Sober Sources

Alcoholism damages are extensive by Lisa Withrow Correspondent

2010-08-30T20:19:00.000-07:00

While a majority of Americans are able to have an occasional alcoholic beverage without repercussion or harm, approximately 10 percent of the population is unable to do so. Early researchers on alcoholism, now referred to as alcohol dependence, described it as an "allergy of mind, body, and spirit" that alters personality and diminishes an individual's ability to function in family, community and social settings.

For individuals who are alcohol dependent, the younger the age that drinking commences and the longer time that alcohol dependency is active, the more extensive the damage to physical health, family functioning, financial viability and recovery potential.

Concurrent disorders, meaning more than one illness occurring in the same person at the same time, increase over the course of a lifetime and chronic alcohol dependence has been linked with increased levels of illness, disability and preventable death across the life span. Alcohol dependence has been linked by the World Health Organization to the preventable onset of 67 other chronic diseases.

At least three of the following symptoms must occur within a 12-month period for Alcohol Dependence to be diagnosed.

n Tolerance is the need to drink increasing amounts of alcohol to become intoxicated.

n Withdrawal occurs after stopping drinking or drinking occurs to interrupt withdrawal.

n More alcohol is consumed for a longer period than intended by the drinker.

n There is an ongoing desire to control or stop alcohol use but attempts at control fail.

n Increasing time is spent on using or recovering from the effects of drinking alcohol.

n Important family, work or social obligations are neglected due to drinking.

n Drinking continues when other health problems will be made worse by the drinking.

Genetics and environment appear to play an equal part in the development of alcohol dependence. Children of alcoholics are 50 percent to 60 percent more likely to develop alcohol dependence than those in the general population. In terms of genetics and environment, children of alcoholics experience the greatest risk.

Brain imaging technology has shed new light on the effects of alcohol on the brain. Difficulty walking, blurred vision, slurred speech and slow reaction times clearly show alcohol affects the brain. Chronic, heavy alcohol use damages the brain beginning with mild "memory slips" to permanent damage requiring custodial care. The factors that effect how and to what extent alcohol affects the brain are: how much and how often a person drinks; age of onset — the earlier age that alcohol use starts the more likely long-term damage; family history of alcoholism; and general health status. In short, the more damage sustained by the brain, the less likely the chances of sustained recovery.

More than 700,000 people receive substance dependence treatment on any given day. Alcohol dependence is now being viewed as a chronic disease, much like diabetes or heart disease, which must be managed by the person with the disorder.

Given the significant brain impairment that accompanies chronic and/or intense intoxication, detoxification of the alcohol dependent individual is the necessary first step.

Depending on the overall health status and chronic nature of the disease, this can be done at a treatment center or in a medical facility.

While no medications cure alcohol dependence, there are a variety of medications which may be used to treat withdrawal symptoms, reduce craving or act as a deterrent to drinking. Evidence indicates that medication alone is not effective without counseling, residential treatment or attendance at 12-step support groups.

The best outcomes may be a combination of the above.

Cognitive-behavior therapy is used with sober patients to increase coping skills and develop a sober disease management plan. Dialectical Behavioral Therapy is used to address emotional coping skills that often are lacking in early sobriety. Alcoholics Anonymous is a worldwide network of recovering alcoholics who assist each other in staying sober and repairing the damage done by alcohol dependence.

It is free of charge, and meetings occur daily in most communities.

Residential treatment often lasts from 10-28 days. It allows newly sober individuals an intensive treatment experience that includes detoxification, education on addiction, 12-step facilitation, individual/family/group therapy and a host of evidence-based practices designed to equip newly sober individuals with a skill set and insights to promote ongoing sobriety.

TEEN DRINKING - NOT JUST A PHASE

2010-01-21T11:15:00.000-08:00

Teens Who Start Early Have Later Problems

Not Benign Conditions What Parents Can Do Teen-agers who exhibit symptoms of drinking problems today are more likely to develop serious drinking problems, other substance abuse, and mental disorders in early adulthood, according to new research.

Rather than "going through a phase" that they will out grow, the new study indicates that their drinking and mental health problems will get worse with age if left untreated.

Previous studies have shown that these "early onset" substance abusers become the most difficult to treat in adulthood.

Dr. Paul Rohde of the Oregon Research Institute interviewed 940 high school students twice during adolescence and again at age 24. The results of the study, published in the January issue of the Journal of the American Academy of Child and Adolescent Psychiatry1, indicate that those will diagnosed drinking problems, or even symptoms of drinking problems as teens were more likely to:

* Develop increased drinking problems.
* Smoke cigarettes and use other drugs.
* Develop depression and personality disorders.

Rohde's initial interviews with the 940 students, which they were teens, showed that 6 percent of the kids had a diagnosed alcohol use disorder, while another 17 percent exhibited some symptoms of problem drinking.

Of these students with alcohol problems as teens, a full 80 percent also had psychological problems such as depression or behavioral disorders.

"Clearly," Rohde and his researchers wrote, "for many adolescents, alcohol use disorders and problematic alcohol consumption are not benign conditions that self-resolve."

Because teens with only some symptoms of problem drinking were at risk for future alcohol use disorders, doctors should look for early signs of alcohol problems, Rohde said. Doctors should also look for psychiatric disorders in teens who exhibit any drinking problems, the researchers concluded.

Author and speaker Shelly Marshall literally wrote the book on treating teen-age abusers. Her book, Parents Need to Know: Teenage Addicts Can Recover2 points out common prejudices about teen addicts and the effectiveness of placing teen addicts in multi-generational programs.

Shelly recommends "treating the addict, not the age" and stresses the importance of placing teens in regular treatment settings, rather than segregating them into "teen programs."

In her book, she gives 21 Questions for Parents3, which she calls "The Winning Hand" and recommends parents "answer these 21 questions for each child in your family age 9 or older. Have your spouse take it independently of you without discussing anything until you are both done. Compare your results with your spouse's. This way the deck will not be stacked against you."

She tells parents whose teens are using to seek professional help immediately.

WOMEN AT GREATER RISK OF HARM BY ALCOHOLISM

2010-01-19T09:55:00.000-08:00

Women At Greater Risk
Of Harm By Alcoholism

Description: Women coping with alcoholism report greater problems with both physical and social functioning, more bodily pain, and poorer physical and mental health than men.

Women at greater risk of harm by alcoholism, says study by U-M researcher.

ANN ARBOR---Women suffering from alcoholism show greater effects on their daily lives than do alcoholic men, according to a study University of Michigan Prof. Kyle L. Grazier plans to present later this month.

Women coping with alcoholism report greater problems with both physical and social functioning, more bodily pain, and poorer physical and mental health than men, according to data Grazier and co-author Kathleen Bucholz at Washington University analyzed in a three-year, $2 million study funded by the National Institute of Alcohol Abuse and Alcoholism. Grazier teaches in the U-M School of Public Health's Department of Health Management and Policy.

