of the prescription drugs—have been declining in use by 12th-graders since 2009, when 9 percent indicated using them without medical supervision in the prior 12 months. Their use continued to drop significantly, from 7 percent in 2013 to 6 percent in 2014. Use of these drugs is reported only for 12th grade; students are reporting that these drugs are increasingly difficult to obtain.

Use in the prior 12 months of the specific narcotic analgesic OxyContin also declined this year, significantly so in 8th grade. OxyContin use reached a recent peak among adolescents around 2009 and use has declined since then in all three grades. The 2014 reports of use in the past 12 months stand at 1.0 percent, 3.0 percent and 3.3 percent in grades 8, 10 and 12, respectively.

Cough and cold medicines constitute a class of drugs available over-the-counter in most drug stores. These medicines usually contain the drug dextromethorphan which, when taken in large quantities, as teens sometimes do to get high, can be dangerous. Abuse of these drugs has been falling among teens since 2006 and declined significantly again in 2014, with annual prevalence declining from 4.0 percent to 3.2 percent for the three grades combined.

Use of a number of the other illicit drugs remained essentially unchanged between 2013 and 2014, including some particularly dangerous ones like heroin, crack, methamphetamine and crystal methamphetamine. Other drugs for which use remained unchanged in 2014 include Ritalin and Adderall—both stimulants used in the treatment of ADHD—as well as LSD, inhalants, powder cocaine, tranquilizers, sedatives and anabolic steroids. However, most of these drugs are now well below their recent peak levels of use according to the investigators.

"In sum, there is a lot of good news in this year's results, but the problems of teen substance use and abuse are still far from going away," Johnston said. "We see a cyclical pattern in the 40 years of observations made with this study. When things are much improved is when the country is most likely to take its eye off the ball, as happened in the early 1990s, and fail to deter the incoming generation of young people from using drugs, including new drugs that inevitably come along."

https://www.sciencedaily.com/releases/2014/12/141216082151.htm

Teen contraband smokers more likely to use illicit drugs

December 16, 2014

Science Daily/University of Alberta

A University of Alberta economics professor has discovered a link between contraband cigarette use and illicit drug use among Canadian teens.

Professor Mesbah Sharaf, a health economics lecturer at the University of Alberta in Canada, recently published a joint study with the University of Waterloo titled "Association Between Contraband Tobacco and Illicit Drug Use Among High School Students in Canada" in The Journal of Primary Prevention.

The study shows that 31 per cent of adolescent smokers in Canada between grades 9 and 12 use contraband tobacco and indicates that teens who smoke contraband tobacco are more likely to use illicit drugs.

"The rate of illicit drug use among the contraband smokers is higher than that among teenagers who smoke non-contraband cigarettes--sometimes double or triple the rate," says Sharaf.

According to the study, 22 per cent of all adolescent smokers in Canada used cocaine. Among those who smoked contraband cigarettes, 31 per cent reported using cocaine, whereas only 18 per cent of non-contraband smokers reported using cocaine. Use of MDMA (ecstasy) was also more prevalent among contraband smokers (45 per cent) than among non-contraband smokers (33 per cent). The rate of ketamine and amphetamine use among the contraband-smoking teens was almost three times as high as the rate among non-contraband-using teens--and more than six times as high for heroin.

This is the first published research to specifically examine the potential connection between contraband cigarette smoking and drug use among adolescents.

"If, as we believe this study shows, contraband cigarette use is associated with illicit drug use, then intensive effort needs to be made to avoid this--by both government and tobacco companies," says Sharaf. "Adolescence is a critical period, and most unhealthy habits are developed at an early age."

Sharaf is calling on the federal government to strengthen contraband enforcement and enhance public education efforts to combat this trend. "This is an important insight, and we encourage the government to come up with measures to tackle this problem," he says.

In producing this study, three researchers--Sharaf, along with Sunday Azagba and David Hammond of the University of Waterloo--used a national sample of 2,136 current smoker students in grades 9 to 12 from the 2010-2011 Youth Smoking Survey conducted by Statistics Canada.

The survey assessed students' past-year use of the following drugs (including some street names for each type of drug): amphetamines, cocaine, hallucinogens, heroin, MDMA and ketamine. The study also showed a significant relationship between truancy and drug use, as well as binge drinking and drug use.

https://www.sciencedaily.com/releases/2014/12/141216144121.htm

Patient use of cannabis in epilepsy

December 8, 2014

Science Daily/American Epilepsy Society (AES)

Three studies offer new insights into diverse patient experiences with CBD. Despite all the media and legislative attention, there is little scientific evidence about its effectiveness.

