Tag Archives: Substance Abuse

Rand Corporation study: Study questions link between medical marijuana and fewer opioid deaths

11 Feb

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

Science Daily reported in: Depression among young teens linked to cannabis use at 18:

A study looking at the cumulative effects of depression in youth, found that young people with chronic or severe forms of depression were at elevated risk for developing a problem with cannabis in later adolescence.
The study led by UW Medicine researchers interviewed 521 students recruited from four Seattle public middle schools. Researchers used data from annual assessments when students were ages 12-15 and then again when they were 18. The results were published in the journal Addiction.
“The findings suggest that if we can prevent or reduce chronic depression during early adolescence, we may reduce the prevalence of cannabis use disorder,” said lead author Isaac Rhew, research assistant professor of psychiatry and behavioral sciences at the University of Washington School of Medicine.
What researchers called “a 1 standard deviation increase” in cumulative depression during early adolescence was associated with a 50 percent higher likelihood of cannabis-use disorder.
According to researchers, during the past decade cannabis has surpassed tobacco with respect to prevalence of use among adolescents. Cannabis and alcohol are the two most commonly used substances among youth in the United States. They pointed to one national study showing increases in prevalence of cannabis use disorder and alcohol use disorder in the United States, especially among young adults.
Longitudinal studies looking at the link between depression and later use of alcohol and cannabis, however, have been mixed. Some show a link. Others don’t. But most studies have assessed adolescent depression at a single point in time — not cumulatively, said the researchers. Further, there have been differences in how substance use has been measured ranging from the initiation of any use to heavier problematic forms of use.
The study oversampled for students with depressive and/or conduct problems. The researchers were surprised to see that the prevalence of cannabis and alcohol use disorder in this study was notably higher than national estimates with 21 percent meeting criteria for cannabis use disorder and 20 percent meeting criteria for alcohol use disorder at age 18.

What effect the easing of marijuana laws in Washington state had on the youth is unclear. Researchers said it would be informative to conduct a similar study in a state with more strict marijuana laws to understand whether the relationship between depression and cannabis misuse would still hold in areas where marijuana may be less accessible…. https://www.sciencedaily.com/releases/2017/07/170717151031.htm

Citation:

Depression among young teens linked to cannabis use at 18
Seattle-focused study suggests earlier intervention with depressed youths could reduce rate of cannabis-use disorder
Date: July 17, 2017
Source: University of Washington Health Sciences/UW Medicine
Summary:
Young people with chronic or severe forms of depression were at elevated risk for developing a problem with cannabis in later adolescence, found a study looking at the cumulative effects of depression in youth.

Journal Reference:
1. Isaac C. Rhew, Charles B. Fleming, Ann Vander Stoep, Semret Nicodimos, Cheng Zheng, Elizabeth McCauley. Examination of cumulative effects of early adolescent depression on cannabis and alcohol use disorder in late adolescence in a community-based cohort. Addiction, 2017; DOI: 10.1111/add.13907

Science Daily reported in Study questions link between medical marijuana and fewer opioid deaths:

The association between medical marijuana and lower levels of opioid overdose deaths — identified previously in several studies — is more complex than previously described and appears to be changing as both medical marijuana laws and the opioid crisis evolve, according to a new RAND Corporation study.
The report — the most-detailed examination of medical marijuana and opioid deaths conducted to date — found that legalizing medical marijuana was associated with lower levels of opioid deaths only in states that had provisions for dispensaries that made medical marijuana easily available to patients. Opioid death rates were not lower in states that just provided legal protections to patients and caregivers, allowing them to grow their own marijuana.
In addition, the association between medical marijuana dispensaries and fewer opioid deaths appears to have declined sharply after 2010, when states began to tighten requirements on sales by dispensaries.
“Our findings are consistent with previous studies showing an association between the legalization of medical marijuana and lower deaths from overdoses of opioids,” said Rosalie Liccardo Pacula, co-author of the study and co-director of the RAND Drug Policy Research Center.
“However, our findings show that the mechanism for this was loosely regulated medical marijuana dispensaries, and that the association between these laws and opioid mortality has declined over time as state laws have more tightly regulated medical dispensaries and the opioid crisis shifted from prescription opioids to heroin and fentanyl,” Pacula said. “This is a sign that medical marijuana, by itself, will not be the solution to the nation’s opioid crisis today….”
When the researchers narrowly focused on the time period from 1999 to 2010 and replicated a model used by other researchers, they obtained results similar to those previously published, showing an approximately 20 percent decline in opioid overdose deaths associated with the passage of any state medical marijuana law. However, these general findings were driven by states that had laws allowing for loosely regulated marijuana dispensary systems.
When researchers extended their analysis through 2013, they found that the association between having any medical marijuana law and lower rates of opioid deaths completely disappeared. Moreover, the association between states with medical marijuana dispensaries and opioid mortality fell substantially as well.
The researchers provide two explanations for the decline in the association between medical marijuana dispensaries and opioid harm. First, states that more recently adopted laws with medical marijuana dispensaries more tightly regulated them, in response to a U.S. Justice Department memo saying it would not challenge state-level medical marijuana laws so long as dispensary sales were in full compliance with state regulations. Second, beginning in 2010, the primary driver of the opioid crisis and related deaths became illicit opioids, mainly heroin and then fentanyl, not prescription opioids…. https://www.sciencedaily.com/releases/2018/02/180207090111.htm

