Tag Archives: Lancet

Lancet study: Parental provision of alcohol to teenagers does not reduce risks, compared to no supply, Australian study finds

28 Jan

Substance abuse is a serious problem for many young people. The Centers for Disease Control provide statistics about underage drinking in the Fact Sheet: Underage Drinking:

Underage Drinking
Alcohol use by persons under age 21 years is a major public health problem.1 Alcohol is the most commonly used and abused drug among youth in the United States, more than tobacco and illicit drugs. Although drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11% of all alcohol consumed in the United States.2 More than 90% of this alcohol is consumed in the form of binge drinks.2 On average, underage drinkers consume more drinks per drinking occasion than adult drinkers.3 In 2008, there were approximately 190,000 emergency rooms visits by persons under age 21 for injuries and other conditions linked to alcohol.4
Drinking Levels among Youth
The 2009 Youth Risk Behavior Survey5 found that among high school students, during the past 30 days
• 42% drank some amount of alcohol.
• 24% binge drank.
• 10% drove after drinking alcohol.
• 28% rode with a driver who had been drinking alcohol.
Other national surveys indicate
• In 2008 the National Survey on Drug Use and Health reported that 28% of youth aged 12 to 20 years drink alcohol and 19% reported binge drinking.6
• In 2009, the Monitoring the Future Survey reported that 37% of 8th graders and 72% of 12th graders had tried alcohol, and 15% of 8th graders and 44% of 12th graders drank during the past month.7
Consequences of Underage Drinking
Youth who drink alcohol1, 3, 8 are more likely to experience
• School problems, such as higher absence and poor or failing grades.
• Social problems, such as fighting and lack of participation in youth activities.
• Legal problems, such as arrest for driving or physically hurting someone while drunk.
• Physical problems, such as hangovers or illnesses.
• Unwanted, unplanned, and unprotected sexual activity.
• Disruption of normal growth and sexual development.
• Physical and sexual assault.
• Higher risk for suicide and homicide.
• Alcohol-related car crashes and other unintentional injuries, such as burns, falls, and drowning.
• Memory problems.
• Abuse of other drugs.
• Changes in brain development that may have life-long effects.
• Death from alcohol poisoning.
In general, the risk of youth experiencing these problems is greater for those who binge drink than for those who do not binge drink.8
Youth who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 years.9, 10 http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm
See, Alcohol Use Among Adolescents and Young Adults http://pubs.niaaa.nih.gov/publications/arh27-1/79-86.htm
https://drwilda.wordpress.com/2012/03/26/seattle-childrens-institute-study-supportive-middle-school-teachers-affect-a-kids-alcohol-use/

According to a Science Daily article, parents might want to think about the risks of providing alcohol to their underage children.

Science Daily reported in Parental provision of alcohol to teenagers does not reduce risks, compared to no supply, Australian study finds:

There is no evidence to support the practice of parents providing alcohol to their teenagers to protect them from alcohol-related risks during early adolescence, according to a prospective cohort study in Australia published in The Lancet Public Health journal.
The six year study of 1927 teenagers aged 12 to 18 and their parents found that there were no benefits or protective effects associated with giving teenagers alcohol when compared to teenagers who were not given alcohol. Instead, parental provision of alcohol was associated with increased likelihood of teenagers accessing alcohol through other sources, compared to teenagers not given any alcohol.
Alcohol consumption is the leading risk factor for death and disability in 15-24 year olds globally. Drinking during adolescence is of concern as this is when alcohol use disorders (ie, dependence on or abuse of alcohol) are most likely to develop….
The study recruited teenagers and their parents between 2010 and 2011 from secondary schools in Perth, Sydney and Hobart (Australia). The teenagers and their parents completed separate questionnaires every year from 2010 to 2016 including information about how teenagers accessed alcohol (from parents, other non-parental sources, or both), binge drinking levels (defined as drinking more than four drinks on a single occasion in the past year), experience of alcohol-related harm, and alcohol abuse symptoms. In the final two years, teenagers were also asked about symptoms of alcohol dependence and alcohol use disorder that could predict alcohol misuse problems in the future.
At the start of the study, the average age of the teenagers was 12.9 years old and by the end of the study the average age was 17.8 years old. The proportion of teenagers who accessed alcohol from their parents increased as the teenagers aged, from 15% (291/1910) at the start of the study to 57% (916/1618) at the end of the study, while the proportion with no access to alcohol reduced from 81% (1556/1910) teenagers to 21% (341/1618).
At the end of the study, 81% (632/784) of teenagers who accessed alcohol through their parents and others reported binge drinking, compared with 62% (224/361) of those who accessed it via other people only, and 25% (33/132) of teens who were given alcohol by their parents only. Similar trends were seen for alcohol-related harm, and for symptoms of possible future alcohol abuse, dependence and alcohol use disorders. The group of teenagers supplied with alcohol from both their parents and other sources were at the greatest risk of the five adverse outcomes, potentially as a result of their increased exposure…. https://www.sciencedaily.com/releases/2018/01/180125161255.htm