There may have been many anecdotal reports about cannabis and its derivative cannabidiol (CBD) in the treatment of people with epilepsy, especially in very young children who have catastrophic forms of epilepsy such as Lennox Gastaut Syndrome (LGS) or Dravet Syndrome (DS). Despite all the media and legislative attention, there is little scientific evidence about its effectiveness. Three studies presented at the American Epilepsy Society's 68th Annual Meeting offer new insights into diverse patient experiences with CBD.

The first of three studies is from Colorado, where much of the nation's attention has been captured by issues surrounding cannabis. The physicians and researchers at Children's Hospital Colorado and the University of Colorado have a unique perspective on CBD given the large number of cases they have treated. In addition to the many children already in their care, these professionals are now caring for many of the patients who have ventured to Colorado in search of cannabis treatment.

Dr. Kevin Chapman, associate professor of pediatrics and neurology at the University of Colorado, and his colleagues conducted a retrospective review of the 58 children and adolescents (average age of 7) with catastrophic forms of epilepsy who were receiving artisanal oral cannabis extracts when they came under the care of the hospital-based team. Chapman's team found that in only one-third of patients did the parents report a seizure reduction of 50% or more, and this did not correlate with an improvement in their electroencephalograms (EEGs). Of the sixteen patients who had baseline EEGs prior to and during treatment with cannabis, only two showed any signs of improvement. The researchers also noted that the response rate did not change with various strains of cannabis. Notably, families who moved to Colorado for CBD treatment were three times as likely to report a reduction greater than 50% than families who were already in Colorado.

Adverse effects occurred in 47% of patients, with increased seizures or new seizures in 21%, somnolence/fatigue in 14%, and rare adverse events of developmental regression in 10% with one patient needing intubation, and one death.

"This substantial gap between the clinical observations and various anecdotal reports highlighted in popular media underscores the desperate need shared by the entire epilepsy community for robust scientific evidence regarding the potential benefit and risks of marijuana in people with epilepsy," said Dr. Chapman.

A second study documents the experiences reported by parents of children with infantile spasms (IS) or LGS who were treated with artisanal CBD-enriched cannabis preparations. Through a survey of 53 parents whose children had IS and/or LGS (n = 53), the UCLA based researchers found that 92% of parents reported a reduction in seizures and 13% reported complete seizure-freedom. The majority of respondents reported using a CBD preparation with a CBD:THC ratio of at least 15:1. Prior to starting CBD, the parents reported that their children (median age for 3.6 years) had typically tried and failed 8 medications prior to CBD. Most patients with IS had failed both hormonal therapy (prednisolone and/or ACTH) and vagabtrin. The median length of other therapies was 6.9 months. The survey participants reported that side effects of treatment were also less than those with other medications. Benefits reported included improvements in sleep, alertness and mood during the CBD treatment.

"Although this study suggests a potential role for CBD in the treatment of IS and LGS, it is important to note that this study does not represent compelling evidence of efficacy or safety," said Raymond Zhou, research associate, UCLA Infantile Spasms Project. "From a methodological standpoint, this study is extraordinarily vulnerable to participation bias and placebo effect as our data is self-reported by parents and did not use objective measures such as EEG. Our hope in presenting this data is to emphasize the need for controlled clinical trials to establish safety and efficacy."

A third study is a single case of a child with Doose Syndrome whose family initiated independent CBD treatment. A child aged 4 experiencing multiple seizure types tried several medications with various and limited benefits. Baseline video EEG showed that the child had at least 10 seizures per day while awake and asleep. Immediately after starting on CBD the child continued to have seizures and Valproic acid levels increased substantially. When the dosage of Valproic acid was reduced the blood level returned to the previous range, and over 4 months seizures disappeared clinically and a repeat EEG was normal in both awake and asleep periods.