Citation:

Study questions link between medical marijuana and fewer opioid deaths
Association appears to be changing as medical marijuana laws and opioid epidemic change
Date: February 7, 2018
Source: RAND Corporation
Summary:
Several studies have shown an association between legalizing medical marijuana and lower death rates from opioids. A new study finds that link is more complex than previously described and appears to be changing as both medical marijuana laws and the opioid crisis evolve.
Journal Reference:
1. David Powell, Rosalie Liccardo Pacula, Mireille Jacobson. Do medical marijuana laws reduce addictions and deaths related to pain killers? Journal of Health Economics, 2018; 58: 29 DOI: 10.1016/j.jhealeco.2017.12.007

Here is the press release from RAND:

Do Medical Marijuana Laws Reduce Addictions and Deaths Related to Pain Killers?
Published in: Journal of Health Economics Volume 58 (March 2018), Pages 29-42. doi: 10.1016/j.jhealeco.2017.12.007
Posted on RAND.org on February 08, 2018
by David Powell, Rosalie Liccardo Pacula, Mireille Jacobson
• Related Topics:
• Drug Markets and Supply,
• Marijuana,
• Substance Use Harm Reduction
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Read More
Access further information on this document at Journal of Health Economics Volume 58 (March 2018)
This article was published outside of RAND. The full text of the article can be found at the link above.
Recent work finds that medical marijuana laws reduce the daily doses filled for opioid analgesics among Medicare Part-D and Medicaid enrollees, as well as population-wide opioid overdose deaths. We replicate the result for opioid overdose deaths and explore the potential mechanism. The key feature of a medical marijuana law that facilitates a reduction in overdose death rates is a relatively liberal allowance for dispensaries. As states have become more stringent in their regulation of dispensaries, the protective value generally has fallen. These findings suggest that broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids.
Access further information on this document at Journal of Health Economics Volume 58 (March 2018)
Link Between Medical Marijuana and Fewer Opioid Deaths Is More Complex Than Previously Reported
FOR RELEASE
Tuesday
February 6, 2018
The association between medical marijuana and lower levels of opioid overdose deaths—identified previously in several studies—is more complex than previously described and appears to be changing as both medical marijuana laws and the opioid crisis evolve, according to a new RAND Corporation study.
The report—the most-detailed examination of medical marijuana and opioid deaths conducted to date—found that legalizing medical marijuana was associated with lower levels of opioid deaths only in states that had provisions for dispensaries that made medical marijuana easily available to patients. Opioid death rates were not lower in states that just provided legal protections to patients and caregivers, allowing them to grow their own marijuana.
In addition, the association between medical marijuana dispensaries and fewer opioid deaths appears to have declined sharply after 2010, when states began to tighten requirements on sales by dispensaries.
“Our findings are consistent with previous studies showing an association between the legalization of medical marijuana and lower deaths from overdoses of opioids,” said Rosalie Liccardo Pacula, co-author of the study and co-director of the RAND Drug Policy Research Center.
“However, our findings show that the mechanism for this was loosely regulated medical marijuana dispensaries, and that the association between these laws and opioid mortality has declined over time as state laws have more tightly regulated medical dispensaries and the opioid crisis shifted from prescription opioids to heroin and fentanyl,” Pacula said. “This is a sign that medical marijuana, by itself, will not be the solution to the nation’s opioid crisis today.”
The study was published online by the Journal of Health Economics.
Researchers from RAND and the University of California, Irvine, analyzed information about treatment admissions for addiction to pain medications from 1999 to 2012 and state-level overdose deaths from opioids from 1999 to 2013. They also identified state laws legalizing medical marijuana, examining provisions such as whether the regulations made marijuana easily accessible to patients by allowing dispensaries.
When the researchers narrowly focused on the time period from 1999 to 2010 and replicated a model used by other researchers, they obtained results similar to those previously published, showing an approximately 20 percent decline in opioid overdose deaths associated with the passage of any state medical marijuana law. However, these general findings were driven by states that had laws allowing for loosely regulated marijuana dispensary systems.
When researchers extended their analysis through 2013, they found that the association between having any medical marijuana law and lower rates of opioid deaths completely disappeared. Moreover, the association between states with medical marijuana dispensaries and opioid mortality fell substantially as well.
The researchers provide two explanations for the decline in the association between medical marijuana dispensaries and opioid harm. First, states that more recently adopted laws with medical marijuana dispensaries more tightly regulated them, in response to a U.S. Justice Department memo saying it would not challenge state-level medical marijuana laws so long as dispensary sales were in full compliance with state regulations. Second, beginning in 2010, the primary driver of the opioid crisis and related deaths became illicit opioids, mainly heroin and then fentanyl, not prescription opioids.
The study also found no evidence that states with medical marijuana laws experience reductions in the volume of legally distributed opioid analgesics used to treat pain. Even if medical marijuana patients were substituting medical marijuana for opioids in medical marijuana states, these patients did not represent a measurable part of the medical opioid analgesic market.
“While our study finds that medical marijuana dispensaries reduce some of the harms associated with the misuse of opioids, there is little evidence that this is happening because a large number of patients suffering from pain are using marijuana instead of opioid medications,” Pacula said. “Either the patients are continuing to use their opioid pain medications in addition to marijuana, or this patient group represents a small share of the overall medical opioid using population.”
The RAND study was conducted before any any states had begun to allow retail sales of recreational marijuana.
“Our research suggests that the overall story between medical marijuana and opioid deaths is complicated,” Pacula said. “Before we embrace marijuana as a strategy to combat the opioid epidemic, we need to fully understand the mechanism through which these laws may be helping and see if that mechanism still matters in today’s changing opioid crisis.”
Support for the study was provided by the National Institute on Drug Abuse. Other authors of the study are David Powell of RAND and Mireille Jacobson of UC Irvine.
RAND Health is the nation’s largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.
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The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous.
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Researcher Spotlight
• Rosalie Liccardo Pacula
Director, Bing Center for Health Economics
Rosalie Liccardo Pacula is a senior economist at the RAND Corporation and a professor at the Pardee RAND Graduate School. She serves as director of RAND’s BING Center for Health Economics, co-director of the RAND Drug Policy Research Center, and associate director of the data core for RAND’s new…
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/

