The government's decision to upgrade the legal status of cannabis to a Class B drug was welcomed as a victory for common sense by Unite/Mental Health Nurses Association.
Unite/MHNA Chair, Andy Lauder said: "It has been proved time and time again by well-respected medical studies that there are strong links between significant cannabis use and those suffering from mental health problems, or have a disposition to mental illness.
"We, therefore, welcome the Home Secretary, Jacqui Smith's announcement that cannabis should be reclassified from Class C to Class B status."
Andy Lauder warned: "There are now much stronger strains of cannabis, such as skunk, entering the UK in response to so-called market forces."
Last month, Unite/MHNA strongly criticised reports that The Advisory Council on the Misuse of Drugs was recommending that the drug should remain on the Class C list. Unite/MNHA said that such a decision would fly in the face of established medical facts and common sense.
Unite (Amicus section) is the third largest union in the NHS. It has seven professional sections: the Community Practitioners and Health Visitors Association, the Mental Health Nurses Association, the Guild of Healthcare Pharmacists, the Society of Sexual Health Advisers, the Medical Practitioners Union, College of Healthcare Chaplains, and the Hospital Physicists Association.
Unite was formed by an amalgamation of Amicus and the Transport and General Workers Union in May 2007.
Unite/Mental Health Nurses Association
вторник, 21 июня 2011 г.
понедельник, 20 июня 2011 г.
American Indian/Alaska Natives Have Significantly Higher Alcohol-Related Death Percentage Than General Population, CDC Reports
Nearly 12% of American Indian and Alaska Native deaths over a four-year period were alcohol related, according to a CDC report released on Thursday, AP/USA Today reports. Researchers found after examining death certificates from 2001 to 2005 that 11.7% of deaths -- or 1,514 deaths -- among American Indians and Alaska Natives were alcohol-related. During the same time period, 3.3% of all deaths in the U.S. were related to alcohol. The report also found:
Traffic accidents and liver disease are the two leading causes of alcohol-related deaths among American Indians and Alaska Natives;
About one-third of alcohol- related deaths in the American Indian/Alaska Native population occurred in the Northern Plains, where reservations are remote and often destitute;
Alaska had the lowest number of alcohol-related deaths among American Indians/Alaska Natives; and
More than 68% of American Indian/Alaska Native alcohol-related deaths were among men, 66% were among those younger than age 50 and 7% were among those younger than age 20.
The report did not include deaths related to tuberculosis, pneumonia and colon cancer, conditions for which alcohol is thought to be a risk factor, and as a result "[t]here may be many more alcohol-related deaths than the study shows," AP/USA Today, reports. The report recommends "culturally appropriate clinical interventions" to reduce alcohol abuse and improved integration between tribal health care centers and tribal courts, which often handle alcohol-related crimes (Jalonick, AP/USA Today, 8/28).
The report is available online.
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Traffic accidents and liver disease are the two leading causes of alcohol-related deaths among American Indians and Alaska Natives;
About one-third of alcohol- related deaths in the American Indian/Alaska Native population occurred in the Northern Plains, where reservations are remote and often destitute;
Alaska had the lowest number of alcohol-related deaths among American Indians/Alaska Natives; and
More than 68% of American Indian/Alaska Native alcohol-related deaths were among men, 66% were among those younger than age 50 and 7% were among those younger than age 20.
The report did not include deaths related to tuberculosis, pneumonia and colon cancer, conditions for which alcohol is thought to be a risk factor, and as a result "[t]here may be many more alcohol-related deaths than the study shows," AP/USA Today, reports. The report recommends "culturally appropriate clinical interventions" to reduce alcohol abuse and improved integration between tribal health care centers and tribal courts, which often handle alcohol-related crimes (Jalonick, AP/USA Today, 8/28).
The report is available online.
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
воскресенье, 19 июня 2011 г.
Preventing Mental, Emotional And Behavioral Disorders In Young People
Around one in five young people in the U.S. have a current mental, emotional, or behavioral disorder. About half of all adults with mental disorders recalled that their disorders began by their mid-teens and three-quarters by their mid-20s. Early onset of mental health problems have been associated with poor outcomes such as failure to complete high school, increased risk for psychiatric and substance problems, and teen pregnancy.
A new article by Mary E. Evans, RN, PhD, FAAN, published in the Journal of Child and Adolescent Psychiatric Nursing assesses the recently released government report on preventing these disorders among young people. Dr. Evans' paper concludes that using certain interventional programs in schools, communities and health care settings, risk for mental illness can be better identified and treated.
The article highlights the fact that specific risk and protective factors have been identified for many disorders. For example, certain thinking and behavioral patterns are risks for the development of depression. Nonspecific factors that increase risk for developing disorders also include poverty, marital conflict, poor peer relations, and community violence. Also, certain neurobiological factors contribute to the development of disorders in youth, but this is also influenced by environmental factors.
A key risk factor for externalizing disorders is aggressive social behavior that begins in early childhood. A number of interventions have been developed to provide training in parenting skills to prevent the development of aggressive and antisocial behavior. In addition, some preventive interventions have targeted specific disorders such as depression and schizophrenia. Cognitive behavioral treatment for high-risk adolescents has lowered the rate of major depressive symptoms. Also, a number of community-based programs have been shown to be effective in promoting healthy behaviors.
"For all nurses, this report will increase our understanding of risk and protective factors related to the healthy development of children and youth," Evans concludes.
Mary E. Evans, RN, PhD, FAAN, is affiliated with the College of Nursing, University of South Florida & Institute of Medicine.
Source:
Amy Molnar
Wiley-Blackwell
A new article by Mary E. Evans, RN, PhD, FAAN, published in the Journal of Child and Adolescent Psychiatric Nursing assesses the recently released government report on preventing these disorders among young people. Dr. Evans' paper concludes that using certain interventional programs in schools, communities and health care settings, risk for mental illness can be better identified and treated.
The article highlights the fact that specific risk and protective factors have been identified for many disorders. For example, certain thinking and behavioral patterns are risks for the development of depression. Nonspecific factors that increase risk for developing disorders also include poverty, marital conflict, poor peer relations, and community violence. Also, certain neurobiological factors contribute to the development of disorders in youth, but this is also influenced by environmental factors.
A key risk factor for externalizing disorders is aggressive social behavior that begins in early childhood. A number of interventions have been developed to provide training in parenting skills to prevent the development of aggressive and antisocial behavior. In addition, some preventive interventions have targeted specific disorders such as depression and schizophrenia. Cognitive behavioral treatment for high-risk adolescents has lowered the rate of major depressive symptoms. Also, a number of community-based programs have been shown to be effective in promoting healthy behaviors.
"For all nurses, this report will increase our understanding of risk and protective factors related to the healthy development of children and youth," Evans concludes.
Mary E. Evans, RN, PhD, FAAN, is affiliated with the College of Nursing, University of South Florida & Institute of Medicine.
Source:
Amy Molnar
Wiley-Blackwell
суббота, 18 июня 2011 г.
"UK Teen Binge Drinking Is Serious And Chronic"
The latest findings on teenage drinking, smoking and drug use across Europe are released the 26th of March, 2009. The European School Survey Project on Alcohol and other Drugs (ESPAD) is a study of 15 and 16 year old teenagers in 35 European countries. It is by far the most detailed international study on this subject. ESPAD has been carried out previously in 1995, 1999 and 2003. The latest ESPAD was carried out in 2007. The new international study findings are revealed at a press conference in London. The press conference was chaired by Professor Ray Hodgson, Director of the Alcohol Education and Research Council (AERC). Study findings are presented and discussed by Professor Martin Plant and Dr Patrick Miller of the University of the West of England, Bristol.
The countries that participated in ESPAD 2007 were Armenia, Austria, Belgium, Bulgaria, Croatia, Cyprus, the Czech Republic, Denmark, Estonia, Faroe Islands, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, the Isle of Man, Italy, Latvia, Lithuania, Malta, Monaco, the Netherlands, Norway, Poland, Portugal, Romania, Russia, the Slovak Republic, Slovenia, Sweden, Switzerland, Ukraine and the United Kingdom. The UK sample included 2,179 teenagers (1004 boys and 1175 girls).
The latest ESPAD findings show that:
ALCOHOL
-- Alcohol consumption at least once in the past year amongst European teenagers (including those in the UK) had remained fairly stable since 1995 at about 80% of all students. The 2007 survey indicated a small fall in the UK overall total from 91% to 88% in 2007.
-- Once more UK teenagers reported high levels of binge drinking, intoxication and alcohol-related individual, relationship, sexual and delinquency problems. They ranked third highest (after Bulgaria and the Isle of Man) in relation to such problems.
-- The UK ranked 7th in relation to the percentage of teens who had 'binged' (consumed five or more drinks on at least one occasion) in the past 30 days. A total of 54% of UK teenagers had reportedly done this. The highest levels of 'binge' drinking were in the Isle of Man (61%), Denmark (60%), Malta (57%), Portugal (56%), Estonia and Latvia (54%).
-- In 2003 it was revealed that teen girls in the UK (as well as Ireland and the Isle of Man) were more likely than boys to have binged in the previous 30 days. The 2007 survey shows that girls were more likely than boys to be binge drinkers in the UK, Iceland, Norway and Sweden.
-- UK teenagers ranked third highest (after Denmark and the Isle of Man) in relation to self-reports of having been drunk in the past 30 days. A total of 33% of UK teens reported such recent intoxication.
-- Girls reported higher levels of such recent drunkenness than boys in nine countries. These were the Isle of Man, the UK, Ireland, Spain, Finland, Norway, Sweden, the Faroe Islands and Monaco. The fact that some teenage girls are 'binge' drinking even more than boys suggests that in the UK and elsewhere a profound social change has been taking place. It is clearly no longer socially unacceptable for females to drink heavily or to become intoxicated. This may reflect factors such as greater female social and economic empowerment and changing social roles as well as the marketing practices of the beverage alcohol industry.
-- The percentages of UK teens who had binged at least three times in the past 30 days was almost the same as it had been in 2003. Altogether, 26% of boys and 27% of girls reported having done this.
-- Binge drinking amongst girls had increased across Europe since 1995. It had remained relatively stable amongst boys since 1999.
-- A striking feature of UK teenagers was that they were more likely than those in nearly all other countries to report that they expected positive consequences from drinking. Only Denmark and the Isle of Man scored higher in this respect.
TOBACCO
-- Overall, cigarette use by European teenagers had fallen since 1999. In the UK it had fallen since 1995.
-- Lifetime prevalence of smoking across Europe ranged from 24% and 80%. Smoking in the past 30 days ranged from 7% in Armenia to 45% in Austria. Altogether 22% of UK teens (17% of boys and 25% of girls) had smoked in the past 30 days.
ILLICIT DRUGS
-- Lifetime illicit drug use amongst teenagers across Europe had risen between 1995 and 2003. It had fallen since then. In the UK it had fallen since 1995.
-- The highest lifetime use of any illicit drug was reported by teenagers in the Czech Republic (46%), followed by Spain (38%), the Isle of Man (35%) and Switzerland ( 34%). UK teens ranked 9th in this respect (29%).
-- The highest lifetime use of cannabis was reported by teens in the Czech Republic (45%), Spain (36%), the Isle of Man (34%) and Switzerland (33%). UK teenagers ranked 7th in this respect (29%). A total of 11% of UK teenagers reported having used cannabis in the past 30 days.
COMMENT
Professor Martin Plant commented: "ESPAD shows that the use of alcohol, tobacco and illicit drugs is widespread amongst 15 and 16 year olds across Europe. Even so, there has been a fall in both smoking and illicit drug use. This is good news for the health of young adults. Alcohol consumption has remained fairly stable, although a small reduction has recently been evident amongst boys. The UK retains its unenviable position in relation to both binge drinking, intoxication and alcohol-related problems amongst teenagers. This problem is both serious and chronic. I hope that the Government will prioritise policies that are effective to reduce heavy drinking and alcohol-related disorder and health problems amongst young people. Increasing numbers of young people are developing serious health problems related to drinking. More and more younger people also are dying prematurely due to their alcohol use.
"There is a clear scientific consensus that alcohol education and mass media campaigns have a very poor track record in influencing drinking habits. Far more effective (and cost effective) policies include using taxation to make alcohol less affordable. Alcohol problems do not only affect a tiny minority of very heavy drinkers. Everyone has a stake in public health and safety. Moreover, many people whose alcohol consumption is generally moderate also experience some adverse effects from their drinking. It is therefore recommended that a minimum price of 50 pence per unit of alcohol should be introduced. This would save over 3,000 lives per year. It would also reduce problems such as absenteeism, public disorder and hospital admissions. This measure would particularly affect harmful and hazardous drinkers. It could save ??1 billion per year in the cost of alcohol-related harm. In addition, serious consideration must be given to raising the minimum age at which young people may consume or purchase alcoholic beverages, perhaps to eighteen years of age."
West of England University
uwe.ac
The countries that participated in ESPAD 2007 were Armenia, Austria, Belgium, Bulgaria, Croatia, Cyprus, the Czech Republic, Denmark, Estonia, Faroe Islands, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, the Isle of Man, Italy, Latvia, Lithuania, Malta, Monaco, the Netherlands, Norway, Poland, Portugal, Romania, Russia, the Slovak Republic, Slovenia, Sweden, Switzerland, Ukraine and the United Kingdom. The UK sample included 2,179 teenagers (1004 boys and 1175 girls).
The latest ESPAD findings show that:
ALCOHOL
-- Alcohol consumption at least once in the past year amongst European teenagers (including those in the UK) had remained fairly stable since 1995 at about 80% of all students. The 2007 survey indicated a small fall in the UK overall total from 91% to 88% in 2007.
-- Once more UK teenagers reported high levels of binge drinking, intoxication and alcohol-related individual, relationship, sexual and delinquency problems. They ranked third highest (after Bulgaria and the Isle of Man) in relation to such problems.
-- The UK ranked 7th in relation to the percentage of teens who had 'binged' (consumed five or more drinks on at least one occasion) in the past 30 days. A total of 54% of UK teenagers had reportedly done this. The highest levels of 'binge' drinking were in the Isle of Man (61%), Denmark (60%), Malta (57%), Portugal (56%), Estonia and Latvia (54%).
-- In 2003 it was revealed that teen girls in the UK (as well as Ireland and the Isle of Man) were more likely than boys to have binged in the previous 30 days. The 2007 survey shows that girls were more likely than boys to be binge drinkers in the UK, Iceland, Norway and Sweden.
-- UK teenagers ranked third highest (after Denmark and the Isle of Man) in relation to self-reports of having been drunk in the past 30 days. A total of 33% of UK teens reported such recent intoxication.
-- Girls reported higher levels of such recent drunkenness than boys in nine countries. These were the Isle of Man, the UK, Ireland, Spain, Finland, Norway, Sweden, the Faroe Islands and Monaco. The fact that some teenage girls are 'binge' drinking even more than boys suggests that in the UK and elsewhere a profound social change has been taking place. It is clearly no longer socially unacceptable for females to drink heavily or to become intoxicated. This may reflect factors such as greater female social and economic empowerment and changing social roles as well as the marketing practices of the beverage alcohol industry.
-- The percentages of UK teens who had binged at least three times in the past 30 days was almost the same as it had been in 2003. Altogether, 26% of boys and 27% of girls reported having done this.
-- Binge drinking amongst girls had increased across Europe since 1995. It had remained relatively stable amongst boys since 1999.
-- A striking feature of UK teenagers was that they were more likely than those in nearly all other countries to report that they expected positive consequences from drinking. Only Denmark and the Isle of Man scored higher in this respect.
TOBACCO
-- Overall, cigarette use by European teenagers had fallen since 1999. In the UK it had fallen since 1995.
-- Lifetime prevalence of smoking across Europe ranged from 24% and 80%. Smoking in the past 30 days ranged from 7% in Armenia to 45% in Austria. Altogether 22% of UK teens (17% of boys and 25% of girls) had smoked in the past 30 days.
ILLICIT DRUGS
-- Lifetime illicit drug use amongst teenagers across Europe had risen between 1995 and 2003. It had fallen since then. In the UK it had fallen since 1995.
-- The highest lifetime use of any illicit drug was reported by teenagers in the Czech Republic (46%), followed by Spain (38%), the Isle of Man (35%) and Switzerland ( 34%). UK teens ranked 9th in this respect (29%).
-- The highest lifetime use of cannabis was reported by teens in the Czech Republic (45%), Spain (36%), the Isle of Man (34%) and Switzerland (33%). UK teenagers ranked 7th in this respect (29%). A total of 11% of UK teenagers reported having used cannabis in the past 30 days.