Citation:

Parental provision of alcohol to teenagers does not reduce risks, compared to no supply, Australian study finds
Date: January 25, 2018
Source: The Lancet
Summary:
There is no evidence to support the practice of parents providing alcohol to their teenagers to protect them from alcohol-related risks during early adolescence, according to a prospective cohort study in Australia.
Journal References:
1. Richard P Mattick, Philip J Clare, Alexandra Aiken, Monika Wadolowski, Delyse Hutchinson, Jackob Najman, Tim Slade, Raimondo Bruno, Nyanda McBride, Kypros Kypri, Laura Vogl, Louisa Degenhardt. Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study. The Lancet Public Health, 2018; DOI: 10.1016/S2468-2667(17)30240-2
2. Stuart A Kinner, Rohan Borschmann. Parental supply and alcohol-related harm in adolescence: emerging but incomplete evidence. The Lancet Public Health, 2018; DOI: 10.1016/S2468-2667(18)30006-9

Here is the abstract from the Lancet:

Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study
Prof Richard P Mattick, PhD Correspondence information about the author Prof Richard P Mattick Email the author Prof Richard P Mattick
,
Philip J Clare, MBiostats
,
Alexandra Aiken, MPH
,
Monika Wadolowski, PhD
,
Delyse Hutchinson, PhD
,
Prof Jackob Najman, PhD
,
Tim Slade, PhD
,
Raimondo Bruno, PhD
,
Nyanda McBride, PhD
,
Prof Kypros Kypri, PhD
,
Laura Vogl, PhD
,
Prof Louisa Degenhardt, PhD
Published: 25 January 2018
Open Access
DOI: http://dx.doi.org/10.1016/S2468-2667(17)30240-2
|
Summary
Background
Some parents supply alcohol to their children, reportedly to reduce harm, yet longitudinal research on risks associated with such supply is compromised by short periods of observation and potential confounding. We aimed to investigate associations between parental supply and supply from other (non-parental) sources, with subsequent drinking outcomes over a 6-year period of adolescence, adjusting for child, parent, family, and peer variables.
Methods
We did this prospective cohort study using data from the Australian Parental Supply of Alcohol Longitudinal Study cohort of adolescents. Children in grade 7 (mean age 12 years), and their parents, were recruited between 2010 and 2011 from secondary schools in Sydney, Perth, and Hobart, Australia, and were surveyed annually between 2010 and 2016. We examined the association of exposure to parental supply and other sources of alcohol in 1 year with five outcomes in the subsequent year: binge drinking (more than four standard drinks on a drinking occasion); alcohol-related harms; and symptoms of alcohol abuse (as defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV]), alcohol dependence, and alcohol use disorder (as defined by DSM-5). This trial is registered with ClinicalTrials.gov, number NCT02280551.
Findings
Between September, 2010, and June, 2011, we recruited 1927 eligible parents and adolescents (mean age 12·9 years [SD 0·52]). Participants were followed up until 2016, during which time binge drinking and experience of alcohol-related harms increased. Adolescents who were supplied alcohol only by parents had higher odds of subsequent binge consumption (odds ratio [OR] 2·58, 95% CI 1·96–3·41; p<0·0001), alcohol-related harm (2·53, 1·99–3·24; p<0·0001), and symptoms of alcohol use disorder (2·51, 1·46–4·29; p=0·0008) than did those reporting no supply. Parental supply of alcohol was not significantly associated with the odds of reporting symptoms of either alcohol abuse or dependence, compared with no supply from any source. Supply from other sources was associated with significant risks of all adverse outcomes, compared with no supply, with an even greater increased risk of adverse outcomes.
Interpretation
Providing alcohol to children is associated with alcohol-related harms. There is no evidence to support the view that parental supply protects from adverse drinking outcomes by providing alcohol to their child. Parents should be advised that this practice is associated with risk, both directly and indirectly through increased access to alcohol from other sources.
Funding
Australian Research Council, Australian Rotary Health, Foundation for Alcohol Research and Education, National Drug and Alcohol Research Centre….. Continue Reading at http://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(17)30240-2/fulltext