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

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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©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Columbia University study: Marijuana smokers 5 times more likely to develop an alcohol problem

18 Feb

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

Science Daily reported in Marijuana smokers 5 times more likely to develop an alcohol problem:

Adults who use marijuana are five times more likely to develop an alcohol use disorder (AUD) –alcohol abuse or dependence– compared with adults who do not use the drug. And adults who already have an alcohol use disorder and use marijuana are more likely to see the problem persist. Results of a study by researchers at Columbia University’s Mailman School of Public Health and the City University of New York appear online in the journal Drug and Alcohol Dependence.

“Our results suggest that cannabis use appears to be associated with an increased vulnerability to developing an alcohol use disorder, even among those without any history of this,” said Renee Goodwin, PhD, associate professor of Epidemiology at the Mailman School of Public Health. “Marijuana use also appears to increase the likelihood that an existing alcohol use disorder will continue over time.”

The researchers analyzed data from 27,461 adults enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions who first used marijuana at a time when they had no lifetime history of alcohol use disorders. The population was assessed at two time points. Adults who had used marijuana at the first assessment and again over the following three years (23 percent) were five times more likely to develop an alcohol use problem, compared with those who had not used marijuana (5 percent). Adult problem drinkers who did not use cannabis were significantly more likely to be in recovery from alcohol use disorders three years later….. https://www.sciencedaily.com/releases/2016/02/160217112847.htm

Citation:

Marijuana smokers 5 times more likely to develop an alcohol problem

Date: February 17, 2016

Source: Columbia University’s Mailman School of Public Health

Summary:
Adults who use marijuana are five times more likely to develop an alcohol use disorder (AUD) — alcohol abuse or dependence — compared with adults who do not use the drug. And adults who already have an alcohol use disorder and use marijuana are more likely to see the problem persist.

Journal Reference:
1. Andrea H. Weinberger, Jonathan Platt, Renee D. Goodwin. Is cannabis use associated with an increased risk of onset and persistence of alcohol use disorders? A three-year prospective study among adults in the United States. Drug and Alcohol Dependence, 2016; DOI: 10.1016/j.drugalcdep.2016.01.014

Here is the press release from the Columbia’s Mailman School of Public Health:

Chronic Disease, Community Health

Feb. 17 2016

Marijuana Smokers Five Times More Likely to Develop an Alcohol Problem

Adults who use marijuana are five times more likely to develop an alcohol use disorder (AUD) —alcohol abuse or dependence— compared with adults who do not use the drug. And adults who already have an alcohol use disorder and use marijuana are more likely to see the problem persist. Results of a study by researchers at Columbia University’s Mailman School of Public Health and the City University of New York appear online in the journal Drug and Alcohol Dependence.

“Our results suggest that cannabis use appears to be associated with an increased vulnerability to developing an alcohol use disorder, even among those without any history of this,” said Renee Goodwin, PhD, associate professor of Epidemiology at the Mailman School of Public Health. “Marijuana use also appears to increase the likelihood that an existing alcohol use disorder will continue over time.”

The researchers analyzed data from 27,461 adults enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions who first used marijuana at a time when they had no lifetime history of alcohol use disorders. The population was assessed at two time points. Adults who had used marijuana at the first assessment and again over the following three years (23 percent) were five times more likely to develop an alcohol use problem, compared with those who had not used marijuana (5 percent). Adult problem drinkers who did not use cannabis were significantly more likely to be in recovery from alcohol use disorders three years later.

“From a public health standpoint we recommend that further research be conducted to understand the pathways underlying these relationships as well as the degree to which various potentially vulnerable population subgroups — youth, for example — are at increased risk,” noted Goodwin. “If future research confirms these findings, investigating whether preventing or delaying first use of marijuana might reduce the risk of developing alcohol use disorders among some segments of the population may be worthwhile.”
Co-authors are Andrea Weinberger, Yeshiva University and Yale University School of Medicine; and Jonathan Platt, Mailman School of Public Health.