COMMENT
Professor Martin Plant commented: "ESPAD shows that the use of alcohol, tobacco and illicit drugs is widespread amongst 15 and 16 year olds across Europe. Even so, there has been a fall in both smoking and illicit drug use. This is good news for the health of young adults. Alcohol consumption has remained fairly stable, although a small reduction has recently been evident amongst boys. The UK retains its unenviable position in relation to both binge drinking, intoxication and alcohol-related problems amongst teenagers. This problem is both serious and chronic. I hope that the Government will prioritise policies that are effective to reduce heavy drinking and alcohol-related disorder and health problems amongst young people. Increasing numbers of young people are developing serious health problems related to drinking. More and more younger people also are dying prematurely due to their alcohol use.
"There is a clear scientific consensus that alcohol education and mass media campaigns have a very poor track record in influencing drinking habits. Far more effective (and cost effective) policies include using taxation to make alcohol less affordable. Alcohol problems do not only affect a tiny minority of very heavy drinkers. Everyone has a stake in public health and safety. Moreover, many people whose alcohol consumption is generally moderate also experience some adverse effects from their drinking. It is therefore recommended that a minimum price of 50 pence per unit of alcohol should be introduced. This would save over 3,000 lives per year. It would also reduce problems such as absenteeism, public disorder and hospital admissions. This measure would particularly affect harmful and hazardous drinkers. It could save ??1 billion per year in the cost of alcohol-related harm. In addition, serious consideration must be given to raising the minimum age at which young people may consume or purchase alcoholic beverages, perhaps to eighteen years of age."
West of England University
uwe.ac
пятница, 17 июня 2011 г.
More Drug Users Are Being Provided With Effective Treatment Services But These Are Still Key Areas For Improvement, UK
Healthcare watchdogs are calling for a continued drive to improve drug addiction treatment, to ensure services are delivered consistently across the country.
A report released today by the Healthcare Commission and the National Treatment Agency (NTA), shows results from the second of three annual reviews to assess the performance of substance misuse treatment services.
Focusing specifically on how services are commissioned and harm reduction service provision, the findings reveal the majority of services are performing well within acceptable levels across these categories.
The number of people receiving specialist drug treatment has increased dramatically, with 195,400 in treatment during 2006/07 - up from 85,000 in 1998/99. Estimates for 2007/8 show 210,800 people will receive treatment. This means that more drug users than ever before are getting the treatment they need.
The review showed that there had been considerable improvement in the commissioning and performance management of drug treatment services, resulting in more service users receiving better treatment.
However, there were significant deficits, particularly in the provision of vaccination for hepatitis B and testing and treatment for hepatitis C. As 90% of all hepatitis C diagnoses are associated with injecting drug use, this is a key area of concern.
The review covered 149 'local drug partnerships' in England. Drug treatment is provided by a network of services, commissioned by local partnerships of statutory agencies within a particular locality, rather than being provided by individual organisations. These networks or 'local drug partnerships' are aligned to local authority boundaries. They bring together representatives of local organisations involved in the delivery of the drug strategy, including primary care trusts, local authorities, the police and the probation service.
Partnerships were asked 45 questions across 10 criteria. Each area was then scored on a scale; "weak", "fair", "good" and "excellent". Thirty four percent of local drug partnerships had an overall score of "excellent", 45% were "good" and 21% were "fair". No partnerships had an overall score of "weak", however the review revealed the majority of partnerships had deficits in key areas.
The review confirmed widespread good practice in relation to commissioning performance management but also showed that many areas did not have an adequate understanding of local need through systematic assessments. Since the review the Commission and the NTA have issued guidance and supported action plans to address this issue.
Partnerships also made significant progress in relation to care planning and treatment discharge systems, with nearly all (99%) achieving or exceeding 70% of their local target.
A good standard of financial management was found across the sector, with 60% of partnerships achieving the maximum score for this area.
Anna Walker, Chief Executive of the Commission, says: "Substance misuse affects not only the individual concerned but their families, friends, and the communities they live in.
"As the UK has one of the highest recorded drug-related death rates in Europe, it is a clear national priority to minimise the impact of substance misuse.
"It's very encouraging that thousands more people are now getting the treatment they need, and this review shows there is much to celebrate about the progress that has been made.
"However, it is worrying that the majority of hepatitis C cases are associated with injecting drugs, yet we know access to testing and treatment for the disease is patchy across the country. Similarly, access to clean needles provided by out of hours exchanges varies considerably. These are the areas that need to improve if the health of those who inject drugs is to be tackled effectively, and drug-related deaths reduced.
"Partnerships must now concentrate on driving improvements in the key areas highlighted by the review, in order to provide an equal service to all patients across the country. It is also important that partnerships really understand the needs in their area for these services and provides them accordingly."
Paul Hayes, the Chief Executive of the National Treatment Agency for substance misuse, said: "Effective commissioning underpins effective drug treatment delivery.
The improvements in commissioning shown by this review are very welcome.
However the review also highlights inconsistent practice across the country in key areas of delivery such as testing for and treatment of hepatitis B and C. The NTA will be working with all partnerships to spread best practice more consistently and has agreed action plans for improvement with the poorest performing areas."
Following the results of this review, work has been carried out by the Commission and the NTA with the 25 lowest performing partnerships. Action plans were to developed to improve performance and good progress has already been made implementing this.
The Commission and the NTA will follow up this report with a third and final review into this sector. This will look at diversity and residential services and will complete what has been a comprehensive review of the provision of substance misuse treatment.
The National treatment agency is engaging the sector in a range of initiatives and programmes to address the deficits identified by the review. The joint NTA/Department of Health action plan, Reducing drug-related harm was published in May 2007, and includes a national campaign aiming to tackle these and other harm reduction issues to begin in October this year.
In relation to commissioning the NTA continues to support the work of local areas in relation to treatment planning and needs assessment. 2008 will also see the publication of new guidance initiatives to enhance commissioning practice.
More information on the Improvement review of substance misuse 2006/2007
Information on the Healthcare Commission
The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services.
Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.
The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.
Information on the NTA
The National Treatment Agency for Substance Misuse (NTA) is a special health authority, created by the Government in 2001 to improve the availability, capacity and effectiveness of treatment for drug misuse in England. The NTA's purpose is to work with local partnerships and health commissioners to deliver high-quality, effective drug misuse treatment that improves individuals' physical and mental health and wellbeing. In turn, this improves public health, reduces crime and helps make communities safer.
The Government set the NTA a target of doubling the number of people in structured treatment programmes between 1998 and 2008. This has been exceeded two years ahead of schedule. The NTA is now concentrating on the quality agenda, improving services for people in treatment and improving outcomes for those who leave.
Briefing note:
Effective commissioning is key to the delivery of effective drug treatment, ensuring it meets local need and is planned, integrated and strategic.
Key areas of improvement for commissioning include:
- Needs assessment
Over a quarter (26%) of local drug partnerships were rated as "weak" for the quality of their needs assessment. The effective commissioning of a drug treatment system is dependent on having a clear profile of the diversity of local need. When asked whether the partnership carried out or updated a local needs assessment during 2005/06 to inform the commissioning for 2006/07, 21% of partnerships were rated "weak" and 79% "fair" - a poor result considering the impact this will have on the delivery of effective treatment.
- Strategic leadership
The review highlighted deficits in the seniority and frequency of attendance of senior representatives from statutory partners at local drug partnerships' strategic board meetings. In 15% of local drug partnerships there were board members below assistant director level.
Blood-borne virus (BBV) infections and drug overdoses account for a significant number of drug-related deaths and poor health among drug misusers and particularly drug injectors.
Recent concerns about the rates of BBV infections and overdoses led the Government to launch a new Reducing Harm Action Plan in May 2007. Recorded drug-related deaths due to overdose in the UK are among the highest recorded levels in Europe. Although a steep increase in the 1990s was halted by the implementation of Government targets in 2001, the target to reduce the number of deaths by 20% by 2004 was not met.
The review showed there are key improvements that need to be made in harm reduction:
- Strategic planning for reducing number of deaths
While strategic planning for harm reduction services was generally good, the scale of both preventable and treatable blood-borne virus infections and the high rates of overdose deaths, call for additional action by local drug partnerships. Only 68% of local drug partnerships had a multi-agency strategic plan for reducing the number of drug related deaths.
Harm reduction interventions were not provided broadly enough across the treatment system or sufficiently integrated into it. Just over a third (37%) of local drug partnerships did not have access to HIV testing with access to pre and post-test counselling integrated with their inpatient drug treatment services.
- Testing for hepatitis B and C
Ninety five percent of partnerships reported that less than half of service users had a recorded test date for hepatitis C. This is a clear national priority for improvement due to the scale of infection amongst injecting drug users.
Vaccination for hepatitis B and testing and treatment for hepatitis C was not provided widely enough via local drug treatment systems. Ninety five percent of local drug partnerships offered a hepatitis B vaccination to less than 75% of their service users and 29% did not have a protocol relating to hepatitis B.
- Out of hours needle exchange
There is a clear deficit nationally in the provision of out-of-hours needle exchange, with just under half (44%) of local drug partnerships scoring "weak". Forty four percent scored "fair" and 12% scored "good".
Healthcare Commission
A report released today by the Healthcare Commission and the National Treatment Agency (NTA), shows results from the second of three annual reviews to assess the performance of substance misuse treatment services.
Focusing specifically on how services are commissioned and harm reduction service provision, the findings reveal the majority of services are performing well within acceptable levels across these categories.
The number of people receiving specialist drug treatment has increased dramatically, with 195,400 in treatment during 2006/07 - up from 85,000 in 1998/99. Estimates for 2007/8 show 210,800 people will receive treatment. This means that more drug users than ever before are getting the treatment they need.
The review showed that there had been considerable improvement in the commissioning and performance management of drug treatment services, resulting in more service users receiving better treatment.
However, there were significant deficits, particularly in the provision of vaccination for hepatitis B and testing and treatment for hepatitis C. As 90% of all hepatitis C diagnoses are associated with injecting drug use, this is a key area of concern.
The review covered 149 'local drug partnerships' in England. Drug treatment is provided by a network of services, commissioned by local partnerships of statutory agencies within a particular locality, rather than being provided by individual organisations. These networks or 'local drug partnerships' are aligned to local authority boundaries. They bring together representatives of local organisations involved in the delivery of the drug strategy, including primary care trusts, local authorities, the police and the probation service.
Partnerships were asked 45 questions across 10 criteria. Each area was then scored on a scale; "weak", "fair", "good" and "excellent". Thirty four percent of local drug partnerships had an overall score of "excellent", 45% were "good" and 21% were "fair". No partnerships had an overall score of "weak", however the review revealed the majority of partnerships had deficits in key areas.
The review confirmed widespread good practice in relation to commissioning performance management but also showed that many areas did not have an adequate understanding of local need through systematic assessments. Since the review the Commission and the NTA have issued guidance and supported action plans to address this issue.
Partnerships also made significant progress in relation to care planning and treatment discharge systems, with nearly all (99%) achieving or exceeding 70% of their local target.
A good standard of financial management was found across the sector, with 60% of partnerships achieving the maximum score for this area.
Anna Walker, Chief Executive of the Commission, says: "Substance misuse affects not only the individual concerned but their families, friends, and the communities they live in.
"As the UK has one of the highest recorded drug-related death rates in Europe, it is a clear national priority to minimise the impact of substance misuse.
"It's very encouraging that thousands more people are now getting the treatment they need, and this review shows there is much to celebrate about the progress that has been made.
"However, it is worrying that the majority of hepatitis C cases are associated with injecting drugs, yet we know access to testing and treatment for the disease is patchy across the country. Similarly, access to clean needles provided by out of hours exchanges varies considerably. These are the areas that need to improve if the health of those who inject drugs is to be tackled effectively, and drug-related deaths reduced.
"Partnerships must now concentrate on driving improvements in the key areas highlighted by the review, in order to provide an equal service to all patients across the country. It is also important that partnerships really understand the needs in their area for these services and provides them accordingly."
Paul Hayes, the Chief Executive of the National Treatment Agency for substance misuse, said: "Effective commissioning underpins effective drug treatment delivery.
The improvements in commissioning shown by this review are very welcome.
However the review also highlights inconsistent practice across the country in key areas of delivery such as testing for and treatment of hepatitis B and C. The NTA will be working with all partnerships to spread best practice more consistently and has agreed action plans for improvement with the poorest performing areas."
Following the results of this review, work has been carried out by the Commission and the NTA with the 25 lowest performing partnerships. Action plans were to developed to improve performance and good progress has already been made implementing this.
The Commission and the NTA will follow up this report with a third and final review into this sector. This will look at diversity and residential services and will complete what has been a comprehensive review of the provision of substance misuse treatment.
The National treatment agency is engaging the sector in a range of initiatives and programmes to address the deficits identified by the review. The joint NTA/Department of Health action plan, Reducing drug-related harm was published in May 2007, and includes a national campaign aiming to tackle these and other harm reduction issues to begin in October this year.
In relation to commissioning the NTA continues to support the work of local areas in relation to treatment planning and needs assessment. 2008 will also see the publication of new guidance initiatives to enhance commissioning practice.
More information on the Improvement review of substance misuse 2006/2007
Information on the Healthcare Commission
The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services.
Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.
The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.
Information on the NTA
The National Treatment Agency for Substance Misuse (NTA) is a special health authority, created by the Government in 2001 to improve the availability, capacity and effectiveness of treatment for drug misuse in England. The NTA's purpose is to work with local partnerships and health commissioners to deliver high-quality, effective drug misuse treatment that improves individuals' physical and mental health and wellbeing. In turn, this improves public health, reduces crime and helps make communities safer.
The Government set the NTA a target of doubling the number of people in structured treatment programmes between 1998 and 2008. This has been exceeded two years ahead of schedule. The NTA is now concentrating on the quality agenda, improving services for people in treatment and improving outcomes for those who leave.
Briefing note:
Effective commissioning is key to the delivery of effective drug treatment, ensuring it meets local need and is planned, integrated and strategic.
Key areas of improvement for commissioning include:
- Needs assessment
Over a quarter (26%) of local drug partnerships were rated as "weak" for the quality of their needs assessment. The effective commissioning of a drug treatment system is dependent on having a clear profile of the diversity of local need. When asked whether the partnership carried out or updated a local needs assessment during 2005/06 to inform the commissioning for 2006/07, 21% of partnerships were rated "weak" and 79% "fair" - a poor result considering the impact this will have on the delivery of effective treatment.
- Strategic leadership
The review highlighted deficits in the seniority and frequency of attendance of senior representatives from statutory partners at local drug partnerships' strategic board meetings. In 15% of local drug partnerships there were board members below assistant director level.
Blood-borne virus (BBV) infections and drug overdoses account for a significant number of drug-related deaths and poor health among drug misusers and particularly drug injectors.
Recent concerns about the rates of BBV infections and overdoses led the Government to launch a new Reducing Harm Action Plan in May 2007. Recorded drug-related deaths due to overdose in the UK are among the highest recorded levels in Europe. Although a steep increase in the 1990s was halted by the implementation of Government targets in 2001, the target to reduce the number of deaths by 20% by 2004 was not met.
The review showed there are key improvements that need to be made in harm reduction:
- Strategic planning for reducing number of deaths
While strategic planning for harm reduction services was generally good, the scale of both preventable and treatable blood-borne virus infections and the high rates of overdose deaths, call for additional action by local drug partnerships. Only 68% of local drug partnerships had a multi-agency strategic plan for reducing the number of drug related deaths.
Harm reduction interventions were not provided broadly enough across the treatment system or sufficiently integrated into it. Just over a third (37%) of local drug partnerships did not have access to HIV testing with access to pre and post-test counselling integrated with their inpatient drug treatment services.
- Testing for hepatitis B and C
Ninety five percent of partnerships reported that less than half of service users had a recorded test date for hepatitis C. This is a clear national priority for improvement due to the scale of infection amongst injecting drug users.
Vaccination for hepatitis B and testing and treatment for hepatitis C was not provided widely enough via local drug treatment systems. Ninety five percent of local drug partnerships offered a hepatitis B vaccination to less than 75% of their service users and 29% did not have a protocol relating to hepatitis B.
- Out of hours needle exchange
There is a clear deficit nationally in the provision of out-of-hours needle exchange, with just under half (44%) of local drug partnerships scoring "weak". Forty four percent scored "fair" and 12% scored "good".
Healthcare Commission
четверг, 16 июня 2011 г.
Spouse May 'DriveYou To Drink' But Also Can Protect You From Alcohol
Men and women at risk for alcohol dependence are more likely to choose a mate who also is at risk, say investigators at Washington University School of Medicine in St. Louis. That doesn't necessarily mean, however, that both spouses will end up as problem drinkers.
Alcoholism is more common among partners of alcoholics than among partners of non-alcoholics, but it isn't as common as it might be. The researchers found that in some cases, one spouse's excesses with alcohol actually could help protect the other from alcohol dependence.
A team of researchers from Washington University and from the Queensland Institute of Medical Research in Brisbane, Australia, studied 5,974 twins born between 1902 and 1964 who were part of the Australian Twin Register. They also spoke with 3,814 of those twins' spouses for the study, published in the May issue of the journal Alcoholism: Clinical & Experimental Research.
