Alcohol Use Rate Among American Indian Or Alaska Native Adults Is Well Below The National Average

A new national study reveals that the rate of past month alcohol use (i.e., at least one drink in the past 30 days) among American Indian or Alaska Native adults is significantly lower than the national average for adults (43.9 percent versus 55.2 percent). The study, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) also shows that American Indian or Native Alaska adults have a rate of past month binge alcohol drinking (i.e., five or more drinks on the same occasion - on at least one day in the past 30 days) well above the national average (30.6 percent versus 24.5 percent). The level of past month illicit drug use was also found to be higher among American Indian or Alaska Native adults than the overall adult population (11.2 versus 7.9 percent).


Among the study's other significant findings:


- Eighteen percent of American Indian or Alaska Native adults needed treatment for an alcohol or illicit drug use problem in the past year, nearly twice the national average (9.6 percent).


- 1 in 8 (12.6 percent) American Indian or Alaska Native adults who were in need of alcohol or illicit drug treatment in the past year received it at a specialty facility - about the same as the national average (10.4 percent).


- American Indian or Alaska Native adults' past month substance use rates drop significantly in older age groups - for example, illicit drug use levels drop from 25.4 percent in the 18 to 25 age group to 4.1 percent in those 50 and older. This pattern is also seen in the general adult population.


The study was developed as part of the agency's strategic initiative on data, outcomes, and quality - an effort to create an integrated data strategy that informs policy makers and service providers on the nature and scope of behavioral health issues. It is one in a series of studies designed to provide more detailed information on substance abuse patterns and treatment needs existing within a wide range of population groups.


"Patterns of substance abuse vary somewhat among different segments of our society," said SAMHSA Administrator, Pamela S. Hyde, J.D. "Prevention, treatment and recovery support services are vitally needed within every community. We are using these studies along with on the ground experience to design and provide these services in a way that is accepted by the community and appropriate for individual needs."


"We appreciate SAMHSA's support of this study, which provides valuable findings that can be used for more targeted treatment programs and patient screening," said Dr. Yvette Roubideaux, the Director of the Indian Health Service.


Source:

Substance Abuse and Mental Health Administration (SAMHSA)

Personality traits and craving among pathological gamblers and alcoholics

There are two types of addiction-related craving: one is physical, which is related to withdrawal; and the other is memory-based, consisting of a desire that persists long after withdrawal has been subdued. A study in the August issue of Alcoholism: Clinical & Experimental Research compares craving between pathological gamblers and alcoholics, correlating craving with personality. Results indicate that gamblers and alcoholics have distinctive personality traits that affect their cravings.


"Personality, and temperament in particular, is defined as the usual basic emotional reactions and preferences towards both external and internal stimuli," said Hermano Tavares, coordinator of the Impulse Control Disorder Unit at the University of S?o Paulo in Brazil, and corresponding author for the study. "Craving is also defined in terms of the desire to use a drug and previous memories of pleasure superimposed upon a negative emotional state. So, both concepts involve emotional regulation and motivation. The idea of our study was to investigate if specific personality traits could influence the craving experience among alcoholics and pathological gamblers, making it stronger, hence rendering more vulnerability to addiction."


Study subjects (49 pathological gamblers, 101 alcoholics) were recruited from individuals seeking outpatient treatment at community agencies and a hospital-based treatment center in Calgary, Alberta between April 2001 and November 2002, as well as through local advertising. All participants were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders IV criteria, rated their cravings (for either alcohol or gambling), answered a semi-structured interview, and completed the Temperament and Character Inventory and Beck Scales for anxiety and depression.


"Both alcohol and gambling craving were directly related to clinical symptoms of depression and anxiety, and inversely related to length of abstinence," said Tavares. "However, alcohol and gambling cravings did not share temperament roots, pointing to different roles of both on emotional regulation. In other words, our study suggests that people turn to either alcohol or gambling for different reasons."


Tavares said that positive emotions and negative emotions are two separate, distinct and independent dimensions, possibly regulated by different brain systems. "We found that alcohol craving was based on the temperament factor responsible for negative emotions," he said. "This suggests that those individuals who are especially vulnerable to negative emotions are the ones who will miss alcohol the most when trying to abstain. Conversely, gambling craving correlated to the temperament factor responsible for positive emotions. This suggests that those individuals who naturally lack positive emotions and require intense stimuli to experience elation are the ones who will miss gambling the most when trying to abstain."















"Thus, gambling seems to be more of a stimulant and anti-depression measure," added Sheila Blume, former medical director of Addiction Programs at South Oaks Hospital in Amityville, New York. "For alcoholics, craving correlated more with anxiety and harm avoidance, which indicates that alcohol is more of an anti-anxiety measure. Of course, these are not exclusive. Alcoholics also drink and crave alcohol while depressed, and gamblers may crave when anxious, but these are statistical differences that can be helpful in understanding patients and in treatment planning."


Both Tavares and Blume dismissed the lay notions of "unhappiness" or "sadness" as factors in addiction.


"Unhappiness is too vague a concept," said Tavares. "Clinically speaking, anxiety is regarded as a state of negative emotionality and heightened arousal, while depression is best described as high negative emotions and low positive emotions. Heightened arousal and low positive emotions respectively differentiate anxiety from depression, and negative emotions are shared by both. Alcohol seems to provide a lessening of negative emotions and may be used as a 'tool' to deal with tensions and nervousness, that is, anxiety. Gambling seems to act as a 'fix' for individuals who are by nature partially deprived of feelings such as joy and elation, and require stronger stimuli to achieve emotional equilibrium and counterbalance depression."


"These findings are not dissimilar to the findings of others in the field with clinical populations," said Blume. "This is not the same as saying that all addicts have the same 'addictive personality' but there are some traits that tend to show up in alcoholics, drug addicts and pathological gamblers more strongly than in the general population. What is novel about this study is their correlation of these traits as well as emotional states with craving. To my knowledge, this has not been done before with alcoholics and pathological gamblers."


Tavares added that "it is important to say that not all individuals with similar personality profiles will develop alcohol or gambling problems, but they may be at greater risk if the environment does not provide the opportunity to learn how to adjust their nature. Being impulsive, prone to negative emotions, or requiring greater stimulation to attain joy may require special attention as these people could be at risk for a wider variety of addictive behaviors. Perhaps a combination of traits, rather than the identification of an isolated one, is a better strategy to re-start investigating the validity of the 'addictive personality structure,'" he said.


Blume suggested that future research look at the neurological basis of craving, as well as the mechanisms of how it works on a basic level. "We need better physiological measurements of craving and better anti-craving strategies," she said.


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, "A Comparison of Craving Between Pathological Gamblers and Alcoholics," were: Monica L. Zilberman of the Department of Psychiatry at the University of S?o Paulo; David C. Hodgins of the Department of Psychology at the University of Calgary; and Nady el-Guebaly of the Department of Psychiatry at the University of Calgary. The study was funded by the Brazilian National Council on Research and Development, and the Alberta Gaming Research Institute.


Hermano Tavares, M.D., Ph.D.

hermanotuol.br

55-11-3814-3920 (Brazil)

University of S?o Paulo

uol.br


Add'l contact: Sheila Blume, M.D.

sheila_blumepost.harvard


Alcoholism: Clinical & Experimental Research

alcoholism-cer

Problem Drug Use Declining In Previous Hot Spots, UK

Research led by the National Drug Evidence Centre at The University of Manchester has found that drug misuse seems to have passed its peak in some previous problem areas.



Mr Tim Millar and colleagues investigated the reality of the situation in perceived drug trouble-spots by estimating trends in the incidence1 of heroin use (i.e. changes in the number of people starting to use heroin). These indicated geographical differences in the progress of heroin ???epidemics??™, and suggested that problem drug use (PDU) is declining in some areas considered hot spots in the 1980s.



The study, undertaken with the Centre for Drug Misuse Research at the University of Glasgow and funded by the Home Office Drugs & Alcohol Research Unit, looked at data on almost 15 000 problem drug users using heroin who sought treatment in Greater Manchester between 1986 and 2000.



It used a new approach which takes account of the time-lag between people starting to use heroin and their coming forward to seek help, and focused on the City of Manchester, Stockport and Wigan. These areas exhibited the clearest patterns in the age-specific prevalence2 estimates produced using the traditional approach as part of the same study.



Mr Millar said: "Problem drug-use prevalence estimates for Wigan progressively declined with age, suggesting a younger PDU population than the other areas. This meant young people must have recently been recruited into the PDU population at a faster rate than previously, suggesting that problem drug use incidence would have recently increased in the area.



"The incidence-rate estimates we produced using the new method supported this, increasing for heroin use during the 1990s.



"By contrast, prevalence estimates for the City of Manchester indicated an older problem drug use population (mainly 25-34 years), prompting us to think that incidence might be in decline - with the rate at which young people are recruited into the PDU population waning and those recruited during an earlier epidemic phase ageing. Our incidence-rate estimates corroborated this, indicating a decrease during the 1990s.



"In Stockport, the prevalence estimates showed less difference between age-groups, suggesting incidence had remained stable, and this was backed-up by our incidence-rate estimates.



"Our theory that the areas would exhibit different patterns of recent incidence trends - with some places having ???passed their peak??™ whilst rates of use continue to rise in others - was borne out using this new approach, which has proven capable of providing valuable indications which may help us to forecast future developments.



"For example it might be expected that PDU prevalence in Wigan will increase but that the rate of growth slow, and older users start to account for a larger proportion.