The study was supported by the National Institutes of Health/National Institute on Drug Abuse (grant R01-DA20892). https://www.mailman.columbia.edu/public-health-now/news/marijuana-smokers-five-times-more-likely-develop-alcohol-problem#sthash.PuhZAXLD.dpuf

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/

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

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Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

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COMMENTS FROM AN OLD BLACK FART: Drink and drugs make college kids STUPID

18 Oct

Here’s today’s COMMENT FROM AN OLD BLACK FART: We live in a society with few personal controls and even fewer people recognize boundaries which should govern their behavior and how they treat others. Aftab Ali wrote in the Independent article, Students more likely to have sex after using marijuana or binge drinking, according to US research:

Students are more likely to have sex on days they’ve used marijuana or binged* on alcohol, according to new research on intercourse and condom use while under the influence.

Professor of psychological science at Oregon State University (OSU) in the US, David Kerr, also found binge drinking and being in a serious dating relationship were linked with less condom use, which puts young adults at risk for sexually-transmitted infections (STIs) and unplanned pregnancies.

The findings – published in the Journal of Studies on Alcohol and Drugs – came to light after researchers recruited 284 students to report on their marijuana use, alcohol use, sexual activity, and condom use every day for 24 consecutive days.
According to the professor, two findings stood out. He said: “Students in serious relationships had almost 90 per cent of the sex reported in our study, but serious partners used a condom only a third of the time – compared to about half the time among single students. More frequent sex, plus less protection equals higher risk.”

The stereotypical image of students drinking and having casual sex is ‘real’, he added. However, in the OSU study, he said it was ‘striking’ how often those in serious relationships were putting their guard down, indicating how people may judge risks differently while under the influence….http://www.independent.co.uk/student/news/students-more-likely-to-have-sex-after-using-marijuana-or-binge-drinking-according-to-us-research-a6685676.html

For many college students, college brings more freedom and fewer restrictions than they may have been accustomed to during their high school years. Many college students are naive about the consequences that can arise from certain social situations. So parents when you are preparing to drop your children off at college, in addition to what type of frig or microwave to buy for the dorm room you need to have the following conversations:

1. Another candid conversation about sex, this conversation should be ongoing from when they were age appropriate children

2. Sexually transmitted diseases and pregnancy

3. Binge drinking and substance abuse

4. Personal safety issues such as always letting at least one person know where they are going

5. The college’s code of conduct

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

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

American Academy of Pediatrics opposes drug testing in schools

5 Apr

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 The National Council on Alcohol and Drug Dependence lists Signs and Symptoms:

1. Physical and health warning signs of drug abuse
• Eyes that are bloodshot or pupils that are smaller or larger than normal.
• Frequent nosebleeds–could be related to snorted drugs (meth or cocaine).
• Changes in appetite or sleep patterns. Sudden weight loss or weight gain.
• Seizures without a history of epilepsy.
• Deterioration in personal grooming or physical appearance.
• Injuries/accidents and person won’t or can’t tell you how they got hurt.
• Unusual smells on breath, body, or clothing.
• Shakes, tremors, incoherent or slurred speech, impaired or unstable coordination.

2. Behavioral signs of drug abuse
• Drop in attendance and performance at work or school; loss of interest in extracurricular activities, hobbies, sports or exercise; decreased motivation.
• Complaints from co-workers, supervisors, teachers or classmates.
• Unusual or unexplained need for money or financial problems; borrowing or stealing; missing money or valuables.
• Silent, withdrawn, engaging in secretive or suspicious behaviors.
• Sudden change in relationships, friends, favorite hangouts, and hobbies.
• Frequently getting into trouble (arguments, fights, accidents, illegal activities).

3. Psychological warning signs of drug abuse
• Unexplained change in personality or attitude.
• Sudden mood changes, irritability, angry outbursts or laughing at nothing.
• Periods of unusual hyperactivity or agitation.
• Lack of motivation; inability to focus, appearing lethargic or “spaced out.”
• Appearing fearful, withdrawn, anxious, or paranoid, with no apparent reason.
Signs and symptoms of Drug Dependence:
Drug dependence involves all the symptoms of drug abuse, but also involves another element: physical dependence.
1. Tolerance: Tolerance means that, over time, you need more drugs to feel the same effects. Do they use more drugs now than they used before? Do they use more drugs than other people without showing obvious signs of intoxication?
2. Withdrawal: As the effect of the drugs wear off, the person may experience withdrawal symptoms: anxiety or jumpiness; shakiness or trembling; sweating, nausea and vomiting; insomnia; depression; irritability; fatigue or loss of appetite and headaches. Do they use drugs to steady the nerves, stop the shakes in the morning? Drug use to relieve or avoid withdrawal symptoms is a sign of addiction.
In severe cases, withdrawal from drugs can be life-threatening and involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous and should be managed by a physician specifically trained and experienced in dealing with addiction.
3. Loss of Control: Using more drugs than they wanted to, for longer than they intended, or despite telling themselves that they wouldn’t do it this time.
4. Desire to Stop, But Can’t: They have a persistent desire to cut down or stop their drug use, but all efforts to stop and stay stopped, have been unsuccessful.
5. Neglecting Other Activities: They are spending less time on activities that used to be important to them (hanging out with family and friends, exercising or going to the gym, pursuing hobbies or other interests) because of the use of drugs.
6. Drugs Take Up Greater Time, Energy and Focus: They spend a lot of time using drugs, thinking about it, or recovering from its effects. They have few, if any, interests, social or community involvements that don’t revolve around the use of drugs.
7. Continued Use Despite Negative Consequences: They continue to use drugs even though they know it’s causing problems. As an example, person may realize that their drug use is interfering with ability to do their job, is damaging their marriage, making problems worse, or causing health problems, but they continue to use…. https://ncadd.org/learn-about-drugs/signs-and-symptoms

Remember, these are very general signs, specific drugs, narcotics, and other substances may have different signs, it is important to know the specific signs.