"We cannot recommend CBD treatment based on the limited evidence at this time, but do hope that families who independently seek CBD treatment will continue conventional therapies and remain in close contact with their healthcare providers," said Jeffery Gold, MD, Ph.D., Rady Children's Hospital of San Diego. "Establishing EEG measures before and after CBD treatment will provide the best possible insight into the benefits of the treatment. Further, since the effect of CBD treatment on other medications is undetermined, we recommend that physicians work with families to determine if adjustments to other medications are necessary."

https://www.sciencedaily.com/releases/2014/12/141208144146.htm

Teens with a history of TBI are nearly 4 times more likely to have used crystal meth

November 26, 2014

Science Daily/St. Michael's Hospital

Ontario students between Grades 9 and 12 who said they had a traumatic brain injury in their lifetime, also reported drug use rates two to four times higher than peers with no history of TBI, according to research published today in The Journal of Head Trauma Rehabilitation.

"Overall, a teen with a history of TBI is at least twice as likely as a classmate who hasn't suffered a brain injury to drink alcohol, use cannabis or abuse other drugs," said Dr. Michael Cusimano, co-principal investigator of the study and a neurosurgeon at St. Michael's Hospital. "But when you look at specific drugs, those rates are often higher."

The research showed that, in the past 12 months, teens with a history of TBI said they were:

·     3.8 times more likely to have used crystal meth

·     3.8 times more likely to have used non-prescribed tranquilizers or sedatives

·     2.8 times more likely to have used Ecstasy

·     2.7 times more likely to have used non-prescribed opioid pain relievers

·     2.6 times more likely to have used hallucinogens

·     2.5 times more likely to have used cocaine

·     2.5 times more likely to have used LSD

·     2.1 times more likely to have used non-prescribed ADHD drugs

"On top of the other health consequences, substance abuse increases the odds of suffering an injury that could result in a TBI," said Dr. Cusimano, who is also a researcher with the Keenan Research Centre for Biomedical Science. "And using some of these substances may also impair recovery after injury."

Teens with a self-reported history of TBI also reported they were 2.5 times more likely to have smoked one or more cigarettes daily over the past 12 months and nearly twice as likely to have binge drank -- consuming five or more drinks in one sitting -- in the past four weeks.

Researchers defined TBI as any hit or blow to the head that resulted in the teenager being knocked out for at least five minutes or spending at least one night in hospital due to symptoms associated with the head injury. Some of these brain injuries could have been also called concussions, which are mild to moderate forms of TBI.

"Some people think of concussions as a less alarming injury than a mild TBI but this is wrong," said Dr. Cusimano. "Every concussion is a TBI. People should take every brain injury seriously because, as this research shows, the immediate and long-term effects can alter lives."

The data used in the study was from the 2011 Ontario Student Drug Use and Health Survey developed by the Centre for Addiction and Mental Health. The survey is one of the longest ongoing school surveys in the world. The OSDUHS began as a drug use survey, but is now a broader study of adolescent health and well-being. Questions about traumatic brain injury were added to the survey for the first time in 2011.

The study looked at reported substance use among 6,383 Ontario students in Grades 9 through12. Data allowed researchers to determine the substance use habits and history of TBIs among students but did not allow researchers to determine whether substance use or brain injury came first.

"These data show us that there are important links between adolescent TBI and substance use," said Dr. Robert Mann, co-principal investigator of the study, senior scientist at CAMH and director of the OSDUHS. "While we can't yet say which one causes the other, we know this combination of factors is something to watch because it can have a serious negative impact on young people as they develop."

Dr. Mann said the relationship between TBI and substance use is concerning and calls for greater focus on prevention. "In terms of our research, the next step is to get a better understanding of the direction of these behaviours and to hopefully pinpoint when and how this relationship starts."

https://www.sciencedaily.com/releases/2014/11/141126185146.htm

Medicinal oil reduces debilitating epileptic seizures associated with Glut1 deficiency, trial shows

August 11, 2014

Science Daily/UT Southwestern Medical Center

A rare metabolic disease that caused hundreds of seizures daily for a 6-year-old is now significantly under control as part of a clinical trial that uses a medicinal oil for treatment. Within hours, treatment with an edible oil dramatically reduced the number of seizures for then-4-year-old.

Two years ago, the parents of Chloe Olivarez watched painfully as their daughter experienced epileptic seizures hundreds of times a day. The seizures, caused by a rare metabolic disease that depleted her brain of needed glucose, left Chloe nearly unresponsive, and slow to develop.

Within hours, treatment with an edible oil dramatically reduced the number of seizures for then-4-year-old Chloe, one of 14 participants in a small UT Southwestern Medical Center clinical trial.

"Immediately we noticed fewer seizures. From the Chloe we knew two years ago to today, this is a completely different child. She has done amazingly well," said Brandi Olivarez, Chloe's mother.