"PDU prevalence in the City of Manchester could decline because of current cessation rates amongst those that joined the population during the 1980s when incidence was at its peak. Movement of existing problem drug users from suburban and rural areas to urban areas could also explain the apparent decline in incidence rates, although this would not be consistent with accepted theories about how problem drug use spreads outwards from urban centres.
















"Of course, Manchester and other 1980s hot spots continue to experience high levels of problem drug use, but it appears that situation could have stopped getting worse and may be starting to get better."






???Incidence??™ is the number of new cases of heroin use that emerge in the population
2 ???Prevalence??™ is the number of cases in the population at any given time
The University of Manchester (manchester.ac/) is the largest single-site higher education institution in the country, with 24 academic schools, over 5200 academic and research staff and around 36 000 students. It was awarded University of the Year by the Times Higher Educational Supplement in 2005 and The Sunday Times in 2006, and receives more undergraduate applications than any other UK university.



Its Faculty of Medical & Human Sciences (mhs.manchester.ac/) is one of the largest faculties of clinical and health sciences in Europe, with a research income of around ??51 million (almost a third of the University??™s total research income). The School of Medicine (medicine.manchester.ac/) is the largest of its five Schools, encompasses five teaching hospitals and is closely linked to general hospitals and community practices across the North West of England.



The National Drug Evidence Centre (NDEC) carries out epidemiological, evaluative and policy-related research in the field of drug misuse, working particularly with the Health Service and Criminal Justice Service at local, national and European levels. It is funded by the UK National Treatment Agency for Substance Misuse and has strong collaborative links with Imperial College London, the University of Glasgow and the Institut f??r Therapieforschung, Munich, as well as working closely with the Department of Health, Home Office and European Monitoring Centre on Drugs and Drug Addiction.



Contact: Jo Nightingale


University of Manchester

Compulsive Eating That Leads To Obesity Has Similar Biology To Drug Addiction

US researchers working with rats have shown for the first time that the compulsion to overeat that leads to obesity has the same biological
mechanism as seen in addiction to drugs like cocaine and heroin abuse: it affects the brain's pleasure circuitry in a similar way.


You can read about the study, conducted by Scripps Research Associate Professor Paul J Kenny and graduate student Paul M Johnson from The
Scripps Research Institute in Jupiter, Florida, in the 28 March advanced online issue of Nature Neuroscience.


According to a press statement from The Scripps Research Institute on Sunday, the study appears to confirm what many obesity patients have been
saying for years: like drug addiction, binging on junk food is very hard to stop.


Kenny and Johnson show that as pleasure centers in the brain become less responsive, rats quickly develop compulsive overeating habits, eating
increasing amounts of high-calorie, high-fat foods until they become obese.


This is the same progressively deteriorating chemical balance in reward brain circuits seen in rats that overconsume cocaine or heroin that is thought to
lie behind the development of compulsive drug use.


Kenny told the press that the study confirms that junk food can become "addictive". It explains what happens in the brains of the animals when they
can easily get hold of high-calorie, high-fat food, he said.


"It presents the most thorough and compelling evidence that drug addiction and obesity are based on the same underlying neurobiological
mechanisms," added Kenny, explaining that:


"In the study, the animals completely lost control over their eating behavior, the primary hallmark of addiction."


One of the tests of addictive behaviour is to train lab animals to anticipate an electric shock. At first the animals receive the mild shocks at the same
time as a light coming on, eventually they learn to anticipate the shock when they see the light and they avoid doing the thing that then triggers the
shock.


In this case, the rats that had become "addicted" to junk food ignored the light and continued to binge, highlighting how motivated they were, said
Kenny.


For the junk food they used in the study, Kenny and Johnson bought foods people love to eat: cheesecake, bacon, sausage, Ding-Dongs (a flat-shaped
chocolate cake popular in the US).


"The stuff that you enjoy, but you really shouldn't eat too often," Kenny said, as reported by Reuters.


They also bought healthy foods and put the rats into three groups: (1) a balanced healthy diet group, (2) a healthy diet group with access to high-calorie
"junk" food for one hour a day, and (3) a group that was fed healthy food but also had unlimited access to the high-calorie "junk" food.


Kenny said the third group quickly showed a preference for the junk food, ate it all day long and quickly became obese.















"They always went for the worst types of food," said Kenny.


"As a result, they took in twice the calories as the control rats," he added, explaining that when they removed the junk food and tried to feed them a
healthy diet, "the salad bar option", they just refused to eat.


"The change in their diet preference was so great that they basically starved themselves for two weeks after they were cut off from junk food," said
Kenny.


"It was the animals that showed the "crash" in brain reward circuitries that had the most profound shift in food preference to the palatable, unhealthy
diet. These same rats were also those that kept on eating even when they anticipated being shocked," he added.


What happens in addiction is "lethally simple", said Kenny, "the body adapts remarkably well to change -- and that's the problem".


"When the animal overstimulates its brain pleasure centers with highly palatable food, the systems adapt by decreasing their activity. However, now the
animal requires constant stimulation from palatable food to avoid entering a persistent state of negative reward," he explained.


After this first stage, where they showed the obese rats had developed clear addiction-like food seeking behavior, Kenny and Johnson then examined
the underlying biological mechanisms that might explain the change.


They were particularly interested in the dopamine D2 receptor in the brain, a receptor that is already known to play a role in vulnerability to drug
addiction and obesity. The receptor responds to dopamine, a chemical that the brain releases in response to pleasurable experiences like food, drugs
and sex.


For example, in cocaine abuse, the drug blocks the retrieval of dopamine, causing it to flood the brain and overstimulate the receptors. Eventually this
leads to physical changes in the brain and how it responds to the drug.


Kenny and Johnson have shown this to be the same in addiction to junk food.


Kenny said their findings confirm what they and many others had long suspected:


"Overconsumption of highly pleasurable food triggers addiction-like neuroadaptive responses in brain reward circuitries, driving the development of
compulsive eating." he said.


They also found that the levels of the D2 dopamine receptors were significantly lower in the brains of the obese animals, similar to what has been
reported in human drug addicts.


And when they used a specialized virus to knock down the receptor ("lentivirus-mediated knockdown") the addiction-like eating accelerated
dramatically.


The addiction-like eating started almost as soon as they knocked down the receptors, said Kenny.


"The very next day after we provided access to the palatable food, their brains changed into a state that was consistent with an animal that had been
overeating for several weeks," he added.


Kenny and Johnson concluded that:


"These data demonstrate that overconsumption of palatable food triggers addiction-like neuroadaptive responses in brain reward circuits and drives the
development of compulsive eating. Common hedonic mechanisms may therefore underlie obesity and drug addiction."


Grants from the Bank of America Fellowship, The Margaret Q. Landenberger Research Foundation and the National Institutes of Health paid for the
study.


"Dopamine D2 receptors in addiction-like reward dysfunction and compulsive eating in obese rats."

Paul M Johnson and Paul J Kenny.

Nature Neuroscience, Published online 28 March 2010.

DOI:10.1038/nn.2519


Sources: Scripps Research Institute, Reuters.



, PhD

Ignoring Scientific Advice About Illegal Drugs In Favour Of Politically And Morally Motivated Judgements Wont Send The Right Signal To Young People

An Editorial in this week's Lancet discusses the decision of the UK home secretary Jacqui Smith to ignore expert advice to downgrade ecstasy. The recent report by the Advisory Council on the Misuse of Drugs concluded "that the harmfulness of MDMA to individuals and society more closely equates to drugs in class B and it should therefore be downgraded."


The Editorial concludes: "Why then did the Home Office veto this recommendation? Apparently, because it did not want to send a signal to young people that MDMA was being taken less seriously. Last year, the Home Secretary also overruled the ACMD's recommendation that cannabis should remain a class C drug rather than gain class B status. These ill-thought out decisions make a mockery of the ACMD and any attempt at a credible, evidence-based system for drug classification. Ignoring scientific advice about illegal drugs in favour of politically and morally motivated judgments will not send the right signal to young people. It will only undermine public health messages about all drugs, be it MDMA or more harmful legal substances such as tobacco and alcohol."


The Lancet

Mental Illness And Drug Addiction May Co-occur Due To Disturbance In Part Of The Brain

Why do mental illness and drug addiction so often go together? New research reveals that this type of dual diagnosis may stem from a common cause: developmental changes in the amygdala, a walnut-shaped part of the brain linked to fear, anxiety and other emotions. A full report on why these "comorbid" disorders may develop appears in the December Behavioral Neuroscience, published by the American Psychological Association (APA).



Dual diagnosis is common yet difficult to treat. Addiction of all types - to nicotine, alcohol and drugs - is often found in people with a wide variety of mental illnesses, including anxiety disorders, unipolar and bipolar depression, schizophrenia, and borderline and other personality disorders. Lead author Andrew Chambers, MD, cites clinical reports that at least half the people who seek help with addiction or mental-health treatment have co-occurring disorders. Epidemiological data says that from two to five of every 10 anxious or depressed people, and from four to eight of every 10 people with schizophrenia, bipolar disorder, or antisocial personality, also have some type of addiction.



To find the scientific basis for this complex, seemingly intractable pairing, which has in the past been attributed to "self-medication," Chambers' team at the Indiana University medical school compared the adult mood- and drug-related behavior of two groups of adult rats: those whose amygdalas were surgically damaged in infancy and those whose amygdalas were left intact but who underwent a sham surgery, to equalize their treatment.