Kathryn Doyle of Reuters wrote in Experts caution against random drug testing in schools:

Schools should not be using random drug tests to catch or deter drug abusers, the American Academy of Pediatrics advises in an updated policy statement.

The Academy recommends against school-based “suspicionless” drug testing in the new issue of the journal Pediatrics.

Identifying kids who use drugs and entering them into treatment programs should be a top priority, but there is little evidence that random drug testing helps accomplish this, said Dr. Sharon Levy, director of the adolescent substance abuse program at Boston Children’s Hospital and lead author of the new policy statement…

Scientifically, the best way to test the value of random drug tests would be to put some kids into a drug testing program and others not, in a single school, but practically, that is difficult to accomplish. Instead, researchers have compared schools with drug testing programs to similar schools without them – and found mixed results.

One study did find a short-term reduction in kids’ self-reported drug use at a school with random testing, but the kids were followed for a relatively short period and reductions in use applied only to the drugs included in the testing. This is a problem since most drug testing panels do not include alcohol, Levy said.
“It’s possible that you do get some prevention out of these programs, but on the other hand it seems very expensive, very invasive, and has pretty limited results,” she said.

Adolescent drug use is usually sporadic, so even a kid who does use illegal substances may easily pass a random annual test and then feel comfortable to use freely for the rest of the year, she said.

Drug tests can result in false positives, and even a true positive says nothing about frequency or quantity of drug use, according to Ken C. Winters of the psychiatry department at the University of Minnesota Medical School in Minneapolis, who is not in the AAP.
http://newsdaily.com/2015/03/experts-caution-against-random-drug-testing-in-schools/#eI8U6EOrbeuGbOZZ.99

Citation:

• From the American Academy of Pediatrics
Adolescent Drug Testing Policies in Schools
1. Sharon Levy, MD, MPH, FAAP,
2. Miriam Schizer, MD, MPH, FAAP,
3. COMMITTEE ON SUBSTANCE ABUSE
Abstract
More than a decade after the US Supreme Court established the legality of school-based drug testing, these programs remain controversial, and the evidence evaluating efficacy and risks is inconclusive. The objective of this technical report is to review the relevant literature that explores the benefits, risks, and costs of these programs.

Here is the AAP statement:

AAP Opposes In School Drug Testing Due to Lack of Evidence
3/30/2015
Drug testing can be useful for pediatricians and other health care providers to assess substance use or mental health disorders in adolescents, but random drug testing in schools is a controversial approach not recommended by the American Academy of Pediatrics (AAP).

In an updated policy statement and technical report, “Adolescent Drug Testing Policies in Schools,” in the April 2015 Pediatrics (published online March 30), the AAP encourages and supports the efforts of schools to identify and address student substance abuse, but recommends against the use of school-based drug testing programs, often called suspicionless or random drug testing.

Proponents of random drug testing refer to potential advantages such as students avoiding drug use because of the negative consequences associated with having a positive drug test results, while opponents of random drug testing agree that the disadvantages are much greater, and can include deterioration in the student-school relationship, confidentiality of students’ medical records, and mistakes in interpreting drug tests that can result in false-positive results.

The AAP recommends against the use of school-based drug testing programs because of limited evidence of efficacy and potential risks associated with this procedure. Pediatricians support the development of effective substance abuse services in schools, along with appropriate referral policies in place for adolescents struggling with substance abuse disorders.
# # #

The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.
https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Opposes-In-school-Drug-Testing-Due-to-Lack-of-Evidence.aspx

The National Institute on Drug Abuse (Institute) has some great information about drug testing. In Frequently Asked Questions About Drug Testing in Schools, the Institute discusses drug testing.

Why test teenagers at all?

Teens are especially vulnerable to drug abuse, when the brain and body are still developing. Most teens do not use drugs, but for those who do, it can lead to a wide range of adverse effects on the brain, the body, behavior and health.
Short term: Even a single use of an intoxicating drug can affect a person’s judgment and decisonmaking—resulting in accidents, poor performance in a school or sports activity, unplanned risky behavior, and the risk of overdosing.
Long term: Repeated drug abuse can lead to serious problems, such as poor academic outcomes, mood changes (depending on the drug: depression, anxiety, paranoia, psychosis), and social or family problems caused or worsened by drugs.
Repeated drug use can also lead to the disease of addiction. Studies show that the earlier a teen begins using drugs, the more likely he or she will develop a substance abuse problem or addiction. Conversely, if teens stay away from drugs while in high school, they are less likely to develop a substance abuse problem later in life….
Is random drug testing of students legal?
In June 2002, the U.S. Supreme Court broadened the authority of public schools to test students for illegal drugs. Voting 5 to 4 in Pottawatomie County v. Earls, the court ruled to allow random drug tests for all middle and high school students participating in competitive extracurricular activities. The ruling greatly expanded the scope of school drug testing, which previously had been allowed only for student athletes.
Just because the U.S. Supreme Court said student drug testing for adolescents in competitive extracurricular activities is constitutional, does that mean it is legal in my city or state?
A school or school district that is interested in adopting a student drug testing program should seek legal expertise so that it complies with all federal, state, and local laws. Individual state constitutions may dictate different legal thresholds for allowing student drug testing. Communities interested in starting student drug testing programs should become familiar with the law in their respective states to ensure proper compliance. http://www.drugabuse.gov/related-topics/drug-testing/faq-drug-testing-in-schools

The primary issue is whether students have privacy rights.

