Older People at Greater Risk for Alcohol Impairment

Older People May Be at Greater Risk for Alcohol Impairment than Teens, According to Baylor Study

An acute dose of alcohol may cause greater impairment in coordination, learning and memory in the elderly than in young people, according to a study by Baylor University.

Researchers said the findings have profound significance for older people –a population that is aging worldwide at an unprecedented rate and that includes Baby Boomers as they become senior citizens.

“Health implications such as falls, accidents and poor medicine-taking are pretty easy to conclude,” said Douglas B. Matthews, Ph.D., senior author of the paper, published online in the journal Alcoholism: Clinical and Experimental Research. April is Alcohol Awareness Month.

In the United States, as many as 13 percent of men and 8 percent of women over age 65 engage in risky drinking behavior, with an estimated 1 to 3 percent of those afflicted with an alcohol use disorder, according to prior research. Because of improvements in medicine and public health, nutrition and education, people 65 and older will account for 20 percent of the U.S. population by the year 2030, according to U.S. Census Bureau estimates.

While previous data have indicated that aged people show significantly greater impairments than younger adults when alcohol is consumed, understanding the neurobiology underlying that increased sensitivity in the aged has been hampered by the lack of an adequate animal model, said Matthews, a research scientist in psychology and neuroscience in Baylor’s College of Arts & Sciences and head of psychology at Nanyang Technological University in Singapore.

The Baylor research, the first of its kind, established a baseline of the acute effects of alcohol in aged populations, which can aid future research into neurobiology and in determining the effect of prolonged alcohol abuse.

The experiment included adult and aged rats (at least 18 months old), Matthews said. It showed a dramatic increase in ethanol-induced ataxia.

“We know a lot of neurobiological changes occur during aging which underlie age-related cognitive and behavioral deficits. It’s reasonable to suspect a significant interaction exists between age-related and alcohol-induced effects in the brain,” said Jim Diaz-Granados, Ph.D., a study co-author, chair of Baylor’s department of psychology and neuroscience, and chair of the Council of Graduate Departments of Psychology, a national organization.

“Our hope would be that further findings in this area will serve as a basis to educate the public regarding the risks and provide insights in the clinic,” Diaz-Granados said.

Findings were presented at the Research Society of Alcoholism conference in San Francisco. Also conducting research in the study was Adelle Novier, a doctoral student in psychology and neuroscience at Baylor.

The Genetics of Alcoholism

Is Alcoholism due to Nature or Nurture

Why can some people have a glass of wine or beer with their meal without feeling compelled to drink more, whereas others can’t seem to stop drinking? Can some people “hold” their liquor better than others? Does alcoholism tend to run in families? Does genetics hold the key to developing medications to treat alcoholism and its effects on the body? Researchers have been trying to find answers to questions such as these for several decades, seeking to identify the factors that influence a person’s risk of becoming alcohol dependent.

Research, to date, indicates that both your genetic makeup (i.e., the information stored in the DNA that you inherited from your parents) and your environment (i.e., how you live) influence your risk for alcohol abuse and alcoholism.

Your genes certainly play an important role, influencing how your body responds to alcohol, how sensitive you are to its effects, and how likely you are to have a problem with alcohol. However, environmental factors—such as being surrounded by people who are heavy drinkers and who encourage you to drink—also can raise your risk for drinking too much.

The next question then becomes just how much of this risk is determined by our genes—that is, how much can be attributed to factors beyond our control. By studying large families with alcoholic and non-alcoholic members, comparing identical and fraternal twins, and studying adopted children and their biological and adoptive families, researchers found that about half of our risk for alcoholism is influenced by genetics. The remaining risk is related to the influence of environment—where and how we live. The two factors also work together in complex ways.

Unlike for some other diseases, there is no single gene that determines whether you will develop a problem with alcohol; instead, many genes influence your risk for developing alcoholism, each of which only has a small impact.

Understanding how genetics influences alcoholism also is important for another reason. Knowing the genes involved in this disease could help researchers and clinicians identify those who are most at risk of becoming alcoholic and understand how alcohol affects the body. These individuals then could be targeted more effectively for prevention and treatment efforts.