Rats with damaged (lesioned) amygdalas grew up abnormally under-responsive to ambiguous or potentially threatening stimuli. Not showing the normal caution, they moved significantly more in response to novelty, showed significantly less fear in an elevated maze, and kept socializing even when exposed to the scent of a predator.



Crucially, these same rats also were significantly more sensitive to cocaine after just one exposure. And rats given repeated cocaine injections later showed even stronger expressions of the enduring changes in behavior - suggesting an overall hypersensitivity to the addictive process.



Given that the experimental and control rats were raised in the same tightly controlled conditions, the only difference being their brain status, researchers concluded that the integrity of the amygdala was the root cause of both impaired fear behavior and heightened drug response.
















"Brain conditions may alter addiction vulnerability independently of drug history," says Chambers. He and his colleagues concluded that someone's greater vulnerability to addiction, rather than a given drug's ability to alter the symptoms of mental illness for better or worse (usually worse), more fully explains the high rates of dual diagnosis.



For these reasons, and given the lab evidence and the fact that dual diagnosis patients do less well on psychiatric medication than other patients, Chambers wondered whether the underlying problems in the brain - what he calls "neural inflexibility" - make it harder for these people to respond.



To improve the effectiveness of treatments for dual diagnosis, Chambers would like to see educators, counselors, physicians, and scientific researchers integrate insights into both mental health and addiction. Funding the simultaneous treatment of both disorders would also help, he observes, given that "dual-diagnosis cases are the mainstream among these patients, probably because addiction and mental illness are strongly linked by neurobiology."



What may harm the amygdala early in human development" Dr. Chambers cites the relatively rare cases of temporal lobe epilepsy, tumors or early brain injury. Far more common, he speculates, are complex interactions among subtle genetic and environmental factors that change the way the amygdala functions or is connected to the rest of the brain during childhood and adolescence. For example, he says, "Early emotional trauma, paired with a certain genetic background, may alter the early development of neural networks intrinsic to the amygdala, resulting in a cascade of brain effects and functional changes that present in adulthood as a dual-diagnosis disorder."







Article: "Neonatal Amygdala Lesions: Co-Occurring Impact on Social/Fear-Related Behavior and Cocaine Sensitization in Adult Rats," R. Andrew Chambers, MD, Tammy J. Sajdyk, PhD, Susan K. Conroy, BS Joan E. Lafuze, PhD, Stephanie D. Fitz, BS, and Anantha Shekhar, MD, PhD; Laboratory for Translational Neuroscience of Dual Diagnosis and Development, Institute of Psychiatric Research, Department of Psychiatry, Indiana University School of Medicine; Behavioral Neuroscience, Vol 121, No. 6.



The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 148,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.



Source:

Pam Willenz

American Psychological Association

Growing Up With Fetal Alcohol Spectrum Disorders

Saint Louis University researchers in the department of family and community medicine have received an $880,000, three-year grant from the Centers for Disease Control (CDC) to develop and test a new program aimed at helping older children and young adults with Fetal Alcohol Spectrum Disorders (FASD) successfully transition into adulthood.


The new program will focus on teaching important life skills, such as how to cope with new situations and minimize disruptive behaviors that could lead to loss of employment or trouble with the law.


According to Leigh Tenkku, Ph.D., assistant professor of family and community medicine at Saint Louis University, while the effects of FASD are life-long, currently there are very few support systems in place to help these individuals and their families as they get older.


"The brains of individuals with FASD are not fully developed, which affects their ability to handle emotions, problem solve and pick up on social cues," Tenkku said. "As they get older, these problems affect their ability to maintain a job, their relationships and their parenting abilities."


The new program, called Partners for Success, combines personal mentors and therapeutic home visits to provide one-on-one support similar to the popular Parents as Teachers model, only intensified. The goal of the program is to give individuals with FASD the tools and support necessary to successfully navigate the challenges of adulthood.


"This is a totally new approach to mentoring older children and adults with FASD, but it's built on well-established research in the field. This program is very promising and we're hopeful that it will revolutionize the way we support these individuals," Tenkku said.


Currently in the U.S., there are no social service programs geared to the specific needs of youth and young adults with FASD. Instead, social agencies offer a hodgepodge of programs that address the broader needs of those with developmental disabilities.


An Investment in the Future: In a time of budget cuts and tightening financial belts, Tenkku says one of the most important aspects of the program is that it is financially feasible and easy for other agencies to implement.


"We want our program to be practical and easily replicated by other agencies that provide FASD services. We're creating the tool, but they have to be able to use it. That's how we'll help the greatest number of people," Tenkku said.


"The overall cost of the program is relatively low. The Partner for Success program is an investment in the future of these individuals. Doing nothing would certainly cost us more in the long run."


About Fetal Alcohol Spectrum Disorder: Drinking during pregnancy can lead to serious physical abnormalities, neurological and behavioral problems, all characteristics of fetal alcohol spectrum disorders. FASD is the greatest cause of children born with developmental disabilities each year in America even though it is 100 percent preventable.















Fetal alcohol syndrome is the most severe form of FASD. Babies born with fetal alcohol syndrome, which is estimated to affect one to two babies born per 1,000, are often born preterm, have low birth weight and long-term growth problems.


About the Study: During the first year of the Partners for Success study, researchers at Saint Louis University will collaborate with several community partners, including the Family Support Network, to design the program.


At the same time, they will recruit 100 youth and young adults with FASD to participate in the study.


The program will be implemented during the second year. Half of the study participants will be enrolled in the new program, while the other half will continue to receive standard support services.


Participants enrolled in the program will receive biweekly home visits from a licensed clinical social worker. They also will be assigned a mentor who will meet with them weekly to socialize, model appropriate behavior in the community, and help the individuals integrate the techniques taught during home visits, in their daily lives.


During the final year of the study, researchers will follow up with participants to measure the success of the program.


"Of course ultimately we'd like to prevent FASDs from occurring. But the sad reality is that 1 percent of children and young adults in our society suffer with the life-long effects of drinking during pregnancy. It's imperative that we find better ways to support these individuals," Tenkku said.


Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.


Source: Saint Louis University Medical Center

Link Between Stress Of Isolation Early In Life And Enhanced Juvenile Response To Cocaine

Drug addiction affects millions of people around the world, causing numerous problems ranging from emotional and psychological difficulties to physical and health issues. Initial drug use can be motivated by curiosity or peer pressure, but in some animals, such as rats, it can also be the result of a stressful early life event, such as social isolation. A new study examines the impact of social isolation on the animal's response to cocaine.



The study, Social Isolation During Perinatal Development Alters the Behavioral Response to Cocaine in Juvenile Rats, was conducted by Natasha Lugo-Escobar, Nicole Carreras and Annabell C. Segarra, University of Puerto Rico, School of Medicine, Rio Piedras, PR. The team will present its findings at the 122nd Annual Meeting of the American Physiological Society, which is part of the Experimental Biology 2009 scientific conference. The meeting will be held April 18-22, 2009 in New Orleans.



The Study



Drugs of abuse act on the reward centers of the brain. These areas are normally involved in mediating pleasure, and also regulate the psycho-stimulant effects of drugs such as cocaine. Stress is known to enhance drug seeking behavior, as well as the psychostimulant effects of cocaine. Since rats are social animals, isolation was used as a stressor to explore the association between stress during development and susceptibility to the psychostimulant effects of drugs of abuse, such as cocaine.



Rats were stressed: (1) as fetuses (by housing the pregnant mother alone), (2) as neonates (by isolating newborn rats for 1 hr daily during the first 9 days of life) or as adolescents (by housing each rat separately during days 21-35). Two additional groups: (4) isolated as fetuses, neonates and adolescents and (5) controls - not isolated during any developmental period, comprised the 5 groups studied. When rats reached 21 days of age, they were weaned from their mothers and tested for the psychostimulant response to cocaine as well as for the development of sensitization, a phenomenon characterized by an increase response to the same amount of a drug over time. For 5 days, half of the rats from all groups were injected with saline and the other half with cocaine (15 mg/kg). This was followed by a 7 day drug free period and an additional cocaine injection on day 13. Locomotor activity was measured on days 1, 5 and 13 immediately after injection.



Results



The researchers found that:
Rats that were isolated during all three developmental periods, showed a higher locomotor response to cocaine than control rats.


The study indicates that the developmental period most susceptible to isolation stress, particularly in males, is the neonatal period, since males isolated as neonates show an increase in the locomotor, and sensitized response to cocaine, compared to male control and to female rats.

Conclusions



This study suggests that isolation during early development alters the brain sensitivity to cocaine, such that when the animal reaches adolescence and is exposed to cocaine, it is more sensitive to the psychostimulant effects of the drug.



These studies contribute to understanding the mechanisms that may lead to greater abuse of drugs during adolescence.



Additional studies are planned.



Source:
Donna Krupa


American Physiological Society

Solagran Ltd Granted Patents For Treatment Of Alzheimers And Alcoholism

Australian Biotech Solagran Limited (ASX: SLA) announced it had been awarded the world's first patents protecting the use of plant polyprenols in the treatment of conditions involving physical, psychological and neurological degeneration.


Two patents were awarded. The first relates to the use of Solagran's drug Ropren and its active ingredient Bioeffective(r) R in the treatment of memory decline and dementia, including Alzheimer's disease. The second relates to the use of Ropren in the treatment of conditions arising from long term addiction to both alcohol and drugs. These conditions involve major changes to personality, as well as severe degeneration of the body, the brain and the nervous system.


