Thursday, October 30, 2008

Can Sips at Home Prevent Binges?

Published: March 26, 2008
New York Times

PARENTS always want to share their passions with their children. Whether you’re a fan of baseball or the blues, sailing or tinkering with old cars, few things are as rewarding as seeing a spark of receptivity in the eyes of the next generation.

It usually doesn’t take. Most of the time kids — teenagers, anyway — would as soon snicker at their old man’s obsessions as indulge him. Even so, I can’t help hoping that my sons might share my taste in music and food, books and movies, ball teams and politics. Why should wine be any different?

It’s the alcohol, of course, which makes wine not just tricky but potentially hazardous. Nonetheless, I would like to teach my sons — 16 and 17 — that wine is a wonderful part of a meal. I want to teach them to enjoy it while also drumming it into them that when abused, wine, like any other alcoholic beverage, can be a grave danger.

As they were growing up I occasionally gave them tastes from my glass — an unusual wine, perhaps, or a taste of Champagne on New Year’s Eve. They’ve had sips at Seders and they see wine nightly at our dinner table. With both boys now in high school, I thought it was time to offer them the option of small tastes at dinner.

In European wine regions, a new parent might dip a finger in the local pride and wipe it lovingly across an infant’s lips — “just to give the taste.” A child at the family table might have a spoonful of wine added to the water, because it says, “You are one of us.” A teenager might have a small glass of wine, introducing an adult pleasure in a safe and supervised manner. This is how I imagined it in my house.

But about a year ago, my wife attended a gathering on the Upper East Side sponsored by several high schools addressing the topic of teenagers and alcohol.

The highly charged discussion centered on the real dangers of binge drinking and peer pressure, of brain damage and parental over-permissiveness, and of the law.

One authority disparaged the European model, saying that teenage drinking in Europe —never mind which part — is much worse than it is in the United States. The underlying message was that nothing good comes from mixing alcohol and teenagers.

My wife was shaken. We agreed to hold off on the tasting plan. But I decided to try to get some answers myself.

Click here to continue reading article at New York Times

Tuesday, October 21, 2008

Drug Offers Effective Alternative Treatment for Heroin Addicts

October 20, 2008
Research Summary

The latest research from the North American Opiate Medication Initiative (NAOMI) suggests that hydromorphone -- an opiate found in prescription cough medicines like Dilaudid -- is more effective than methadone in reducing rates of illicit drug use and improving abstinence retention rates among opiate addicts, the National Post reported Oct. 18.

NAOMI researchers prescribed medical-grade heroin, methadone and hydromorphone to individuals addicted to heroin. After three years, the study found that those both the heroin-maintenance and hydromorphone group had better outcomes than the methadone group. Hydromorphone was so effective that almost all the participants in the group believed they were being given heroin.

"To be perfectly frank, there is a stigma attached to heroin. That would make [hydromorphone] particularly attractive in places where the concept of using heroin would be untenable as a public policy," said Martin Schechter, lead investigator of the project and director of the University of British Columbia School of Population and Public Health.

Schechter said that while there would be challenges to using hydromorphone to treat addiction, the hurdles would be small compared to getting prescription heroin approved. The researchers are already in negotiations with the Vancouver Coastal Health Authority about making the NAOMI research center into a permanent drug-treatment clinic that would offer methadone and hydromorphone maintenance.

From Join - Research News

Wednesday, October 15, 2008

Drinking Alcohol Associated With Smaller Brain Volume

ScienceDaily (Oct. 14, 2008)

The more alcohol an individual drinks, the smaller his or her total brain volume, according to a new report.

Brain volume decreases with age at an estimated rate of 1.9 percent per decade, accompanied by an increase in white matter lesions, according to background information in the article. Lower brain volumes and larger white matter lesions also occur with the progression of dementia and problems with thinking, learning and memory. Moderate alcohol consumption has been associated with a lower risk of cardiovascular disease; because the brain receives blood from this system, researchers have hypothesized that small amounts of alcohol may also attenuate age-related declines in brain volume.