This Alcohol Alert describes how research is helping to identify the genes involved in alcoholism. In examining this research, one thing becomes clear: Unlike for some other diseases, there is no single gene that determines whether you will develop a problem with alcohol; instead, many genes influence your risk for developing alcoholism, each of which only has a small impact. Further, environmental influences may override or blunt the effects of the genes that increase risk. This overview describes how researchers are trying to tease apart which of the thousands of genes and millions of gene variants that make up your DNA play a role in alcoholism, how some of these genes act, and how these genes interact with your environment to determine how you and your body respond to alcohol.

Genes v’s Environment

As described above, researchers are learning more and more about how your genetic makeup can influence your drinking behavior and its consequences and which genes may put you at increased risk of alcoholism. But does this mean that if you inherit a certain combination of genes from your parents, you are destined to become an alcoholic? The answer to this is a clear “no” because how you live also plays an important role. People with the same genetic makeup may be more or less likely to develop alcoholism depending on their environment and life circumstances.

Researchers can study the interactions between genes and the environment and the relative impact of each through a variety of direct and indirect approaches.³⁸ These approaches have helped identify several environmental factors that either protect us from or place us at increased risk for alcoholism; for example, marital status and religiosity have been found to be protective factors, lessening the impact of genetic risk factors on drinking in women. For adolescents in particular, drinking seems to be influenced strongly by environmental factors in addition to genetic makeup. Adolescents who carry high-risk genes and whose parents do not monitor their activities and/or who have friends that use alcohol and other drugs are more likely to develop alcohol problems than those with a similar genetic makeup whose behavior is monitored more closely. Modifying the environment also can help adolescents avoid risky drinking behavior. Participants in one prevention program designed for youth were less likely to engage in high-risk behavior, such as drinking, even though they had a high-risk genetic background.

The bottom line is that genes alone do not determine our destiny—lifestyle choices and other environmental factors have a substantial impact. In addition, many other individual and psychosocial variables influence when and how much we drink, both in the short and long term, and how this influences our risk of alcoholism.

Full story at; http://pubs.niaaa.nih.gov/publications/AA84/AA84.htm

Treat, Don’t Blame Addicts

Why We Should Treat, Not Blame Addicts Struggling to Get ‘Clean’

Journalist David Sheff’s son Nic began using marijuana and alcohol at the age of 12, then heroine and crystal meth. Sheff was baffled; his son transformed from an intelligent student and athlete into an addict living on the streets. At first he thought Nic was just being a wild teenager who needed some tough love. But after struggling to find Nic treatment — and keep him alive — Sheff realized that his son was dealing with a serious disease, more similar than different from diabetes, hypertension or even cancer.

With his personal experience and more than 10 years of research, Sheff concluded that addiction is a health crisis with a price tag of US$600 billion in combined medical, economic, criminal and social costs every year.

In a follow-up to his memoir “Beautiful Boy,” David Sheff has written a new book, “Clean: Overcoming Addiction and Ending America’s Greatest Tragedy,” in order to outline a slew of reasons why society and addiction treatments have largely failed to help the 20 million Americans with addictions.

Sheff asserts that the reason that addiction treatments overwhelmingly fail is because of how we view addiction. And he says correcting common misconceptions about the disease can be the first step towards improving the social support and medical treatment systems for those struggling with their addictions.

Below are the top myths about addiction, according to David Sheff.  

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Myth No. 1: Good kids don’t use drugs, bad kids do. 

Myth No. 2: It’s impossible to prevent drug use. Kids who are going to use are going to use.

Myth No. 3: People who get addicted are weak and without morals.

Myth No. 4: Addicts must hit bottom before they can be treated.

Myth No. 5: You don’t treat drug problems with drugs.

Myth No. 6: The only way for addicts to stop using is by going to AA meetings.

Myth No. 7: Marijuana is not addictive. No one’s ever died from marijuana. It’s not a gateway drug. Marijuana shouldn’t be legalized.