Both patents are comprehensive in nature. They cover the active ingredient, the therapeutic substance based on the active ingredient, its pharmaceutical composition, and the method of treatment. They were awarded by ! the Russian Agency for Patents and Trademarks and provide exce! llent in tellectual property protection with a priority date of 23 May 2007.


Under the international Patent Convention Treaty (PCT), Solagran can now obtain patent protection in whatever countries it considers it necessary to protect this intellectual property.


According to Solagran Executive Chairman Dr Vagif Soultanov, securing these two patents provides clear confirmation of the multi-faceted nature of Ropren. "Ropren is not only effective in treating chronic liver disease - the condition for which it is registered as a pharmaceutical in Russia. It is also effective in treating neurodegeneration and addiction" he said.


The patent for the treatment of memory decline and dementia has arisen as a result of the findings of research and trials undertaken in St Petersburg at the I.M. Sechanov Institute of Evolutionary Physiology and at the Skvortsova Stepanova Psychiatric Hospital, as well as in Melbourne at the Brain Sciences Institute within Sw! inburne University.


The patent for the treatment of conditions associated with chronic alcoholism and drug addiction has stemmed from the results of trials with critical and seriously ill heroin addicted chronic alcoholics conducted at the Skvortsova Stepanova Psychiatric Hospital.


According to Solagran, the worldwide commercial potential of an effective treatment for both these conditions is subsantial. Although further specific trials are planned in Russia, the fact that Ropren has already been entered in the Russian Pharmacopoeia means that it can be used for these conditions at the discretion of the treating clinician as soon as it is available commercially. Dr Nina Petrovna Golovkina of the Skvortsova Stepanova Psychiatric Hospital has already indicated that her hospital would be using Ropren to treat alcoholics, drug addicts and patients with neurodegenerative disorders once it was available.


Ropren was registered as a new and lo! w side effect pharmaceutical to treat chronic liver disease (h! epatitis and cirrhosis) by the Russian Ministry of Health in July last year. Since then, Solagran has been working with its Russian associate SibEX to build a production facility capable of meeting the first wave of demand.


About Solagran Limited


Solagran is a biotechnology company with a portfolio of higly effective, low side effect, natural pharmaceuticals that it obtains from gree tree foliage. Its patented technology enables the extraction of the live elements of trees in a way that both preserves and amplifies their biological activity.


solagran

Dialogue & personal example work best for parents in drug talks with teens

Parents can more effectively advise teens about alcohol and drug use if, first, they try dialogue instead of lecture and,
second, they set an everyday example, rather than give the one-time drug sermon, according to a Penn State researcher.



Drug talks can work best when parents and teens routinely share insights on the benefits and risks of drug use, says Dr.
Michelle Miller-Day, associate professor of communication arts and sciences. One tactic would be for parents to ask teens
what they hope to gain from use of alcohol, drugs and tobacco (e.g. relaxation, especially around the opposite sex; greater
peer acceptance). The parent can then suggest wholesome alternatives to achieve the same end.


These tools for a healthy lifestyle include specific, practical advice about drinking and driving, coping with peer pressure,
and remembering to call for a ride when needed, Miller-Day notes. Once parents and teens learn to communicate on a regular
basis about drugs, then the targeted drug talk becomes more helpful, especially before events such as a prom or dance when
teens face stronger temptations to use alcohol beverages or take drugs.


Miller-Day and Dr. Ann H. Dodd, assistant dean in the University's College of Agricultural Sciences, are co-authors of the
paper, "Toward a Descriptive Model of Parent-Offspring Communication About Alcohol and Other Drugs," recently published in
the Journal of Social and Personal Relationships.


The Penn State study examined the taped narratives of 75 college students regarding talks with a parent about alcohol and
drugs. For each of the students, a single parent was also interviewed. In the case of one of the students, both parents were
interviewed, making 151 respondents in all. Both students and parents were asked to recall the methods used by parents in
broaching the subjects of drugs with their teen children and to weigh their effectiveness.


In the study, 44 percent of the respondents (66 out of 151) recalled that parents talked about the potential health and legal
risks of drug use, with some parents even warning about the chances of incarceration for serious drug offenses.


Miller-Day says, "Over two-thirds of the persons interviewed reported integrating ongoing socialization efforts into the
fabric of their everyday lives as opposed to the more targeted one-shot 'drug talks.' "


For parents, it is critical to hone both listening and observation skills in discussions with their children about drugs or
other issues faced by young people, the researchers note. Parents can significantly boost their credibility in drug talks
with teens by offering personal examples, their own testimonials being the best.


Miller-Day says, "In our study, parents often provided accounts of how their own life or the lives of friends and family
members were affected by drugs or drug use. Stories of a relative's alcohol-related death, liver failure, or drug abuse and
recovery support claims of the harmful effects of drugs."


With younger teens and teens still at home, parents can exercise greater power in monitoring and sanctioning their children's
choices about drugs. Often this means a no-tolerance policy, with rules clearly spelling out rewards and punishments for
behaviors involving alcohol and drugs. Penalties can include loss of allowance, loss of car privileges, strict curfews, and
drug and alcohol counseling sessions with a professional, the researchers say.


The strategy for drug talks changes once teen children move out of the house or go to college, Miller-Day says. At that
point, parents would do better to encourage teens to use their own judgment; require them to pay for their own alcohol,
cigarettes and over-the-counter and prescription drugs; and accept the consequences for use of those drugs.


"There is no one right way to conduct parent-child discussions about drugs and drug use," says the Penn State researcher.
"Parents must consider their own experiences, their goals for the drug talk, and the developmental level of the child. But
preliminary evidence suggests that the most effective pathway for influencing drug use among late adolescent youth is ongoing
discussion, by both parents.


"This much is clear -- connecting with children about drugs and drug use is an essential part of parenting," she adds.
"Parents may or may not be anti-drug, but they should talk with their children about alcohol, tobacco and other drug use, and
they should combine their talk with a concentrated effort to listen."


Paul Blaum - aem1psu

Penn State

psu

Unravelling The Genetics Of Alcohol Sensitivity With The Help Of Fruit Flies

Research published in the online open access journal Genome Biology this week has identified a number of genes that are associated with sensitivity to alcohol in fruit flies (Drosophila melanogaster). It is hoped that these findings will help researchers uncover the genetic basis of drinking behaviour in humans.



Fruit flies are a useful model for investigating the contribution genes make to human alcohol sensitivity because, like humans, fruit flies can get 'drunk' if exposed to high levels of alcohol. Similar to many of us after a tipple or two, the intoxicated flies show movement problems, loss of postural control, and sleepiness; they also develop alcohol tolerance after repeated exposure to alcohol.



The research team, comprising Tatiana Morozova, Richard Anholt and Trudy Mackay,at the North Carolina State University, USA identified a number of genes in the fruit fly that appear to be associated with alcohol sensitivity. Interestingly, 23 of these genes have human equivalents (orthologs), which the authors suggest could be linked to alcohol sensitivity in people.



"We can now translate these findings from Drosophila to the human population by asking whether any of the 23 human orthologs are indeed associated with alcohol sensitivity -- either drinking behaviour or addiction -- in the human population," says Professor Trudy Mackay,.



The researchers bred fruit flies for over 25 generations to produce two distinct groups -- flies that were highly sensitive to alcohol, and flies that were highly resistant to alcohol.



They then performed whole-genome transcript expression analysis to see how the genetic make-up of these flies had changed from the original base population. This technique allows all genes in the fruit fly to be examined in parallel, whereas earlier studies usually focused on particular individual genes.



Genes that are differentially expressed between the alcohol-resistant and alcohol-sensitive flies are candidate genes for alcohol sensitivity. Over 1000 such genes were identified in this study.



To explore if some of the differentially expressed genes were causally linked to alcohol sensitivity, the researchers looked at mutated versions of the genes. Tests of 35 mutated genes revealed 32 that directly affected sensitivity to alcohol; three of these genes had previously been associated by the research team with alcohol sensitivity or tolerance.



This further study by Mackay and colleagues may provide clues to the genetic basis of alcohol related issues in humans.







Article:

Phenotypic and transcriptional response to selection for alcohol sensitivity in Drosophila melanogaster
Tatiana V Morozova, Robert RH Anholt and Trudy FC Mackay
Genome Biology (in press)



Source: Lauren Hillman


BioMed Central

Drug Addiction Treatment Sees Drop In Success Rate

According to new research by Liverpool John Moores University, the proportion of drug users who completed treatment for drug addiction decreased between 1998 and 2002, although the overall number of drug users who entered treatment increased.


A British study of the outcome of treatment for drug addiction, published today in the open access journal BMC Public Health, also reveals that drug users were more likely to drop out of treatment if they had been coerced into it by the criminal justice system than if they had entered by other routes.


The authors of the study conclude that efforts to make treatment for drug addiction more accessible have succeeded in getting more people into treatment, but the impact of coercive measures to push drug users into treatment needs further consideration. They write: "recent measures to increase drug treatment participation have speeded up a revolving door both into and out of treatment".


Dr. Caryl Beynon and colleagues from Liverpool John Moores University, analysed the records of 26,415 anonymous drug users who had entered treatment for drug addiction between 1997 and 2004 in Cheshire and Merseyside (England, UK).


The results of Beynon et al.'s study show that the proportion of individuals who dropped out of treatment increased from 7.2% in 1998 to 9.6% in 2002. Individuals coerced into treatment by the criminal justice system were more likely to drop out of treatment than those referred through other routes. The proportion of drug users who successfully completed treatment decreased from 5.8% in 1998 to 3.5% in 2002, but the proportion of drug users who came back to start treatment again after dropping out of treatment increased from 22.9% in 1998 to 48.6% in 2002.