For Chloe and the other trial participants who suffer from the disease called Glut1 deficiency (G1D), seizure frequency declined significantly. Most showed a rapid increase in brain metabolism and improved neuropsychological performance, findings that suggested the oil derived from castor beans called triheptanoin, ameliorated the brain glucose-depletion associated with this genetic disorder, which is often undiagnosed.

"This study paves the way for a medical food designation for triheptanoin, thus significantly expanding therapeutic options for many patients," said Dr. Juan Pascual, Associate Professor of Neurology and Neurotherapeutics, Physiology, and Pediatrics at UT Southwestern and lead author of a study on the findings, published in JAMA Neurology.

For the estimated 38,000 Americans suffering from this disease, the only proven treatment has been a high-fat ketogenic diet, which only works for about two-thirds of patients. In addition, this diet carries long-term risks, such as development of kidney stones and metabolic abnormalities.

Based on the results of this trial, triheptanoin appears to work as efficiently as the ketogenic diet; however, more research needs to be done before the oil is made available as a medical food therapy, researchers said.

"Triheptanoin byproducts produced in the liver and also in the brain refill brain chemicals that we found are preferentially diminished in the disorder, and this effect is precisely what defines a medical food rather than a drug," said Dr. Pascual, who heads UT Southwestern's Rare Brain Disorders Program, maintains an appointment in the Eugene McDermott Center for Human Growth and Development, and holds The Once Upon a Time Foundation Professorship in Pediatric Neurologic Diseases.

The oil, approved for use in research only, is an ingredient in some cosmetic products and is added to butter in some European countries. It is not commercially available in the U.S. for clinical use.

Triheptanoin's success as an experimental treatment for other metabolic diseases, along with preclinical success in G1D mice, led Dr. Pascual and his trial collaborator, Dr. Charles Roe, Clinical Professor of Neurology and Neurotherapeutics, to first conceive the idea and then launch this trial for G1D patients. The 14 pediatric and adult patients in the study consumed varying amounts of the oil, based on their body weight, four times a day. Given the trial's success, Dr. Pascual plans further research to refine the optimal dosage toward the goal of facilitating medical food designation of triheptanoin as a new G1D treatment.

While some trial participants reported mild stomach upset as a side effect, for Chloe the oil has been a miracle medicine without negative effects. Her parents, Brandi and Josh Olivarez of Waco, Texas, continue to be amazed by her progress.

"Before, she was having so many seizures a day that she couldn't even talk. Now she sings all the time, she can eat whatever she wants, and her speech is greatly improved. She still has some learning delays, but has come a long way," said Mrs. Olivarez.

Many Glut1 patients suffer from movement disorders that limit their physical capabilities, but that does not appear to be the case with Chloe. As for the seizures, she still has minor ones occasionally, but they are not debilitating.

"She is now able to run a solid mile without stopping. This would not have been possible without the oil," Mrs. Olivarez said. "Before, she had almost no muscle tone, was lethargic and had a very wide gait due to trying to balance herself while walking, which was very tiring for her."

To better understand this disease, UT Southwestern established a patient-completed registry to track G1D incidence and what treatments work or do not work for those registered.

Study author Dr. Hanzhang Lu, Associate Professor in the Advanced Imaging Research Center and of Psychiatry and Radiology, a TI Scholar in Advanced Imaging Technologies, devised a novel MRI technique used in the trial to measure brain metabolism.

https://www.sciencedaily.com/releases/2014/08/140811165819.htm

Trends in substance use among high school athletes suggests increase of prescription pain medication usage

July 28, 2014

Science Daily/Taylor & Francis

Newly published research from Journal of Child & Adolescent Substance Abuse (Routledge) reports on the current trends of substance use by high school student athletes and notes an increase in the use of prescription pain medications among football players. "High School Sports Participation and Substance Use: Differences by Sport, Race, and Gender," conducted by Bryan E. Denham of Clemson University, is now available online with Free Access.

In the United States, alcohol and marijuana use continue to threaten the collective health of American teenagers. At least half of the students enrolled in U.S. high schools consume alcohol. Furthermore, while the term "hard drug" often applies to illicit substances such as cocaine or LSD, it also now pertains to prescription pain relievers or analgesics (e.g. methadone, opium, morphine, and codeine). "The study seeks to account for multiple determinants of substance use before attempting to draw substantive conclusions about sport-specific patterns," wrote Denham.