Myth No. 8: America’s drug problem is unsolvable.

• We’ve failed at solving America’s drug problem not because it’s impossible to do so, but we’ve been focusing on the wrong things. The main problem is that we’ve treated drug use as a criminal problem and drug users as morally bankrupt.
• There are several developments that make me optimistic that we can lower drug use, treat addicts and potentially solve many of the problems in America caused by addiction:
• There’s a growing understanding and acceptance that addiction is a disease and must be treated like we treat other diseases.
• There are advances in treatment that will dramatically improve the likelihood that addicts will get well. There are also new prevention strategies, early assessment, and brief intervention strategies that work.
• There is progress toward making sure that people who need treatment will be able to find programs that use evidence-based treatment.
• There is a new organization founded called Brian’s Wish To End Addiction

The top myths about addiction above were adapted from content from David Sheff’s new book, “Clean: Overcoming Addiction and Ending America’s Greatest Tragedy. The views are his own.

Full story at; http://www.pbs.org/newshour/rundown/2013/04/addiction-mythbusters-understand-what-triggers-addiction-and-how-to-manage-the-disease.html

Teen Drinking in College

Talk to Your Teens About Drinking Before They Start College

Parents who discuss drinking with their teens before they start college can influence their children’s drinking behavior once they are at school, a new study suggests.

A parental talk can reduce the chances that light drinkers will become heavier drinkers, and increase the odds that teens who already drink heavily will reduce their drinking or stop, Time.com reports.

Effective strategies can include discussing why some teens drink and others don’t, and the potential dangers of drinking too much, the article notes.

The study included 1,900 students and their parents, who were surveyed in the summer before the teens started college, and again in the fall of the teens’ freshman and sophomore years. The parents were divided into four groups. One group was given a handbook to guide discussions. The book provided tips on starting casual and nonjudgmental conversations, as well as information on the risks of underage drinking.

A second group used the handbook, as well as “booster” discussions. A third group did not talk about drinking with their children until they had already begun school, and a fourth group was not given any instructions on talking with their children about drinking.

Before the study began, 51 percent of students described themselves as nondrinkers, 30 percent said they drank heavily on some weekends, and 15 percent drank moderately on weekends. An additional 5 percent said they were frequent, heavy drinkers. After 15 months of college, only 25 percent were nondrinkers and 29 percent were heavy drinkers.

Students whose parents talked to them about drinking before they left for school were 20 times more likely to have healthier drinking patterns, including not drinking at all, than they were to stay heavy drinkers 15 months later.

The researchers found parental talks were effective only if they took place before students left for college.

The study appears in the Journal of Studies of Alcohol and Drugs.

By Join Together Staff 

Alcohol and Pregnancy

Alcohol and Pregnancy: The Long-Term Consequences

Now, there’s more evidence of the dangers of heavy drinking while pregnant. New research shows that children whose mothers drank while pregnant had abnormal brain development patterns years after being exposed to alcohol in the womb.

The study is the first to follow children over time using magnetic resonance imaging technology to look at how heavy alcohol exposure before birth interferes with brain growth in childhood and adolescence.

The findings suggest that children with heavy alcohol exposure may have decreased brain plasticity—the brain’s ability to grow and remodel itself based on experience with the outside world.

Such adaptation continues throughout tone’s life and is crucial to learning new skills and adapting to the environment.

During normal development, brain volume increases rapidly at a young age as new neural connections form and then decrease in certain regions during adolescence as underused brain connections are cleared away to increase efficiency. While children whose mothers didn’t drink showed this pattern of robust brain growth and reduction, children with heavy exposure to alcohol showed patterns of static growth.

Among the 70 children in the study who had been heavily exposed to alcohol in utero (13 drinks per week throughout the pregnancy, on average), lack of growth was most obvious in the rear portions of the brain—particularly in the parietal cortex, which is thought to be involved in selective attention and the production of planned movement.