"As they say, 'like marries like,'" says first author Julia D. Grant, Ph.D., research assistant professor of psychiatry at Washington University. "Spouse selection is not a random process, and we call this non-random mating. People tend to choose mates who are similar to them, not only from the same neighborhood or socio-economic background but also alike in personality and other behaviors. We found that people at risk for alcohol dependence tend to marry others who are at risk."
Alcohol dependence is influenced by both genetic and environmental factors. Genetic influences explain about half of the variance in a person's total risk for alcohol dependence. The other half of an individual's risk for alcohol dependence comes from environmental factors - such things as employment, interests, friends and family.
"There's lots of room for different factors to influence the behavior of two people who are married," Grant says. "One spouse could work at a place where the co-workers go out for a drink after work. Or one spouse could be a regular churchgoer, while the other prefers to sleep."
Another aspect of the environment is the drinking behavior of one's partner. The researchers found that the impact of the partner's drinking depends on whether it's examined along with non-random mating. Once the researchers accounted statistically for the fact that "like marries like," they saw that the additional influence of the partner's behavior tended to reduce the likelihood of problem drinking. Grant says that although non-random mating means that a person with genetic risks for alcohol problems will tend to marry another with a propensity toward alcohol dependence, it appears that when one spouse begins to abuse alcohol, the other might actually reduce alcohol intake.
"We don't really know how this works," she explains. "It is possible that an individual decreases his or her alcohol consumption in reaction to the other's excessive alcohol use. Maybe one person is responsible for getting the kids up and out for school in the morning, for example."
Grant says she hopes soon to study how spouses might influence not only each other's risk of alcohol dependence but also other psychiatric disorders, such as depression and how those factors interact. And she says as more is learned about these risks, it's important to let people know what they're up against.
"Education is a key to reducing risk for alcohol dependence," she says. "Regardless of genetic risks, there are other detrimental environmental factors associated with alcohol, including reduced educational attainment and income, fewer social and neighborhood support networks, higher rates of divorce and single parenthood and exposure to other psychiatric problems. We need to make people aware of all of their risks, so they can take steps to protect themselves."
Grant JD, Heath AC, Bucholz KK, Madden PAF, Agrawal A, Stratham DJ, Martin NG. Spousal concordance for alcohol dependence: evidence for assortative mating or spousal interaction effects? Alcoholism: Clinical & Experimental Research, vol. 31 (5), pp. 717-728, May 2007.
DOI: 10.1111/j/1530-0277.2007.00356.x
This research was supported by was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health.
Washington University School of Medicine's full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.
Contact: Jim Dryden
Washington University School of Medicine
Alcoholism is more common among partners of alcoholics than among partners of non-alcoholics, but it isn't as common as it might be. The researchers found that in some cases, one spouse's excesses with alcohol actually could help protect the other from alcohol dependence.
A team of researchers from Washington University and from the Queensland Institute of Medical Research in Brisbane, Australia, studied 5,974 twins born between 1902 and 1964 who were part of the Australian Twin Register. They also spoke with 3,814 of those twins' spouses for the study, published in the May issue of the journal Alcoholism: Clinical & Experimental Research.
"As they say, 'like marries like,'" says first author Julia D. Grant, Ph.D., research assistant professor of psychiatry at Washington University. "Spouse selection is not a random process, and we call this non-random mating. People tend to choose mates who are similar to them, not only from the same neighborhood or socio-economic background but also alike in personality and other behaviors. We found that people at risk for alcohol dependence tend to marry others who are at risk."
Alcohol dependence is influenced by both genetic and environmental factors. Genetic influences explain about half of the variance in a person's total risk for alcohol dependence. The other half of an individual's risk for alcohol dependence comes from environmental factors - such things as employment, interests, friends and family.
"There's lots of room for different factors to influence the behavior of two people who are married," Grant says. "One spouse could work at a place where the co-workers go out for a drink after work. Or one spouse could be a regular churchgoer, while the other prefers to sleep."
Another aspect of the environment is the drinking behavior of one's partner. The researchers found that the impact of the partner's drinking depends on whether it's examined along with non-random mating. Once the researchers accounted statistically for the fact that "like marries like," they saw that the additional influence of the partner's behavior tended to reduce the likelihood of problem drinking. Grant says that although non-random mating means that a person with genetic risks for alcohol problems will tend to marry another with a propensity toward alcohol dependence, it appears that when one spouse begins to abuse alcohol, the other might actually reduce alcohol intake.
"We don't really know how this works," she explains. "It is possible that an individual decreases his or her alcohol consumption in reaction to the other's excessive alcohol use. Maybe one person is responsible for getting the kids up and out for school in the morning, for example."
Grant says she hopes soon to study how spouses might influence not only each other's risk of alcohol dependence but also other psychiatric disorders, such as depression and how those factors interact. And she says as more is learned about these risks, it's important to let people know what they're up against.
"Education is a key to reducing risk for alcohol dependence," she says. "Regardless of genetic risks, there are other detrimental environmental factors associated with alcohol, including reduced educational attainment and income, fewer social and neighborhood support networks, higher rates of divorce and single parenthood and exposure to other psychiatric problems. We need to make people aware of all of their risks, so they can take steps to protect themselves."
Grant JD, Heath AC, Bucholz KK, Madden PAF, Agrawal A, Stratham DJ, Martin NG. Spousal concordance for alcohol dependence: evidence for assortative mating or spousal interaction effects? Alcoholism: Clinical & Experimental Research, vol. 31 (5), pp. 717-728, May 2007.
DOI: 10.1111/j/1530-0277.2007.00356.x
This research was supported by was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health.
Washington University School of Medicine's full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.
Contact: Jim Dryden
Washington University School of Medicine
среда, 15 июня 2011 г.
Preventing Risk-Taking And Self-Destructive Behavior In Young People
At the beginning of 2010, the Child and Adolescent Psychiatry Department at the Center for Psychosocial Medicine at Heidelberg University Hospital will conduct a study named "Saving and Empowering Young Lives in Europe (SEYLE) - promoting the health of young people through the prevention of risk-taking and self-destructive behavior" in cooperation with twelve centers in other EU countries and Israel. The 12-month study, which will receive some 3 million euros in funding from the European Union, was presented in Heidelberg on November 24, 2009. The Karolinska Institute in Stockholm will assume the Europe-wide direction of the study.
Promote health, reduce injurious behavior
Risk-taking and self-destructive behavior is understood to mean alcohol and drug consumption, self-injury and suicidal actions, aggression, anxiety, depression, and various dangerous situations that youth in particular expose themselves to.
The primary objective of the study is to promote the psychological health of youth at schools. To do this, over 1,000 pupils per country will be surveyed by means of questionnaires. In the Rhein-Neckar region, several types of secondary schools will participate. Information will be gathered on factors such as eating behavior, Internet and media use, depression, and social situation. "This information will indicate the extent of the problems and which pupils are at risk," explains the head of the study Professor Dr. Romuald Brunner, consultant at the Child and Adolescent Psychiatry Department at Heidelberg University Hospital.
"The SEYLE study builds on the experience of the "Heidelberg school study" that has been examining the psychological health of 15-year-olds for many years," reported Professor Dr. Franz Resch, Medical Director of the Department of Child and Adolescent Psychiatry at Heidelberg University Hospital. Among other things, this study determined that some 5 percent of female pupils and 2 percent of male pupils frequently inflicted injuries on themselves.
Four different preventive measures to be tested
In the SEYLE study, following the initial survey, one of a total of four different preventive measures will be conducted at every participating school and then examined as to effectiveness.
"Gatekeeper Training" for teachers and school staff to recognize and help at-risk pupils.
"Awareness Program", in which pupils learn to deal with the risks by engaging in role-play.
"Professional Screening": after evaluation of the questionnaires, at-risk pupils are identified and interviewed.
Minimal intervention with posters and contact information for pupils.
Use regional help centers and treatment systems
All preventive measures are conducted in close cooperation with regional outpatient treatment systems and therapists and should introduce youth who exhibit risk-taking and self-injurious behavior to these regional help centers and treatment systems. In the longer term, the goal is to establish effective preventive measures for all schools.
The results of the study should help develop a comprehensive, country-specific concept for youth that takes the needs and wishes of all involved into consideration and can be integrated as a fixed component of preventive healthcare in Germany and other countries.
This project is under the patronage of Dr. Eckart W??rzner, Lord Mayor of the City of Heidelberg.
Source: Professor Dr. Franz Resch
University Hospital Heidelberg
Promote health, reduce injurious behavior
Risk-taking and self-destructive behavior is understood to mean alcohol and drug consumption, self-injury and suicidal actions, aggression, anxiety, depression, and various dangerous situations that youth in particular expose themselves to.
The primary objective of the study is to promote the psychological health of youth at schools. To do this, over 1,000 pupils per country will be surveyed by means of questionnaires. In the Rhein-Neckar region, several types of secondary schools will participate. Information will be gathered on factors such as eating behavior, Internet and media use, depression, and social situation. "This information will indicate the extent of the problems and which pupils are at risk," explains the head of the study Professor Dr. Romuald Brunner, consultant at the Child and Adolescent Psychiatry Department at Heidelberg University Hospital.
"The SEYLE study builds on the experience of the "Heidelberg school study" that has been examining the psychological health of 15-year-olds for many years," reported Professor Dr. Franz Resch, Medical Director of the Department of Child and Adolescent Psychiatry at Heidelberg University Hospital. Among other things, this study determined that some 5 percent of female pupils and 2 percent of male pupils frequently inflicted injuries on themselves.
Four different preventive measures to be tested
In the SEYLE study, following the initial survey, one of a total of four different preventive measures will be conducted at every participating school and then examined as to effectiveness.
"Gatekeeper Training" for teachers and school staff to recognize and help at-risk pupils.
"Awareness Program", in which pupils learn to deal with the risks by engaging in role-play.
"Professional Screening": after evaluation of the questionnaires, at-risk pupils are identified and interviewed.
Minimal intervention with posters and contact information for pupils.
Use regional help centers and treatment systems
All preventive measures are conducted in close cooperation with regional outpatient treatment systems and therapists and should introduce youth who exhibit risk-taking and self-injurious behavior to these regional help centers and treatment systems. In the longer term, the goal is to establish effective preventive measures for all schools.
The results of the study should help develop a comprehensive, country-specific concept for youth that takes the needs and wishes of all involved into consideration and can be integrated as a fixed component of preventive healthcare in Germany and other countries.
This project is under the patronage of Dr. Eckart W??rzner, Lord Mayor of the City of Heidelberg.
Source: Professor Dr. Franz Resch
University Hospital Heidelberg
вторник, 14 июня 2011 г.
Brain areas activated by food craving and drug craving overlap
Researchers at the Monell Chemical Senses Center and the University of Pennsylvania School of Medicine used functional
magnetic resonance imaging (fMRI) to reveal that food cravings activate brain areas related to emotion, memory and reward -
areas also activated during drug-craving studies. Study lead author Marcia Levin Pelchat, PhD, a Monell Center sensory
psychologist, comments, "This is consistent with the idea that cravings of all kinds, whether for food, drugs, or designer
shoes, have common mechanisms."
Studies of food craving, possibly the evolutionary basis of all craving behavior, may provide insight into drug craving and
how it contributes to maintenance and relapse of drug addiction. Pelchat notes, "Identifying the brain regions involved can
tell us a great deal about the normal and pathological neurochemistry of craving, and in turn, lead us to better
pharmacological treatments for obesity and drug addiction."
During food craving episodes, craving-specific activation was seen in three regions of the brain: the hippocampus, insula,
and caudate. These same three areas have also been reported to be involved in drug craving.
J. Daniel Ragland, PhD of the Department of Psychiatry, University of Pennsylvania School of Medicine, was responsible for
the imaging part of the study. Ragland comments, "The pattern of fMRI results suggests that memory areas of the brain
responsible for associating a food with a reward are more important to food craving than are the actual reward centers." He
goes on to say, "This result fits nicely with animal research that has shown that stimulation of memory centers is more
effective than stimulation of reward centers in getting animals to work for drug rewards."
In the study, to be published in the December 2004 issue of NeuroImage, 10 healthy volunteers were not permitted to consume
anything other than a vanilla nutritional supplement beverage for the one-and-a-half days before the imaging session. The
researchers used the monotonous diet to increase the probability of cravings during fMRI sessions. Previous findings had
shown that consuming a monotonous diet leads to large increases in the number of food cravings.
Subjects received enough of the beverage to provide sufficient calories and nutrients. A control group was allowed to eat
whatever they wanted, along with several servings of the vanilla supplement.
Each subject provided names of two foods that they "really like." To trigger cravings during the fMRI scan, names of the
liked foods and the liquid diet were alternated on a screen. Subjects were instructed to think about the food listed on the
screen, along with its taste, smell, and texture. The researchers decided to use words as cues - rather than pictures - so
each subject could imagine their own most desirable version of the liked food.
After the session subjects reported whether they had experienced any food cravings. As expected, the monotonous diet
increased the likelihood of food craving when imagining the liked foods. All monotonous diet participants reported food
craving while imagining the liked foods, but not while visualizing the monotonous food.
Food cravings are very common: surveys estimate that almost 100% of young women and nearly 70% of young men report having
experienced cravings during the past year. The high prevalence of craving behavior increases its potential nutritional
impact, as cravings have been linked to snacking behavior and diet compliance, both related to obesity.
Pelchat notes the significance of activation of memory structures, "During a craving we have a sensory memory or template for
the food that will satisfy the craving. The food we eat has to match that template for the craving to be satisfied. It's as
if our brain is saying, 'It has to be chocolate ice cream, lemon pie just won't do.'" She continues, "Cravings are also like
habits. We often reach for a craved food without thinking of it."
Looking to the future, Pelchat comments, "We need to know more about food cravings in pathological conditions such as
obesity, alcoholism, cocaine addiction, and so on. If all these excesses of desire share common brain mechanisms, then it
might be possible to use motivational trades-off to treat cravings for harmful substances by substituting craving for
something healthier, such as good food."
Penn researchers Andrea Johnson, Robin Chan, and Jeffrey Valdez also contributed to the work.
The Monell Chemical Senses Center is a nonprofit basic research institute based in Philadelphia, Pennsylvania. For 35 years,
Monell has been the nation's leading research center focused on understanding the senses of smell, taste and chemical
irritation: how they function and affect lives from before birth through old age. Using a multidisciplinary approach,
scientists from a variety of backgrounds collaborate to address topic areas in the areas of: sensation and perception,
neuroscience and molecular biology, environmental and occupational health, nutrition and appetite, health and well-being, and
chemical ecology and communication. For more information about Monell, visit the Center's web site at monell or email inquiries to mediamonell.
This project is funded, in part, under a grant with the Pennsylvania Department of Health. The Department specifically
disclaims responsibility for any analyses, interpretations or conclusions.
Contact: Marcia Pelchat
pelchatmonell
215-898-4266
Monell Chemical Senses Center
magnetic resonance imaging (fMRI) to reveal that food cravings activate brain areas related to emotion, memory and reward -
areas also activated during drug-craving studies. Study lead author Marcia Levin Pelchat, PhD, a Monell Center sensory
psychologist, comments, "This is consistent with the idea that cravings of all kinds, whether for food, drugs, or designer
shoes, have common mechanisms."
Studies of food craving, possibly the evolutionary basis of all craving behavior, may provide insight into drug craving and
how it contributes to maintenance and relapse of drug addiction. Pelchat notes, "Identifying the brain regions involved can
tell us a great deal about the normal and pathological neurochemistry of craving, and in turn, lead us to better
pharmacological treatments for obesity and drug addiction."
During food craving episodes, craving-specific activation was seen in three regions of the brain: the hippocampus, insula,
and caudate. These same three areas have also been reported to be involved in drug craving.
J. Daniel Ragland, PhD of the Department of Psychiatry, University of Pennsylvania School of Medicine, was responsible for
the imaging part of the study. Ragland comments, "The pattern of fMRI results suggests that memory areas of the brain
responsible for associating a food with a reward are more important to food craving than are the actual reward centers." He
goes on to say, "This result fits nicely with animal research that has shown that stimulation of memory centers is more
effective than stimulation of reward centers in getting animals to work for drug rewards."
In the study, to be published in the December 2004 issue of NeuroImage, 10 healthy volunteers were not permitted to consume
anything other than a vanilla nutritional supplement beverage for the one-and-a-half days before the imaging session. The
researchers used the monotonous diet to increase the probability of cravings during fMRI sessions. Previous findings had
shown that consuming a monotonous diet leads to large increases in the number of food cravings.
Subjects received enough of the beverage to provide sufficient calories and nutrients. A control group was allowed to eat
whatever they wanted, along with several servings of the vanilla supplement.