Assuming you are not one of those ill-advised parents who supply their child with alcohol or drugs like marijuana in an attempt to be hip or cool, suspicions that your child may have a substance abuse problem are a concern. Confirmation that your child has a substance abuse problem can be heartbreaking. Even children whose parents have seemingly done everything right can become involved with drugs. The best defense is knowledge about your child, your child’s friends, and your child’s activities. You need to be aware of what is influencing your child.
Our goal should be:

A Healthy Child In A Healthy Family Who Attends A Healthy School In A Healthy Neighborhood. ©

Related:

More school districts facing a financial crunch are considering school ads https://drwilda.wordpress.com/2012/06/04/more-school-districts-facing-a-financial-crunch-are-considering-school-ads/

Should there be advertising in schools? https://drwilda.wordpress.com/2011/11/10/should-there-be-advertising-in-schools/

Talking to your teen about risky behaviors https://drwilda.wordpress.com/2012/06/07/talking-to-your-teen-about-risky-behaviors/

Television cannot substitute for quality childcare https://drwilda.wordpress.com/2012/04/23/television-cannot-substitute-for-quality-childcare/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
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Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

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Australian study: Frequent marijuana use among those under 17 may result in lower educational achievement

23 Sep

Often children who evidence signs of a substance abuse problem come from homes where there is a substance abuse problem. That problem may be generational. eMedicineHealth lists some of the causes of substance abuse:

Substance Abuse Causes
Use and abuse of substances such as cigarettes, alcohol, and illegal drugs may begin in childhood or the teen years. Certain risk factors may increase someone’s likelihood to abuse substances.
Factors within a family that influence a child’s early development have been shown to be related to increased risk of drug abuse.
o Chaotic home environment
o Ineffective parenting
o Lack of nurturing and parental attachment
Factors related to a child’s socialization outside the family may also increase risk of drug abuse.
o Inappropriately aggressive or shy behavior in the classroom
o Poor social coping skills
o Poor school performance
o Association with a deviant peer group
o Perception of approval of drug use behavior http://www.emedicinehealth.com/substance_abuse/article_em.htm

Substance abuse is often a manifestation of other problems that child has either at home or poor social relations including low self-esteem. Dr. Alan Leshner summarizes the reasons children use drugs in why do Sally and Johnny use drugs? http://archives.drugabuse.gov/Published_Articles/Sally.html

Simon Makin reported in the Scientific American article, Does Marijuana Harm the Brain?