From; NIAAA Spectrum Volume 5, Issue 1 | February 2013. American National Institutes of Health • National Institute on Alcohol Abuse and Alcoholism

| http://www.spectrum.niaaa.nih.gov

Heavy Drinkers

8 Percent of Men, 3 Percent of Women are Heavy Drinkers, Study Finds

A new study finds 8 percent of men and 3 percent of women are heavy drinkers, according to government guidelines. On any given day, 18 percent of men and 11 percent of women drink more alcohol than advised by federal dietary guidelines, Reuters reports.

The recommended limit is two drinks per day for men and one for women, the article notes. The study found 8 percent of men had five or more drinks, and 3 percent of women had four or more.

“And in fact, most adults don’t drink at all on any given day. But the fact remains that it is a significant public health problem that many people do drink in excess,” Patricia Guenther, the lead study author and a nutritionist at the U.S. Department of Agriculture’s (USDA) Center for Nutrition Policy and Promotion, told Reuters.

Among males, the largest percentage of heavy drinkers was found in the 31-to-50-year-old age group. Among women, the heaviest drinkers were ages 51 to 70. “People need to be aware that there are people of all ages who drink to excess,” Guenther said.

The researchers studied data from about 5,400 adults over age 21. They found 64 percent of men and 79 percent of women did not drink any alcohol the day they were surveyed. They reported their findings in the Journal of the Academy of Nutrition and Dietetics.

See more at: Heavy Drinkers

By Join Together Staff

Deaths Fall When Alcohol Price Increases

Drop in alcohol related deaths by nearly a third follows minimum alcohol price increase of 10%

A new study made available online today in ‘Addiction’ shows that, between 2002 and 2009, the percentage of deaths caused by alcohol in British Columbia, Canada dropped more than expected when minimum alcohol price was increased, while alcohol-related deaths increased when more private alcohol stores were opened. The paper has significant implications for international alcohol policy.

The study was carried out by researchers from British Columbia, the westernmost province in Canada, using three categories of death associated with alcohol – wholly alcohol attributable (AA), acute, and chronic*, analysing death rates across the time period against increases in government set minimum prices of alcohol drinks.

The study was complicated by another provincial policy which allowed partial privatisation of alcohol retail sales, resulting in a substantial expansion of alcohol stores.  Previously, alcohol could only be sold directly to the public in government owned stores, unlike in Europe where it is widely available in supermarkets, off-licences and petrol stations.  The researchers therefore had to both control for the effects of the wider availability of alcohol, and assess what effect this measure had on mortality rates.

The major finding was that increased minimum alcohol prices were associated with immediate, substantial and significant reductions in wholly AA deaths:

A 10% increase in the average minimum price for all alcoholic beverages was associated with a 32% reduction in wholly AA deaths

Some of the effect was also detected up to a year after minimum price increases

Significant reductions in chronic and total AA deaths were detected between two and three years after minimum price increases

A 10% increase in private liquor stores was associated with a 2% increase in acute, chronic, and total AA mortality rates

This overall drop in deaths was more than expected, and disproportionate to the size of the minimum price increase – a minimum price increase of 1% was associated with a mortality decline of more than 3%.

The authors suggest that the reason for the reduction in mortality is that increasing the price of cheaper drinks reduces the consumption of heavier drinkers who prefer these drinks. They note that other research has also suggested that impacts on some types of mortality may be delayed by one or two years after price increases.

Dr Tim Stockwell, director of the University of Victoria’s Centre for Addictions Research of British Columbia and a lead author, said “This study adds to the scientific evidence that, despite popular opinion to the contrary, even the heaviest drinkers reduce their consumption when minimum alcohol prices increase. It is hard otherwise to explain the significant changes in alcohol-related deaths observed in British Columbia.”

Zhao J, Stockwell T, Martin G, Macdonald S, Vallance K, Treno A, Ponicki W, Tu A, and Buxton J. (2013) The relationship between changes to minimum alcohol prices, outlet densities and alcohol attributable deaths in British Columbia in 2002-2009. Addiction, 108: doi:  10.1111/add.12139

* Wholly alcohol attributable deaths included the following: poisonings due to alcohol, alcoholic psychoses, alcohol dependence, alcohol abuse, alcoholic cardiomyopathy, alcoholic gastritis, chronic pancreatitis (alcohol induced), fetal alcohol syndrome and excess alcohol blood level; acute alcohol attributable deaths comprised mainly injuries whether caused intentionally or unintentionally while chronic alcohol attributable deaths were those caused by alcohol-related illnesses such as liver cirrhosis and various cancers (e.g. cancers of the mouth, oesophagus, stomach, colon and breast). These types of diagnosis were determined from the underlying cause of death identified on the death certificates.