Your Debate.com summarizes the pros and cons of School Drug Testing:

PRO 1
The main purpose of random school drug testing is not to catch kids using drugs, it to keep them from ever using them. Once their using drugs its harder for them to break their addiction. With many employers drug testing its very important for a kid’s future not to use drugs. Drug use is responsible for many crimes. Its worth the inconvenience for all our future.
CON 2
One of the fundamental features of our legal system is that we are presumed innocent of any wrongdoing unless and until the government proves otherwise. Random drug testing of student athletes turns this presumption on its head, telling students that we assume they are using drugs until they prove to the contrary with a urine sample.
CON 3
“If school officials have reason to believe that a particular student is using drugs, they already have the power to require that student to submit to a drug test,” said ACLU-NJ Staff Attorney David Rocah.
CON 4
The constitutional prohibition against “unreasonable” searches also embodies the principle that merely belonging to a certain group is not a sufficient reason for a search, even if many members of that group are suspected of illegal activity. Thus, for example, even if it were true that most men with long hair were drug users, the police would not be free to stop all long haired men and search them for drugs.
PRO 5
Peer pressure is the greatest cause of kids trying drugs. If by testing the athletes or other school leaders, we can get them to say no to drugs, it will be easier for other kids to say no.
CON 6
Some also argue that students who aren’t doing anything wrong have nothing to fear. This ignores the fact that what they fear is not getting caught, but the loss of dignity and trust that the drug test represents. And we should all be afraid of government officials who believe that a righteous cause warrants setting aside bedrock constitutional protections. The lesson that our schools should be teaching is respect for the Constitution and for students’ dignity and privacy, not a willingness to treat cherished constitutional principles as mere platitudes. http://www.youdebate.com/DEBATES/school_drug_testing.HTM

See, What Are the Benefits of Drug Testing?http://www.livestrong.com/article/179407-what-are-the-benefits-of-drug-testing/

Substance abuse is often a manifestation of other problems that child has either at home or poor social relations including low self-esteem.

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

Al-Anon and Alateen

http://al-anon.alateen.org/

National Clearinghouse for Drug and Alcohol Information

http://www.samhsa.gov/

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment?

http://www.samhsa.gov/kap

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/

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

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

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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New York University study: 18% of higher income kids smoke Hookah

7 Jul

Douglas Quenqua reported in the New York Times article, Putting A Crimp In the Hookah about hookah.

Kevin Shapiro, a 20-year-old math and physics major at the University of Pennsylvania, first tried a hookah at a campus party. He liked the exotic water pipe so much that he chipped in to buy one for his fraternity house, where he says it makes a useful social lubricant at parties.
Like many other students who are embracing hookahs on campuses nationwide, Mr. Shapiro believes that hookah smoke is less dangerous than cigarette smoke because it “is filtered through water, so you get fewer solid particles….”
Many young adults are misled by the sweet, aromatic and fruity quality of hookah smoke, which causes them to believe it is less harmful than hot, acrid cigarette smoke. In fact, because a typical hookah session can last up to an hour, with smokers typically taking long, deep breaths, the smoke inhaled can equal 100 cigarettes or more, according to a 2005 study by the World Health Organization.
That study also found that the water in hookahs filters out less than 5 percent of the nicotine. Moreover, hookah smoke contains tar, heavy metals and other cancer-causing chemicals. An additional hazard: the tobacco in hookahs is heated with charcoal, leading to dangerously high levels of carbon monoxide, even for people who spend time in hookah bars without actually smoking, according to a recent University of Florida study. No surprise, then, that several studies have linked hookah use to many of the same diseases associated with cigarette smoking, like lung, oral and bladder cancer, as well as clogged arteries, heart disease and adverse effects during pregnancy. And because hookahs are meant to be smoked communally — hoses attached to the pipe are passed from one smoker to the next — they have been linked with the spread of tuberculosis, herpes and other infections…
http://www.nytimes.com/2011/05/31/health/31hookah.html?emc=eta1&_r=0

Kids mistakenly think hookah is safe.