About the LIVERPOOL JOHN MOORES UNIVERSITY


Our mission is to serve and enrich our students, clients and communities by providing opportunities for advancement through education, training, research and the transfer of knowledge


LIVERPOOL JOHN MOORES UNIVERSITY

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2 Rodney Street

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Research Shows Those Who Are Fit Fight Drugs Better

Research by a Davidson College neuroscientist and students demonstrates that the benefits of regular exercise include a lowered tendency to become addicted to illegal drugs.


The online version of the journal Drug and Alcohol Dependence published this week the results of the study by Associate Professor Mark A. Smith that shows that exercise can help prevent drug addiction.


Smith said his research provides scientific validity for a long-standing suspicion among drug abuse researchers that exercise plays a role in helping people avoid and overcome drug addiction. "We've known that individuals who engage in exercise have lower rates of substance abuse," said Smith. "But there were previously no data that showed a cause and effect relationship."


Smith's findings take on added importance in light of a newly announced initiative by the National Institute of Drug Abuse (NIDA) to support research on exercise and drug abuse. Recent studies show that about 20 million Americans age 12 and older (about 8.3% of the population) have used an illicit drug in the past month. Speaking at a NIDA conference June 4-5, director Dr. Nora Volkow committed $4 million for studies about the effect of exercise on drug use. Smith's Davidson research was not published until after the NIDA conference.


He did, however, present his findings in a poster to enthusiastic researchers attending a conference of the College on the Problems of Drug Dependence in mid-June. "I've never had so many people interested in my research," he said. "I felt like a rock star. At the end of the two-hour session I had to ask people to contact me later by email so we could all go hear the next speaker."


Smith worked for about two years on the study with three Davidson student research assistants Karl Schmidt, Jordan Iordanou and Martina Mustroph all of whom graduated in May. They compared the tendency to self-administer cocaine between two groups of rats. One group of rats lived in laboratory cages equipped with a running wheel, and the other group lived in a standard cage with no wheel. During six weeks, the rats in the wheel cages increased their running to about 10 kilometers per day, while those without wheels got no exercise at all.


At the end of six weeks, all the rats were connected to an infusion pump that would provide a dose of cocaine if they pushed a lever in their cage. However, the number of pushes necessary to deliver a dose increased geometrically for each subsequent dose.


The researchers found that the fit rats abandoned the task when 70 lever presses were required for a cocaine infusion. However, sedentary rats kept pushing the lever even when 250 lever presses were required for an infusion. In addition, the rats that ran the most on the wheel abandoned the task at a lower number of pushes than their fellow exercising rats.


"We concluded that aerobic exercise reduces the rewarding effects of cocaine, and probably also has protective effects against cocaine abuse." Smith said. "That shows me that in the real world, exercise can be an effective intervention in drug abuse prevention and treatment programs. As a treatment, it's widely available, easy to execute, inexpensive, and feasible for use in diverse patient populations. In addition, its principle side effects are all positive weight loss, lower blood pressure, and increased confidence and self-esteem."















Smith said exercise works because both exercise and illicit drugs prompt the same release in the brain of the euphoria-inducing protein, dopamine. Long-term exercise alters the number of dopamine receptors in the brain, meaning that drugs then have less of a euphoric effect.


Smith said he expects other researchers to begin working on exercise studies with human patients. His subsequent project at Davidson, however, will determine whether exercise can help mitigate the effects of relapse to drug use among rats.


Smith and student researchers Katie Walker '10 and Kathryn Cole '09 are beginning by having the entire group of rats self-administer cocaine. The drugs are then stopped, with one group abstaining in wheel-equipped cages and the other in standard cages with no wheel. After a period of time, they will reintroduce the self-administration of cocaine to determine whether exercise lessens the relapse rate in those rats that were able to exercise. The study is funded by grants from the National Institute on Drug Abuse, the Davidson Research Initiative, and Howard Hughes Medical Institute.


Smith believes exercise can prevent not only addiction to cocaine, but other drugs as well since they all affect dopamine levels. In the future, he plans to conduct a similar study at Davidson with heroin.


Smith is enthusiastic about the contribution of his study. He said, "Exercise has long been known to produce positive cardiovascular effects. We're now also finding that it has positive psychological effects as well, in the treatment and prevention of drug abuse, depression, and anxiety disorders. I think there's even more and we're just beginning to scratch the surface."


Smith, a 1992 magna cum laude graduate of Lenoir Rhyne College, earned his Ph.D. in experimental and biological psychology at UNC before joining the faculty at Davidson in 1998. He has published more than 25 articles in journals, most of which concern the neurological effects of illegal drugs. He teaches courses in general psychology, learning and behavioral pharmacology, and has mentored 15 students in their thesis work.


Davidson is a highly selective independent liberal arts college for 1,700 students located 20 minutes north of Charlotte in Davidson, N.C. Since its establishment in 1837 by Presbyterians, the college has graduated 23 Rhodes Scholars and is consistently regarded as one of the top liberal arts colleges in the country. Through The Davidson Trust, the college became the first liberal arts institution in the nation to replace loans with grants in all financial aid packages, giving all students the opportunity to graduate debt-free. Davidson competes in NCAA athletics at the Division I level, and a longstanding Honor Code is central to student life at the college.


Davidson College

Box 7171

Davidson, NC 28035

United States

davidson

College Binge Drinking Unlikely To Be Curbed By Lowering The Drinking Age

Although presidents at some U.S. colleges have argued that lowering the minimum legal drinking age could help curb binge drinking on campuses, a new study in the January issue of the Journal of Studies on Alcohol and Drugs suggests such a measure would be ineffective.



In 2008, a group of college presidents and chancellors formed the Amethyst Initiative, a call to rethink the current minimum legal drinking age of 21. They argue that the law encourages underage college students to drink at parties, where binge drinking is common. The main argument states that if students as young as 18 could legally drink in bars and restaurants, they might instead learn more-moderate drinking habits, which could then lead to less binge drinking on college campuses.



So far, 135 college presidents have signed the Initiative's public statement urging lawmakers to reconsider the legal drinking age.



But to simply lower the drinking age without an understanding of its effects would constitute a "radical experiment," said Richard A. Scribner, M.D., M.P.H., of the Louisiana State University School of Public Health, one of the researchers on the new study.



So Scribner and colleagues at BioMedware Corporation in Ann Arbor, MI, and other institutions used a mathematical model to estimate the effects that a lower drinking age would have on college binge drinking.



The model, developed based on survey data from students at 32 U.S. colleges, aimed to evaluate the "misperception effect" emphasized by the Amethyst Initiative -- that is, the idea that underage students widely perceive "normal" drinking levels to be higher than they actually are and that students would adjust their own habits if they were surrounded by social drinkers rather than binge-drinking party-goers.



Overall, the researchers found that the campuses that were most likely to see a decline in binge drinking from a lowered legal drinking age were those that had the poorest enforcement of underage drinking laws -- being surrounded, for instance, by bars that do not check identification -- and a significant level of student misperception of "normal" drinking (that is, students thinking that the average fellow student drinks much more than he or she actually does). If misperception levels were not present or were at the levels shown by the survey data, these campuses would likely see more binge-drinking if the legal age were lowered.



On "drier" campuses, the study found, student misperceptions would have to be even greater.



"The higher the level of enforcement of underage drinking laws, the higher the level of misperception would have to be for the Amethyst Initiative to have any hope of being effective," explained lead researcher Dr. Jawaid W. Rasul, of BioMedware Corporation. "The misperception effect would have to be extremely large."



And without data supporting the existence of such high levels of student misperception, Rasul said, lowering the legal drinking age would be unlikely to curb college binge drinking.



Scribner also pointed out that lowering the drinking age would not only affect college students but all currently underage young adults. And past research has suggested that when alcohol becomes more readily accessible to young people, alcohol-related problems, such as drunk driving, go up.



Rasul, J. W., Rommell, R. G., Jacquez, G. M., Fitzpatrick, B. G., Ackleh, A. S., Simonsen, N., & Scribner, R. A. (January 2011). Heavy Episodic Drinking on College Campuses: Does Changing the Legal Drinking Age Make a Difference? Journal of Studies on Alcohol and Drugs, 72 (1), 15- 23.



Source:

Sue Hinton

Journal of Studies on Alcohol and Drugs

Alcohol's Hidden Effects Revealed In New NHS Campaign

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Ortho-Clinical Diagnostics Offers Complete Drugs-of-Abuse Panel With Addition Of Five New Assays

Ortho-Clinical Diagnostics, a Johnson & Johnson company, announces FDA 510(k) clearance and worldwide availability of five additional MicroTip™ assays for use in the diagnosis and treatment of drug use or overdose. The five new tests complete the menu of eight drugs-of-abuse assays now available for use on the Ortho-Clinical Diagnostics VITROS® 5,1 FS Chemistry System. These assays are used to detect the presence in urine of the following substances:


Barbiturates (BARB)


Benzodiazepines (BENZ)


Cannabinoids (THC)


Methadone (METD)


Opiates (OP)


Barbiturates, also known as "downers," are sedative hypnotics with central nervous system depressant activity. Benzodiazepines are prescribed for the treatment of anxiety or panic disorder, and as a sleeping aid, anticonvulsant or muscle relaxant. They also can be used as hypnotics. Cannabinoids from the marijuana plant produce a variety of pharmacological effects including sedation, euphoria, hallucinations, memory and learning impairment and temporal distortion. Methadone is a synthetic opioid drug with narcotic/analgesic properties that are similar to morphine. It is used in the treatment of opioid addiction and in the management of chronic pain. Opiates are alkaloid compounds that are derived naturally from the poppy plant. Morphine, codeine, and heroin are the most common opiates.