The Claim
Casual cannabis use harms young people’s brains.
The Facts
A study found differences in the brains of users and nonusers, but it did not establish that marijuana use caused the variations or that they had any functional significance.
The Details
Researchers at Northwestern University and Harvard Medical School conducted MRI scans of two groups of 20 young adults ages 18 to 25. One group reported using marijuana at least once a week, smoking 11 joints a week on average, whereas the other had used it less than five times total and not at all during the last year. Neither group had any psychiatric disorders, and the users were psychiatrically assessed as not dependent on the drug.
The study focused on two brain regions involved in processing rewards, the nucleus accumbens and the amygdala. These areas create pleasurable experiences of things such as food and sex, as well as the high associated with drugs, and have been shown to change in animals given THC, the main psychoactive component of cannabis.
The researchers found that cannabis users had more gray matter density in the left nucleus accumbens and left amygdala, as well as differences in the shape of the left nucleus accumbens and right amygdala. The left nucleus accumbens also tended to be slightly larger in users. They concluded that recreational cannabis use might be associated with abnormalities in the brain’s reward system. News reports have proclaimed that scientists have shown that even casual cannabis use harms young people’s brains.
The Caveats
The most obvious problem with leaping to that conclusion is that the scans were conducted at only one point. This approach can compare the two groups, but it cannot prove cannabis caused any differences between them—or even that the differences represent changes over time. They could be preexisting variations, or cannabis use and brain changes may both be related to a third factor, such as tobacco (although the study did attempt to take levels of smoking into account)…..
Reality Check—Cannabis use has been found to:
• Cause dependence, at some point in their lives, in about 9 percent of people who try it.
• Impair various aspects of cognitive function, particularly memory. Impairments can remain for several days. One study showed that performance returns to nonusers’ levels after 28 days of abstinence, but evidence is mixed about how long the impairments last.
• Potentially reduce the volume of the hippocampus, which is critical for memory—but only after heavy and prolonged use. The evidence linking cognitive impairments to specific brain changes is inconclusive, and the degree to which such changes are reversible is hotly debated. http://www.scientificamerican.com/article/does-marijuana-harm-the-brain/

Science Daily reported a longitudinal study from Australia and New Zealand.

In Frequent cannabis use in adolescence linked with reduced educational attainment, other problems in young adults, Science Daily reported:

Individuals who are daily users of cannabis before age 17 are over 60% less likely to complete high school or obtain a degree compared to those who have never used the drug, new research published in The Lancet Psychiatry journal shows. The large meta-analysis also indicates that daily users of cannabis during adolescence are seven times more likely to attempt suicide, have an 18 times greater chance of cannabis dependence, and are eight times as likely to use other illicit drugs in later life.
“Our findings are particularly timely given that several US states and countries in Latin America have made moves to decriminalize or legalize cannabis, raising the possibility that the drug might become more accessible to young people”, says Richard Mattick, study author and Professor of Drug and Alcohol Studies at the National Drug and Alcohol Research Centre, University of New South Wales, in Australia.
Cannabis is the most widely used illicit drug globally and recent statistics have shown that in some countries adolescents are starting cannabis use at a younger age and more adolescents are using cannabis heavily. In England, 4% of 11-15 year olds report cannabis use in the past month, roughly 7% of US high-school seniors are daily or near-daily cannabis users, and in Australia, around 1% of 14-19 year olds are daily users of the drug, whilst 4% use weekly.
In this study, a team of Australian and New Zealand researchers combined individual-level data on up to 3765 participants who used cannabis from three large, long-running longitudinal studies to find out more about the link between the frequency of cannabis use before the age of 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes up to the age of 30 years (completing high school, obtaining a university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence)….
http://www.sciencedaily.com/releases/2014/09/140909192001.htm

Citation:

Frequent cannabis use in adolescence linked with reduced educational attainment, other problems in young adults
Date: September 9, 2014

Source: The Lancet
Summary:
Individuals who are daily users of cannabis before age 17 are over 60% less likely to complete high school or obtain a degree compared to those who have never used the drug, new research shows. The large meta-analysis also indicates that daily users of cannabis during adolescence are seven times more likely to attempt suicide, have an 18 times greater chance of cannabis dependence, and are eight times as likely to use other illicit drugs in later life.

Copyright © 2014 Elsevier Ltd All rights reserved.
Young adult sequelae of adolescent cannabis use: an integrative analysis
Dr Edmund Silins PhD a Corresponding AuthorEmail Address, L John Horwood MSc c, Prof George C Patton MD d g, Prof David M Fergusson PhD c, Craig A Olsson PhD d e g h, Delyse M Hutchinson PhD a, Elizabeth Spry BA d, Prof John W Toumbourou PhD d e, Prof Louisa Degenhardt PhD a d f i, Wendy Swift PhD a, Carolyn Coffey PhD d, Robert J Tait PhD j k, Primrose Letcher PhD g, Prof Jan Copeland PhD b, Richard P Mattick PhD a, for the Cannabis Cohorts Research Consortium†