Anthony Rivas reported in the Medical Daily article, 1 In 5 High School Seniors Smoke Hookah;

Educating Them About Its Harms Is Crucial:
There’s no questioning the stigma cigarette smoking has developed over the past couple of decades. The health risks associated with smoking has led to large declines in the amount of smokers in the U.S. since the 1970s, dropping from around 40 percent to about 18 percent of adults. But as always, as one popular vice fades away, another one gains steam — or in this case, smoke. Now, a new study from New York University has determined how popular hookah smoking has become among high school seniors.
Traditionally from the Middle East, hookah involves smoking flavored tobacco from a large water pipe. It’s become increasingly popular in North America and other parts of the world, in part, because it’s believed to be less harmful to the body — the tobacco is considered to be milder. However, that’s not entirely the case because hookah smokers tend to take more puffs in one session, resulting in similar, if not worse effects than smoking.
The NYU researchers’ study involved data from the Monitoring the Future nationwide study, which follows teens’ behaviors, values, and attitudes. Of the almost 15,000 kids aged 18 involved in the study, 5,540 were questioned about their hookah use between 2010 and 2012. They discovered that 18 percent, or almost one in five high school seniors, had smoked hookah within the 12 months prior to being surveyed.
Interestingly, they also found that “students of higher socioeconomic status appear to be more likely to use hookah,” said Dr. Joseph Palamar, assistant professor of population health at NYU Langone Medical Center, in a press release. “Surprisingly, students with more educated parents or higher personal income are at high risk for use. We also found that hookah use is more common in cities, especially big cities. So hookah use is much different from cigarette use, which is more common in non-urban areas….” http://www.medicaldaily.com/1-5-high-school-seniors-smoke-hookah-educating-them-about-its-harms-crucial-291584

Citation:

Hookah Use Among US High School Seniors
1. Joseph J. Palamar, PhD, MPHa,
2. Sherry Zhou, BAb,
3. Scott Sherman, MD, MPHa, and
4. Michael Weitzman, MDb
+ Author Affiliations
1. Departments of aPopulation Health, and
2. bPediatrics and Environmental Medicine, New York University Langone Medical Center, New York, New York
Abstract
OBJECTIVES: Prevalence of hookah use is increasing significantly among adolescents. This study aimed to delineate demographic and socioeconomic correlates of hookah use among high school seniors in the United States. We hypothesized that more impoverished adolescents and those who smoked cigarettes would be more likely to use hookahs.
METHODS: Data were examined for 5540 high school seniors in Monitoring the Future (years 2010–2012), an annual nationally representative survey of high school students in the United States. Using data weights provided by Monitoring the Future, we used multivariable binary logistic regression to delineate correlates of hookah use in the last 12 months.
RESULTS: Eighteen percent of students reported hookah use in the past year. Compared with white students, black students were at lower odds for use (adjusted odds ratio [AOR] = 0.27, P < .0001). High parent education increased the odds for use (AOR = 1.58, P $50/week (AOR = 1.26, P < .05) or $11 to $50 per week from other sources (AOR = 1.35, P < .01) also increased odds for use. Males and urban students were also at higher odds for use, as were users of alcohol, marijuana, and other illicit substances. Former cigarette smokers were at higher risk, and current smokers were at highest risk for use.
CONCLUSIONS: Adolescents of higher socioeconomic status appear to be at particularly high risk for hookah use in the United States. Prevention efforts must target this group as prevalence continues to increase. http://pediatrics.aappublications.org/content/early/2014/07/01/peds.2014-0538.full.pdf+html

Here is the press release from New York University:

Jul 6 at 10:26 PM
PUBLIC RELEASE DATE:
7-Jul-2014
[ Print | E-mail ] Share [ Close Window ]