Each subject provided names of two foods that they "really like." To trigger cravings during the fMRI scan, names of the
liked foods and the liquid diet were alternated on a screen. Subjects were instructed to think about the food listed on the
screen, along with its taste, smell, and texture. The researchers decided to use words as cues - rather than pictures - so
each subject could imagine their own most desirable version of the liked food.
After the session subjects reported whether they had experienced any food cravings. As expected, the monotonous diet
increased the likelihood of food craving when imagining the liked foods. All monotonous diet participants reported food
craving while imagining the liked foods, but not while visualizing the monotonous food.
Food cravings are very common: surveys estimate that almost 100% of young women and nearly 70% of young men report having
experienced cravings during the past year. The high prevalence of craving behavior increases its potential nutritional
impact, as cravings have been linked to snacking behavior and diet compliance, both related to obesity.
Pelchat notes the significance of activation of memory structures, "During a craving we have a sensory memory or template for
the food that will satisfy the craving. The food we eat has to match that template for the craving to be satisfied. It's as
if our brain is saying, 'It has to be chocolate ice cream, lemon pie just won't do.'" She continues, "Cravings are also like
habits. We often reach for a craved food without thinking of it."
Looking to the future, Pelchat comments, "We need to know more about food cravings in pathological conditions such as
obesity, alcoholism, cocaine addiction, and so on. If all these excesses of desire share common brain mechanisms, then it
might be possible to use motivational trades-off to treat cravings for harmful substances by substituting craving for
something healthier, such as good food."
Penn researchers Andrea Johnson, Robin Chan, and Jeffrey Valdez also contributed to the work.
The Monell Chemical Senses Center is a nonprofit basic research institute based in Philadelphia, Pennsylvania. For 35 years,
Monell has been the nation's leading research center focused on understanding the senses of smell, taste and chemical
irritation: how they function and affect lives from before birth through old age. Using a multidisciplinary approach,
scientists from a variety of backgrounds collaborate to address topic areas in the areas of: sensation and perception,
neuroscience and molecular biology, environmental and occupational health, nutrition and appetite, health and well-being, and
chemical ecology and communication. For more information about Monell, visit the Center's web site at monell or email inquiries to mediamonell.
This project is funded, in part, under a grant with the Pennsylvania Department of Health. The Department specifically
disclaims responsibility for any analyses, interpretations or conclusions.
Contact: Marcia Pelchat
pelchatmonell
215-898-4266
Monell Chemical Senses Center
понедельник, 13 июня 2011 г.
Quitting Smoking Increases The Chance Of Staying Sober
People who are dependent on alcohol are also likely to smoke cigarettes. Many experts believe that it's important to counsel alcohol-dependent individuals to give up smoking as well as drinking not just to improve their health, but also to increase their chances of staying sober, reports the June 2008 issue of the Harvard Mental Health Letter.
It is a common worry that trying to quit smoking and drinking at the same time will undermine treatment for alcohol dependence. However, most studies have reported that efforts to quit smoking either have no impact on maintaining sobriety or actually increase success of alcohol treatment.
There are no smoking cessation guidelines specifically for alcohol-dependent adults. For now, the best option is to follow the federal guidelines for treating tobacco dependence, which recommend a combination of counseling and medication.
A major and still unresolved question is whether it's better to give up smoking and drinking together, or whether it's better to tackle one addiction at a time. Researchers have found that when smoking cessation support was delayed by six months, study participants were more likely to remain sober compared with those who received concurrent treatment for both addictions. But a follow-up analysis found that this may have been true only for white people in the study.
Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter, notes that no single approach is best for every person struggling with both alcohol and nicotine addiction. Whether an individual quits smoking during alcohol treatment or later, it's a net health gain.
Harvard Health Publications
Harvard Medical School 10 Shattuck St., Ste. 612
Cambridge, MA 02115
United States
health.harvard
It is a common worry that trying to quit smoking and drinking at the same time will undermine treatment for alcohol dependence. However, most studies have reported that efforts to quit smoking either have no impact on maintaining sobriety or actually increase success of alcohol treatment.
There are no smoking cessation guidelines specifically for alcohol-dependent adults. For now, the best option is to follow the federal guidelines for treating tobacco dependence, which recommend a combination of counseling and medication.
A major and still unresolved question is whether it's better to give up smoking and drinking together, or whether it's better to tackle one addiction at a time. Researchers have found that when smoking cessation support was delayed by six months, study participants were more likely to remain sober compared with those who received concurrent treatment for both addictions. But a follow-up analysis found that this may have been true only for white people in the study.
Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter, notes that no single approach is best for every person struggling with both alcohol and nicotine addiction. Whether an individual quits smoking during alcohol treatment or later, it's a net health gain.
Harvard Health Publications
Harvard Medical School 10 Shattuck St., Ste. 612
Cambridge, MA 02115
United States
health.harvard
воскресенье, 12 июня 2011 г.
Economic Study Estimates Meth Abuse Costs The U.S. $23.4 Billion
A RAND Corporation study released today, "The Economic Cost of Methamphetamine Use in the United States, 2005," estimates the national cost of Meth abuse is $23.4 billion. The study represents the first time that a comprehensive assessment of the annual costs of methamphetamine abuse has been analyzed on a national scale.
"The RAND study is a crucial step forward in drug research, and is the first time we have been able to quantify the cost of Meth use for both the user and society as a whole," said Rick Rawson, Ph.D., Associate Director of UCLA Integrated Substance Abuse Programs. "While the $23 billion dollar figure for 2005 is staggering, in my opinion, this study provides a conservative estimate of the financial impact Meth has on the U.S. each year."
The study found that Meth use imposes a significant and disproportionate burden on both individuals and society in money spent on treatment, healthcare, and foster care services, as well as the costs of crime and lost productivity associated with the drug. Law enforcement and the criminal justice system bear some of the greatest financial burden, making up more than 15%-$4 billion-of the total annual cost. Lawmakers in recent years have passed legislation that makes it more difficult for Meth producers to buy the components needed to make the drug, but even in light of these efforts, 47% of county sheriffs in 2007 reported that Meth remains their #1 drug problem.1
"Our goal in sponsoring this study was to provide a definitive economic cost estimate of the Meth problem that legislators and regulators can consider while establishing social priorities," said Tom Siebel, founder and chairman of the Meth Project. "This appears to be a preventable problem. The significant economic and human costs of Meth use can be avoided."
The U.S. Department of Justice continues to report that an overwhelming majority (68%) of state and local agencies in the 20 western states say Meth is their greatest drug threat. Communities with high levels of Meth addiction experience significant increases in crime and spend more on social services, corrections, unemployment pools, workers' compensation, and healthcare.
"Meth is a scourge. It ruins families, friends-tears lives apart. As this study shows, there is a huge economic toll, as well," said Montana's senior U.S. Senator Max Baucus. "That's why I've fought so hard for funding to help with Meth prevention, treatment and rehabilitation. I've also secured much-needed funding for our law enforcement officials who help fight Meth. I'll continue to work together with my colleagues in Congress to secure funding to help stamp out Meth once and for all."
The RAND study found that methamphetamine places a significant economic burden on society when compared to other illicit drugs. In addition to funds spent on crime and criminal justice programs associated with Meth use, $905 million is spent on foster care and $646 million is spent on lost productivity due to absenteeism, incarceration, unemployment, and other employer costs attributable to Meth use in the U.S.
According to the RAND study, $712 million was spent on treatment and hospital care for Meth users in the U.S. in 2005. Additionally, the study found that nearly two-thirds of the economic costs of methamphetamine use result from the burden of addiction, and the nearly 900 premature deaths among users. Using data from the 2007 National Survey of Drug Use and Health, SAMHSA Treatment Episode Data Set, and the economic models developed in RAND's "Economic Cost of Methamphetamine Use in the United States, 2005," the best estimated cost of Meth use in 2007 is $26.5 billion.
The study confirms what many treatment and healthcare providers understand about the nature of methamphetamine. Meth is one of the most highly addictive substances and consumes a tremendous amount of resources to aid in recovery and treatment.
The Meth Project has launched large-scale research-based prevention campaigns-including public service messaging and public outreach programs-in several states throughout the nation and achieved significant results. Montana and Arizona, the first two states to launch Meth Project prevention campaigns in 2005 and 2007, respectively, have each seen a 45% decrease in teen Meth use after two years of the Meth Project campaign.2, 3
The Meth Project launched in 2005 as a private-sector response to a significant social problem. Cited by the White House as a model for national prevention programs, the Meth Project has been deployed in five states, with an additional three states expected to adopt the model in 2009.
For further information or to read the full RAND report please visit methproject.
About the Meth Project
The Meth Project is a national non-profit organization headquartered in Palo Alto, California, aimed at significantly reducing Meth use through public service messaging, public policy, and community outreach. The Montana Meth Project, Arizona Meth Project, Idaho Meth Project, Illinois Meth Project, Wyoming Meth Project, and other state affiliates implement the Meth Project prevention programs in their respective states. The Meth Project is a project of the Thomas and Stacey Siebel Foundation.
methproject
1 National Association of Counties, Research Division, "The Meth Epidemic: The Changing Demographics of Methamphetamine." 2007.
2 Montana Office of Public Instruction, "2007 Montana Youth Risk Behavior Survey." September 2007.
3 Arizona Criminal Justice Commission, "Arizona Youth Survey." 2008.
RAND Corporation Report:
"The Economic Cost of Methamphetamine Use in the United States"
Key Findings
Findings from the RAND Corporation's "The Economic Cost of Methamphetamine Use in the United States" represent the first rigorous attempt to calculate the cost methamphetamine use imposes on individuals and society at the national level. The report estimates the annual total cost to the U.S. is $23.4 billion.
The RAND study found that methamphetamine use imposes a significant and disproportionate burden on both individuals and society in money spent on treatment, healthcare, and foster care services, as well as the costs of crime and lost productivity associated with the drug. For the complete report, please visit methproject.
Crime and Criminal Justice
Crimes attributable to Meth use, as well as criminal justice costs associated with enforcing Meth laws represent the second largest category of costs at $4.2 billion.
- Methamphetamine-specific offenses, including processing offenders for possession and sale of Meth, represent over half of the criminal justice costs, totaling $2.4 billion.
- Meth-induced violent and property crime represent an additional $1.76 billion in costs.
Health Care and Drug Treatment
Costs including health services used in the treatment of medical conditions attributed to or exacerbated by Meth use, and Meth treatment delivered in general, short-stay hospitals and the specialty treatment sector are approximately $900 million.
- $545 million for treatment admissions, of which $491 million is in the community-based specialty treatment sector.
- Methamphetamine use results in approximately $351 million in additional health costs.
Child Endangerment
Meth-related child endangerment costs, including the burden on the foster care system due to parental involvement with Meth are approximately $905 million.
- The largest contributor to these costs is the medical, mental and quality of life losses suffered by children ($502 million) and the cost to the foster care system ($403 million).
- These estimates are limited to children who are removed from their homes by the foster-care system, so these costs are likely an underestimate of the full burden of Meth abuse.
Decreased Productivity
Costs associated with productivity losses represent another substantial category of costs with a best estimate of $687 million.
- Productivity losses are due to absenteeism ($275 million), incarceration ($305 million), lower probability of working among Meth users ($63 million) and the cost of employer Meth attributed drug testing ($44 million).
- The study estimates that approximately 126,091 members of the workforce in the U.S. are working Meth users who use Meth at least once a week.
Premature Death and Qualitative Impact on the User
The RAND study considers the intangible costs associated with premature death caused by Meth abuse and the health burden of Meth addiction.
- The estimated cost of premature death due to Meth abuse is approximately $4 billion.
- The intangible health burden associated with methamphetamine use is nearly $12.6 billion.
methproject
"The RAND study is a crucial step forward in drug research, and is the first time we have been able to quantify the cost of Meth use for both the user and society as a whole," said Rick Rawson, Ph.D., Associate Director of UCLA Integrated Substance Abuse Programs. "While the $23 billion dollar figure for 2005 is staggering, in my opinion, this study provides a conservative estimate of the financial impact Meth has on the U.S. each year."
The study found that Meth use imposes a significant and disproportionate burden on both individuals and society in money spent on treatment, healthcare, and foster care services, as well as the costs of crime and lost productivity associated with the drug. Law enforcement and the criminal justice system bear some of the greatest financial burden, making up more than 15%-$4 billion-of the total annual cost. Lawmakers in recent years have passed legislation that makes it more difficult for Meth producers to buy the components needed to make the drug, but even in light of these efforts, 47% of county sheriffs in 2007 reported that Meth remains their #1 drug problem.1
"Our goal in sponsoring this study was to provide a definitive economic cost estimate of the Meth problem that legislators and regulators can consider while establishing social priorities," said Tom Siebel, founder and chairman of the Meth Project. "This appears to be a preventable problem. The significant economic and human costs of Meth use can be avoided."
The U.S. Department of Justice continues to report that an overwhelming majority (68%) of state and local agencies in the 20 western states say Meth is their greatest drug threat. Communities with high levels of Meth addiction experience significant increases in crime and spend more on social services, corrections, unemployment pools, workers' compensation, and healthcare.
"Meth is a scourge. It ruins families, friends-tears lives apart. As this study shows, there is a huge economic toll, as well," said Montana's senior U.S. Senator Max Baucus. "That's why I've fought so hard for funding to help with Meth prevention, treatment and rehabilitation. I've also secured much-needed funding for our law enforcement officials who help fight Meth. I'll continue to work together with my colleagues in Congress to secure funding to help stamp out Meth once and for all."
The RAND study found that methamphetamine places a significant economic burden on society when compared to other illicit drugs. In addition to funds spent on crime and criminal justice programs associated with Meth use, $905 million is spent on foster care and $646 million is spent on lost productivity due to absenteeism, incarceration, unemployment, and other employer costs attributable to Meth use in the U.S.
According to the RAND study, $712 million was spent on treatment and hospital care for Meth users in the U.S. in 2005. Additionally, the study found that nearly two-thirds of the economic costs of methamphetamine use result from the burden of addiction, and the nearly 900 premature deaths among users. Using data from the 2007 National Survey of Drug Use and Health, SAMHSA Treatment Episode Data Set, and the economic models developed in RAND's "Economic Cost of Methamphetamine Use in the United States, 2005," the best estimated cost of Meth use in 2007 is $26.5 billion.
The study confirms what many treatment and healthcare providers understand about the nature of methamphetamine. Meth is one of the most highly addictive substances and consumes a tremendous amount of resources to aid in recovery and treatment.
The Meth Project has launched large-scale research-based prevention campaigns-including public service messaging and public outreach programs-in several states throughout the nation and achieved significant results. Montana and Arizona, the first two states to launch Meth Project prevention campaigns in 2005 and 2007, respectively, have each seen a 45% decrease in teen Meth use after two years of the Meth Project campaign.2, 3
The Meth Project launched in 2005 as a private-sector response to a significant social problem. Cited by the White House as a model for national prevention programs, the Meth Project has been deployed in five states, with an additional three states expected to adopt the model in 2009.
For further information or to read the full RAND report please visit methproject.
About the Meth Project
The Meth Project is a national non-profit organization headquartered in Palo Alto, California, aimed at significantly reducing Meth use through public service messaging, public policy, and community outreach. The Montana Meth Project, Arizona Meth Project, Idaho Meth Project, Illinois Meth Project, Wyoming Meth Project, and other state affiliates implement the Meth Project prevention programs in their respective states. The Meth Project is a project of the Thomas and Stacey Siebel Foundation.
methproject
1 National Association of Counties, Research Division, "The Meth Epidemic: The Changing Demographics of Methamphetamine." 2007.
2 Montana Office of Public Instruction, "2007 Montana Youth Risk Behavior Survey." September 2007.
3 Arizona Criminal Justice Commission, "Arizona Youth Survey." 2008.
RAND Corporation Report:
"The Economic Cost of Methamphetamine Use in the United States"
Key Findings
Findings from the RAND Corporation's "The Economic Cost of Methamphetamine Use in the United States" represent the first rigorous attempt to calculate the cost methamphetamine use imposes on individuals and society at the national level. The report estimates the annual total cost to the U.S. is $23.4 billion.
The RAND study found that methamphetamine use imposes a significant and disproportionate burden on both individuals and society in money spent on treatment, healthcare, and foster care services, as well as the costs of crime and lost productivity associated with the drug. For the complete report, please visit methproject.
Crime and Criminal Justice
Crimes attributable to Meth use, as well as criminal justice costs associated with enforcing Meth laws represent the second largest category of costs at $4.2 billion.
- Methamphetamine-specific offenses, including processing offenders for possession and sale of Meth, represent over half of the criminal justice costs, totaling $2.4 billion.
- Meth-induced violent and property crime represent an additional $1.76 billion in costs.
Health Care and Drug Treatment
Costs including health services used in the treatment of medical conditions attributed to or exacerbated by Meth use, and Meth treatment delivered in general, short-stay hospitals and the specialty treatment sector are approximately $900 million.