Summary

Background

Debate continues about the consequences of adolescent cannabis use. Existing data are limited in statistical power to examine rarer outcomes and less common, heavier patterns of cannabis use than those already investigated; furthermore, evidence has a piecemeal approach to reporting of young adult sequelae. We aimed to provide a broad picture of the psychosocial sequelae of adolescent cannabis use.
Methods

We integrated participant-level data from three large, long-running longitudinal studies from Australia and New Zealand: the Australian Temperament Project, the Christchurch Health and Development Study, and the Victorian Adolescent Health Cohort Study. We investigated the association between the maximum frequency of cannabis use before age 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes assessed up to age 30 years (high-school completion, attainment of university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence). The number of participants varied by outcome (N=2537 to N=3765).

Findings

We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high-school completion (adjusted odds ratio 0•37, 95% CI 0•20—0•66) and degree attainment (0•38, 0•22—0•66), and substantially increased odds of later cannabis dependence (17•95, 9•44—34•12), use of other illicit drugs (7•80, 4•46—13•63), and suicide attempt (6•83, 2•04—22•90).

Interpretation

Adverse sequelae of adolescent cannabis use are wide ranging and extend into young adulthood. Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefits. Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse developmental effects.

Funding

Australian Government National Health and Medical Research Council.
Young adult sequelae of adolescent cannabis use: an integrative analysis : The Lancet Psychiatry National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia
Young adult sequelae of adolescent cannabis use: an integrative analysis : The Lancet Psychiatry
Young adult sequelae of adolescent cannabis use: an integrative analysis. By – Dr Edmund Silins PhD, L John Horwood MSc, Prof George C Patton MD, Prof David M Fergusson PhD, Craig A Olsson PhD, Del…
View on http://www.thelancet.com
b National Cannabis Prevention and Information Centre, UNSW Australia, Sydney, NSW, Australia
c Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
d Centre for Adolescent Health, Murdoch Childrens Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia
e School of Psychology, Deakin University, Geelong, VIC, Australia
f School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
g Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
h Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
i Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA
j National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
k Centre for Research on Ageing Health and Wellbeing, Australian National University, Canberra, ACT, Australia
Corresponding Author Information Correspondence to: Dr Edmund Silins, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW 2052, Australia
† Other members listed at end of paper

What Steps Should a Parent Take?

The Drug Enforcement Agency (DEA) has a series of questions parents should ask http://www.getsmartaboutdrugs.com/content/default.aspx?pud=a8bcb6ee-523a-4909-9d76-928d956f3f91
If you suspect that your child has a substance abuse problem, you will have to seek help of some type. You will need a plan of action. The Partnership for a Drug Free America lists 7 Steps to Take and each step is explained at the site. http://www.drugfree.org/intervene
If your child has a substance abuse problem, both you and your child will need help. “One day at a time” is a famous recovery affirmation which you and your child will live the meaning. The road to recovery may be long or short, it will have twists and turns with one step forward and two steps back. In order to reach the goal of recovery, both parent and child must persevere.

Related:

University of Washington study: Heroin use among young suburban and rural non-traditional users on the https://drwilda.com/2013/10/13/university-of-washington-study-heroin-use-among-young-suburban-and-rural-non-traditional-users-on-the-increase/

Resources

Adolescent Substance Abuse Knowledge Base http://www.crchealth.com/troubled-teenagers/teenage-substance-abuse/adolescent-substance-abuse/signs-drug-use/

Warning Signs of Teen Drug Abuse
http://parentingteens.about.com/cs/drugsofabuse/a/driug_abuse20.htm?r=et

Is Your Teen Using?
http://www.drugfree.org/intervene

Al-Anon and Alateen http://www.al-anon.alateen.org/

WEBMD: Parenting and Teen Substance Abuse http://www.webmd.com/mental-health/tc/teen-substance-abuse-choosing-a-treatment-program-topic-overview

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment? http://store.samhsa.gov/home

The National Institute on Drug Abuse (NIDA) has a web site for teens and parents that teaches about drug abuse NIDA for Teens: The Science Behind Drug Abuse
http://teens.drugabuse.gov/

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