Carol Ann Paul, M.S., of Wellesley College, Mass., and colleagues studied 1,839 adults (average age 60) who were part of the Framingham Offspring Study, which began in 1971 and includes children of the original Framingham Heart Study participants and their spouses. Between 1999 and 2001, participants underwent magnetic resonance imaging (MRI) and a health examination. They reported the number of alcoholic drinks they consumed per week, along with their age, sex, education, height, body mass index and Framingham Stroke Risk Profile (which calculates stroke risk based on age, sex, blood pressure and other factors).

"Most participants reported low alcohol consumption, and men were more likely than women to be moderate or heavy drinkers," the authors write. "There was a significant negative linear relationship between alcohol consumption and total cerebral brain volume."

Although men were more likely to drink alcohol, the association between drinking and brain volume was stronger in women, they note. This could be due to biological factors, including women's smaller size and greater susceptibility to alcohol's effects.

"The public health effect of this study gives a clear message about the possible dangers of drinking alcohol," the authors write. "Prospective longitudinal studies are needed to confirm these results as well as to determine whether there are any functional consequences associated with increasing alcohol consumption. This study suggests that, unlike the associations with cardiovascular disease, alcohol consumption does not have any protective effect on brain volume."

This study was supported by a contract from the National Heart, Lung, and Blood Institute's Framingham Heart Study, National Institutes of Health; grants from the National Institute on Aging; and a grant from the National Institute of Neurological Disorders and Stroke.

Monday, October 13, 2008

Thinner Cortex In Cocaine Addicts May Reflect Drug Use And A Pre-existing Disposition To Drug Abuse

ScienceDaily (Oct. 13, 2008)

New research findings suggest that structural abnormalities in the brains of cocaine addicts are related in part to drug use and in part to a predisposition toward addiction. The research, published by Cell Press in the October 9th issue of the journal Neuron, maps the topography of the addicted brain and provides new insight into the effect of cocaine on neural systems mediating cognition and motivation.

"Human studies have shown differences in how addicts make judgments and decisions, but it is not well understood how these differences relate to alterations in the structure of the brains of addicts. Claims have been made that cocaine, potentially in connection with alcohol or other drugs, may be toxic to brain cells. We sought evidence supporting a hypothesis that brain thickness is reduced in some brain regions in addicts, is related to altered decision-making and cognition, and might to some limited degree, be connected to their exposure to cocaine," explains senior study author Dr. Hans Breiter from Massachusetts General Hospital.

Dr. Breiter and colleagues found that brain regions involved with regulation of attention and reward, specifically the dorsolateral prefrontal cortex (DLPFC) and insular cortices, were significantly thinner in cocaine addicts when compared with matched controls. Behavioral tests revealed that the thinner cortex was associated with restrictions in preference-based judgment and decision-making, and with less accurate effortful attention. A general reduction in the level of preference and in the range of decisions reflecting these preferences can be considered an example of a fundamental feature of addiction—the loss of interest in many things outside of drug use.

Some cortical thickness differences were associated with years of drug use, but the researchers also observed differences in the symmetry of DLPFC thickness between control subjects and cocaine addicts that suggested predisposition to drug abuse. "In human and animal studies, differences in the structure of the right and left sides of the brain are important for many behaviors, and when these normal differences in brain structure are altered, there may be a genetic basis for the change. We found an altered right/left relationship in a part of the frontal cortex that was also associated with altered judgment and decision-making in addicts. We further found that the overall brain thickness in the cocaine addicts was more uniform across the brain, which is quite different from what is observed in non-drug users. These differences did not correlate with any drug use measure. Together, this set of findings point to predisposing factors being a potential contributing factor to the addiction," explains Dr. Breiter.