- $545 million for treatment admissions, of which $491 million is in the community-based specialty treatment sector.
- Methamphetamine use results in approximately $351 million in additional health costs.
Child Endangerment
Meth-related child endangerment costs, including the burden on the foster care system due to parental involvement with Meth are approximately $905 million.
- The largest contributor to these costs is the medical, mental and quality of life losses suffered by children ($502 million) and the cost to the foster care system ($403 million).
- These estimates are limited to children who are removed from their homes by the foster-care system, so these costs are likely an underestimate of the full burden of Meth abuse.
Decreased Productivity
Costs associated with productivity losses represent another substantial category of costs with a best estimate of $687 million.
- Productivity losses are due to absenteeism ($275 million), incarceration ($305 million), lower probability of working among Meth users ($63 million) and the cost of employer Meth attributed drug testing ($44 million).
- The study estimates that approximately 126,091 members of the workforce in the U.S. are working Meth users who use Meth at least once a week.
Premature Death and Qualitative Impact on the User
The RAND study considers the intangible costs associated with premature death caused by Meth abuse and the health burden of Meth addiction.
- The estimated cost of premature death due to Meth abuse is approximately $4 billion.
- The intangible health burden associated with methamphetamine use is nearly $12.6 billion.
methproject
суббота, 11 июня 2011 г.
Needle-Exchange Programs Effective HIV Prevention Methods, Letter To Editor Says
The "notion that clean needle-exchange programs are enabling and encouraging drug use is nonsense," Stephen Heath, public relations director for the Drug Policy Forum of Florida, writes in a New York Times letter to the editor in response to a recent Times editorial. It is "possible to overcome drug addiction," Heath writes, adding that it is "of course impossible to overcome a case of HIV and hepatitis C that's been received by use of dirty needles." According to Heath, communities benefit by "reducing the peripheral and associated disease that is passed by dirty or infected needles" (Heath, New York Times, 6/11).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
пятница, 10 июня 2011 г.
Miami Program Aims To Teach Hispanics About Healthy Food Choices; Grants Fund Refugee Services In Indiana, Substance Abuse Services For American Ind.
Create Your Weight: The 10-week, no-cost diet program aimed at Hispanics kicked off at Aventura Hospital in Miami last week. The program is offered completely in Spanish and teaches Hispanics about healthy food choices, cooking and exercise. The program aims to "lure people away from fast-food restaurants and toward the healthier foods of their culture: corn, beans, rice, lean cuts of fish and chicken," the Miami Herald reports. The Florida Department of Health's Hispanic Obesity Prevention and Education program is funding the program with a $20,000 grant (Amerikaner, Miami Herald, 1/13).
Fort Wayne, Ind.: Charities in northeastern Indiana have received $133,000 in grants from Catholic Charities to help provide health services to refugees expected from Myanmar over the next year. An estimated 800 to 1,000 refugees from Myanmar are expected to settle in Fort Wayne in 2008. According to the AP/WLFI, about 40% of adult refugees are expected to have latent tuberculosis and hepatitis, while many child refugees have low body weights (AP/WLFI, 1/12).
Montana-Wyoming Tribal Leaders Council: The council has received a three-year, $5.6 million federal grant that it will use to help American Indian communities fight substance use. The money will go to Rocky Mountain Tribal Access to Recovery, a new program that aims to broaden treatment and support systems. The program offers services such as transportation, child care, cultural mentoring, spiritual support and programs for sober recreation and exercise (Cochran, Billings Gazette, 1/15).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Fort Wayne, Ind.: Charities in northeastern Indiana have received $133,000 in grants from Catholic Charities to help provide health services to refugees expected from Myanmar over the next year. An estimated 800 to 1,000 refugees from Myanmar are expected to settle in Fort Wayne in 2008. According to the AP/WLFI, about 40% of adult refugees are expected to have latent tuberculosis and hepatitis, while many child refugees have low body weights (AP/WLFI, 1/12).
Montana-Wyoming Tribal Leaders Council: The council has received a three-year, $5.6 million federal grant that it will use to help American Indian communities fight substance use. The money will go to Rocky Mountain Tribal Access to Recovery, a new program that aims to broaden treatment and support systems. The program offers services such as transportation, child care, cultural mentoring, spiritual support and programs for sober recreation and exercise (Cochran, Billings Gazette, 1/15).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
четверг, 9 июня 2011 г.
SAMHSA Releases New Data On Drug-Related Hospital Emergency Department Visits
The latest Drug Abuse Warning Network (DAWN) report - drawn from a sample of hospital emergency departments across the Nation - indicates that more than 1.7 million visits for treatment were associated with some form of substance misuse or abuse. The 2006 DAWN report, developed by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides the latest estimates on how substance use affects this critical part of the Nation's healthcare system.
Among the report's more notable findings:
- Cocaine was involved in 548,608 emergency department visits.
- Marijuana was involved in 290,563 emergency department visits.
- Heroin was involved in 189,780 emergency department visits.
- There were 126,704 emergency department visits by patients under age 21 where alcohol was the only substance involved in the visit.
- Stimulants, including amphetamines and methamphetamines, were involved in 107,575 emergency department visits.
The DAWN report provides a great deal of other detailed information on how problems with a wide range of other substances contribute to hospital emergency department visits. These substance problems include the use of other illicit drugs as well as the non-medical use of prescription medications and over-the-counter drugs.
The report also provides statistical breakdowns on drug-related hospital emergency department visits by key demographic groups and other factors.
Several sampling and estimation improvements were incorporated in the development of the 2006 DAWN report. Many of these improvements in methodology were retroactively applied to 2004 and 2005 DAWN data to promote greater comparability among the estimates for 2004-2006.
The full DAWN report is available at dawninfo.samhsa/pubs/edpubs/default.asp. For related publications and information, visit samhsa/.
SAMHSA is a public health agency within the Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation's substance abuse prevention, addictions treatment, and mental health services delivery system.
SAMHSA
Among the report's more notable findings:
- Cocaine was involved in 548,608 emergency department visits.
- Marijuana was involved in 290,563 emergency department visits.
- Heroin was involved in 189,780 emergency department visits.
- There were 126,704 emergency department visits by patients under age 21 where alcohol was the only substance involved in the visit.
- Stimulants, including amphetamines and methamphetamines, were involved in 107,575 emergency department visits.
The DAWN report provides a great deal of other detailed information on how problems with a wide range of other substances contribute to hospital emergency department visits. These substance problems include the use of other illicit drugs as well as the non-medical use of prescription medications and over-the-counter drugs.
The report also provides statistical breakdowns on drug-related hospital emergency department visits by key demographic groups and other factors.
Several sampling and estimation improvements were incorporated in the development of the 2006 DAWN report. Many of these improvements in methodology were retroactively applied to 2004 and 2005 DAWN data to promote greater comparability among the estimates for 2004-2006.
The full DAWN report is available at dawninfo.samhsa/pubs/edpubs/default.asp. For related publications and information, visit samhsa/.
SAMHSA is a public health agency within the Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation's substance abuse prevention, addictions treatment, and mental health services delivery system.
SAMHSA
среда, 8 июня 2011 г.
Heavy Drinking Raises Blood Pressure In Older Men Regardless Of "Good" Cholesterol
A large new Japanese study suggests that middle aged men who drink heavily could see their blood pressure rise, regardless of whether their levels of "good" cholesterol also go up.
Study author Ichiro Wakabayashi also found that the older men who participated all in their 50s were more susceptible to the blood pressure-boosting effects of heavy drinking than younger men.
While there are signs that drinking can be good for the heart and boost good cholesterol levels, "this emphasizes that alcohol is not for everyone," said Kenneth Mukamal, M.D., an assistant professor of medicine at Harvard Medical School who is familiar with the study findings.
"This really fits well with the observation that the risk of stroke which is more sensitive to blood pressure than heart attack is not really substantially lower in moderate drinkers," Mukamal said. According to him, an increase in blood pressure might eliminate any benefit from higher levels of good cholesterol.
Wakabayashi, of the Hyogo College of Medicine in Japan, launched the study to explore whether high-density lipoprotein (HDL) cholesterol which is thought to protect the heart from disease might play a role in how drinking affects blood pressure in men.
He looked at two groups of male workers, one 20 to 29 years old and the other 50 to 59 in all, 21,301 subjects. All had periodic health examinations.
Young drinkers with low HDL cholesterol levels were no more likely to have high blood pressure than were nondrinkers with similar cholesterol levels.
However, young men who drank heavily and had higher levels of HDL were more likely than nondrinkers were to have high blood pressure, suggesting that the "good" cholesterol did not stop the bad effects of drinking.
When looking at men of all ages, those with the lowest level of good cholesterol had the highest blood pressure in all three groups: nondrinkers, moderate drinkers and heavy drinkers. However, high levels of good cholesterol HDL did not do as much for the heavy drinkers.
Among older men, blood pressure was "significantly higher" in both light and heavy drinkers, regardless of their HDL cholesterol levels, according to the study. Author Wakabayashi was not available for comment.
The findings appear in the September issue of the journal Alcoholism: Clinical and Experimental Research.
So should men of a certain age stop drinking? It all depends on how much they are imbibing, said Arthur Klatsky, M.D., senior consultant in cardiology at the Kaiser Permanente Medical Center in Oakland, Calif.
In middle-aged and older people who have reached the ages when heart attacks are more common, "light to moderate drinking appears to reduce that risk," said Klatsky, who studies alcohol use and is familiar with the study findings.
On the other hand, Klatsky said, "people who drink a lot of alcohol ought to drink less or quit. This study doesn't affect that message one way or another."
Wakabayashi I. Blood HDL cholesterol levels influence association of alcohol intake with blood pressure in young men but not in middle-aged men. Alcoholism: Clinical and Experimental Research 31(9), 2007.
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
hbns
Study author Ichiro Wakabayashi also found that the older men who participated all in their 50s were more susceptible to the blood pressure-boosting effects of heavy drinking than younger men.
While there are signs that drinking can be good for the heart and boost good cholesterol levels, "this emphasizes that alcohol is not for everyone," said Kenneth Mukamal, M.D., an assistant professor of medicine at Harvard Medical School who is familiar with the study findings.
"This really fits well with the observation that the risk of stroke which is more sensitive to blood pressure than heart attack is not really substantially lower in moderate drinkers," Mukamal said. According to him, an increase in blood pressure might eliminate any benefit from higher levels of good cholesterol.
Wakabayashi, of the Hyogo College of Medicine in Japan, launched the study to explore whether high-density lipoprotein (HDL) cholesterol which is thought to protect the heart from disease might play a role in how drinking affects blood pressure in men.
He looked at two groups of male workers, one 20 to 29 years old and the other 50 to 59 in all, 21,301 subjects. All had periodic health examinations.
Young drinkers with low HDL cholesterol levels were no more likely to have high blood pressure than were nondrinkers with similar cholesterol levels.
However, young men who drank heavily and had higher levels of HDL were more likely than nondrinkers were to have high blood pressure, suggesting that the "good" cholesterol did not stop the bad effects of drinking.
When looking at men of all ages, those with the lowest level of good cholesterol had the highest blood pressure in all three groups: nondrinkers, moderate drinkers and heavy drinkers. However, high levels of good cholesterol HDL did not do as much for the heavy drinkers.
Among older men, blood pressure was "significantly higher" in both light and heavy drinkers, regardless of their HDL cholesterol levels, according to the study. Author Wakabayashi was not available for comment.
The findings appear in the September issue of the journal Alcoholism: Clinical and Experimental Research.
So should men of a certain age stop drinking? It all depends on how much they are imbibing, said Arthur Klatsky, M.D., senior consultant in cardiology at the Kaiser Permanente Medical Center in Oakland, Calif.
In middle-aged and older people who have reached the ages when heart attacks are more common, "light to moderate drinking appears to reduce that risk," said Klatsky, who studies alcohol use and is familiar with the study findings.
On the other hand, Klatsky said, "people who drink a lot of alcohol ought to drink less or quit. This study doesn't affect that message one way or another."
Wakabayashi I. Blood HDL cholesterol levels influence association of alcohol intake with blood pressure in young men but not in middle-aged men. Alcoholism: Clinical and Experimental Research 31(9), 2007.
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
hbns
вторник, 7 июня 2011 г.
More Evidence Low-Moderate Alcohol Consumption Does Not Impair Vitamin D Status In Women
For as long as our ancestors have been drawing pictograms or writing prose about food and culture, humans have been imbibing various forms of alcohol. Once simply a process by which nutritious beverages could be preserved and stored for later use, there is no doubt that the production and consumption of wines, beers, and spirits now provides integral texture to the fabric of many cultures. However, whether alcoholic drinks provide health benefits is an area of active and on-going debate and research among health and nutrition experts. For instance, moderate alcohol consumption is linked to increased risks of some forms of cancer. Conversely, drinking in reasonable amounts is associated with protection from cardiovascular disease and premature death.
Because many of the studies that have been conducted on this topic have utilized epidemiologic (observational) study designs, they unfortunately cannot provide definitive information on whether alcohol actually influences health or is just related to other lifestyle factors that are actually more physiologically relevant. Indeed, one of the basic tenets of scientific method is the phrase "correlation does not infer causation." In other words, just because people who drink alcohol tend to have fewer heart attacks does not mean that drinking alcohol actually prevents heart disease. In addition, there is a relative dearth of information on low to moderate alcohol consumption and bone health, especially in women. This may be particularly important because alcoholics tend to have weak bones possibly due to low levels of vitamin D which would hinder absorption of dietary calcium in the small intestine.
To help fill in a knowledge gap in this area, researchers at the National Cancer Institute (NCI) and the US Department of Agriculture ARS Beltsville Human Nutrition Research Center teamed up to rigorously test whether they could demonstrate any negative effects of low to moderate alcohol consumption on bone health in postmenopausal women. As part of the scientific program of the American Society for Nutrition, home to the world's leading nutrition researchers, results from this study will be presented on April 27, 2010 at the Experimental Biology 2010 meeting in Anaheim by Dr. Somdat Mahabir.
This study was part of the Women's Alcohol Study which involved 51 postmenopausal women who did not smoke or use hormone replacement therapy. The research team measured the effects of controlled alcohol consumption during three periods of time. In one of these experimental periods, subjects consumed an alcohol-free beverage once each day. During the other two, they consumed either 15 or 30 g of nearly pure alcohol (Everclear) served up in orange juice. These amounts of alcohol are equivalent to 1 or 2 glasses, respectively, of wine or a bottle of beer. Each study period lasted for 8 weeks, during which time all meals were also provided to the women either in the USDA's Beltsville Human Nutrition Research Center or provided as "take-out" for the weekends.
The good news for those of us who enjoy a glass or two of wine or beer with dinner or at the football game, is that the scientists did not find any negative effects of either dose of alcohol on circulating levels of vitamin D. Low to moderate intake also did not affect a variety of markers (single-nucleotide polymorphisms or SNPs) which influence alcohol metabolism. These results suggest that the relationship previously documented between alcohol consumption and bone disease in alcoholics may only be seen in very heavy drinkers, or may be due to something other than the alcohol itself.
Dr. Mahabir concluded that "It looks like low to moderate alcohol consumption, at least over the short term, does not harm bone health. Collectively, when all the available published epidemiologic data are considered, it looks like low to moderate alcohol may actually have a beneficial effect." In the end, nutritional scientists once again remind us that all foods and beverages can be part of a healthful diet and urge us to carefully balance the risks against the benefits of our daily dietary choices.
Dr. Somdat Mahabir (National Cancer Institute); Dr. David Baer (US Department of Agriculture); Dr. Ruth Pfeiffer (National Cancer Institute), and Dr. Philip Taylor (National Cancer Institute) were coauthors on this paper.
Source: Federation of American Societies for Experimental Biology (FASEB)
Because many of the studies that have been conducted on this topic have utilized epidemiologic (observational) study designs, they unfortunately cannot provide definitive information on whether alcohol actually influences health or is just related to other lifestyle factors that are actually more physiologically relevant. Indeed, one of the basic tenets of scientific method is the phrase "correlation does not infer causation." In other words, just because people who drink alcohol tend to have fewer heart attacks does not mean that drinking alcohol actually prevents heart disease. In addition, there is a relative dearth of information on low to moderate alcohol consumption and bone health, especially in women. This may be particularly important because alcoholics tend to have weak bones possibly due to low levels of vitamin D which would hinder absorption of dietary calcium in the small intestine.
To help fill in a knowledge gap in this area, researchers at the National Cancer Institute (NCI) and the US Department of Agriculture ARS Beltsville Human Nutrition Research Center teamed up to rigorously test whether they could demonstrate any negative effects of low to moderate alcohol consumption on bone health in postmenopausal women. As part of the scientific program of the American Society for Nutrition, home to the world's leading nutrition researchers, results from this study will be presented on April 27, 2010 at the Experimental Biology 2010 meeting in Anaheim by Dr. Somdat Mahabir.