For the research, Denham cross-tabulated quantitative data collected from the answers of 2273 high school seniors who participated in the 2009 Monitoring the Future survey, sponsored by the National Institute on Drug Abuse (NIDA) and conducted at the Institute for Social Research at the University of Michigan. This study divided the data based on gender and included two categorical factors -- race and competitive sports participation. Male participants in these sports were interviewed: baseball, basketball, football, soccer, swimming and diving, and track and field. Female participants in these sports were interviewed: softball, basketball, soccer, swimming and diving, track and field, and volleyball.

The results did find a few common trends, some of which included: student athletes generally partake in illicit substance use more frequently than non-competitors, potentially due to assimilation with their peer groups. Among all of the sports studied, football players use the most illegal substances. Males consume more illegal substances than females. White students use substances more than African American and Hispanic classmates. Most revealing, 12 percent of males and 8 percent of females reported using analgesics in the past year, an increase from previous surveys.

"I've studied the use of performance-enhancing substances in sports for about 15 years, and this study extended that line of research to mind-altering substances," said Denham. "Alcohol has always been available, as has marijuana, but young people also may look to stronger drugs for euphoric effects. If prescription pain relievers are over-prescribed in certain regions, their use may trickle down to adolescents. Use of narcotic pain relievers may become a habit with some adolescent athletes."

https://www.sciencedaily.com/releases/2014/07/140728104601.htm

'Yes' to one drug could become 'yes' for other drugs

October 8, 2013

Science Daily/Springer Science+Business Media

High school seniors who frown upon the use of drugs are most likely to be female, nonsmokers or hold strong religious beliefs, according to a study¹ by Joseph Palamar of New York University. Palamar examines how teenagers' attitudes toward marijuana influenced their thoughts on the further use of other illicit drugs. The work appears online in the journal Prevention Science², published by Springer.

The study was conducted as marijuana use continues to be on the upswing in the United States, along with more lenient legislation and diminishing public disapproval toward its use. Although previous research has shown that people who disapprove of a particular drug will in all likelihood not use it, little is known about how the use of one drug affects people's attitudes toward using other drugs.

Palamar therefore examined how demographics and a lifetime use of various drugs -- marijuana use in particular -- can predict if a person will become partial to using "harder" and more dangerous drugs, such as powder cocaine, crack, LSD, heroin, amphetamine and ecstasy, also known as "Molly." Data was obtained from 29,054 high school seniors who took part in the Monitoring the Future annual cross-sectional survey of approximately 130 public and private schools in 48 states between 2007 and 2011.

Palamar found that youths who smoked cigarettes or used more than one "hard" drug were consistently less critical of other drug use. The lifetime use of alcohol had no impact on people's attitudes. Those who used only marijuana tended to be less judgmental of further using such so-called "socially acceptable" drugs as LSD, amphetamine and ecstasy. They did not approve of cocaine, crack or heroin, however, most likely because of their perceived dangers and addictive qualities.

Unsurprisingly, female high school seniors consistently disapproved of using cocaine, crack, LSD and ecstasy. Compared to their male counterparts, females are generally less likely to use most drugs. Palamar was also not surprised by the finding that religiosity robustly increased attitudes against drug use, as it is a major force in societal values.

Youths from more advantaged socio-economic backgrounds with highly educated parents as well as those living in urban areas were much less disapproving of the use of the so-called "less dangerous" drugs. Palamar believes that the higher prevalence of illicit drug use in urban areas may be helping to normalize drug use in cities.

The finding that Black students are less disapproving of powder cocaine, crack and ecstasy is somewhat paradoxical as members of this group generally use such drugs less than White students do. This could, in part, be explained by their strong religious beliefs and the higher rates of arrests and incarceration among Blacks that may serve as a deterrent. The normalization of ecstasy, specifically in rap and hip-hop music, may explain why Black youths are less disapproving of it.

"Public health and policy experts need to ensure that the use of other drugs does not increase in light of the growing prevalence of marijuana use and more lenient policies surrounding it," Palamar explains. "Although it may be difficult to prevent an adolescent or a young adult from using alcohol, tobacco or marijuana, we need to prevent individuals from becoming users of multiple drugs."

https://www.sciencedaily.com/releases/2013/10/131008112434.htm

Perception of marijuana as a 'safe drug' is scientifically inaccurate, finds review of teen brain studies

August 27, 2013

Science Daily/Universite de Montreal

The nature of the teenage brain makes users of cannabis amongst this population particularly at risk of developing addictive behaviors and suffering other long-term negative effects, according to researchers at the University of Montreal and New York's Icahn School of Medicine at Mount Sinai.