Grazier and Bucholz tracked more than 700 people initially interviewed as part of a larger National Institutes of Health study conducted in five American cities 20 years ago.

In their study, Grazier and Bucholz located three groups of respondents from the St. Louis sample: those diagnosed as stably alcoholic, borderline alcoholic and those unaffected by alcohol in the original study. They conducted three interviews and reviewed all medical records for care received over a two-year period. Grazier noted that their approach is unique because most research examines alcoholics in treatment centers where they're easiest to find, but they looked at individuals in the community, including a broad spectrum of alcoholics who have and have not received treatment.

"We don't know very much about people in the general community," Grazier said. There have been no other community-based longitudinal studies that have followed individuals for almost 20 years to examine the long-term health services effects of alcohol use and abuse.

Women considered stable alcoholics showed greater effects on their daily life, including simple activities like walking and shopping, than men in that group.

Grazier and Bucholz are exploring reasons for the disparity, whether biological or social.

Those causes carry implications for the way physicians treat female patients and ways community-based programs educate people about the long-term health risks of alcohol.

Grazier plans to present the study at the First World Congress on Women and Mental Health in Berlin, Germany, March 27-31 (http://www.akm.ch/wmh2001/). This is the first meeting of its kind in which investigators from around the world will focus on the relationship between psychiatry, psychosomatics, neurosciences, obstetrics and gynecology.

In addition, Grazier will present a second study at the Congress---a $300,000, three-year National Institute for Mental Health-funded study on the effects of managed mental health care on women. She looked in particular at what are known as "carve out" programs, in which a separate administrative structure manages mental health and substance abuse service apart from other medical care.

Grazier gained access to records for 45,000 employees at a large West Coast company, one of the first to implement a carve out program, and looked for changes in costs and health care use over the six years since the inception of the program.

In looking at the records, which were stripped of employees' personal identifiers, Grazier saw that carve outs had more effect on women than men---for example, they made fewer visits to care givers, and when they did receive care, they more frequently used alternative providers such as social workers, which are less expensive to insurers.

She noted that carve out programs appear to increase access and utilization among both men and women in need of entry-level services. "However, the managed care arrangement significantly reduced access to higher-intensity service use to a greater extent for women than for men. Women with mental health needs were almost twice as likely as men to have health services curtailed beyond the minimal level," Grazier wrote in her study overview.

Grazier said she can't draw conclusions about the quality of care received by women, but said the study does raise the question.

She is now looking at the impact of insurance coverage level on women's treatment, as she believes women in dual-income households where both spouses are insured get different care than those who are single. In those dual-insurance situations, often the coverage from one plan can pick up what's not paid for by the other, making care more affordable.

When You Can Ask Who Can Help Me Heal – The Time Is Right

2010-01-19T08:58:00.001-08:00

When You Can Ask Who Can Help Me Heal – The Time Is Right
January 13, 2010 – 7:54 am

Thoughts about quitting your addiction can pop up at any time. Usually, however, they creep in slowly, gradually taking root until the desire to quit your drug of choice becomes almost unbearable. While it would be wonderful to be able to predict when such an intention to change begins to command more and more of your attention, it just doesn’t happen that way. Some addicts need to lose everything – family, relationships with friends, home, car, job and health – before they grudgingly accept they have a problem. Others come to the realization more quickly after only a few negative consequences. While each person arrives at the decision differently, there’s one thing in common: when you can ask who can help me heal, the time is definitely right.

Addiction: the Long Battle

Sit in on any 12-step group meeting and listen to the stories of the addicts. Whether the addiction is to alcohol or drugs, gambling, eating, sex, overspending, overwork, or a combination of simultaneous addictions, a pattern emerges from the tales that causes other group members to nod in recognition. They’ve been there, or experienced something akin to the kind of misery and misfortune that’s befallen the addict speaking at the time.

This sense of kinship is one of the keys to the success of 12-step groups. The mutual support members provide for each other is transformative. The power of the group support is so important in an addict’s recovery that some members continue to attend meetings for years. Many even give back by serving as group or team leaders, sponsors to new members, or otherwise volunteer to help out.

Everyone knows that addiction is a long battle. In fact, addiction is never over, never cured, never far from the addict’s consciousness. It isn’t something that happened before and can be shoved aside because we’ve somehow got beyond it. Certainly, following treatment, our hope and intention is to put our addictive behaviors behind us and progress with the plan for recovery that we create for ourselves.

Still, we need to remember when we groveled in the pain of our addiction, when we blew our savings and those of our children on gambling or getting high or drowning our sorrows in endless bottles of whiskey or vodka. We have to acknowledge the hurt we’ve done to others and try to make amends. In fact, in order to progress in our recovery, we need to do all this and more by following the Twelve Steps and act according to our group’s Twelve Principles.

Every Addict Deserves Redemption

The core principle of 12-step groups may very well be boiled down to a simple principle: every person, every addict, deserves a chance at redemption. This is not meant in a religious sense, although for many recovering addicts redemption does involve a profoundly spiritual reawakening. Call it redemption, a second chance or starting over. The term itself doesn’t matter. What’s important is that no one is beyond help. No matter how despicable their actions, the abject misery, poor health, financial ruin or other blots on their lives they’ve racked up, everyone has an equal, and deserved, opportunity to change their behavior and chart a new course for the future.

Many addicts fear the judgment and condemnation of others, especially in a group setting, and for that reason they stay away from meetings. This is a mistake. There is no room for condemnation in recovery. Judging others is not conducive to healing, nor is it tolerated.

Attending a 12-step group meeting is simple and easy to do. Look up any of the 12-step groups appropriate to your addiction. Check their websites out and see where meetings are held in your area. Addiction experts recommend you attend at least six meetings of a particular group in order to see whether or not it’s a good fit for you. If not, try another. There are group meetings available online and over the phone, as well as meetings in numerous international locations. In fact, you can get support from your group members wherever and whenever you need it. These are your allies, your lifeline, in your recovery. Don’t be afraid to use it.

How Do You Know You’re Ready?

Okay, so you know there’s a resource available to you in the form of the 12-step groups. And they’re free. There’s never a charge for membership. The only requirement is that you have a genuine desire to quit your addiction.

But how do you know when you’re ready to get help? What are the signs you should look for? Or, are there any? Again, the answers are different for everyone. And, no, this isn’t a copout. Just as the path toward addiction is unique to each individual, so, too, is the path toward recovery. There are, however, some things to look out for that may signal your readiness to change.

• You begin to hate the fact of your addiction.

• You hate yourself and what you’ve done to others as a result of your addiction.

• You’ve lost your family and want to reconnect with them.

• Due to your addiction, you’ve been unable to hold a job, been fired from your job, or quit going to your job – and now you are destitute, or nearly so, and want to do something to remedy the situation.