This study was part of the Women's Alcohol Study which involved 51 postmenopausal women who did not smoke or use hormone replacement therapy. The research team measured the effects of controlled alcohol consumption during three periods of time. In one of these experimental periods, subjects consumed an alcohol-free beverage once each day. During the other two, they consumed either 15 or 30 g of nearly pure alcohol (Everclear) served up in orange juice. These amounts of alcohol are equivalent to 1 or 2 glasses, respectively, of wine or a bottle of beer. Each study period lasted for 8 weeks, during which time all meals were also provided to the women either in the USDA's Beltsville Human Nutrition Research Center or provided as "take-out" for the weekends.
The good news for those of us who enjoy a glass or two of wine or beer with dinner or at the football game, is that the scientists did not find any negative effects of either dose of alcohol on circulating levels of vitamin D. Low to moderate intake also did not affect a variety of markers (single-nucleotide polymorphisms or SNPs) which influence alcohol metabolism. These results suggest that the relationship previously documented between alcohol consumption and bone disease in alcoholics may only be seen in very heavy drinkers, or may be due to something other than the alcohol itself.
Dr. Mahabir concluded that "It looks like low to moderate alcohol consumption, at least over the short term, does not harm bone health. Collectively, when all the available published epidemiologic data are considered, it looks like low to moderate alcohol may actually have a beneficial effect." In the end, nutritional scientists once again remind us that all foods and beverages can be part of a healthful diet and urge us to carefully balance the risks against the benefits of our daily dietary choices.
Dr. Somdat Mahabir (National Cancer Institute); Dr. David Baer (US Department of Agriculture); Dr. Ruth Pfeiffer (National Cancer Institute), and Dr. Philip Taylor (National Cancer Institute) were coauthors on this paper.
Source: Federation of American Societies for Experimental Biology (FASEB)
понедельник, 6 июня 2011 г.
Washington Post Columnist Examines Washington, D.C., Program Aimed At Curbing Spread Of HIV Among Injection Drug Users
Washington Post columnist Courtland Milloy on Wednesday examined PreventionWorks! -- a privately funded needle-exchange program in Washington, D.C., that aims to curb the spread of HIV among injection drug users in the city. According to the district's Administration for HIV Policy and Programs, injection drug use is the second leading mode of HIV transmission among men in the district, and it is the leading mode of transmission among women, Milloy writes. PreventionWorks! was launched in 1998 and provides counseling, treatment referrals and HIV tests to IDUs. Last year, the program had a budget of $600,000, all of which was donated. The program is run by Ron Daniels, four staff members and a group of volunteers, who visit 12 cites in the district six days weekly. Last year, the program provided 1,963 IDUs with access to educational materials, treatment referrals and clean needles. According to Milloy, the district has an estimated 9,700 IDUs. "The needle exchange is just the beginning," Daniels said, adding, "We use the syringe to engage in conversations with those people nobody wants to talk to. We believe in meeting people where they are, treating them like human beings and helping them avoid catching and spreading diseases" (Milloy, Washington Post, 2/7).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
воскресенье, 5 июня 2011 г.
What Is Alcoholic Liver Disease?
Alcoholic liver disease, which arises from the overconsumption of alcohol, is the main cause of liver disease in Western nations. Viral hepatitis continues to be the major cause of liver disease in Asian countries, and several others. Experts say a considerable number of heavy, regular drinkers never develop liver damage - they do not fully understand why this is so and how exactly alcohol damages the liver.
We know that acetaldehyde damages the liver. Acetaldehyde is a toxic chemical produced by alcohol. It seems to affect some regular heavy drinkers' livers more severely than others. It takes a long time for any liver damage to become noticeable. The liver is amazingly good at regenerating and repairing itself. Even if three-quarters of a patient's liver is damaged, it is able to continue to function virtually normally.
Eventually, long-term heavy drinking takes its toll, resulting in liver scarring - cirrhosis or end-stage alcoholic liver disease.
The following factors increase the risk of developing alcoholic liver disease:
Beer and liquor (spirits), compared to other alcoholic beverages
Sex - women metabolize alcohol more slowly than men, and are thus more susceptible to developing the disease
Hepatitis C. Regular drinkers who have had any type of hepatitis have a greater risk of developing the disease
Changes in the genetic profiles of some enzymes which are key to alcohol metabolism, such as ADH, ALDH, CYP4502E1
Malnutrition
Some vitamin deficiencies, such as a lack of vitamins E and A
Diet - many alcoholics eat poorly
Iron overload
After the brain, the liver is the most complex organ in the human body, with over 500 functions. Some examples of liver functions include:
Fighting infection and disease
Filtering out blood toxins
Manufacturing hormones, proteins and other vital chemicals
Regulating our levels of blood cholesterol
Storing energy
Alcoholic liver disease has three main stages:
Alcoholic fatty liver disease - heavy drinking can result in an accumulation of fatty acids in the liver. Sometimes, the heavy drinking need only have occurred daily over a period of than less than a week. This usually asymptomatic (no symptoms) stage is reversible if the individual abstains from alcohol for a couple of weeks.
If the accumulation of fatty acids in the liver is severe, the patient may experience weakness, nausea, abdominal pain, loss of appetite, and malaise (generally feeling unwell).
Alcoholic hepatitis - hepatitis means inflammation (swelling) of the liver from any cause. In this case it means swelling because of alcohol. After many years of heavy drinking the liver can swell. In rarer occasions alcoholic hepatitis can affect individuals involved in binge drinking - heavy drinking over a relatively short period. If the patient abstains from alcohol for some months, alcoholic hepatitis is usually reversible. In some cases abstention has to go on for years.
Symptoms may include pain or tenderness in the abdomen, jaundice (yellowing of skin and whites of the eyes), spider-like veins appear on the skin, general tiredness, fever, nausea and loss of appetite.
Cirrhosis - the liver has been inflamed for a long time, causing scarring and loss of function. This can be a life-threatening condition. Cirrhosis damage is irreversible and the best the patient can do is prevent any further damage by stopping drinking. A long period of abstention will improve liver function. If the damage is severe, the patient may need a liver transplant to survive.
During the early stage the patient will feel tired and weak, their palms may be blotchy and red, they lose more weight, have itchy skin, insomnia, abdominal pain and/or tenderness, and loss of appetite.
During what is termed the end stage there will be hair loss, jaundice, dark urine, black or pale stools, dizziness, fatigue, loss of libido, bleeding gums and/or nose, the skin will easily bruise, edema, vomiting (with blood in vomit), muscle cramps, irregular breathing, accelerated heartbeat, personality changes, walking problems (staggering), and weight loss. As the liver no longer processes toxins properly there will be heightened sensitivity to medications and alcohol.
According to the NHS (National Health Service), UK, alcoholic fatty liver disease affects between 90% to 100% of heavy drinkers, approximately one in every four heavy drinkers eventually develops alcoholic hepatitis, and one in five of those with fatty liver disease will go on to suffer from cirrhosis.
Further reading:
"What Is An Alcoholic? What Is Alcoholism? What Is Alcohol Abuse?"
Sources: National Health Service, National Institutes of Health
We know that acetaldehyde damages the liver. Acetaldehyde is a toxic chemical produced by alcohol. It seems to affect some regular heavy drinkers' livers more severely than others. It takes a long time for any liver damage to become noticeable. The liver is amazingly good at regenerating and repairing itself. Even if three-quarters of a patient's liver is damaged, it is able to continue to function virtually normally.
Eventually, long-term heavy drinking takes its toll, resulting in liver scarring - cirrhosis or end-stage alcoholic liver disease.
The following factors increase the risk of developing alcoholic liver disease:
Beer and liquor (spirits), compared to other alcoholic beverages
Sex - women metabolize alcohol more slowly than men, and are thus more susceptible to developing the disease
Hepatitis C. Regular drinkers who have had any type of hepatitis have a greater risk of developing the disease
Changes in the genetic profiles of some enzymes which are key to alcohol metabolism, such as ADH, ALDH, CYP4502E1
Malnutrition
Some vitamin deficiencies, such as a lack of vitamins E and A
Diet - many alcoholics eat poorly
Iron overload
After the brain, the liver is the most complex organ in the human body, with over 500 functions. Some examples of liver functions include:
Fighting infection and disease
Filtering out blood toxins
Manufacturing hormones, proteins and other vital chemicals
Regulating our levels of blood cholesterol
Storing energy
Alcoholic liver disease has three main stages:
Alcoholic fatty liver disease - heavy drinking can result in an accumulation of fatty acids in the liver. Sometimes, the heavy drinking need only have occurred daily over a period of than less than a week. This usually asymptomatic (no symptoms) stage is reversible if the individual abstains from alcohol for a couple of weeks.
If the accumulation of fatty acids in the liver is severe, the patient may experience weakness, nausea, abdominal pain, loss of appetite, and malaise (generally feeling unwell).
Alcoholic hepatitis - hepatitis means inflammation (swelling) of the liver from any cause. In this case it means swelling because of alcohol. After many years of heavy drinking the liver can swell. In rarer occasions alcoholic hepatitis can affect individuals involved in binge drinking - heavy drinking over a relatively short period. If the patient abstains from alcohol for some months, alcoholic hepatitis is usually reversible. In some cases abstention has to go on for years.
Symptoms may include pain or tenderness in the abdomen, jaundice (yellowing of skin and whites of the eyes), spider-like veins appear on the skin, general tiredness, fever, nausea and loss of appetite.
Cirrhosis - the liver has been inflamed for a long time, causing scarring and loss of function. This can be a life-threatening condition. Cirrhosis damage is irreversible and the best the patient can do is prevent any further damage by stopping drinking. A long period of abstention will improve liver function. If the damage is severe, the patient may need a liver transplant to survive.
During the early stage the patient will feel tired and weak, their palms may be blotchy and red, they lose more weight, have itchy skin, insomnia, abdominal pain and/or tenderness, and loss of appetite.
During what is termed the end stage there will be hair loss, jaundice, dark urine, black or pale stools, dizziness, fatigue, loss of libido, bleeding gums and/or nose, the skin will easily bruise, edema, vomiting (with blood in vomit), muscle cramps, irregular breathing, accelerated heartbeat, personality changes, walking problems (staggering), and weight loss. As the liver no longer processes toxins properly there will be heightened sensitivity to medications and alcohol.
According to the NHS (National Health Service), UK, alcoholic fatty liver disease affects between 90% to 100% of heavy drinkers, approximately one in every four heavy drinkers eventually develops alcoholic hepatitis, and one in five of those with fatty liver disease will go on to suffer from cirrhosis.
Further reading:
"What Is An Alcoholic? What Is Alcoholism? What Is Alcohol Abuse?"
Sources: National Health Service, National Institutes of Health
суббота, 4 июня 2011 г.
American Society Of Anesthesiologists Helps Parents Identify Over-the-Counter Drug Abuse In Children
In recent years, a growing and potentially life-threatening trend known as Robo tripping, the abuse of over-the-counter cough and cold medications, has emerged among America's youth. As the Society representing the front-line physicians responsible for treating patients in the Intensive Care Unit (ICU) who have overdosed on over-the-counter medications, the American Society of Anesthesiologists (ASA) has developed information to help parents recognize the signs of Robo tripping and to prevent overdose and longer-term health complications.
Nearly 10 percent of American teens have admitted to getting high on cough medication containing a synthetic drug, dextromethorphan (DXM), which produces a hallucinogenic high when consumed in large amounts.1 Teens and tweens ranging in age from as young as nine to 17 have admitted to Robo tripping, oftentimes because it is legal, readily available - without a prescription - and inexpensive.2
"Consuming large amounts of drugs containing DXM can have a variety of serious and very dangerous side effects on a child's short- and long-term health, ranging from hallucinations to loss of motor control, and even death," said Michael H. Entrup, M.D., ASA member and ASA Director for the Massachusetts Society of Anesthesiologists. "As summer swings into high gear and many kids are home from school, it's especially important for parents to be aware of what their kids are doing during the break. As anesthesiologists, we want to help family members not only recognize the signs of Robo tripping but also to ensure that children are aware of the danger inherent in this type of drug abuse."
The ASA is taking action to curb Robo tripping among teens and tweens by providing parents with the information to recognize and prevent it. DXM, the active ingredient in cough medications that is abused when children Robo trip - also referred to as Robo, Skittles, Dex and Tussin - is available in more than 125 medications, including well-known brands. Parents should actively monitor for possible signs of Robo tripping, which can include:
- An unusual medicinal smell on your child.
- Empty or missing cough and cold medicine bottles.
- An unexplainable disappearance of money from the house.
- A sudden change in your child's physical appearance, attitude, and sleeping and/or eating habits.
- Questionable or unexpected packages arriving in the mail addressed to your child.
- Visits by your child to pro-drug websites.
Parents can help protect their children from DXM abuse by:
- Educating your child about the dangers of drug abuse.
- Controlling access to cough and cold medicines (which may include locking your medicine cabinet).
- Keeping your own medications out of the reach of your child.
- Familiarizing yourself with - and not stockpiling - medicines that contain DXM.
- Actively checking your credit card statements.
- Monitoring your child's Internet use.
1. drugfree/
2. archpedi.ama-assn/cgi/content/abstract/160/12/1217
Source:
American Society of Anesthesiologists
Nearly 10 percent of American teens have admitted to getting high on cough medication containing a synthetic drug, dextromethorphan (DXM), which produces a hallucinogenic high when consumed in large amounts.1 Teens and tweens ranging in age from as young as nine to 17 have admitted to Robo tripping, oftentimes because it is legal, readily available - without a prescription - and inexpensive.2
"Consuming large amounts of drugs containing DXM can have a variety of serious and very dangerous side effects on a child's short- and long-term health, ranging from hallucinations to loss of motor control, and even death," said Michael H. Entrup, M.D., ASA member and ASA Director for the Massachusetts Society of Anesthesiologists. "As summer swings into high gear and many kids are home from school, it's especially important for parents to be aware of what their kids are doing during the break. As anesthesiologists, we want to help family members not only recognize the signs of Robo tripping but also to ensure that children are aware of the danger inherent in this type of drug abuse."
The ASA is taking action to curb Robo tripping among teens and tweens by providing parents with the information to recognize and prevent it. DXM, the active ingredient in cough medications that is abused when children Robo trip - also referred to as Robo, Skittles, Dex and Tussin - is available in more than 125 medications, including well-known brands. Parents should actively monitor for possible signs of Robo tripping, which can include:
- An unusual medicinal smell on your child.
- Empty or missing cough and cold medicine bottles.
- An unexplainable disappearance of money from the house.
- A sudden change in your child's physical appearance, attitude, and sleeping and/or eating habits.
- Questionable or unexpected packages arriving in the mail addressed to your child.
- Visits by your child to pro-drug websites.
Parents can help protect their children from DXM abuse by:
- Educating your child about the dangers of drug abuse.
- Controlling access to cough and cold medicines (which may include locking your medicine cabinet).
- Keeping your own medications out of the reach of your child.
- Familiarizing yourself with - and not stockpiling - medicines that contain DXM.
- Actively checking your credit card statements.
- Monitoring your child's Internet use.
1. drugfree/
2. archpedi.ama-assn/cgi/content/abstract/160/12/1217
Source:
American Society of Anesthesiologists
пятница, 3 июня 2011 г.
High Rate Of IDUs In Pakistan Living With HIV/AIDS, Official Says
Approximately 30% of Pakistan's injection drug users are living with HIV/AIDS, Arshad Altaf -- senior provincial surveillance support officer with an HIV/AIDS surveillance program called the Sindh AIDS Control Program that is managed jointly by Canada and Pakistan -- said on Wednesday at the International Symposium on Tropical Medicine and Hygiene, Pakistan's Daily Times reports. According to the Times, 7.5% of IDUs living with HIV/AIDS in Pakistan are male commercial sex workers and 3% are transgender sex workers.
Altaf also said the rapid increase in Pakistan's population is a major factor in the spread of HIV in the country, adding, "Unless reasonable efforts are made to contain the disease, it may infect the general population in the near future." Arif Hassan, a consultant at the Urban Resource Center, said the "lack of resources and education, coupled with the utter disregard for social and environmental conditions in poor settlements, has led to congestion in the city." He also said that this is "aggravating" the spread of HIV/AIDS and "harming the mental and physical health of the citizens." The symposium is scheduled to continue through Thursday and also will focus on tuberculosis and hepatitis C in Pakistan (Daily Times, 11/12).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Altaf also said the rapid increase in Pakistan's population is a major factor in the spread of HIV in the country, adding, "Unless reasonable efforts are made to contain the disease, it may infect the general population in the near future." Arif Hassan, a consultant at the Urban Resource Center, said the "lack of resources and education, coupled with the utter disregard for social and environmental conditions in poor settlements, has led to congestion in the city." He also said that this is "aggravating" the spread of HIV/AIDS and "harming the mental and physical health of the citizens." The symposium is scheduled to continue through Thursday and also will focus on tuberculosis and hepatitis C in Pakistan (Daily Times, 11/12).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
четверг, 2 июня 2011 г.