Contact: Lorinda Klein
lorindaann.klein@nyumc.org
212-404-3533
NYU Langone Medical Center / New York University School of Medicine
NYU researchers find 18 percent of high school seniors smoke hookah
Higher socioeconomic status associated with higher rates of hookah use
New York, NY – July 7, 2014 – While cigarette use is declining precipitously among youth, evidence indicates that American adolescents are turning to ethnically-linked alternative tobacco products, such as hookahs, cigars, and various smokeless tobacco products, according to a recent report from the Centers for Disease Control and Prevention (CDC).
Now a new study by researchers affiliated with New York University’s Center for Drug Use and HIV Research (CDUHR), in the August 2014 edition of Pediatrics identifies how prevalent Hookah use is and which teens are most likely to be using it.
The study, “Hookah Use Among U.S. High School Seniors,” published online July 7, used data from Monitoring the Future (MTF), a nation-wide ongoing annual study of the behaviors, attitudes, and values of American secondary school students. The MTF survey is administered in approximately 130 public and private schools throughout 48 states in the US. Roughly 15,000 high school seniors are assessed annually. This study examined data from the 5,540 students (modal age = 18) who were asked about Hookah use from 2010-2012. The researchers found the annual prevalence (use in the last 12 months) of hookah use was nearly 1 in 5 high school seniors.
“What we find most interesting is that students of higher socioeconomic status appear to be more likely to use hookah,” said Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). “Surprisingly, students with more educated parents or higher personal income are at high risk for use. We also found that hookah use is more common in cities, especially big cities. So hookah use is much different from cigarette use, which is more common in non-urban areas.”
Hookah, an ancient form of smoking, in which charcoal-heated tobacco or non-tobacco based shisha smoke is passed through water before inhalation, is rapidly gaining popularity among adolescents in the US. The researchers found those students who smoked cigarettes, and those who had ever used alcohol, marijuana or other illicit substances were more likely to use hookah.
“Tobacco use and exposure to secondhand smoke are the leading preventable causes of morbidity and mortality in the US,” said a study co-author Michael Weitzman, MD, a professor of Pediatrics and of Environmental Medicine at the NYULMC. “Cigarette use has decreased by 33% in the past decade in the US, while the use of alternative tobacco products such as hookahs has increased an alarming 123%. This is especially worrisome given the public misperception that hookahs are a safe alternative to cigarettes whereas evidence suggests that they are even more damaging to health than are cigarettes.”
While the US is experiencing an alarming increase in hookah use among adolescents, Dr. Palamar does point out that “Use tends to be much different from traditional cigarette smoking. Right now it appears that a lot of hookah use is more ritualistic, used occasionally–for example, in hookah bars, and not everyone inhales.”
“However, times are beginning to change,” notes Dr. Palamar. “Now something called hookah pens, which are similar to e-cigarettes, are gaining popularity. While not all hookah pens contain nicotine, this new delivery method might normalize hookah use in everyday settings and bring use to a whole new level.”
Researchers note that social stigma toward cigarette use appears to have played a large part in the recent decrease in rates of use, but they caution that it is doubtful these new hookah pens are frowned upon as much as cigarettes. Hookah pens also come in trendy designs and colors, which may be appealing to both adolescents and adults.
“These nifty little devices are likely to attract curious consumers, possibly even non-cigarette smokers,” said Dr. Palamar. “And unlike cigarettes, hookah comes in a variety of flavors and is less likely to leave users smelling like cigarette smoke after use. This may allow some users to better conceal their use from their parents or peers.”
Researchers conclude increased normalization might lead to increases in use, and possibly adverse consequences associated with repeated use. “This portends a potential epidemic of a lethal habit growing among upper and middle class adolescents,” said Dr. Weitzman. They stress that it is crucial for educators and public health officials to fill in the gaps in public understanding about the harm of hookah smoking.
###
Researcher Affiliations: Joseph J. Palamar, PhD–NYULMC, Department of Population Health; NYU CDUHR; Sherry Zhou, MD, MSc 2015, NYULMC, Departments of Pediatrics and Environmental Medicine; Scott Sherman, MD, MPH, NYULMC, Department of Population Health; Michael Weitzman, MD, NYULMC, Departments of Pediatrics and Environmental Medicine.
Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
Acknowledgements: This project was not funded. The National Institute on Drug Abuse, Inter-university Consortium for Political and Social Research, and Monitoring the Future principal investigators, had no role in analysis, interpretation of results, or in the decision to submit the manuscript for publication. Monitoring the Future data were collected through a research grant (R01 DA-01411) from the National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the principal investigators, NIH or NIDA
About CDUHR
CDUHR, funded by the National Institute on Drug Abuse, is the first center for the socio-behavioral study of substance use and HIV in the United States. The Center is dedicated to increasing the understanding of the substance use-HIV/AIDS epidemic, particularly among individuals in high-risk contexts. The Center’s theme is “Discovery to Implementation & Back: Research Translation for the HIV/Substance Use Epidemic.” The Center facilitates the development of timely new research efforts, enhances implementation of funded projects and disseminates information to researchers, service providers and policy makers.
About NYU Langone Medical Center
NYU Langone Medical Center, a world-class, patient-centered, integrated academic medical center, is one of the nation’s premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals—Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, the Medical Center’s dedicated inpatient orthopaedic hospital; and Hassenfeld Children’s Hospital, a comprehensive pediatric hospital supporting a full array of children’s health services across the Medical Center—plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The Medical Center’s tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education, and research. For more information, go to http://www.NYULMC.org, and interact with us on Facebook, Twitter, and YouTube.
About New York University College of Nursing
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science in Nursing, a Master of Science and Post-Master’s Certificate Programs, a Doctor of Philosophy in Research Theory and Development, and a Doctor of Nursing Practice degree. For more information, visit https://nursing.nyu.edu/
Contact: Lorinda Klein, NYULMC | 212.404.3533 |917.693.4846 LorindaAnn.Klein@nyumc.org
Christopher James, CDUHR | 212.998.6876 | christopher.james@nyu.edu

As with a many issues adolescents face, it is important for parents and guardians to know what is going on in their children’s lives. You should know who your children’s friends are and how these friends feel about smoking, drugs, and issues like sex. You should also know how the parents of your children’s friends feel about these issues. Do they smoke, for example, or are they permissive in allowing their children to use alcohol and/or other drugs. Are these values in accord with your values?

Resources:

1. A History of Tobacco http://archive.tobacco.org/History/Tobacco_History.html

2. American Lung Association’s Smoking and Teens Fact Sheet Women and Tobacco Use
African Americans and Tobacco Use
American Indians/Alaska Natives and Tobacco Use
Hispanics and Tobacco Use
Asian Americans/Pacific Islanders and Tobacco Use
Military and Tobacco Use
Children/Teens and Tobacco Use
Older Adults and Tobacco Use http://www.lung.org/stop-smoking/about-smoking/facts-figures/specific-populations.html

3. Center for Young Women’s Health A Guide for Teens
http://www.youngwomenshealth.org/smokeinfo.html

4. Kroger Resources Teens and Smoking
http://kroger.staywellsolutionsonline.com/Wellness/Smoking/Teens/

5. Teens Health’s Smoking
http://kidshealth.org/teen/drug_alcohol/tobacco/smoking.html

6. Quit Smoking Support.com http://www.quitsmokingsupport.com/teens.htm

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