• People used to look up to you as a role model. But now they turn away in disgust – all as a result of who you’ve become in your addiction.

• You’ve fallen into a deep depression, so much so that you’ve contemplated or attempted suicide as the only way out of your addiction.

• Your life has deteriorated so much that you can’t justify your continued addiction any longer. You feel that perhaps giving treatment a chance may

• You realize you can’t blame your addiction on your failed chances, or excuse it because you’ve been wronged, suffered losses, or had a miserable childhood.

• You begin to understand that you are responsible for your continued addiction.

• While your spouse or family have been after you for years to quit your addiction, it finally occurs to you that you really do want to change your life. You accept that you have a problem, and you want to quit your addiction.

• You admit you cannot quit your addiction on your own.

• You ask for help.

Where to Find Help

Money is often a problem with addiction. Don’t let lack of finances prevent you from seeking help for your addiction, since there is help available. You already know that 12-step meetings are free of charge, and many addicts start off by attending these meetings. The various groups also offer a number of publications, books, pamphlets, workbooks and other literature that can prove helpful. Learning about addiction, the sources and causes, as well as urges and cravings, tools to overcome negative behavior, and how to restructure your life without drugs, alcohol or other addictive behaviors – all are crucial to your early recovery.

But there are other sources of help. Ask your 12-step group sponsor or the group leader for help finding treatment. Talk with your family physician, your minister, or family members and enlist their assistance in finding appropriate treatment. If you really want to get treatment, you will find it. But be prepared to do some serious legwork. You not only need to find treatment for your addiction, you also need to find the right treatment that works for you.

How do you go about this? One good way to start is to use the Substance Abuse Treatment Facility Locator sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). This is a searchable directory of drug and alcohol treatment programs that shows the location of facilities across the country. There are more than 11,000 listings for treatment programs, updated weekly, including residential treatment centers, outpatient treatment programs, and hospital inpatient programs for alcoholism and drug addiction. In addition, listings include treatment programs for cocaine, heroin, and marijuana addiction and for drug and alcohol treatment programs for adults and adolescents. SAMHSA also operates a toll-free 24-hour confidential referral helpline at 1-800-662-HELP (available in English and Spanish), or TDD at 1-800-487-4889.

When you enter the locator site, you’ll also have access to many other links and resources. Check out the frequently asked questions, do a quick search, detailed search or list search. In the quick search, click on a state on the map and enter city or zip code. A street address, if known, can be entered to more precisely center your search. Then, choose a radius for the search. Information returned per facility includes the name, address, and phone number of the facility, distance in miles from your starting location, and the ability to map it. Each listing also includes:

• Primary focus of the facility – such as substance abuse treatment services

• Services provided – such as substance abuse treatment, halfway house

• Type of care – such as residential long-term (more than 30 days) treatment, outpatient

• Forms of payment accepted – such as self-payment

• Payment assistance – if there is payment assistance available, it will say so. Usually, the listing will say “check with facility for details”

• Website URL

The locator site also provides a compilation of State Substance Abuse Agencies. In California, for example, the agency is the Department of Alcohol and Drug Programs, with address, phone and fax numbers, email and link to the agency’s website. State of California Find Treatment Help page includes phone numbers and links to other resources. Other state agency listings have similar information.

SAMHSA also sponsors a Mental Health Services Locator, offering comprehensive information about mental health services and resources available to consumers and their families, the general public, and professionals. Similar to the substance abuse treatment facility locator, the mental health services locator is accessible by clicking on the map or the drop-down menu of states and U.S. territories.

Next Steps

Once you find several listings for treatment facilities in your area, go to their websites to check them out. See what services they provide, and look through all the information available on the site. Make a list of questions to ask and then contact them.

The Partnership for a Drug-Free America lists 13 questions to ask when choosing an addiction treatment program. These include questions on licensing and accreditation, effectiveness of the program’s treatment methods, medication support, aftercare programs and services, relapse prevention, insurance coverage or financial aid, ongoing assessment, individual and group counseling and behavioral therapies, and services and referrals for family members, and other questions. Use these as a starting point for when you contact each facility.

After going through several potential treatment facilities, you should have a better idea of which one seems more appropriate for your particular addiction and situation. Arrange to visit the facility and, if it is a fit, undergo an initial assessment. You are on your way toward entering treatment for your addiction.

What’s Most Important

Having the desire to overcome your addiction and being willing to stick it out, no matter how difficult or unpleasant, is the most important part of entering treatment. Before you can get there, however, you have to be honestly able to ask: Who can help me heal? Once you reach this point, you are ready to embrace a new life – one without reliance or dependence on addictive substances or behaviors.

How long will it take? Think of it this way. Each day is one step closer to recovery. Concentrate on healing, on rebuilding your mind-body-spirit balance, learning new coping methods, improving your communication skills, and charting your future. And, once you are on the path to recovery, think about giving back to others who may be just beginning their journey – just like you did. You may one day be the inspiration that helps another addict who has finally found the courage to ask: Who can help me heal?

CHRONIC ALCOHOL CONSUMPTION

2010-01-19T08:56:00.000-08:00

Chronic Alcohol Consumption Impairs Formation of New Brain Cells

A new study found that chronic alcohol consumption reduces the number of new brain cells that form in the hippocampus of adolescent rhesus monkeys. This finding suggests that these cells are vulnerable to alcohol and their presence may be essential for preventing alcohol dependence.

Science Daily reports that the findings were presented at Neuroscience 2009, the annual meeting of the Society for Neuroscience and the world’s largest source of emerging news about brain science and health.

“We’ve found a potential mechanism for alcohol’s harmful effects on the hippocampus and other brain regions associated with executive function and memory,” said Chitra Mandyam, PhD, of the Scripps Research Institute in San Diego and lead author of the study. “This may lead to more effective medications for helping alcoholics overcome their addiction.”

In this study, male rhesus monkeys (aged four to five years early in the study and five to six years at the end) were allowed to voluntarily consume a Tang-sweetened solution containing 6 percent alcohol during one-hour sessions, Monday through Friday. A control group of monkeys had similar access to alcohol-free Tang. The alcohol group consumed an average of 1.78 g/kg of alcohol per session.

After five months the primates’ brain tissue was analyzed, with careful attention to sections containing the hippocampus for signs of neurogenesis, or creating of new brain cells.

The researchers found that chronic alcohol consumption significantly altered neurogenesis in the region of the hippocampus that produces self-renewing neural stem cells. Specifically, the alcohol-consuming monkeys exhibited a 58 percent decrease in proliferation (stem cell birth) and a 63 percent decrease in differentiation and neurogenesis (stem cell survival).

“Our results demonstrate that in addition to causing existing cells to degenerate, excessive alcohol keeps new stem cells from forming,” Mandyam said.

Research was supported by the National Institutes of Health.