In total, these observations provide evidence that cortical thickness abnormalities associated with cocaine addiction may be a reflection of both drug use and a preexisting inclination to drug abuse. "A fundamental component of addiction may involve adaptations and/or developmental predispositions involving brain regions necessary for judgment and decision-making regarding complex rewards and attention towards goal-objects. Addiction thus may represent a complex phenotype with multiple effects necessary for compulsive drug use, and the resulting restriction in the range of behaviors they show," concludes Dr. Breiter.

Saturday, October 11, 2008

Sacred Intentions - Inside The Johns Hopkins Psilocybin Studies

"And I felt like I was being whisked...whoa, boy...and then I went to all these other places." [Sandy Lundahl (left)]; "We have to move beyond the concept of getting high and seek to become more mature human beings. " [Bill Richards]

By Michael M. Hughes

Sandy Lundahl lies on a couch, her eyes covered with a dark cloth mask. She's listening to classical music through enormous headphones: Brahms' Symphony No. 2, the "Kyrie" from Bach's Mass in B Minor, Barber's Adagio for Strings. An hour earlier, she had swallowed two blue capsules containing close to 30 milligrams of psilocybin, the primary active chemical in Psilocybe cubensis and other "magic" mushrooms, and she's already well on her way on a trip into the hidden spaces of her psyche.

Lundahl, a 55-year-old self-described skeptic and health educator from Bowie, is looking for God.

Two experienced guides are with her in the room, monitoring her: Mary Cosimano, a clinical social worker, and William "Bill" Richards, a white-haired, 68-year-old psychiatrist and scholar of comparative religion. He's sitting cross-legged on the carpet in front of the couch, ready to help Lundahl--to talk her out of any negative trips, to help her remain focused on the scenes unfolding behind the mask, to offer a drink or some fruit or escort her to the bathroom. The space resembles a clean, warm, but decidedly offbeat living room. The lighting is spare and soft, emanating from two lamps. A bookshelf holds a variety of picture books and well-known spiritual and psychological classics like Freud's The Interpretation of Dreams and The Varieties of Religious Experience by William James. Above the books sits a wooden sculpture of Psilocybe mushrooms. Behind the couch are a Mesoamerican mushroom stone replica and a statue of a serene, seated Buddha. An eye-popping abstract expressionist painting hangs on the wall, an explosion of color and intersecting lines.

This isn't a metaphysical retreat center in San Francisco, or the Manhattan office of a New Age therapist-cum-shaman. Lundahl's first psychedelic experience is taking place in the heart of the Behavioral Biology Research Center building at the Johns Hopkins Bayview campus in Southeast Baltimore, in a room affectionately referred to by both the scientists and the volunteers as the "psilocybin room." She's taking part in the first study of its kind since the early '70s--a rigorous, scientific attempt to determine if drugs like psilocybin and LSD, demonized and driven underground for more than three decades, can facilitate life-changing, transformative mystical experiences.

The study, which took place from 2001 to 2005, and was published in 2006 in the journal Psychopharmacology with a follow-up in 2008 in the Journal of Psychopharmacology, made news around the globe and was greeted by nearly unanimous praise by both the scientific community and the mainstream press. Flying in the face of both government policy and conventional wisdom, its conclusion--that psychedelic drugs offer the potential for profound, transformative, and long-lasting positive changes in properly prepared individuals--may herald a revival in the study of altered states of consciousness.

Nonetheless, Lundahl, for one, wasn't initially impressed by the vibrant imagery behind her closed eyelids.

Click here to continue reading article and see more images at the Baltimore City Paper

Friday, October 10, 2008

Law Equalizes Coverage For Mental, Physical Care

'Milestone' Measure Could Expand Treatment Services

By Chris L. Jenkins
Washington Post Staff Writer
Friday, October 10, 2008; Page B01

An estimated 113 million Americans, including hundreds of thousands in the Washington region, will receive better insurance coverage for their mental health and substance abuse problems because of landmark legislation that for the first time requires mental and physical illnesses to be treated equally.