Drug abuse is a major problem around the world. The World Health Organization estimates that some 200,000 people died because of drug abuse in the year 2000, equivalent to 0.4 percent of all deaths worldwide.1 In the U.S. alone, there were an estimated two million drug-related emergency room visits in 2004.2 Substance abuse puts a significant financial burden on the health care system every year. It is estimated that in 2000, drug abuse in the U.S. represented nearly $13 billion in health care costs.3


The VITROS® 5,1 FS Chemistry System allows the consolidation of drugs of abuse testing (DAT) with routine chemistry testing on a single platform. In addition to the five new DAT assays, the VITROS® 5,1 FS DAT menu includes amphetamines, cocaine metabolites and phencyclidine.


These latest product launches increase the MicroTip™ assay menu that Ortho-Clinical Diagnostics has introduced for use on the VITROS® 5,1 FS Chemistry System since October 2004 to a total of 34 new assays. VITROS® MicroTip™ technology provides an extended menu of proteins, therapeutic drugs, cardiac, diabetes and other critical assays. MicroTip™ technology is unique in that assays are processed using single-use tips and cuvettes, which eliminates sample and reagent carryover. In addition, MicroTip™ technology reduces the maintenance associated with other wet chemistry analyzers. Costs associated with water, plumbing, fixed probes, mixing assemblies, liquid waste management and compliance with local waste disposal regulations are minimized.


About Ortho-Clinical Diagnostics


Ortho-Clinical Diagnostics, a Johnson & Johnson company, is a leading provider of high-value diagnostic solutions for the global health care community. Committed to developing the most advanced tests for early detection or diagnosis of disease, the company brings products to market that provide timely information and help to facilitate better medical decisions. Ortho-Clinical Diagnostics also provides blood screening and typing products that help to ensure the safety of the world's blood supply. In addition, through its VITROS® MicroSlide™ and enhanced chemiluminescence technologies, the company has transformed the way that clinical laboratories perform testing. Worldwide, health care professionals rely on Ortho-Clinical Diagnostics for innovative diagnostic solutions and services that promote effective diagnoses and enhance patient care. For more information, visit orthoclinical.


1. United Nations Information Service


2. DAWNinfo.samhsa/


3. National Institute on Drug Abuse


Ortho-Clinical Diagnostics

orthoclinical

Scientists Shed Light On Painkilling System In Brain

Repeatedly boosting brain levels of one natural painkiller soon shuts down the brain cell receptors that respond to it, so that the painkilling effect is lost, according to a surprising new study led by Scripps Research Institute and Virginia Commonwealth University scientists. The study has important implications for drug development.



The natural painkiller, 2-AG, is one of the two major "endocannabinoid" neurotransmitters. The other, anandamide, can be kept at high levels in the brain without losing its therapeutic effects, and researchers had hoped that the same would be true for 2-AG.



"One implication is that maximally elevating 2-AG levels in the brain might not provide a straightforward path to new pain drugs," says Benjamin F. Cravatt III, PhD, professor and chair of the Department of Chemical Physiology and member of the Skaggs Institute for Chemical Biology at Scripps Research in La Jolla, California, who led the study with Aron Lichtman, PhD, a professor of pharmacology and toxicology at Virginia Commonwealth University in Richmond, Virginia. "But we remain optimistic that more modest elevations in 2-AG could produce sustained pain relief. Perhaps more importantly, on a basic science level, we've been able to tease apart a key difference between the two major endocannabinoid signaling pathways, since one can maximally elevate anandamide without observing tolerance."



The report appears in Nature Neuroscience.



A Better Chill Pill



Like the opioid system, the endocannabinoid system was discovered as a result of humans identifying a plant - in this case marijuana (cannabis sativa) - that artificially boosts its activity. Marijuana's main active ingredient, THC, typically reduces pain and anxiety. Researchers have sought to develop drugs that reproduce such therapeutic effects while leaving out THC's unwanted side effects - which include memory impairment, locomotor dysfunction, and possibly addiction.



Cannabinoid research received a boost in 1990 with the description of the main cannabinoid receptor in the brain, CB1, and a few years later with the discoveries of the body's own (endo-) cannabinoids, anandamide and 2-AG, which exert most of their effects by binding to CB1. Cannabinoid receptors are now known to be widely distributed in the brain, and when activated by anandamide or 2-AG, tend to calm the activity of the neurons where they reside. However, researchers so far have been unable to develop artificial cannabinoids that bind to CB1 without producing unwelcome THC-like side effects.



An alternative strategy has been to boost levels of the body's own cannabinoids by inhibiting the enzymes that normally break them down. And so far this has worked for anandamide. Inhibitors of its breakdown enzyme, fatty acid amide hydrolase (FAAH), have been shown to boost anandamide levels and reduce pain and inflammation without adverse side effects in animal tests and early clinical trials.
















A similar strategy for boosting 2-AG may be promising, too, especially since 2-AG levels in the brain are naturally higher than anandamide's. Two years ago, the Cravatt and Lichtman laboratories jointly reported the development of an inhibitor of 2-AG's breakdown enzyme, monoacylglycerol lipase (MAGL). When administered to mice, it boosted their brain levels of 2-AG on average by a factor of eight, and produced a pain-killing effect comparable to that of FAAH inhibitors.



Diminishing Returns



Now the two labs report that 2-AG's pain-killing effect disappears after six days of treatment. "When you continually stimulate the endocannabinoid system by maximally raising 2-AG levels, you effectively desensitize the system," says Cravatt.



In one experiment, an injection of the MAGL inhibitor into mice showed evidence of pain relief on standard tests, but after six consecutive daily injections the drug could no longer achieve this effect. These chronically treated mice also lost much of their sensitivity to THC and to a synthetic CB1-binding compound, and showed a classic sign of drug dependency - when abruptly withdrawn from 2-AG's influence by having their CB1 receptors blocked, they developed paw flutters - a murine version of the shakes.



"When we investigated at the molecular level, we found that the number of CB1 receptors in the mouse brains had been reduced," says Jacqueline Blankman, a graduate student at the Scripps Research Kellogg School of Science and Technology who was co-first-author on the paper with Joel Schlosburg of the Lichtman lab. This receptor "downregulation" occurred in some brain areas but not others



To confirm this effect, the researchers utilized another experimental mouse model where the gene for MAGL was inactivated. This lifelong genetic disruption of MAGL also resulted in high 2-AG levels as well as a reduced and desensitized CB1 system.



"Because we're seeing downregulation of the whole cannabinoid system and tolerance to the anti-pain effects, it does raise some concern about whether MAGL would be a suitable pain target," says Blankman.



"If you are going to inhibit MAGL, you probably wouldn't want to produce a complete inactivation of the enzyme," Cravatt adds.



By contrast with the 2-AG experiments, chronically boosting anandamide had none of these effects on the CB1 system. Cravatt doesn't yet know why these two molecules have such different impacts when delivered chronically. He notes, however, that anandamide may be produced selectively under stress conditions, and perhaps for that reason is less likely to trigger a brain-wide CB1 downregulation.



"The question of why anandamide and 2-AG have such different effects when given chronically is certainly going to be motivating us from now on," says Cravatt. "But already with this finding and the development of these models we've taken a significant step forward in understanding and being able to manipulate this important neurotransmitter system."



In addition to Cravatt, Lichtman, Blankman, and Schlosburg, co-authors of the article "Chronic monoacylglycerol lipase blockade causes functional antagonism of the endocannabinoid system" include Jonathan Z. Long, Daniel K. Nomura, and Elizabeth A. Thomas of Scripps Research; Steven G. Kinsey, Peter T. Nguyen, Divya Ramesh, Lamont Booker, James J. Burston, Dana E Selley and Laura J. Sim-Selley of Virginia Commonwealth University; and Bin Pan and Qing-song Liu of the Medical College of Wisconsin in Milwaukee, Wisconsin.



This study was supported by the National Institutes of Health.



Source:
Scripps Research Institute

Study Seeks To Debunk Myths About HIV-Infection Among Black Women

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AAP Calls For New Limits On Tobacco And Alcohol Advertising

Despite ongoing efforts by parents, teachers and the federal government to urge adolescents to "just say no" to tobacco, alcohol and drugs, more than $25 billion worth of advertising for these products is working to get them to "say yes." Because of these mixed messages, a new American Academy of Pediatrics (AAP) policy statement, "Children, Adolescents, Substance Abuse and the Media," published in the October 2010 print issue of Pediatrics (published online Sept. 27), calls for a ban on tobacco advertising in all media, limitations on alcohol advertising, and no erectile dysfunction drug advertisements until 10 p.m.


In addition, the AAP recommends that parents exercise extreme caution in letting their younger children view PG-13 and R-rated movies and television shows, which often feature substance abuse, and that all substance abuse prevention programs, including those in the classroom, include media education.


The policy statement recommends that pediatricians actively encourage parents to limit unsupervised media use and television channels with excessive depictions of substance abuse, and that the White House Office on Drug Control Policy begin producing and airing anti-smoking and anti-drinking public service announcements.