COLLEGE BING DRINKING

2010-01-19T08:53:00.000-08:00

College Binge Drinking & Hazing: An Emerging Epidemic
January 12, 2010 – 7:01 am

For American youngsters, moving away to college is a rite of passage the likes of which will never be experienced again in their lifetimes. Faced with sudden, unlimited freedom, college freshmen everywhere drink themselves into oblivion whenever they can afford to. Pregame tailgating, post-exam celebrations, happy hours, and fraternity and sorority mixers just wouldn’t be the same without alcohol. Weekends start on Thursday night, “chugging” is encouraged, and lifelong reputations for being able to “drink anyone under the table” are made or lost during this phase of adolescent development. Sadly, students think that drinking is the one and only way to socialize with friends and classmates.

Binge drinking is defined as four to five drinks in one sitting to the point of putting your health and safety in danger. The tragedies of binge drinking do not always occur in as a direct result of alcohol poisoning or cardiac arrest. At Virginia Tech, 19-year-old Mindy Somers fell eight stories to her death after waking up from sleeping off a bender and rolling out of her dorm room window. Mindy had passed out, fully clothed, after binge drinking and was found to have drunk the equivalent of five beers in an hour.

Fraternities and sororities bear the brunt of the blame for the phenomenon of “binge” drinking, probably because they deserve it. Sixty-five percent of members of the Greek system self-report as binge drinkers. Not only does the Greek system play host to the majority of on-campus parties, but older members frequently “haze” new recruits by encouraging or demanding rapid consumption of alcohol in a short period of time in order to determine who is “man” enough to become their frat brother. Binge drinking is not a phenomenon restricted solely to college-age boys; females are guilty of overindulging too.

When identifying who should be responsible for stopping such incredibly dangerous behavior, college administrators are well aware that they are at the head of the line. Perhaps in an effort to deflect some of the blame, colleges are now embracing the notion that reducing the drinking age will end binge drinking. In the United States, people must be 21 in order to consume alcoholic beverages. The regulation stems largely from the fact that the federal government will not give federal highway money to any state that allows people under 21 to drink. College presidents from 100 of the US’s top universities have banded together, calling on lawmakers to consider lowering the drinking age to 18, citing evidence that the current age of 21 encourages dangerous binge drinking on campuses. Founders of the “Amethyst Initiative” claim that adolescents feel that the law is unjust, unfair and discriminatory and routinely ignore it. The name stems from a Greek myth that the amethyst could ward off drunkenness if used in cups and jewelery. However, opponents such as Mothers Against Drunk Driving (MADD) fear that lowering the drinking age will result in more car crashes and accuse the college presidents of looking for a way to evade responsibility for a phenomenon which is largely under their power to control.

Neither side would disagree, however, that binge drinking is a big problem on college campuses. Studies show that 4 out of 10 college students report at least one symptom of a problem with alcohol. It is estimated that half a million students suffer drinking-related injuries each year; 1700 die as a result. One argument in favor of lowering the drinking age is that by the time the 18 year old gets to college, the novelty of being able to drink non-stop may have already worn off.

Such “binge” drinking can have severe consequences on the student’s health and even lead to death. In 1997 at Lousiana State University (LSU) at Baton Rouge, new pledges to the Sigma Alpha Epsilon fraternity looked forward to a night of heavy drinking and began the festivities with a kegger. The party moved to a bar; after heavy drinking and throwing up into strategically placed trash cans pledges were taken back to the frat house to “sleep it off”. However, the night would end badly for Donald Hunt, 21, and his friend Benjamin Wynne, 20.

Paramedics were called to the house around midnight and encountered a dozen college kids sprawled out in the living room, reeking of alcohol. Paramedics were unable to wake four of the pledges and Benjamin Wynne was in cardiac arrest with a BAC of .588, the equivalent of 21 shots an hour. Donald Hunt was also in rough shape, nearly dying from the alcohol poisoning that would claim his friend’s life.

Leslie Baltz, a senior at the University of Virginia, fell down a flight of stairs after drinking too much and died. Even more horrifying was the story of Lorraine Hanna, a freshman at Penn who was found dead by her twin sister after having been left alone after a New Year’s Eve party. Toxicology reports found her blood alcohol content to be .429 (over five times the legal limit permitted for operating a motor vehicle).

Binge drinking and underage partying is no longer limited to college campuses. High school students, and even middle school students, party every weekend, and on weeknights too.

In 2006, the Haddonfield Board of Education in New Jersey created the “24/7″ policy, whereby any student arrested for drug or alcohol use, whether or not on school grounds, would be suspended from sports and other extracurricular activities.

A female student recently filed suit challenging the “24/7″ rule, arguing that the board has no right to regulate off-campus activities. Under federal law, school districts cannot suspend students from classes for illegal activity that occurs off campus. However, they may restrict participation in after-school activities as they are a privilege, not a right. Some argue that the “24/7″ rule punishes only those students who actually participate in extracurricular activities, allowing others to avoid punishment. Parents argue that extracurricular activities are necessary for college applications and that the school board is treading on areas normally reserved for parental regulation. Apparently, the school board feels that the parents are not doing such a great job.

http://www.philly.com/philly/news/local/80492882.html

http://www.rd.com/living-healthy/binge-drinking-on-campus/article15309.html

http://www.nysun.com/national/college-presidents-want-lower-drinking-age/84123/

California adopts stricter rules for drug abusers in the health industry

2009-11-20T07:55:00.000-08:00

Nurses, dentists and other professionals with addictions will be subject to more drug tests, and any restrictions to their licenses will be listed on public websites.

In a major shift, California will impose tough new standards on drug-abusing health professionals, strictly scrutinizing those in treatment and immediately removing from practice anyone who relapses.

"The bottom line is we're in the business of protecting consumers," said Brian Stiger, director of the state Department of Consumer Affairs, which announced the rules Thursday. "We're not in the business of rehabilitation."

The rules will require nurses, dentists and other health workers in state-run recovery programs to take at least 104 drug tests in their first year -- more than double any current requirement.

Health professionals will be automatically pulled from practice, at least temporarily, after a single positive result. And any restrictions to their licenses will be listed on public websites, easing the long-standing confidentiality protections that have shielded participants and kept their patients in the dark.

The changes appear to address problems raised in a July investigation by The Times and the nonprofit newsroom ProPublica, which detailed how registered nurses were able to treat patients without permission and steal drugs while participating in the confidential recovery program known as diversion.

Even when the state Board of Registered Nursing kicked them out, labeling them "public safety risks," it took a median 15 months to file public accusations, the investigation found.

The standards were drafted by a committee created by the Legislature last year after repeated audits revealed that the recovery program for doctors poorly monitored participants and failed to terminate those who relapsed. The Medical Board of California shut down that program June 30, 2008.

Until now, each of the state's 21 health licensing agencies determined its own policies for dealing with professionals who had substance abuse problems.