"Of the illicit drugs, cannabis is most used by teenagers since it is perceived by many to be of little harm. This perception has led to a growing number of states approving its legalization and increased accessibility. Most of the debates and ensuing policies regarding cannabis were done without consideration of its impact on one of the most vulnerable population, namely teens, or without consideration of scientific data," wrote Professor Didier Jutras-Aswad of the University of Montreal and Yasmin Hurd, MD, PhD, of Mount Sinai. "While it is clear that more systematic scientific studies are needed to understand the long-term impact of adolescent cannabis exposure on brain and behavior, the current evidence suggests that it has a far-reaching influence on adult addictive behaviors particularly for certain subsets of vulnerable individuals."

The researchers reviewed over 120 studies that looked at different aspects of the relationship between cannabis and the adolescent brain, including the biology of the brain, chemical reaction that occurs in the brain when the drug is used, the influence of genetics and environmental factors, in addition to studies into the "gateway drug" phenomenon. "Data from epidemiological studies have repeatedly shown an association between cannabis use and subsequent addiction to heavy drugs and psychosis (i.e. schizophrenia). Interestingly, the risk to develop such disorders after cannabis exposure is not the same for all individuals and is correlated with genetic factors, the intensity of cannabis use and the age at which it occurs. When the first exposure occurs in younger versus older adolescents, the impact of cannabis seems to be worse in regard to many outcomes such as mental health, education attainment, delinquency and ability to conform to adult role," Dr Jutras-Aswad said.

Although it is difficult to confirm in all certainty a causal link between drug consumption and the resulting behavior, the researchers note that rat models enable scientists to explore and directly observe the same chemical reactions that happen in human brains. Cannabis interacts with our brain through chemical receptors (namely cannabinoid receptors such as CB1 and CB2.) These receptors are situated in the areas of our brain that govern our learning and management of rewards, motivated behavior, decision-making, habit formation and motor function. As the structure of the brain changes rapidly during adolescence (before settling in adulthood), scientists believe that the cannabis consumption at this time greatly influences the way these parts of the user's personality develop. In adolescent rat models, scientists have been able to observe differences in the chemical pathways that govern addiction and vulnerability -- a receptor in the brain known as the dopamine D2 receptor is well known to be less present in cases of substance abuse.

Only a minority (approximately one in four) of teenage users of cannabis will develop an abusive or dependent relationship with the drug. This suggests to the researchers that specific genetic and behavioral factors influence the likelihood that the drug use will continue. Studies have also shown that cannabis dependence can be inherited through the genes that produce the cannabinoid receptors and an enzyme involved in the processing of THC. Other psychological factors are also likely involved. "Individuals who will develop cannabis dependence generally report a temperament characterized by negative affect, aggressivity and impulsivity, from an early age. Some of these traits are often exacerbated with years of cannabis use, which suggests that users become trapped in a vicious cycle of self-medication, which in turn becomes a dependence," Jutras-Aswad said.

The researchers stress that while a lot remains unknown about the mechanics of cannabis abuse, the body of existing research has clear implications for society. "It is now clear from the scientific data that cannabis is not harmless to the adolescent brain, specifically those who are most vulnerable from a genetic or psychological standpoint. Identifying these vulnerable adolescents, including through genetic or psychological screening, may be critical for prevention and early intervention of addiction and psychiatric disorders related to cannabis use. The objective is not to fuel the debate about whether cannabis is good or bad, but instead to identify those individuals who might most suffer from its deleterious effects and provide adequate measures to prevent this risk" Jutras-Aswad said. "Continuing research should be performed to inform public policy in this area. Without such systematic, evidenced-based research to understand the long-term effects of cannabis on the developing brain, not only the legal status of cannabis will be determined on uncertain ground, but we will not be able to innovate effective treatments such as the medicinal use of cannabis plant components that might be beneficial for treating specific disorders," Dr Hurd said.

https://www.sciencedaily.com/releases/2013/08/130827091401.htm

Ecstasy harms memory with one year of recreational use

July 25, 2012

Science Daily/Wiley

There has been significant debate in policy circles about whether governments have over-reacted to ecstasy by issuing warnings against its use and making it illegal. In the UK, David Nutt said ecstasy was less dangerous than horseback riding, which led to him being fired as the government's chief drug advisor. Others have argued that ecstasy is dangerous if you use it a lot, but brief use is safe.