Source:

American Academy of Pediatrics

Drinking Alcohol During Pregnancy Could Lead To Acute Myeloid Leukemia In Children

Although acute myeloid leukemia (AML) is relatively rare in children, drinking alcohol during pregnancy could increase the risk, according to a recent paper published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.


Julie Ross, Ph.D., director of the division of pediatric epidemiology and clinical research at the University of Minnesota, said there are about 700 cases of AML in the United States in children each year.


"It's quite rare, so we want to be careful about worrying parents too much," said Ross, who was not involved in the study, but is an editorial board member of Cancer Epidemiology, Biomarkers & Prevention.


Ross and the lead researcher of this study, Paule Latino-Martel, Ph.D., research director at the Research Center for Human Nutrition in France, agreed that these findings should strengthen the public health recommendation against alcohol consumption during pregnancy.


"Despite the current recommendation that pregnant women should not drink alcohol during pregnancy, alcohol consumption during pregnancy is 12 percent in the United States, 30 percent in Sweden, 52 percent in France, 59 percent in Australia and 60 percent in Russia," said Latino-Martel.


Latino-Martel and colleagues analyzed 21 case control studies. Alcohol intake during pregnancy, defined as a response to a yes or no question, was associated with a 56 percent increased risk of AML in children. The risk of AML was higher in children aged 0 to 4 years old at diagnosis. There was no significant association with acute lymphoblastic leukemia.


Source

American Association for Cancer Research

Link Between Racial Discrimination And Substance Use Studied By Mailman School Of Public Health

In one of the first studies to focus on the relationship between racial discrimination and health risk behaviors, researchers at the Columbia University Mailman School of Public Health with colleagues from the Universities of Minnesota, Alabama (Birmingham), and California (San Francisco), and Harvard University found African Americans experiencing racial discrimination were more likely to report current tobacco use or recent alcohol consumption and lifetime use of marijuana and cocaine.



Although racial discrimination was far less common in Whites (38%) than in African Americans (89%), the researchers assessed whether parallel associations exist in Whites and found similar associations with smoking, alcohol, and lifetime use of marijuana and cocaine as they did in African Americans. Thus, substance use may be an unhealthy coping response to perceived unfair treatment for some individuals regardless of their race/ethnicity. "However, it is worth noting that racial discrimination may be a different phenomenon for African Americans than it is for Whites, and thus, lead to very different consequences," said Luisa N. Borrell, DDS, PhD, of the Mailman School of Public Health's Department of Epidemiology and principal investigator of the study.



African Americans experiencing racial discrimination also reported having more education, higher income, and a stronger social network than those reporting no racial discrimination. In contrast to African Americans, Whites reporting racial discrimination reported less education and lower income than did those who reported none. Similar to African Americans, Whites reporting any discrimination were more likely to report less control of their life, more anger, less emotional support, and more negative interactions than did their counterparts reporting none.



"We found that African Americans reporting discrimination in three or more domains in both years had higher levels of education and income than did those who reported experiencing less or no discrimination," said Dr. Borrell. "Possibly, African Americans with a higher socioeconomic position report more discrimination because they are more exposed to situations in which they are discriminated, or they may be more aware of subtle forms of discrimination," noted Dr. Borrell.



According to the findings, in contrast, Whites with a low socioeconomic position may be more likely to be exposed to environments in which they are the minority and, therefore, be more likely to feel discriminated.



Among the strengths of the study are its population-based nature, the focus on young to middle-aged adults, the wide ranges of educational attainment and income, the information on illicit substance use, and socioeconomic position indicators. "It is possible that use of a recreational drug helps to cope with life stress resulting from perceived unfair treatment because of one's race/ethnicity," observed Dr. Borrell. "Our findings that current use of marijuana was not related to discrimination and that risk of being a former smoker was increased suggest that, by early middle age (average age, 40 years), people may have found other ways to cope. However, the finding of an excess of current smoking in this population, suggest that this addictive habit may be long lasting, even when alternative coping behaviors are adopted."
















Source of the data was the CARDIA study, a prospective study of cardiovascular risk among young adults. 3,330 persons aged 18-30 years examined at baseline (1985-1986) and re-examined again seven (1992-1993) and 15 years (2000-2001) later in the (CARDIA) Study were included in this study.







The study was supported by the National Institute of Dental and Craniofacial Research, the National Heart, Lung, and Blood Institute and the Robert Wood Johnson Health and Society Scholars Program. The findings are published online in the American Journal of Epidemiology at aje.oxfordjournals/cgi/reprint/kwm180v1



About the Mailman School of Public Health



The only accredited school of public health in New York City, and among the first in the nation, Columbia University's Mailman School of Public Health provides instruction and research opportunities to more than 950 graduate students in pursuit of masters and doctoral degrees. Its students and more than 300 multi-disciplinary faculty engage in research and service in the city, nation, and around the world, concentrating on biostatistics, environmental health sciences, epidemiology, health policy and management, population and family health, and sociomedical sciences.mailman.hs.columbia/



Source: Stephanie Berger


Columbia University's Mailman School of Public Health

Alcohol Tax Increases Deter Drinking

As leaders of many national, state and local governments debate whether to raise taxes on alcohol to boost revenues, their decisions also could influence how much their constituents imbibe in coming years, say University of Florida researchers.


In a study to be published online Thursday in the journal Addiction, UF researchers report that the more alcohol costs, the less likely people are to drink it. And when they do drink, they drink less, a concrete association researchers documented after analyzing 112 studies spanning four decades.


"Results from over 100 separate studies reporting over 1,000 distinct statistical estimates are remarkably consistent, and show without doubt that alcohol taxes and prices affect drinking," said Alexander C. Wagenaar, Ph.D., a professor of epidemiology and health policy research at the UF College of Medicine and the senior author of the study. "When prices go down, people drink more, and when prices go up, people drink less."


The consistency of this association between cost and consumption indicates that using taxes to raise prices on alcohol could be among the most effective deterrents to drinking that researchers have discovered, better than law enforcement, media campaigns or school programs, said Wagenaar.


The study, funded by the Robert Wood Johnson Foundation, also determined that tax or price increases affect the broad population of drinkers, including heavy drinkers as well as light drinkers, and teens as well as adults.


Many studies have analyzed how tax or price increases affect people's drinking habits, but the UF study is the first to examine all of these findings as a whole, using a statistical procedure called meta-analysis. This technique allows researchers to draw conclusions that are not limited to specific policy changes or a single state or country, said Wagenaar.


Researchers scoured through decades of studies examining links between price and alcohol use. The studies were all reported in English but not limited to any single country. The data resulting from these reports were compiled and analyzed to glean more precise answers than can be obtained from just one study, Wagenaar noted.


In a commentary in the same issue of Addiction, Frank Chaloupka, Ph.D., a professor of economics at the University of Illinois at Chicago, describes the research as a "true tour de force," and adds, "these findings provide a strong rationale for using increases in alcoholic beverage taxes to promote public health by reducing drinking."


The University of Florida Health Science Center - the most comprehensive academic health center in the Southeast - is dedicated to high-quality programs of education, research, patient care and public service. The Health Science Center encompasses the colleges of Dentistry, Public Health and Health Professions, Medicine, Nursing, Pharmacy and Veterinary Medicine, as well as the Veterinary Medical Teaching Hospital and an academic campus in Jacksonville offering graduate education programs in dentistry, medicine, nursing and pharmacy. Patient care activities, under the banner UF&Shands, are provided through teaching hospitals and a network of clinics in Gainesville and Jacksonville. The Health Science Center also has a statewide presence through satellite medical, dental and nursing clinics staffed by UF health professionals; and affiliations with community-based health-care facilities stretching from Hialeah and Miami to the Florida Panhandle.



University of Florida Health Science Center

UBC Study Finds Nearly 1 In 5 University Students Experienced Violence In Last 6 Months

While attending university, men are equally likely as women to have been victims of physical or emotional violence, and that violence is often linked to drinking, according to a new study led by University of British Columbia researcher Elizabeth Saewyc.



The study, first published online in the Journal of Adolescent Health last month and scheduled for print publication this fall, found 17 per cent of men and 16 per cent of women reported emotional or physical violence in the past six months. It's the first multi-site study covering both the U.S. and Canada that focuses on recent violence while attending university.



"Whether it's from intimate partners or relative strangers, violence has a significant effect on young people's health," says Saewyc, a professor in the School of Nursing and lead author of the study. "At university, the stress from experiencing violence can affect students' grades, their mental health, even their long-term physical health. When nearly one in five young people report recent violence, that's a serious concern for campus health services."



Almost half of the emotional violence and 20 per cent of the physical violence reported by both genders came from intimate partners. "It appears that young men in college are as likely to experience violence as young women, and much of that violence is from their intimate partners," says Saewyc.



Saewyc, who also holds a Canadian Institutes of Health Research (CIHR) Applied Public Health Chair in Youth Health, worked with researchers at the University of Wisconsin and University of Washington in Seattle to survey more than 2,000 students who attended campus health services for routine clinic appointments. The study was part of a larger project on problem drinking and campus health funded by CIHR and the U.S. National Institutes of Health.



The study also found links between alcohol use and violence victimization.



"We've known that drinking increases the risk of perpetrating violence," says Saewyc. "But in this study we found alcohol consumption puts both young men and women at higher risk of being victimized, too."



Of those who experienced violence, more than one in three young women and 59 percent of young men said they had been drinking when the violence happened. Two-thirds of young men experiencing physical violence reported they had been drinking at the time.