The new rules would apply directly to the seven boards that operate diversion programs, in which licensees avoid discipline by agreeing to drug tests, support group meetings and heightened monitoring.

More than 300 people entered those programs in fiscal 2008; many more have been enrolled on a long-term basis.

But the rules also would apply more broadly, even to the medical board and other agencies without diversion programs, if a licensee has been placed on probation for a substance abuse problem.

Julianne D'Angelo Fellmeth, who audited the medical board's program, said the changes address gaping holes in the oversight of potentially dangerous caregivers.

"The state is finally taking responsibility for protecting the public," said D'Angelo Fellmeth, administrative director of the Center for Public Interest Law at the University of San Diego. "The state not only is taking control, but instituting pretty strict and strong standards."

But Ellen Brickman, president of the National Organization of Alternative Programs and director of Statewide Peer Assistance for Nurses in New York, said she was concerned that the new rules would keep addicted health professionals from seeking help, driving the problem underground.

"I'm listening to this and I'm cringing," she said. "I'm not optimistic that this is going to work the way they want it to. It won't keep people from abusing substances. It will keep them out of the system, where they'll be sicker before anybody can do anything about it."

Diversion programs, used in many states, were designed to encourage health workers to fight their addiction in a safe environment without ruining their careers.

D'Angelo Fellmeth said those who want to pursue confidential treatment still can enter private programs. Many turn to state-run programs, she said, only to avoid discipline -- because they are on the verge of being turned in by their employers or have been arrested in or convicted of drug- or alcohol-related offenses.

Among the new standards:

* Licensees suspected of drug abuse must undergo a clinical evaluation at their own expense to determine whether they can still practice safely. During this process, their licenses will be placed on inactive status, meaning they cannot work, and they must submit to drug tests twice a week. They can't return to work until they have at least one month of negative test results.

During their first year of participation, professionals will be randomly tested at least 104 times. After that, it drops to at least 50 times annually. Current programs require testing only 12 to 52 times, Stiger said.

* For the first time, the public will be able to review any restrictions placed on a health professional. Boards won't be allowed to directly say that someone is in substance abuse treatment, but they must publicly disclose that a person has an inactive license or is subject to increased supervision or limited work hours.

If someone is kicked out of the program, disciplinary proceedings will begin immediately, Stiger said. "If you have a major violation," such as use of a banned substance, "thou shalt not practice," he said.

Some states have gone even further than California. North Carolina, for instance, immediately suspends the licenses of nurses for a minimum of one year after a single relapse.

In California, all boards will be required to provide detailed information on their performance to the Legislature and the Department of Consumer Affairs.

The committee that drafted the new rules is calling for each program to successfully graduate every participant, but Stiger said officials haven't determined the consequences if they don't.

Last year, the nursing board's program had a 59% graduation rate.

The new standards are part of a broader effort to revamp the disciplinary process for health professionals in the state, speeding it up and prioritizing the most serious cases. To that end, Stiger appointed Paul Riches to a new post of deputy director for enforcement and compliance. Riches was previously executive officer of the Board of Behavioral Sciences.

The timetable for the new standards has not been finalized. The standards are due to the Legislature by Jan. 1, and boards will be asked to implement them afterward. Lawyers are still reviewing whether certain rules will require formal approval by the Legislature, Stiger said.

If these diversion programs cannot prove their worth soon, they could be eliminated, according to proposals under consideration.

"Quite frankly, we don't run them very well," Stiger said. "What we do well is enforce the law and that's where we need to be."

Attitude of Gratitude

2009-11-18T17:57:00.000-08:00

Google Reader (364): "True friendship comes when silence between two people is comfortable. ~Dave Tyson Gentry

Today I am grateful…

* for the dawning of a new day and the discomforts of yesterday are lessened
* that the world is full of inspiration, al kinds, when I am willing to see it
* that it almost feels like winter outside this morning
* for spiritual maintenance, both comfortable and uncomfortable
* that I have today what I never thought would be available to me, a drunk

If you were walking back from a well, carrying a bucket of water & someone jostled you, there could be spilled from the bucket only that which it contained. As you walk along the way of life, people are constantly bumping into you. If your heart is full of ill nature, bad temper, and ugly disposition, only those things will be spilled from it. On the other hand, if it is full of love, you will spill a smile or pleasant remark. You can spill from your bucket only that which it contains. ~Author Unknown"

The Link Between Genetics & Addiction

2009-11-13T13:48:00.000-08:00

Brentwood, TN 11/13/2009 08:50 PM GMT (TransWorldNews)

Will it one day be possible to customize our kids, ordering up offspring with specific traits and free of risk factors for certain diseases?

As geneticists make new strides, it’s possible that in the near future average individuals will be able to choose what genetic traits their children receive. Boy or girl? Blonde or brunette? Tall or short? Prone to addiction or not?

Wait! What was that last option?

Scientists are already looking for an “addiction gene,” a biological difference that makes one person more vulnerable to addiction than the general population. If it’s possible in the future to order up offspring without a high risk of heart disease or obesity, wouldn’t it follow that doctors would also be able to remove the addiction gene from a baby’s DNA before it’s born?

“Scientists will never find just one single addiction gene,” Learn.Genetics insists. “Susceptibility to addiction is the result of many interacting genes … Like other behavioral diseases, addiction vulnerability is a very complex trait. Many factors determine the likelihood that someone will become an addict.”

While addiction is certainly more than just genetics, there are certain genes thought to be more responsible than others. Check out these study results from Learn.Genetics:

· The A1 allele of the dopamine receptor gene DRD2 is more common in people addicted to alcohol or cocaine.

· Increased expression of the Mpdz gene results in mice experiencing less severe withdrawal symptoms from sedative-hypnotic drugs such as barbiturates.

· Mice bred to lack the cannabinoid receptor gene Cnr1 have a reduced reward response to morphine.

· Mice bred to lack the serotonin receptor gene Htr1b are more attracted to cocaine and alcohol.

· Mice with low levels of neuropeptide Y drink more alcohol, whereas those with higher levels tend to abstain.

· Fruit flies mutated to be unable to synthesize tyramine remain sedate even after repeated doses of cocaine.

· Mice mutated with a defective Per2 gene drink three times more alcohol than normal.

· Non-smokers are more likely than smokers to carry a protective gene, CYP2A6, which causes them to feel more nausea and dizziness from smoking.

· Alcoholism is rare in people with two copies of the ALDH*2 gene variation

· Mice with the Creb gene "knocked-out" are less likely to develop morphine dependence.

Whatever genetic mix you inherit, addiction isn’t a foregone conclusion. Just because your genetic makeup may put you at greater risk of addiction, it doesn’t doom you to inevitably become an addict. “Environment makes up a large part of addiction risk,” Learn.Genetics reminds us. And beyond all the genetics, there is one much more common trait that everyone with a drug addiction or alcohol problem has in common: At some point in time, they choose to use.