Guide for Parents on Talking to Kids About Alcohol

Science can be a powerful tool for parents and educators seeking to persuade middle-school students not to drink alcohol, says a new book from the American Association for the Advancement of Science (AAAS).

“Delaying That First Drink: A Parents’ Guide” was produced by the AAAS Science Inside Alcohol Project, which is funded by the National Institute on Alcohol Abuse and Alcoholism. It discusses research on the impact of alcohol on the growing body and offers tips on how to talk to kids about drinking.

“Studies show that adolescents who start drinking before age 15 are five times more likely to have alcohol-related problems later in life,” the book says. “So, convincing your kids to delay that first drink can make a big difference to the rest of their lives.”

Shirley Malcom, the director of Education and Human Resources programs for AAAS, said the new book spotlights the need for parents and others to pay more attention to the risks of pre-teen drinking.

“A lot of people pay attention to high schoolers who drink because they often will combine that with driving,” Malcom said. “What has a lot less visibility is the fact that you have fourth, fifth and sixth graders who drink, leading to later consumption at even higher levels.”

Such drinking can lead to impaired school performance, early sexual activity, and other risky behaviors, Malcom said.

The book is available online at: http://www.sciencenetlinks.com/alcohol/parents/book-final.pdf. It is meant to build awareness among parents, caregivers, coaches and others who interact with kids about the effects that alcohol can have on young bodies, particularly on brain development. It discusses the impact of alcohol on the digestive system, the central nervous system, the heart, the liver and other organs.

As part of the alcohol project, AAAS conducted an online survey with seventh graders from several middle schools in the northeastern United States. Responses from 143 students showed that they knew very little about the science of alcohol and how it affects the human body. Nearly half of the respondents had no idea how alcohol is derived and nearly one-third could not describe which body systems are affected by the substance.

The book will be available for incorporation into school curricula where appropriate, Malcom said, but it is intended primarily as a practical, plain language guide for parents.

“Parents need all the tools they can get” in talking to their children about alcohol, Malcom said. “You can use moral arguments, you can be preachy and that may not work. You can forbid behaviors and that may not work. This is a way of saying, ‘Let’s look at the actual impact on the body.’”

The guide was written by Aimee Stern of Stern Communications in Silver Spring, Md., with the help of an advisory board of specialists on alcohol use and abuse.

As part of her research for the guide, Stern attended a 2009 meeting of the International Conference of Young People in Alcoholics Anonymous. The majority of those she met and listened to had started drinking in middle school or the first year in high school. One started drinking vanilla extract from the kitchen cabinet at age 9.

“All parents hope that their child will not be the one who gives in to alcohol and drug abuse,” Stern writes. “But as our children get older and more independent, it’s harder to keep watch and control what they do.”

Young students “generally believe that bad things happen to others and by default minimize the risk inherent in their own choices and behaviors,” said Rebecca Kullback, a licensed clinical social worker and co-founder of Metropolitan Counseling Associates in Bethesda, Md. She said the new guide provides an opportunity to teach them “about the dangers of substance use in a way that is relevant and real.”

Kullback, who was an adviser for the book project, added: “Delaying the first drink has proven to result in lower rates of substance use and abuse in teens. Helping them understand how drinking interferes with things they appreciate and respect—appearance, athletic and academic ability—will provide value to saying ‘no.’”

Parents should starting talking to their kids about alcohol and drug use as early as the fourth grade and continue through middle and high school, the book says. In schools, it notes, information about alcohol is usually taught as part of a larger curriculum dealing with sex, drugs, and sexually transmitted diseases and can receive minimal attention.