Saewyc and her colleagues propose campus health services should do more to screen for violence exposure among students, and universities also need interventions to promote healthy dating relationships.



"There are established guidelines that recommend screening women for intimate partner violence in routine clinical care on campus, but not for men. This study shows we need the same routine screening for young men, too," says Saewyc.



"CIHR is proud to support Dr. Saewyc's study. Her new insights on student victims of violence will help create better violence prevention and intervention programs," says Dr. Nancy Edwards, Scientific Director of CIHR's Institute of Population and Public Health. "Violence is an important public health issue in Canada, so it is necessary to identify people at risk to reduce the number of victims."



Source:
Randy Schmidt


University of British Columbia

US Prison System Falls Short In Treating Drug Addiction, Study Finds

Almost a quarter of a million individuals addicted to heroin are incarcerated in the United States each year. However, many prison systems across the country still do not offer medical treatment for heroin and opiate addiction, despite the demonstrated social, medical and economic benefits of opiate replacement therapy (ORT).



According to new research from The Miriam Hospital, Brown University and their affiliated Center for Prisoner Health and Human Rights, just half of all federal and state prison systems offer ORT with the medications methadone and buprenorphine, and only in very limited circumstances. Similarly, only twenty-three states provide referrals for some inmates to treatment upon release from prison. These policies are counter to guidelines issued by both the World Health Organization (WHO) and the Centers for Disease Control and Prevention, which say prisoners should be offered ORT for treatment of opiate dependence.



The study's findings are published online by Drug and Alcohol Dependence.



"Pharmacological treatment of opiate dependence is a proven intervention, is cost-effective and reduces drug-related disease and reincarceration rates, yet it remains underutilized in U.S. prison systems," said Amy Nunn, ScD, the study's lead author and an assistant professor of medicine (research) at The Warren Alpert Medical School of Brown University. "Improving correctional policies for addiction treatment could dramatically improve prisoner and community health as well as reduce both taxpayer burden and reincarceration rates."



"Opiate addiction, like all forms of addiction, causes long-term changes to the structure and functioning of the brain, which is why it is classified as a disease. Addiction requires treatment just as other chronic diseases, like diabetes and cancer, do. Unfortunately, there is a large gap between the number of prisoners who require addiction treatment and those who actually receive it," added senior author Josiah Rich, MD, MPH, co-director of the Center for Prisoner Health and Human Rights at The Miriam Hospital and Alpert Medical School.



The U.S. has the world's highest incarceration rate, with approximately 10 million individuals incarcerated each year. More than half of inmates have a history of substance use and more than 200,000 people with heroin addiction are incarcerated annually. Inmates face disproportionately higher burdens of mental illness, substance use and infectious diseases, including HIV/AIDS. Meanwhile, their transition back to their communities is often associated with increased sexual health and drug-related risks, and more than half will relapse within one month of their release.



For the past four decades, methadone has been the treatment of choice for opiate dependence. It prevents withdrawal symptoms and drug cravings, blocks the euphoric effects of other opiates, and reduces the risk of relapse, infectious disease transmission and overdose death. The drug buprenorphine is a newer treatment for opiate replacement that has less likelihood of overdose and is associated with less social stigma. Like methadone, it prevents withdrawal symptoms when an individual stops taking opioid drugs by producing similar effects. Both methadone and buprenorphine are included in WHO's "Essential Medicines" list of drugs that should be made available at all times by health systems to patients.
















The Miriam/Brown research team surveyed the medical directors at the 50 state departments of corrections, along with the Federal Bureau of Prisons and the District of Columbia prison, about their facilities' ORT prescribing policies and referral programs for inmates leaving prison. They received a total of 51 of 52 responses.



Although it appears methadone is offered more frequently that buprenorphine, only 28 facilities (55 percent) offer it under any circumstances, although more than half of these provide it only to pregnant women or for chronic pain management. Approximately 45 percent of facilities provided some community linkage to methadone treatment post-release. Meanwhile, only seven prison systems (14 percent) offer buprenorphine in some circumstances, while 15 facilities (29 percent) offer referrals for some inmates to community buprenorphine providers upon release.



When asked why these treatments are not available in their prison system, the majority of facilities indicated they prefer drug-free detoxification over ORT. A number of prison systems also cited security concerns about providing methadone and buprenorphine to inmates. Interestingly, 27 percent of medical directors said they did not know how beneficial methadone is for treating inmates with opiate addiction, while half were unaware of the benefits of buprenorphine.



A major barrier to providing ORT after incarceration appears to be the lack of partnerships with community ORT providers. Many providers also cited their focus on inmate health during incarceration, rather than upon release, as another reason for not linking inmates to ORT after they've been released.



"In spite of overwhelming scientific evidence demonstrating that pharmacological treatment for addiction has greater health and social benefits than abstinence-only policies, many prison directors are philosophically opposed to treating substance use. Most prisons also do not provide referrals for substance use treatment for prisoners upon release," said Nunn. "These trends contribute to high reincarceration rates and have detrimental impacts on community health. Our interviews with prison medical directors suggest that changing these policies may require an enormous cultural shift within correctional systems."



The study was supported by grants from the National Institute of Health's National Institute on Drug Abuse (NIDA/NIH) and Center for AIDS Research (CFAR); and the Tufts Nutrition Collaborative. In addition to Nunn and Rich, co-authors include Nickolas Zeller and Ank Nijhawan from both The Miriam Hospital and Alpert Medical School; Samuel Dickman from Brown University; and Catherine Trimbur from the University of Rochester School of Medicine and Dentistry.



Source:
Jessica Collins Grimes


Lifespan

In Reducing The Spread Of AIDS, Expansion Of HIV Screening Found To Be Cost-Effective

An expanded U.S. program of HIV screening and treatment could prevent as many as 212,000 new infections over the next 20 years and prove to be very cost-effective, according to a new study by Stanford University School of Medicine researchers.



The researchers found that screening high-risk people annually and low-risk people once in their lifetimes was a worthwhile and cost-effective approach to help curtail the epidemic. The screening would have to be coupled with treatment of HIV-infected individuals, as well as programs to help change risky behaviors.



"We find that expanded screening and treatment could offer substantial health benefits, preventing 15 to 20 percent of new cases," said Elisa Long, PhD, first author of the study. "And the strategy of one-time screening of low-risk individuals and annual screening of high-risk individuals is very cost-effective."



Long, now an assistant professor of operations management at Yale University, began the study while a graduate student at Stanford, working with Margaret Brandeau, PhD, professor of management science and engineering, and Douglas K. Owens, MD, MS, a senior researcher at the Veterans Affairs Palo Alto Health Care System and a professor of medicine at Stanford.



The study is the first to use a national model of HIV transmission to gauge the impact of scaling up screening and treatment. It was published in the Dec. 21 issue of the Annals of Internal Medicine.



An estimated 21 percent of HIV-infected individuals in the United States are not aware they carry the deadly virus and may continue to spread it to others, according to the Centers for Disease Control and Prevention. Some 56,000 people are newly infected with the virus every year in the country, according to CDC figures.



In 2006, the federal agency revised its guidelines to recommend that all patients ages 13 to 64 be screened for HIV, and many other professional groups, such as the American College of Physicians, advise routine patient screening as well. Still, universal screening, followed by treatment, has never been achieved in this country. So the researchers set out to see how the course of the epidemic might change with a scaled-up program involving screening or treatment or both.



They projected that 1.23 million people would become newly infected in the next 20 years if things remained as they are today. Some 74 percent of new infections would be among high-risk individuals, particularly men who have sex with men and intravenous drug users.



The researchers found that if all adults United States were screened annually, regardless of risk, the cost would be staggering - exceeding $750,000 per quality-adjusted life year gained. QALY is a measure of how long people live and their quality of life.



But screening everyone in the general population just once, together with yearly screening of high-risk individuals, would be significantly more cost-effective: It would have a cost of less than $25,000 per QALY gained. At that price, "screening is a good value for the money," Owens said, comparable to other widely accepted programs, such as breast cancer mammography and screening for type-2 diabetes.
















Screening alone, however, would not be sufficient to stem the epidemic, but would have to go hand in hand with treatment, the researchers found.



"If you scale up screening but those people don't get treatment, you don't get as much benefit," Owens said. "If you scale up treatment but still have a lot of people who aren't identified, then they aren't going to benefit. You do the most for health outcomes by scaling up these programs together. They are synergistic."



Treating patients is important because it avoids complications and costly hospitalizations and also makes it less likely they will transmit the virus to others because the amount of virus in their systems is low. If 75 percent of individuals identified as HIV-positive receive access to therapy, the health outcomes are improved and the program provides better value at $22,000 per QALY gained, the researchers calculate.



That combination strategy could prevent an estimated 17.3 percent of new infections, or 212,000 new cases, the researchers found.



This expanded screening and treatment program still wouldn't eliminate the epidemic, as at-risk individuals would still have to change their behaviors. If men who have sex with men reduce their number of sexual partners by half and intravenous drug users cut needle sharing by the same amount, 65 percent of all new infections would be prevented, the researchers found. That would reduce the incidence of HIV to approximately 20,000 new cases per year, the researchers calculate.



"So in terms of eliminating the epidemic, targeting high-risk individuals with effective prevention programs is going to be necessary," Long said.


Notes:


The study was funded by the National Institute on Drug Abuse and the National Institutes of Health. Owens was supported by the Department of Veterans Affairs. Tthe Department of Medicine also supported the research.



Source:

Ruthann Richter

Stanford University Medical Center