EXPANDING DRUG TREATMENT

2009-11-13T11:12:00.001-08:00

Expanding drug treatment: Is US ready to step up?

By DAVID CRARY (AP) – 4 days ago

NEW YORK — Based on the rhetoric, America's war on drugs seems poised to shift into a more enlightened phase where treatment of addicts gains favor over imprisonment of low-level offenders. Questions abound, however, about the nation's readiness to turn the talk into reality.

The economic case for expanding treatment, especially amid a recession, seems clear. Study after study concludes that treating addicts, even in lengthy residential programs, costs markedly less than incarcerating them, so budget-strapped states could save millions.

The unmet need for more treatment also is vast. According to federal data, 7.6 million Americans needed treatment for illicit drug use in 2008, and only 1.2 million — or 16 percent — received it.

But the prospect of savings on prison and court costs hasn't produced a surge of new fiscal support for treatment. California's latest crisis budget, for example, strips all but a small fraction of state funding away from a successful diversion and treatment program that voters approved in 2000.

"It's easy to talk a good game about more treatment and helping people," said Scott Burns, executive director of the National District Attorneys Association. "But it smashes head on into reality when they don't put their money where their mouth is."

Money aside, the treatment field faces multiple challenges. At many programs, counselors — often former addicts themselves — are low-paid and turnover is high. Many states have yet to impose effective systems for evaluating programs, a crucial issue in a field where success is relative and relapses inevitable.

"Fifty percent of clients who enter treatment complete it successfully — that means we're losing half," said Raquel Jeffers, director of New Jersey's Division of Addiction Services. "We can do better."

The appointment of treatment expert Tom McLellan as deputy director of the White House Office of National Drug Control Policy in April was seen as part of a shift of priorities for the drug czar's office.

McLellan said he sees greater openness to expanding treatment but also deep misunderstanding or ignorance about scientific advances in the field and the need to integrate it into the health care system.

Most Americans, he suggested, have an image of drug treatment formed from the movies — "cartoon treatment" involving emotional group encounters — and are unaware of a new wave of medications and other therapies that haven't gained wide use despite proven effectiveness

"For the first time, it can truly be said that we know what to do — we know the things that work," he said. "But do we have the economic and political willingness to put them into place? If we do, we'll see results."

McLellan, insisting he's not "a wild-eyed liberal," said expanding treatment wouldn't negate the war on drugs.

"Law enforcement is necessary, but it's not sufficient," he said. "You need effective preventive services, addiction and mental health services integrated with the rest of medicine. You shouldn't have to go to some squalid little place across the railroad tracks."

By federal count, there are more than 13,640 treatment programs nationwide, ranging from world-class to dubious and mostly operating apart from the mainstream health-care industry.

Dr. H. Westley Clark, director of the federal Center for Substance Abuse Treatment, said his agency wants states to develop better measurements of programs' performance.

"The data shows treatment saves money — $1 spent to $4 or $7 saved," Clark said. "If you're an altruist, making treatment available is a good thing. If you're a narcissist, it's a good thing — you'd pay less in taxes."

Treatment advocates are closely watching Congress, hoping the pending health care overhaul will expand insurance coverage for substance abuse programs. Recent federal data indicates that 37 percent of those seeking treatment don't get it because they can't pay for it — and many land in prison.

The work force in drug treatment is, for the most part, modestly paid, with counselors often earning less than the $40,000 per year that it costs to keep an inmate in prison in many states.

"Some of the stigma that goes with addiction adheres to the staff as well," Jeffers said. "Most agencies are trying to do right — but the field is getting increasingly complicated. The business skills that are needed aren't always the same skills that make a good clinician."

Yet generally, front-line counselors win high praise — especially the ex-addicts who bring savvy and credibility to the job.

"People in the field weren't driven to it by the money or glamour, but often by personal experience or that of a loved one," said Keith Humphreys, a treatment expert from Stanford University now working for the drug czar's office. "They may not have the fanciest degrees, but they are incredibly caring."

Garnett Wilson served prison time for armed robbery in the 1980s and now — at 61 — has two decades of drug counseling under his belt as a valued employee of the Fortune Society, which provides support services to ex-offenders in New York City.

As he cajoles the men in his groups, he strives to remember his own battle to change.

"Some of the people who've been through it become too rigid," he said. "Preaching doesn't work. They forget how hard it is to rise above your environment, and they alienate the people they're trying to help."

Wilson says he focuses his efforts on "those guys that are ready."

Perhaps Joe Smith is one of them.

A 29-year-old from Brooklyn, Smith recently served eight months in prison for a weapons offense and was a heavy marijuana user, but now — studying and job-hunting — says he's determined to go straight.

"It's been kind of tough," he said. "The hardest part is just to come to it every day, but when you come to think about it, it's not so hard — because if you don't, it's back to jail."

Another client, Ronnie Johnson, has been back in New York City barely a month after more than a decade in prison upstate.

"It's like family here — everybody's supportive," said Johnson, 39, contrasting the Fortune Society staff with drug treatment workers in prison who were "just doing it for a paycheck."

In the years ahead, New York may serve as a test case for the potential to expand treatment programs.

Earlier this year, its legislature approved sweeping reforms of harsh drug laws enacted in 1973 under Gov. Nelson Rockefeller.

The changes mean that thousands of nonviolent offenders who would have faced long, mandatory prison terms will be diverted to treatment. Even in a difficult financial climate, the state is allocating $50 million to boost treatment programs.

"New York will now treat addiction as a health concern and focus on treating the disease, rather than locking up the patient," said Karen Carpenter-Palumbo, commissioner of the state's Office of Alcoholism and Substance Abuse.

Her office oversees one of nation's largest addiction service systems, with some 1,550 programs serving more than 110,000 people a day. Yet that caseload represents only 15 percent of those needing treatment. An estimated 80 percent of the 60,000 offenders in New York's prisons have substance abuse problems.

As the system expands, Carpenter-Palumbo is working with treatment providers on new standards. If the field wants to be a full partner in the medical community, she said, it must be ready for rigorous evaluation.

Problems can range from inadequate staff levels to fraud to the simple lack of a warm welcome when clients first visit.

"Any person with an addiction, if you give them an excuse, they'll run," she said.

Paul Samuels of the Legal Action Center, a public interest law firm, hopes New York and other states will reduce the criminal justice system's role in determining details of treatment, such as whether an addict should be given methadone or other medication.

"That would be like a judge determining the kind of treatment you get for heart disease," he said. "It really should be decided by treatment experts."

The Rockefeller law reforms foretell a potential boom for organizations like Odyssey House, a New York City nonprofit.

It serves 300 people — young mothers, senior citizens, ex-convicts and others — at a residential treatment center in East Harlem. At another site, run by the state corrections department, Odyssey House has just taken over a treatment program for offenders who abused drugs in violation of parole.