Parent also should be aware of external factors, such as advertising, music lyrics and Internet sites that can influence their children to drink. A recent YouTube search found more than 250,000 videos dealing with alcohol use, the book says, including more than 5,000 dealing with “cool” alcohol drinks.

The guide can be used as a companion to a series of Science Inside Alcohol lessons developed by AAAS (Go to http://www.sciencenetlinks.com/alcohol/index.php) or as a stand-alone tool that parents can use in talking with their children. An e-book for students will be available online soon as well.

Alcohol Abuse Screenings at the Dentist

Health experts have warned that people who consume alcohol excessively are exposed to an extremely high risk of developing dental disease and mouth cancer.

Experts have also noted that in order to be able to keep things under control, treatment and constant screenings for alcohol abuse is extremely important. The published paper has been called “Alcohol misuse: screening and treatment in primary dental care”.

The study has also brought to light the fact that people generally do not visit their doctor (GP), unless they are extremely ill. On the other hand, people generally respect their regular dental visits, and therefore dentists are the professionals mostly suited to test patients for alcohol abuse issues.

If health professionals would start asking a few standard questions regarding the patient’s alcoholism problem, it would be much easier to help the patient fight against these issues.

Professor of Oral and Maxillofacial Surgery, Jonathan Shepherd clearly points out that people struggling with excessive alcohol consumption can develop cancer of the mouth, esophagus and larynx. The dental professionals may actually be the first who can discover these health complications.

There should be introduced an alcohol screening device which is extremely reliable and which can detect alcoholism, and then suggest the right path for treatment.

The paper notes that today in the UK approximately 1 in 5 men and 1 in 7 women are drinking excessively. If dental professionals would be the first to suggest the patient the importance of moderation in drinking, both the health and economic implications linked to excessive alcohol consumption could be considerably reduced.

Professor Shepherd further reveals that one of the main responsibilities of the dentist is to promote overall good health.

They are not only responsible for dental health promotion, but also for helping the patient fight off bad habits that lead to severe oral health complications, or to severe damages in any other major organ of the body.

The Government and the dentists should join their forces and provide proper screenings and treatments before it is not too late for the patient.

Genetics and Family Environment Influence Drug Abuse

Risk for Drug Abuse in Adopted Children Appears Influenced by Family, Genetics

In a national Swedish adoption study, the risk for drug abuse appears to be increased among adopted children whose biological parents had a history of drug abuse, according to a report published online by Archives of General Psychiatry.

Drug abuse is a worldwide public health problem and much effort has gone into understanding the nature of familial factors, the authors write in their study background.

Kenneth S. Kendler, and colleagues evaluated the association between genetic and environmental factors and the risk of drug abuse. Their study included 18,115 adopted children born in Sweden between 1950 and 1993, as well their biological and adoptive relatives. Researchers relied on national registries and health databases, as well as information about drug abuse from medical, legal or pharmacy records.

The adoptees, whose average age at last available information was 46.2 years, had a 4.5 percent prevalence of drug abuse compared with 2.9 percent in all of Sweden from the same birth years.

The authors suggest the risk for drug abuse among children given up for adoption by biological parents, of whom a least one had drug abuse, was 8.6 percent, which they note was "substantially and significantly elevated over that seen in children given up for adoption when neither biological parent had drug abuse (4.2 percent)."

"Risk for drug abuse in adopted children is increased by a history in biological parents and siblings not only of drug abuse but also of alcoholism, major psychiatric illness and criminal convictions," the authors note. "Risk for drug abuse in adopted children is increased by disruption in the adoptive parent-adopted child bond by death or divorce but also by a range of indices of a disturbed adoptive home environment and deviant peer influences such as parental alcoholism and sibling drug abuse, respectively."

Researchers also suggest a gene-environment interaction in the etiology (the study of the causes of a disease) of drug abuse.

"Adopted children at high genetic risk were more sensitive to the pathogenic effects of adverse family environments than those at low genetic risk. In other words, genetic effects on drug abuse were less potent in low-risk than high-risk environments," the authors conclude.

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