The law is a culmination of a decade of lobbying and negotiating among advocates for the mentally ill, the insurance industry, the business community -- including the U.S. Chamber of Commerce -- and doctors' groups. The change, which was included in the economic rescue package signed by President Bush last week, will take effect Jan. 1, 2010, for most plans. Businesses with 50 or fewer employees would be exempt.

For decades, insurance companies could offer less coverage for the treatment of depression, anxiety and bipolar disorder than of such diseases as cancer and diabetes -- so people with mental illness or substance abuse problems often had to pay for expensive treatment and medication out-of-pocket.

The new law bars companies from setting higher co-pays or deductibles for mental health and substance abuse treatment. Plans also will be prohibited from lowering benefit levels or restricting the number of outpatient therapy sessions or hospital treatment days. And if a health plan allows out-of-network visits for the treatment of physical illnesses, it will also have to offer identical out-of-network coverage for mental health care.

Advocates and experts said the change represents a fundamental shift in how the mentally ill are treated and could bring medical parity to tens of millions of people.

"This is absolutely milestone legislation for those people who have mental health and substance abuse problems," said Doug Walter, counsel for legislative and regulatory affairs at the American Psychological Association. "It ends the discrimination against people who have long needed the help."

Click here to continue reading article at The Washington Post

Monday, October 6, 2008

Psychoanalytic Therapy Wins Backing

Published: September 30, 2008

Intensive psychoanalytic therapy, the “talking cure” rooted in the ideas of Freud, has all but disappeared in the age of drug treatments and managed care.

But now researchers are reporting that the therapy can be effective against some chronic mental problems, including anxiety and borderline personality disorder.

In a review of 23 studies of such treatment involving 1,053 patients, the researchers concluded that the therapy, given as often as three times a week, in many cases for more than a year, relieved symptoms of those problems significantly more than did some shorter-term therapies.

The authors, writing in Wednesday’s issue of The Journal of the American Medical Association, strongly urged scientists to undertake more testing of psychodynamic therapy, as it is known, before it is lost altogether as a historical curiosity.

The review is the first such evaluation of psychoanalysis to appear in a major medical journal, and the studies on which the new paper was based are not widely known among doctors.

The field has resisted scientific scrutiny for years, arguing that the process of treatment is highly individualized and so does not easily lend itself to such study. It is based on Freud’s idea that symptoms are rooted in underlying, often longstanding psychological conflicts that can be discovered in part through close examination of the patient-therapist relationship.

Experts cautioned that the evidence cited in the new research was still too meager to claim clear superiority for psychoanalytic therapy over different treatments, like cognitive behavior therapy, a shorter-term approach. The studies that the authors reviewed are simply not strong enough, these experts said.

Click here to continue reading article at the New York Times

Sunday, October 5, 2008

Adolescent Insomnia Linked To Depression And Substance Abuse During Adolescence And Young Adulthood

ScienceDaily (Oct. 5, 2008)

A study in the Oct. 1 issue of the journal Sleep shows that adolescent insomnia symptoms are associated with depression, suicide ideation and attempts, and the use of alcohol, cannabis and other drugs such as cocaine.

Findings suggest that the presence of insomnia in adolescents increases the risk of developing mental health problems and also may increase the severity of these problems. Results indicate that adolescents who had symptoms of insomnia were 2.3 times more likely to develop depression in early adulthood than adolescents without symptoms of insomnia. Specifically, at baseline, the insomnia group was more likely to use alcohol, cannabis, and non-cannabis drugs, and was more likely to suffer from depression, suicide thoughts, and suicide attempts. The insomnia group also had a greater risk of developing new incidences of depression and suicide attempts after excluding participants who suffered from these specific psychopathologies at baseline.