Darrin Brown, who runs that program, says one challenge is convincing prison staff that treatment has merits.

"It's up to us to win them over," Brown said. "Their attitude is changing for the better — they can see the results."

Peter Provet, CEO of Odyssey House, says most of the East Harlem clients stay nine months or more, in a comprehensive program that costs $20,000 per year per client.

"You're talking about some of the most deprived, abused individuals there are," he said. "Part of our struggle, for years, is to get others interested in these people."

Among them is Clinton Goodwin, 59, who started dealing drugs at 19. Since then, he's served four stints in prison and been arrested five times, mostly recently in May. As an alternative to prison, he was given the option of participating in the Odyssey House program for at least 18 months.

Twenty years ago, serving time in Virginia, he entered a treatment program that failed to produce lasting change. "Nothing in it put me to the test," he said. "I kind of manipulated it.

"I might be more receptive now — I have daughters and grandchildren, and I don't want to betray them again," he said. "I know it can work for me — if I'm ready for it."

Some addicts prefer prison to a rigorous treatment program, said Provet. Others adjust only gradually.

Mary Celestino, 66, was arrested a year ago when officers found cocaine in her apartment, and entered Odyssey House in January in lieu of two years in prison.

"They're telling you what to do, when to get up, when to eat, when to sleep," she said. "I'm still trying to get used to it."

New York stands in contrast to many other states, where the push for more treatment has been undercut by the recession.

In fiscally troubled California, state funding for a landmark drug treatment program has fallen from $145 million three years ago to $18 million in the latest budget.

The result is limbo for many nonviolent offenders who, under terms of a 2000 ballot measure, are supposed to get treatment as an alternative to prison. There's now little space available as programs retrench, and experts worry that some offenders on waiting lists will lapse into crime.

"They end up being basically out on the street," said Thomas Renfree, executive director of the County Alcohol and Drug Program Administrators Association of California. "If they can't get into treatment right way, you're going to lose some of them."

Renfree says the diversion program had been highly successful — saving up to $4 for every dollar spent and diverting 36,000 people to treatment each year.

"There's a lot of lip service paid to it," he said. "But even some of those who think it's a good idea aren't willing to kick in the resources."

Meanwhile, California's corrections department has had to slash $250 million worth of rehabilitation services, forcing cutbacks in a drug treatment program that had sharply reduced recidivism rates.

Treatment advocates say their efforts to lobby for scarce funds often lag behind those of law enforcement.

"The treatment community has never been as effective — they're not as aggressive, not as well organized," said Margaret Dooley-Sammuli, the Drug Policy Alliance's deputy state director in Southern California. "If those two go at it, fighting for resources, who's going to win?"

Scott Burns, of the National District Attorneys Association, said many law enforcement officials are increasingly open to treatment, but not at the expense of their anti-crime budgets.

"There's always been competition between law enforcement and the treatment community for funds," Burns said. "Legislatures, and to some degree the federal government, talk a lot about how important treatment is, but somehow never seem to fund it at the levels people in the field feel they must have to make a difference."

NEW ALCOHOLISM DRUG

2009-11-13T11:09:00.000-08:00

New alcoholism drug gives addicts a chance
by Alonzo Weston
Friday, November 13, 2009

David More ran away from home at 9. He experimented with drinking at 13. When he turned 17, his brother, after getting into a scuffle with him, committed suicide with their father’s pistol.

By the time he was 21, the Independence, Mo., man said he was pretty much an alcoholic.

“That’s when my experimenting went into overdrive,” Mr. More said. It got even worse in his 20s, when his son was killed in a car wreck.

For 37 of his 50 years on earth, Mr. More said he’s had troubles with the bottle. Only a few stints in prison kept him sober. That was until after he came to Family Guidance Center’s addiction treatment services in August, and he began taking a new drug to help curb his alcohol cravings.

Mr. More received his first shot of Vivitrol five weeks ago. He’s now looking forward to his second, he said.

“I don’t have cravings. Every time before, I always went back,” Mr. More said. “This time around, there is absolutely no craving.”

Vivitrol is a new, extended-release, injectable form of Naltrexone for the treatment of alcohol dependence. It works by blocking the opiate receptors and pleasure centers in the brain, which in turn makes alcohol use less rewarding. One Vivitrol injection lasts 30 days.

Family Guidance Center’s addiction treatment services began offering Vivitrol for its clients in September. Currently, 12 of their treatment center clients are voluntarily taking the medication, said Myra Trickey, Family Guidance Center vice president. Clients wishing to try Vivitrol have to undergo a physical exam, urinalysis and lab work to be sure they’re able to take the drug.

“Vivitrol is not right for every person,” Ms. Trickey said. “If you’ve got liver disease or hepatic failure of any type, this is not for you. You also cannot have any opioids (narcotic pain medication) in your system, because it could kill you.”

Of the 200 clients enrolled in the treatment program, half are there for alcohol dependence.

According to a 2004 Substance Abuse and Mental Health Services Administration (SAMHSA) study, alcohol dependence is a growing problem in Missouri.

The study showed there were 13,266 admissions in Missouri where a person’s primary drug of choice was alcohol. That figure was higher than in Kansas, with 6,761 admissions, Iowa with 13,250 and Nebraska with 10,871.

Leo Hammel, treatment services program manager, said Vivitrol has an excellent success rate. The focus date is for six to 18 months of use, but some people have been on the medication for four years and have not had any side effects.

“I’ve had clients use alcohol while on Vivitrol, and they said they just fall asleep. They don’t get any pleasure whatsoever,” Mr. Hammel said.

Mr. More said the Vivitrol, plus the classes at the Family Guidance Center and Alcoholics Anonymous meetings all contribute to his sobriety. His goal is to eventually become an alcohol treatment counselor.

“If you abuse alcohol, there is no other choice,” Mr. More said. “With Vivitrol, active AA sponsorship and counseling, you stand more than just a chance.”

Alonzo Weston can be reached

at alonzow@npgco.com.

ALCOHOL BLACKOUTS

2009-11-13T11:02:00.000-08:00

Alcohol, Memory Blackouts and the Brain
By National Institute of Health

Most of the research conducted on blackouts during the past 50 years has involved surveys, interviews, and direct observation of middle-aged, primarily male alcoholics, many of whom were hospitalized. Researchers have largely ignored the occurrence of blackouts among young social drinkers, so the idea that blackouts are an unlikely consequence of heavy drinking in nonalcoholics has remained deeply entrenched in both the scientific and popular cultures. Yet there is clear evidence that blackouts do occur among social drinkers. Knight and colleagues observed that 35 percent of trainees in a large pediatric residency program had experienced at least one blackout. Similarly, Goodwin reported that 33 percent of the first-year medical students he interviewed acknowledged having had at least one blackout. "They were inexperienced," he wrote. "They drank too much too quickly, their blood levels rose extremely quickly, and they experienced amnesia". In a study of 2,076 Finnish males, Poikolainen found that 35 percent of all males surveyed had had at least one blackout in the year before the survey.