Conference about Complexities of Co-Occurring Medical Conditions USA
NIDA Co-Hosts Meeting To Share Research Aimed at Improving Care for People With Coexisting Mental, Substance Use, and Medical/Physical Disorders.
WHAT: Many individuals simultaneously suffer from mental illness, problem alcohol and drug use, and other medical or physical disorders, resulting in levels of individual suffering and societal costs that are magnified well beyond those associated with these disorders when considered in isolation.
This conference will foster an exchange of information about treating those at risk for, or suffering from, co-occurring mental illness, alcohol or drug abuse, and other conditions.
WHO: Health services researchers, care providers, administrators, policymakers, and members of the media are encouraged to attend.
HOSTS: Sponsors include: The National Institute on Drug Abuse, the National Institute of Mental Health, the National Institute on Alcohol Abuse and Alcoholism, the Agency for Healthcare Research and Quality, the Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration.
WHEN: Wednesday - Friday, June 23-25, 2004
WHERE: Marriott Wardman Park, 2660 Woodley Rd., NW, Washington, DC
Woodley Park stop on Metro's Red Line
INFO: More information on the conference and registration is available at CCCconference/
The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports more than 85 percent of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at drugabuse
SAVE-THE-DATE
June 23-25, 2004
CONTACT:
Michelle Person
Blair Gately
301-443-6245
Contacto en Espa?ol:
Sara Rosario
301-594-6145
WHAT: Many individuals simultaneously suffer from mental illness, problem alcohol and drug use, and other medical or physical disorders, resulting in levels of individual suffering and societal costs that are magnified well beyond those associated with these disorders when considered in isolation.
This conference will foster an exchange of information about treating those at risk for, or suffering from, co-occurring mental illness, alcohol or drug abuse, and other conditions.
WHO: Health services researchers, care providers, administrators, policymakers, and members of the media are encouraged to attend.
HOSTS: Sponsors include: The National Institute on Drug Abuse, the National Institute of Mental Health, the National Institute on Alcohol Abuse and Alcoholism, the Agency for Healthcare Research and Quality, the Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration.
WHEN: Wednesday - Friday, June 23-25, 2004
WHERE: Marriott Wardman Park, 2660 Woodley Rd., NW, Washington, DC
Woodley Park stop on Metro's Red Line
INFO: More information on the conference and registration is available at CCCconference/
The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports more than 85 percent of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at drugabuse
SAVE-THE-DATE
June 23-25, 2004
CONTACT:
Michelle Person
Blair Gately
301-443-6245
Contacto en Espa?ol:
Sara Rosario
301-594-6145
среда, 1 июня 2011 г.
San Diego Union-Tribune Publishes Correction Regarding Information Contained in Editorial on Needle-Exchange Program
A San Diego Union-Tribune opinion piece published on July 29 stated incorrectly that the city's needle-exchange program continued to operate after the City Council voted not to renew the program, according to the... Union-Tribune (San Diego Union-Tribune, 8/10). In the opinion piece, the Union-Tribune reported that San Diego's needle-exchange program, which the City Council on July 18 failed to renew for the first time since it began four years ago, was operating illegally and "should be halted immediately." The editorial also said the government should provide drug treatment programs to help injection drug users stop their "deadly habit," rather than implementing the "misguided experiment" of dispensing clean needles (Kaiser Daily HIV/AIDS Report, 8/1). According to the Union-Tribune correction, the needle exchange was suspended directly after the council vote, but the program's mobile unit continues to operate in order to provide program participants with health education, counseling and referrals (San Diego Union-Tribune, 8/10).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
вторник, 31 мая 2011 г.
The Brain's White Matter, Necessary For Information Relay, May Be Compromised By Adolescent Binge Drinking
Researchers know that the integrity of the brain's white matter is compromised in adult alcoholics, but it is unclear when during the course of drinking white matter abnormalities become apparent. A study of adolescent binge drinkers has found that even relatively infrequent exposure to large doses of alcohol during youth may compromise white matter fiber coherence.
Results will be published in the July issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Because the brain is still developing during adolescence, there has been concern that it may be more vulnerable to the effects of neurotoxins, such as high doses of alcohol," said Susan F. Tapert, associate professor of psychiatry at the University of California, San Diego and director of Substance Abuse/Mental Illness in the VA San Diego Healthcare System. In fact, added the study's corresponding author, animal studies have suggested this is accurate.
"'White matter'" refers to brain areas that appear light in color due to being primarily lipids," added Duncan Clark, associate professor of psychiatry at the University of Pittsburgh Medical Center. "White matter is composed of bundles of myelinated axons connecting grey matter areas of the brain, and has been shown to continue to develop throughout adolescence. These systematic changes in white matter organization reflect not only maturation of interconnections but continued maturation of the brain as a whole."
"White matter, and its integrity, are essential to the efficient relay of information within the brain," said Tapert. "Indicators of white matter integrity are linked to performance on a range of cognitive tests, including measures of reading, copying complex figures, and speeded coding of information. Abnormalities in white matter health could relate to compromised ability to consider multiple sources of information when making decisions, and to emotional functioning."
Tapert and her colleagues used diffusion tensor imaging - an MRI technique sensitive to the random movement of water in cells of a target tissue - to examine fractional anisotropy, a measure of directional coherence of white matter tracts, among 28 teens. Of the 28, 14 (12 males, 2 females) had and 14 (12 males, 2 females) did not have histories of binge drinking. No participants had a history of an alcohol use disorder; drinkers were matched to non-drinkers on age, gender and education.
"This study showed that adolescents with histories of binge drinking episodes have lower coherence of white matter fibers, suggesting poorer white matter health, in a variety of brain regions," said Tapert. "Frankly, I was surprised we found this, because the drinkers did not meet criteria for alcohol abuse or dependence."
"These findings add to a growing literature indicating that adolescent alcohol involvement is associated with specific brain characteristics," said Clark. "One of the advantages of this study was that the adolescents with binge drinking did not have major mental disorders. Adolescents with alcohol-use disorders often have other problems. This suggests that the observed brain characteristics may be associated with alcohol involvement specifically rather than other complications."
"These findings, although cross-sectional, make me feel inclined to discourage adolescents from engaging in any binge drinking, that is, four or more drinks on an occasion for females, and five or more drinks on an occasion for males," said Tapert. "Drinking to the point of being drunk or experiencing hangover symptoms may be detrimental to the adolescent brain. However, long-term studies following adolescents over time are essential to clarify the extent to which alcohol causes these brain abnormalities."
Clark agreed: "These findings indicate that adolescents who engage in binge drinking show low levels of brain organization," he said. "This characteristic could be a risk factor for accelerated alcohol use or an effect of alcohol. We need to know more about how alcohol influences adolescent brain development, [given] that alcohol may disrupt brain development."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Altered White Matter Integrity in Adolescent Binge Drinkers," were: Tim McQueeny of the University of Cincinnati; Brian C. Schweinsburg of the Department of Psychiatry at Yale University, and the VA Connecticut Healthcare System; Alecia D. Schweinsburg of the Department of Psychiatry at Yale University; Joanna Jacobus of the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology; Sunita Bava of the University of California San Diego, La Jolla; and Lawrence R. Frank of the VA San Diego Healthcare System, and the University of California San Diego, La Jolla. The study was funded by the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Drug Abuse.
Source:
Susan F. Tapert, Ph.D.
University of California, San Diego
Duncan Clark, M.D.
University of Pittsburgh Medical Center
Alcoholism: Clinical & Experimental Research
Results will be published in the July issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Because the brain is still developing during adolescence, there has been concern that it may be more vulnerable to the effects of neurotoxins, such as high doses of alcohol," said Susan F. Tapert, associate professor of psychiatry at the University of California, San Diego and director of Substance Abuse/Mental Illness in the VA San Diego Healthcare System. In fact, added the study's corresponding author, animal studies have suggested this is accurate.
"'White matter'" refers to brain areas that appear light in color due to being primarily lipids," added Duncan Clark, associate professor of psychiatry at the University of Pittsburgh Medical Center. "White matter is composed of bundles of myelinated axons connecting grey matter areas of the brain, and has been shown to continue to develop throughout adolescence. These systematic changes in white matter organization reflect not only maturation of interconnections but continued maturation of the brain as a whole."
"White matter, and its integrity, are essential to the efficient relay of information within the brain," said Tapert. "Indicators of white matter integrity are linked to performance on a range of cognitive tests, including measures of reading, copying complex figures, and speeded coding of information. Abnormalities in white matter health could relate to compromised ability to consider multiple sources of information when making decisions, and to emotional functioning."
Tapert and her colleagues used diffusion tensor imaging - an MRI technique sensitive to the random movement of water in cells of a target tissue - to examine fractional anisotropy, a measure of directional coherence of white matter tracts, among 28 teens. Of the 28, 14 (12 males, 2 females) had and 14 (12 males, 2 females) did not have histories of binge drinking. No participants had a history of an alcohol use disorder; drinkers were matched to non-drinkers on age, gender and education.
"This study showed that adolescents with histories of binge drinking episodes have lower coherence of white matter fibers, suggesting poorer white matter health, in a variety of brain regions," said Tapert. "Frankly, I was surprised we found this, because the drinkers did not meet criteria for alcohol abuse or dependence."
"These findings add to a growing literature indicating that adolescent alcohol involvement is associated with specific brain characteristics," said Clark. "One of the advantages of this study was that the adolescents with binge drinking did not have major mental disorders. Adolescents with alcohol-use disorders often have other problems. This suggests that the observed brain characteristics may be associated with alcohol involvement specifically rather than other complications."
"These findings, although cross-sectional, make me feel inclined to discourage adolescents from engaging in any binge drinking, that is, four or more drinks on an occasion for females, and five or more drinks on an occasion for males," said Tapert. "Drinking to the point of being drunk or experiencing hangover symptoms may be detrimental to the adolescent brain. However, long-term studies following adolescents over time are essential to clarify the extent to which alcohol causes these brain abnormalities."
Clark agreed: "These findings indicate that adolescents who engage in binge drinking show low levels of brain organization," he said. "This characteristic could be a risk factor for accelerated alcohol use or an effect of alcohol. We need to know more about how alcohol influences adolescent brain development, [given] that alcohol may disrupt brain development."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Altered White Matter Integrity in Adolescent Binge Drinkers," were: Tim McQueeny of the University of Cincinnati; Brian C. Schweinsburg of the Department of Psychiatry at Yale University, and the VA Connecticut Healthcare System; Alecia D. Schweinsburg of the Department of Psychiatry at Yale University; Joanna Jacobus of the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology; Sunita Bava of the University of California San Diego, La Jolla; and Lawrence R. Frank of the VA San Diego Healthcare System, and the University of California San Diego, La Jolla. The study was funded by the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Drug Abuse.
Source:
Susan F. Tapert, Ph.D.
University of California, San Diego
Duncan Clark, M.D.
University of Pittsburgh Medical Center
Alcoholism: Clinical & Experimental Research
понедельник, 30 мая 2011 г.
Adolescent Drinking Adds To Risk Of Breast Disease, Breast Cancer
Girls and young women who drink alcohol increase their risk of benign (noncancerous) breast disease, says a study by researchers at Washington University School of Medicine in St. Louis and Harvard University. Benign breast disease increases the risk for developing breast cancer.
"Our study clearly showed that the risk of benign breast disease increased with the amount of alcohol consumed in this age group," says Graham Colditz, MD, DrPH, associate director of prevention and control at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. "The study is an indication that alcohol should be limited in adolescence and early adult years and further focuses our attention on these years as key to preventing breast cancer later in life."
The study was published in the May issue of Pediatrics (online April 12, 2010).
About 80 percent of breast lumps are benign. But these benign breast lesions can be a step in a pathway leading from normal breast tissue to invasive breast cancer, so the condition is an important marker of breast cancer risk, Colditz indicates.
The researchers studied girls aged 9 to 15 years at the study's start and followed them using health surveys from 1996 to 2007. A total of 6,899 participants reported on their alcohol consumption and whether they had ever been diagnosed with benign breast disease. The participants were part of the Growing Up Today Study of more than 9,000 girls from all 50 states who are daughters of participants in the Nurses' Health Study II, one of the largest and longest-running investigations of factors that influence women's health.
The study showed that the more alcohol consumed, the more likely the participants were to have benign breast disease. Girls and young women who drank six or seven days a week were 5.5 times more likely to have benign breast disease than those who didn't drink or who had less than one drink per week. Participants who reported drinking three to five days per week had three times the risk.
The participants who were diagnosed with benign breast disease on average drank more often, drank more on each occasion and had an average daily consumption that was two times that of those who did not have benign breast disease. They also had more episodes of binge drinking.
The study is unique because it asked about alcohol intake while participants were adolescents instead of asking them to recall many years later how often they drank.
"We know from many other studies of adult women that alcohol intake later in life increases breast cancer risk," Colditz says. "But many women begin drinking alcohol as adolescents right at the time in which breast tissue is going through stages of rapid proliferation. So we wanted to see if the effect of alcohol on breast cancer risk was operative in this younger group."
The results of this study provide more evidence that steps can be taken to prevent breast cancer.
"There's growing evidence that physical activity can lower breast cancer risk," Colditz says. "We also know that diet and weight are important factors. Now it is clear that drinking habits throughout life affect breast cancer risk, as well."
Berkey CS, Willet WC, Frazier AL, Rosner B, Tamimi RM, Rockett HRH, Colditz GA. Prospective study of adolescent alcohol consumption and risk of benign breast disease in young women. Pediatrics. April 12, 2010 (advance online publication).
Funding from the Breast Cancer Research Foundation and the National Institutes of Health supported this research.
Source
Washington University in St. Louis
Siteman Cancer Center
"Our study clearly showed that the risk of benign breast disease increased with the amount of alcohol consumed in this age group," says Graham Colditz, MD, DrPH, associate director of prevention and control at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. "The study is an indication that alcohol should be limited in adolescence and early adult years and further focuses our attention on these years as key to preventing breast cancer later in life."
The study was published in the May issue of Pediatrics (online April 12, 2010).
About 80 percent of breast lumps are benign. But these benign breast lesions can be a step in a pathway leading from normal breast tissue to invasive breast cancer, so the condition is an important marker of breast cancer risk, Colditz indicates.
The researchers studied girls aged 9 to 15 years at the study's start and followed them using health surveys from 1996 to 2007. A total of 6,899 participants reported on their alcohol consumption and whether they had ever been diagnosed with benign breast disease. The participants were part of the Growing Up Today Study of more than 9,000 girls from all 50 states who are daughters of participants in the Nurses' Health Study II, one of the largest and longest-running investigations of factors that influence women's health.
The study showed that the more alcohol consumed, the more likely the participants were to have benign breast disease. Girls and young women who drank six or seven days a week were 5.5 times more likely to have benign breast disease than those who didn't drink or who had less than one drink per week. Participants who reported drinking three to five days per week had three times the risk.
The participants who were diagnosed with benign breast disease on average drank more often, drank more on each occasion and had an average daily consumption that was two times that of those who did not have benign breast disease. They also had more episodes of binge drinking.
The study is unique because it asked about alcohol intake while participants were adolescents instead of asking them to recall many years later how often they drank.
"We know from many other studies of adult women that alcohol intake later in life increases breast cancer risk," Colditz says. "But many women begin drinking alcohol as adolescents right at the time in which breast tissue is going through stages of rapid proliferation. So we wanted to see if the effect of alcohol on breast cancer risk was operative in this younger group."
The results of this study provide more evidence that steps can be taken to prevent breast cancer.
"There's growing evidence that physical activity can lower breast cancer risk," Colditz says. "We also know that diet and weight are important factors. Now it is clear that drinking habits throughout life affect breast cancer risk, as well."
Berkey CS, Willet WC, Frazier AL, Rosner B, Tamimi RM, Rockett HRH, Colditz GA. Prospective study of adolescent alcohol consumption and risk of benign breast disease in young women. Pediatrics. April 12, 2010 (advance online publication).
Funding from the Breast Cancer Research Foundation and the National Institutes of Health supported this research.
Source
Washington University in St. Louis
Siteman Cancer Center
воскресенье, 29 мая 2011 г.
Brain Mechanism Linked To Relapse After Cocaine Withdrawal
Addictive drugs are known to induce changes in the brain's reward circuits that may underlie drug craving and relapse after long periods of abstinence. Now, new research, published by Cell Press in the September 9 issue of the journal Neuron, uncovers a specific neural mechanism that may be linked to persistent drug-seeking behavior and could help to guide strategies for development of new therapies for cocaine addiction.