New research published online July 25 by the scientific journal Addiction, gives some of the first information available on the actual risk of using ecstasy. It shows that even in recreational amounts over a relatively short time period, ecstasy users risk specific memory impairments. Further, as the nature of the impairments may not be immediately obvious to the user, it is possible people wouldn't get the signs that they are being damaged by drug use until it is too late.

According to the study, new ecstasy users who took ten or more ecstasy pills over their first year of use showed decreased function of their immediate and short-term memory compared with their pre-ecstasy performance. These findings are associated with damage of the hippocampus, the area of the brain that oversees memory function and navigation. Interestingly, hippocampal damage is one of the first signs of Alzheimer's disease, resulting in memory loss and disorientation.

The study participants took an average of 32 pills each over the course of the year, or about two and a half pills per month. Some participants took as few as ten pills over the year and still showed signs of memory impairments.

Lead author Dr. Daniel Wagner says: "This study was designed to minimize the methodological limitations of earlier research, in which it was not possible to say whether cognitive impairments seen among ecstasy users were in place before drug use began. By measuring the cognitive function of people with no history of ecstasy use and, one year later, identifying those who had used ecstasy at least ten times and remeasuring their performance, we have been able to start isolating the precise cognitive effects of this drug."

https://www.sciencedaily.com/releases/2012/07/120725200258.htm

Ecstasy Can Harm the Brains of First-time Users

November 28, 2006

Science Daily/Radiological Society of North America

Researchers have discovered that even a small amount of MDMA, better known as ecstasy, can be harmful to the brain, according to the first study to look at the neurotoxic effects of low doses of the recreational drug in new ecstasy users. The findings were presented today at the annual meeting of the Radiological Society of North America (RSNA).

"We found a decrease in blood circulation in some areas of the brain in young adults who just started to use ecstasy," said Maartje de Win, M.D., radiology resident at the Academic Medical Center at the University of Amsterdam in the Netherlands. "In addition, we found a relative decrease in verbal memory performance in ecstasy users compared to non-users."

Ecstasy is an illegal drug that acts as a stimulant and psychedelic. A 2004 survey by the National Institute on Drug Abuse (NIDA) found that 450,000 people in the United States age 12 and over had used ecstasy in the past 30 days. In 2005, NIDA estimated that 5.4 percent of all American 12th graders had taken the drug at least once.

Ecstasy targets neurons in the brain that use the chemical serotonin to communicate. Serotonin plays an important role in regulating a number of mental processes including mood and memory.

Research has shown that long-term or heavy ecstasy use can damage these neurons and cause depression, anxiety, confusion, difficulty sleeping and decrease in memory. However, no previous studies have looked at the effects of low doses of the drug on first-time users.

Dr. de Win and colleagues examined 188 volunteers with no history of ecstasy use but at high-risk for first-time ecstasy use in the near future. The examinations included neuroimaging techniques to measure the integrity of cells and blood flow in different areas of the brain and various psychological tests. After 18 months, 59 first-time ecstasy users who had taken six tablets on average and 56 non-users were re-examined with the same techniques and tests.

The study found that low doses of ecstasy did not severely damage the serotonergic neurons or affect mood. However, there were indications of subtle changes in cell architecture and decreased blood flow in some brain regions, suggesting prolonged effects from the drug, including some cell damage. In addition, the results showed a decrease in verbal memory performance among low-dose ecstasy users compared to non-users.

"We do not know if these effects are transient or permanent," Dr. de Win said. "Therefore, we cannot conclude that ecstasy, even in small doses, is safe for the brain, and people should be informed of this risk."

This research is part of the Netherlands XTC Toxicity (NeXT) study, which also looks at high-dose ecstasy users and aims to provide information on long-term effects of ecstasy use in the general population.

Co-authors are Gerard J. Den Heeten, M.D., Ph.D., Gerry Jager, M.S., Liesbeth Reneman, M.D., T. Schilt, M.S., Jan Booij, M.D., Ph.D., C. Lavini, D.Phil., and Win van den Brink, M.D., Ph.D.

https://www.sciencedaily.com/releases/2006/11/061128084458.htm