As might be expected given the excessive drinking habits of many college students, this population commonly experiences blackouts. White and colleagues recently surveyed 772 undergraduates regarding their experiences with blackouts. Respondents who answered yes to the question "Have you ever awoken after a night of drinking not able to remember things that you did or places that you went?" were considered to have experienced blackouts. Fifty-one percent of the students who had ever consumed alcohol reported blacking out at some point in their lives, and 40 percent reported experiencing a blackout in the year before the survey. Of those who had consumed alcohol during the 2 weeks before the survey, 9.4 percent reported blacking out during this period. Students in the study reported that they later learned that they had participated in a wide range of events they did not remember, including such significant activities as vandalism, unprotected intercourse, driving an automobile, and spending money.

During the 2 weeks preceding the survey, an equal percentage of males and females experienced blackouts, despite the fact that males drank significantly more often and more heavily than females. This outcome suggests that at any given level of alcohol consumption, females - a group infrequently studied in the literature on blackouts - are at greater risk than males for experiencing blackouts. The greater tendency of females to black out likely arises, in part, from well-known gender differences in physiological factors that affect alcohol distribution and metabolism, such as body weight, proportion of body fat, and levels of key enzymes. There also is some evidence that females are more susceptible than males to milder forms of alcohol-induced memory impairments, even when given comparable doses of alcohol.

In a subsequent study, White and colleagues interviewed 50 undergraduate students, all of whom had experienced at least one blackout, to gather more information about the factors related to blackouts. As in the previous study, students reported engaging in a range of risky behaviors during blackouts, including sexual activity with both acquaintances and strangers, vandalism, getting into arguments and fights, and others. During the night of their most recent blackout, most students drank either liquor alone or in combination with beer. Only 1 student out of 50 reported that the most recent blackout occurred after drinking beer alone. On average, students estimated that they consumed roughly 11.5 drinks before the onset of the blackout. Males reported drinking significantly more than females, but they did so over a significantly longer period of time. As a result, estimated peak BACs during the night of the last blackout were similar for males and females. As Goodwin observed in his work with alcoholics, fragmentary blackouts occurred far more often than en bloc blackouts, with four out of five students indicating that they eventually recalled bits and pieces of the events. Roughly half of all students indicated that their first full memory after the onset of the blackout was of waking up in the morning, often in an unfamiliar location. Many students, more females than males, were frightened by their last blackout and changed their drinking habits as a result.

Use of Other Drugs During Blackouts

Alcohol interacts with several other drugs, many of which are capable of producing amnesia on their own. For instance, diazepam (Valium®) and flunitrazepam (Rohypnol) are benzodiazepine sedatives that can produce severe memory impairments at high doses. Alcohol enhances the effects of benzodiazepines. Thus, combining these compounds with alcohol could dramatically increase the likelihood of experiencing memory impairments. Similarly, the combination of alcohol and THC, the primary psychoactive compound in marijuana, produces greater memory impairments than when either drug is given alone. Given that many college students use other drugs in combination with alcohol, some of the blackouts reported by students may arise from polysubstance use rather than from alcohol alone. Indeed, based on interviews with 136 heavy-drinking young adults, Hartzler and Fromme concluded that en bloc blackouts often arise from the combined use of alcohol and other drugs. White and colleagues observed that, among 50 undergraduate students with a history of blackouts, only 3 students reported using other drugs during the night of their most recent blackout, and marijuana was the drug in each case.

BINGE DRINKING DAMAGES BRAIN - NOVEMBER 10, 2009

2009-11-10T12:35:00.000-08:00

Nearly half of students at four-year colleges do it regularly (and, it's not sex). Rather, it's binge drinking -- downing five or more alcoholic drinks at a sitting.

"People have a hard time identifying alcohol as a drug," said Jenny Hwang, associate dean of students and director of the counselling centre at Stony Brook University on Long Island, NY. In fact, she said, heavy drinking is glamorised as a rite of passage in college years.

But it's a dangerous rite.

The death toll from alcohol has been rising among US college students. According to the US National Institute on Alcohol Abuse and Alcoholism, alcohol-related deaths have increased in this group from 1 440 in 1998 to 1 825 less than a decade later, in 2005.

Even if the binge drinking doesn't result in death, Hwang and others emphasise, the risks can be great. In a study published in April, researchers from San Diego reported that young people who binge drink can seriously damage the white matter in their brain, which is crucial for relaying information between brain cells.

Brain damage noticed in young drinkers
Though damage to white matter has long been observed in the brains of adult alcoholics, the researchers expressed surprise at seeing it in young drinkers.

Because of such dangers and the rising death toll, Hwang and other college officials across the United States have taken action, putting into place peer programs and educational outreach to try to stem the tide of drinking-related hazards.

College officials also have begun to reach out to bars near their campuses to enlist their help in the effort. Parents of college students can help as well, experts said, by making sure their college-age offspring are aware of the dangers and don't become a statistic.

"You want to try to reach students before they get to a state where they are in an emergency, such as an alcoholic overdose," said Shirley Haberman, director of GatorWell Health Promotion Services at the University of Florida, in Gainesville.

Her department tries to be proactive, she said, getting the word out that binge drinking is risky drinking and letting students know how to help when fellow students might need emergency care. New students, she said, are given a brochure developed by the alcohol industry that encourages responsible drinking.

Anti-drinking programme launched
In the surrounding community, Haberman said, the city council has worked to encourage bars and taverns to be responsible by ensuring, for instance, that patrons are 21 or older.

At Stony Brook, it took a tragedy to inspire an anti-binge-drinking programme. The college-age son of a long-time faculty member died of acute alcohol poisoning while attending a university in the Midwest.

This past spring, Hwang and others created a peer-training programme that teaches students to recognise dangerous symptoms of intoxication and to call 911 when needed.

Students who complete the four-hour program, which also includes CPR training, learn that letting those who are drunk and passed out sleep it off is not the safe or wise thing to do, Hwang said. It's called the Red Watch Band Program because those who complete it are given a red watch to wear to show they are part of the programme.

Among the students who've signed up for the programme so farm, "many of them are concerned about their friends," Hwang said. Some have called 911, and others have distracted friends headed to a party where heavy drinking was expected by suggesting alternate activities.

More than 20 other colleges are planning to launch the programme, she said.

How can parents help? For starters, don't share your own war stories of college drinking, Hwang urged. Parents can also discuss the legal problems associated with underage drinking and encourage their offspring to look out for their friends.

Also keep an ear out when visiting colleges, she added.

"When parents shop around for colleges, they really should be able to find out what kind of policies, practices [each has] to address the national problem of alcohol," Hwang said. And if college officials claim there is not problem? "I would say they are not being fully honest," she said. – (HealthDay News, November 2009)