When excluding participants who endorsed any mental health problem at baseline, the insomnia group was significantly more likely to develop incident depression. In addition, gender differences emerged for alcohol use, cannabis use, non-cannabis drug use, and depression. Independently of insomnia status, males were significantly more likely to endorse alcohol use, cannabis use, and the use of other drugs, while females were twice as likely to develop depression.

"Previous research in adults has found similar results to this study," said principal investigator and lead author Brandy M. Roane, MS, a doctoral student at the University of North Texas. "The current study suggests adolescents with insomnia are more prone to developing mental disorders, specifically depression."

Insomnia symptoms were reported by 9.4 percent of the adolescents in the study. Information discovered during this study could potentially provide parents, educators and mentors with a sign of a risk factor for the development of mental health issues.

The study involved 4,494 adolescents between 12 and 18 years of age at the beginning of the study, and 3,582 young adults between the ages of 18 and 25 years in a six-to-seven year follow up. One-hundred and forty-five U.S. middle, junior and high schools were selected to participate based on size, school type, census region, level of urbanization, percentage of Caucasian and African-American students, grade span and curriculum. Health-related variables such as height, weight, pubertal development, mental health status, and chronic and disabling conditions were obtained through in-home interviews and self-report.

Adolescents who reported having trouble falling asleep every day or almost every day were categorized as having insomnia symptoms. Binge drinking was defined as drinking five or more alcoholic beverages in a row, and suicide ideation was based on whether or not a participant had endorsed having thoughts of suicide in the last year.

Thursday, October 2, 2008

Strict Societies May Foster Violent Drinking Cultures

ScienceDaily (Oct. 2, 2008)

Countries with strict social rules and behavioral etiquette such as the United Kingdom may foster drinking cultures characterized by unruly or bad behavior, according to a new report on alcohol and violence released today by International Center for Alcohol Policies (ICAP). The report lists 11 cultural features that may predict levels of violence such as homicide and spousal abuse.

The report, “Alcohol and Violence: Exploring Patterns and Responses,” examines the association between alcohol and violence through the disciplines of anthropology, clinical psychology, human rights law, gender, and public health.

“We need to look more closely at the meaning attached to both drinking and violence in different cultures, without assuming that the one causes the other,” writes Anne Fox, PhD, a contributor to the report and founding director of Galahad SMS Ltd. in England.

Dr. Fox writes that the presence of certain cultural features can largely predict levels of homicide, spousal abuse and other forms of violence. Violence-reinforcing cultures tend to share the following features:

* Cultural support (in media, norms, icons, myths, and so on) for aggression and aggressive solutions;
* Militaristic readiness and participation in wars—societies that are frequently at war have consistently higher rates of interpersonal violence as well;
* Glorification of fighters;
* Violent sports;
* Corporal and capital punishment;
* Socialization of male children toward aggression;
* Belief in malevolent magic;
* Conspicuous inequality in wealth;
* A higher than normal proportion of young males in the society;
* Strong codes of male honor—in general, societies and subgroups that actively subscribe to strong codes of honor tend to have higher rates of homicide;
* A culture of male domination.

In her paper, “Sociocultural Factors that Foster or Inhibit Alcohol-related Violence,” Dr. Fox argues that efforts to counteract a “culture of violence” and “the male propensity for aggression” should be channeled toward altering “beliefs about alcohol” and “social responses to violence and aggression.”

The report includes other papers including “The Role of Drinking Patterns and Acute Intoxication in Violent Interpersonal Behaviors” which looks at patterns of violence at the individual level. The paper “Working with Culture to Prevent Violence and Reckless Drinking” studies alcohol and violence from a gender perspective and identifies strategies used to respond to analogous social problems. “Practical Responses: Communications Guidelines for First Responders in Cases of Alcohol-related Violence” presents international guidelines for enhanced communication among first responders (police, emergency room staff, social workers) to alcohol-related violence, particularly between the health and law enforcement sectors.