Previous research has shown that the ventral tegmental area (VTA) is a brain region that is activated when cocaine users experience a craving for cocaine after being exposed to cocaine-associated cues. The medial prefrontal cortex (mPFC), which receives input from the VTA via circuits that use the "reward" neurotransmitter dopamine, has also been implicated in drug craving after cocaine withdrawal. Further, increases in the level of brain-derived neurotrophic factor (BDNF) have been observed in the VTA and mPFC in rats after withdrawal from repeated cocaine exposure.
"BDNF plays a key role in modulating the structure and function of synapses, the sites of communication between neurons. Therefore, increased BDNF after cocaine withdrawal may drive synaptic changes that contribute to compulsive drug seeking behavior," explains senior author, Dr. Mu-ming Poo from the University of California, Berkeley. "It has been shown that increased BDNF in the VTA after cocaine withdrawal in rats promotes the drug-dependent motivational state. However, nothing is known about the potential BDNF effect on synaptic function and plasticity in mPFC neurons after cocaine withdrawal."
Dr. Poo and colleagues designed a study to examine how BDNF and the mPFC might contribute to relapse after cocaine addiction. The researchers found that the gradual increase in BDNF expression in the rat mPFC after terminating repeated cocaine exposure significantly enhanced the activity-induced potentiation of specific synapses. Dr. Poo's group went on to uncover the specific cellular mechanism linking increased BDNF with enhanced synaptic plasticity and demonstrated that interference with the key molecule in the BDNF signaling process reduced behavioral sensitivity after cocaine withdrawal in rats.
"In short, our results demonstrate that elevated BDNF expression after cocaine withdrawal sensitizes the excitatory synapses in the mPFC to undergo activity-induced persistent potentiation that may contribute to cue-induced drug cravings and drug-seeking behavior," concludes Dr. Poo. Although a clear correlation between rat and human behaviors of cocaine craving and relapse remains to be established, the cellular mechanism uncovered in this study does appear to have behavioral relevance and may represent a direct brain sensitization that is involved in triggering relapse.
The researchers include Hui Lu, Pei-lin Cheng, Byung Kook Lim, Nina Khoshnevisrad, and Mu-ming Poo, University of California, Berkeley, Berkeley, CA.
Source:
Cathleen Genova
Cell Press
Previous research has shown that the ventral tegmental area (VTA) is a brain region that is activated when cocaine users experience a craving for cocaine after being exposed to cocaine-associated cues. The medial prefrontal cortex (mPFC), which receives input from the VTA via circuits that use the "reward" neurotransmitter dopamine, has also been implicated in drug craving after cocaine withdrawal. Further, increases in the level of brain-derived neurotrophic factor (BDNF) have been observed in the VTA and mPFC in rats after withdrawal from repeated cocaine exposure.
"BDNF plays a key role in modulating the structure and function of synapses, the sites of communication between neurons. Therefore, increased BDNF after cocaine withdrawal may drive synaptic changes that contribute to compulsive drug seeking behavior," explains senior author, Dr. Mu-ming Poo from the University of California, Berkeley. "It has been shown that increased BDNF in the VTA after cocaine withdrawal in rats promotes the drug-dependent motivational state. However, nothing is known about the potential BDNF effect on synaptic function and plasticity in mPFC neurons after cocaine withdrawal."
Dr. Poo and colleagues designed a study to examine how BDNF and the mPFC might contribute to relapse after cocaine addiction. The researchers found that the gradual increase in BDNF expression in the rat mPFC after terminating repeated cocaine exposure significantly enhanced the activity-induced potentiation of specific synapses. Dr. Poo's group went on to uncover the specific cellular mechanism linking increased BDNF with enhanced synaptic plasticity and demonstrated that interference with the key molecule in the BDNF signaling process reduced behavioral sensitivity after cocaine withdrawal in rats.
"In short, our results demonstrate that elevated BDNF expression after cocaine withdrawal sensitizes the excitatory synapses in the mPFC to undergo activity-induced persistent potentiation that may contribute to cue-induced drug cravings and drug-seeking behavior," concludes Dr. Poo. Although a clear correlation between rat and human behaviors of cocaine craving and relapse remains to be established, the cellular mechanism uncovered in this study does appear to have behavioral relevance and may represent a direct brain sensitization that is involved in triggering relapse.
The researchers include Hui Lu, Pei-lin Cheng, Byung Kook Lim, Nina Khoshnevisrad, and Mu-ming Poo, University of California, Berkeley, Berkeley, CA.
Source:
Cathleen Genova
Cell Press
суббота, 28 мая 2011 г.
Factors That Increase Death In Stroke Patients Ages 15 To 49: Finnish Study
Heavy drinking, being 45 to 49 years old, type 1 diabetes or having a preceding infection are associated with more than twice the risk of death in stroke patients 15 to 49 years old, according to a Finnish study.
Furthermore, heart failure was associated with seven times the risk of death and active cancer malignancy with 16 times the risk of death in stroke patients.
The overall death rate is low in this age group, said Jukka Putaala, M.D., who led the study. Risk of death was 2.7 percent at one month, 4.7 percent at one year and 10.7 percent at five years with no difference based on gender.
Detecting these factors associated with higher risk of death is important because they can be modified by lifestyle changes, strictly controlled medication or medical procedures in most patients, Putaala said.
Note:
For more information on stroke, visit the American Stroke Association Web site: strokeassociation.
NR09 - 1082 (Stroke/Putaala)
Source:
Bridgette McNeill
American Heart Association
Furthermore, heart failure was associated with seven times the risk of death and active cancer malignancy with 16 times the risk of death in stroke patients.
The overall death rate is low in this age group, said Jukka Putaala, M.D., who led the study. Risk of death was 2.7 percent at one month, 4.7 percent at one year and 10.7 percent at five years with no difference based on gender.
Detecting these factors associated with higher risk of death is important because they can be modified by lifestyle changes, strictly controlled medication or medical procedures in most patients, Putaala said.
Note:
For more information on stroke, visit the American Stroke Association Web site: strokeassociation.
NR09 - 1082 (Stroke/Putaala)
Source:
Bridgette McNeill
American Heart Association
пятница, 27 мая 2011 г.
Moderate Wine Intake Associated With Higher Levels Of Omega-3 Fatty Acids, Considered As Protective Against Coronary Heart Disease
Moderate alcohol intake is associated with higher levels of omega-3 fatty acids in plasma and red blood cells. This is the major finding of the European study IMMIDIET that will be published in the January issue of the American Journal of Clinical Nutrition, an official publication of the American Society for Nutrition and is already available on line (ajcn ). The study suggests that wine does better than other alcoholic drinks. This effect could be ascribed to compounds other than alcohol itself, representing a key to understand the mechanism lying behind the heart protection observed in moderate wine drinkers.
The IMMIDIET study examined 1,604 citizens from three geographical areas: south-west London in England, Limburg in Belgium and Abruzzo in Italy. Thanks to a close cooperation with General Practitioners of these areas, all participants underwent a comprehensive medical examination, including a one year recall food frequency questionnaire to assess their dietary intake, alcohol consumption included.
Omega-3 fatty acids, mainly derived from fish, are considered as protective against coronary heart disease and sudden cardiac death, thus their high blood concentration is definitely good for our health.
Now European researchers found that moderate alcohol drinking acts like a 'trigger', boosting the amount of omega-3 fatty acids in our body.
"Several studies have shown that moderate alcohol consumption, including wine, is associated with protection against coronary heart disease and ischemic stroke - says Romina di Giuseppe, lead author of the study, from the Research Laboratories at Catholic University of Campobasso - Although the mechanisms are not completely defined, there was some evidence that alcohol intake might influence the metabolism of essential polyunsaturated fatty acids, as omega-3. That is exactly what we found in our population study. People drinking moderate amounts of alcohol, one drink a day for women and two for men, had higher concentration of omega-3 fatty acids in plasma and red blood cells independently of their fish intake".
However important these results appear to be, the best is yet to come. Researchers from Catholic University of Campobasso, in Italy, and from University of Grenoble, in France, turned their attention on the variety of alcoholic beverages consumed in order to see whether the high levels of omega-3 fatty acids detected might be ascribed to alcohol itself or to other substances.
"From our previous studies we know that association between wine drinking and increased concentration of omega-3 fatty acids have been observed - says Michel de Lorgeril, from the University of Grenoble, partner of the IMMIDIET project and co-leader of the study - Nevertheless, it was not possible to separate the effects of wine from those of beer or spirits. Our study of 3 populations with different dietary habits and different consumption of alcoholic beverages types allowed us to explore this aspect.".
"Analysis carried out on different alcoholic beverages - argues Licia Iacoviello coordinator of the IMMIDIET study at Catholic University of Campobasso - showed that the association between alcohol and omega-3 fatty acids was present in both wine drinkers and beer or spirits drinkers. However, the association was stronger between wine drinking and omega-3 fatty acids levels. This suggests that components of wine other than alcohol is associated with omega-3 fatty acids concentration. We may guess this effect can be ascribed to polyphenols".
Polyphenols are naturally occurring compounds contained in a different variety of food and beverages, such as wine. Due to their strong antioxidant activity, they are able to reduce oxidation processes caused by free radicals.
"We consider these data to be a major finding - de Lorgeril concludes - opening a new window in the field of cardiovascular prevention. Beyond the alcohol issue, our results raise crucial questions regarding the effects of polyphenols on lipids (both in blood and cell membranes) and possibly of lipids on polyphenols".
The IMMIDIET study
Funded by the European Union under Key Action 1: Food, Nutrition and Health QLK1-CT-2000-00100, IMMIDIET aims to acquire fundamental knowledge in the field of cardiovascular disease, especially regarding the interaction between genetics and lifestyle.
At the core of the study there is an important episode of Italian migration: Belgium, a country that became the new home for thousands of Italians, mostly from the Abruzzo region, who came to work in the mines. Many of those emigrants didn't come back to Italy but remained in their new country. Some of them married a Belgian partner. Their genes remained the same, of course, but how much "Italy" is still there in their diet? And how much did they transmit it to their spouses? Moreover, how many Italian emigrants assimilate dietary habits of the country in which they were guests? In this framework, the role of genetic factors and lifestyle can be assessed to explore new ways in prevention of cardiovascular diseases.
To carry on the research, married couples have been recruited in three European areas: South-East London in England, Limburg in Belgium and Abruzzo in Italy. In the first phase of the study the couples involved were formed by people from the same area, Italians married with Italians (in the Abruzzo region), Belgians married with Belgians (in the Limburg area) and English married with English (in the South-East part of London)".
The second phase of IMMIDIET recruited mixed Italian-Belgian couples to understand if, acquiring dietary habits from Abruzzo, the Belgian partner changed his own risk regarding heart diseases.
IMMIDIET PARTNERS
Scientific coordinator:
Licia Iacoviello
Laboratory of Genetic and Environmental Epidemiology, Research Laboratories, "John Paul II" Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso - Italy
Participants:
Jozef Arnout
Center for Molecular and Vascular Biology, Katholieke Universiteit, Leuven - Belgium
Frank Buntinx
Department of General Practice, Katholieke Universiteit, Leuven - Belgium
Francesco P. Cappuccio
Clinical Sciences Research Institute, University of Warwick Medical School, Coventry - United Kingdom
Pieter C. Dagnelie
Department of Epidemiology, NUTRIM Subdivision of Nutritional Epidemiology, Maastricht University - The Netherlands
Michel de Lorgeril
Nutrition Vieillissement et Maladies Cardiovasculaires, UFR de Medecine, La Tronche, Grenoble - France
Vittorio Krogh
Nutritional Epidemiology Unit, National Cancer Institute, Milan - Italy
Alfonso Siani
Unit of Epidemiology and Population Genetics, Institute of Food Sciences CNR, Avellino - Italy
Source: Americo Bonanni
Catholic University
The IMMIDIET study examined 1,604 citizens from three geographical areas: south-west London in England, Limburg in Belgium and Abruzzo in Italy. Thanks to a close cooperation with General Practitioners of these areas, all participants underwent a comprehensive medical examination, including a one year recall food frequency questionnaire to assess their dietary intake, alcohol consumption included.
Omega-3 fatty acids, mainly derived from fish, are considered as protective against coronary heart disease and sudden cardiac death, thus their high blood concentration is definitely good for our health.
Now European researchers found that moderate alcohol drinking acts like a 'trigger', boosting the amount of omega-3 fatty acids in our body.
"Several studies have shown that moderate alcohol consumption, including wine, is associated with protection against coronary heart disease and ischemic stroke - says Romina di Giuseppe, lead author of the study, from the Research Laboratories at Catholic University of Campobasso - Although the mechanisms are not completely defined, there was some evidence that alcohol intake might influence the metabolism of essential polyunsaturated fatty acids, as omega-3. That is exactly what we found in our population study. People drinking moderate amounts of alcohol, one drink a day for women and two for men, had higher concentration of omega-3 fatty acids in plasma and red blood cells independently of their fish intake".
However important these results appear to be, the best is yet to come. Researchers from Catholic University of Campobasso, in Italy, and from University of Grenoble, in France, turned their attention on the variety of alcoholic beverages consumed in order to see whether the high levels of omega-3 fatty acids detected might be ascribed to alcohol itself or to other substances.
"From our previous studies we know that association between wine drinking and increased concentration of omega-3 fatty acids have been observed - says Michel de Lorgeril, from the University of Grenoble, partner of the IMMIDIET project and co-leader of the study - Nevertheless, it was not possible to separate the effects of wine from those of beer or spirits. Our study of 3 populations with different dietary habits and different consumption of alcoholic beverages types allowed us to explore this aspect.".
"Analysis carried out on different alcoholic beverages - argues Licia Iacoviello coordinator of the IMMIDIET study at Catholic University of Campobasso - showed that the association between alcohol and omega-3 fatty acids was present in both wine drinkers and beer or spirits drinkers. However, the association was stronger between wine drinking and omega-3 fatty acids levels. This suggests that components of wine other than alcohol is associated with omega-3 fatty acids concentration. We may guess this effect can be ascribed to polyphenols".
Polyphenols are naturally occurring compounds contained in a different variety of food and beverages, such as wine. Due to their strong antioxidant activity, they are able to reduce oxidation processes caused by free radicals.
"We consider these data to be a major finding - de Lorgeril concludes - opening a new window in the field of cardiovascular prevention. Beyond the alcohol issue, our results raise crucial questions regarding the effects of polyphenols on lipids (both in blood and cell membranes) and possibly of lipids on polyphenols".
The IMMIDIET study
Funded by the European Union under Key Action 1: Food, Nutrition and Health QLK1-CT-2000-00100, IMMIDIET aims to acquire fundamental knowledge in the field of cardiovascular disease, especially regarding the interaction between genetics and lifestyle.
At the core of the study there is an important episode of Italian migration: Belgium, a country that became the new home for thousands of Italians, mostly from the Abruzzo region, who came to work in the mines. Many of those emigrants didn't come back to Italy but remained in their new country. Some of them married a Belgian partner. Their genes remained the same, of course, but how much "Italy" is still there in their diet? And how much did they transmit it to their spouses? Moreover, how many Italian emigrants assimilate dietary habits of the country in which they were guests? In this framework, the role of genetic factors and lifestyle can be assessed to explore new ways in prevention of cardiovascular diseases.
To carry on the research, married couples have been recruited in three European areas: South-East London in England, Limburg in Belgium and Abruzzo in Italy. In the first phase of the study the couples involved were formed by people from the same area, Italians married with Italians (in the Abruzzo region), Belgians married with Belgians (in the Limburg area) and English married with English (in the South-East part of London)".
The second phase of IMMIDIET recruited mixed Italian-Belgian couples to understand if, acquiring dietary habits from Abruzzo, the Belgian partner changed his own risk regarding heart diseases.
IMMIDIET PARTNERS
Scientific coordinator:
Licia Iacoviello
Laboratory of Genetic and Environmental Epidemiology, Research Laboratories, "John Paul II" Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso - Italy
Participants:
Jozef Arnout
Center for Molecular and Vascular Biology, Katholieke Universiteit, Leuven - Belgium
Frank Buntinx
Department of General Practice, Katholieke Universiteit, Leuven - Belgium
Francesco P. Cappuccio
Clinical Sciences Research Institute, University of Warwick Medical School, Coventry - United Kingdom
Pieter C. Dagnelie
Department of Epidemiology, NUTRIM Subdivision of Nutritional Epidemiology, Maastricht University - The Netherlands
Michel de Lorgeril
Nutrition Vieillissement et Maladies Cardiovasculaires, UFR de Medecine, La Tronche, Grenoble - France
Vittorio Krogh
Nutritional Epidemiology Unit, National Cancer Institute, Milan - Italy
Alfonso Siani
Unit of Epidemiology and Population Genetics, Institute of Food Sciences CNR, Avellino - Italy
Source: Americo Bonanni
Catholic University
Подписаться на:
Комментарии (Atom)