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

Drug Addiction Treatment

Principles of Drug Addiction and Alcoholism Treatment: A Research-Based Guide (Third Edition)

Principles of Effective Treatment

1. Addiction is a complex but treatable disease that affects brain function and behavior.  Drugs of abuse alter the brain’s structure and function, resulting in changes that persist long after drug use has ceased. This may explain why drug abusers are at risk for relapse even after long periods of abstinence and despite the potentially devastating consequences.

2. No single treatment is appropriate for everyone.  Treatment varies depending on the type of drug and the characteristics of the patients. Matching treatment settings, interventions, and services to an individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society.

3. Treatment needs to be readily available.  Because drug-addicted individuals may be uncertain about entering treatment, taking advantage of available services the moment people are ready for treatment is critical. Potential patients can be lost if treatment is not immediately available or readily accessible. As with other chronic diseases, the earlier treatment is offered in the disease process, the greater the likelihood of positive outcomes.

4. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.  To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems. It is also important that treatment be appropriate to the individual’s age, gender, ethnicity, and culture.

5. Remaining in treatment for an adequate period of time is critical.  The appropriate duration for an individual depends on the type and degree of the patient’s problems and needs. Research indicates that most addicted individuals need at least 3 months in treatment to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment. Recovery from drug addiction is a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug abuse can occur and should signal a need for treatment to be reinstated or adjusted. Because individuals often leave treatment prematurely, programs should include strategies to engage and keep patients in treatment.

6. Behavioral therapies—including individual, family, or group counseling—are the most commonly used forms of drug abuse treatment.   Behavioral therapies vary in their focus and may involve addressing a patient’s motivation to change, providing incentives for abstinence, building skills to resist drug use, replacing drug-using activities with constructive and rewarding activities, improving problem-solving skills, and facilitating better interpersonal relationships. Also, participation in group therapy and other peer support programs during and following treatment can help maintain abstinence.

7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.  For example, methadone, buprenorphine, and naltrexone (including a new long-acting formulation) are effective in helping individuals addicted to heroin or other opioids stabilize their lives and reduce their illicit drug use. Acamprosate, disulfiram, and naltrexone are medications approved for treating alcohol dependence. For persons addicted to nicotine, a nicotine replacement product (available as patches, gum, lozenges, or nasal spray) or an oral medication (such as bupropion or varenicline) can be an effective component of treatment when part of a comprehensive behavioral treatment program.

8. An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.  A patient may require varying combinations of services and treatment components during the course of treatment and recovery. In addition to counseling or psychotherapy, a patient may require medication, medical services, family therapy, parenting instruction, vocational rehabilitation, and/or social and legal services. For many patients, a continuing care approach provides the best results, with the treatment intensity varying according to a person’s changing needs.

9. Many drug-addicted individuals also have other mental disorders.  Because drug abuse and addiction—both of which are mental disorders—often co-occur with other mental illnesses, patients presenting with one condition should be assessed for the other(s). And when these problems co-occur, treatment should address both (or all), including the use of medications as appropriate.

10. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse.  Although medically assisted detoxification can safely manage the acute physical symptoms of withdrawal and can, for some, pave the way for effective long-term addiction treatment, detoxification alone is rarely sufficient to help addicted individuals achieve long-term abstinence. Thus, patients should be encouraged to continue drug treatment following detoxification. Motivational enhancement and incentive strategies, begun at initial patient intake, can improve treatment engagement.

11. Treatment does not need to be voluntary to be effective.  Sanctions or enticements from family, employment settings, and/or the criminal justice system can significantly increase treatment entry, retention rates, and the ultimate success of drug treatment interventions.

12. Drug use during treatment must be monitored continuously, as lapses during treatment do occur.  Knowing their drug use is being monitored can be a powerful incentive for patients and can help them withstand urges to use drugs. Monitoring also provides an early indication of a return to drug use, signaling a possible need to adjust an individual’s treatment plan to better meet his or her needs.

13. Treatment programs should test patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling, linking patients to treatment if necessary.   Typically, drug abuse treatment addresses some of the drug-related behaviors that put people at risk of infectious diseases. Targeted counseling focused on reducing infectious disease risk can help patients further reduce or avoid substance-related and other high-risk behaviors. Counseling can also help those who are already infected to manage their illness. Moreover, engaging in substance abuse treatment can facilitate adherence to other medical treatments. Substance abuse treatment facilities should provide onsite, rapid HIV testing rather than referrals to offsite testing—research shows that doing so increases the likelihood that patients will be tested and receive their test results. Treatment providers should also inform patients that highly active antiretroviral therapy (HAART) has proven effective in combating HIV, including among drug-abusing populations, and help link them to HIV treatment if they test positive.

More at; http://www.drugabuse.gov/publications/principles-drug-addiction-treatment

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

Synthetic Drugs Outlawed

Obama Signs Legislation Banning Synthetic Drugs

President Obama on Monday signed legislation that bans synthetic drugs. The law also expedites the Food and Drug Administration’s (FDA) approval of new drugs and medical devices.

The law bans harmful chemicals in synthetic drugs such as those used to make synthetic marijuana and “bath salts,” according to the Star Tribune. While more than 30 states have banned various compounds in synthetic drugs, new ones are continually being created, the newspaper notes.

“In Minnesota and across the country, we are seeing more and more tragedies where synthetic drugs are taking lives and tearing apart families,” Senator Amy Klobuchar of Minnesota said in a statement. “Today’s action means that this critical legislation to give law enforcement the tools they need to crack down on synthetic drugs is finally the law of the land.” Senator Klobuchar co-sponsored bills banning synthetic drugs, which were included in an amendment to the FDA’s Safety and Innovation Act.

Synthetic drugs are readily available online. The law outlaws sales of synthetic drugs by both retail stores and online retailers.

In December, the National Institute on Drug Abuse released new information indicating that one in nine high school seniors had used “Spice” or “K2” over the past year, making synthetic marijuana the second most frequently used illicit drug, after marijuana, among high school seniors. Poison control centers operating across the nation have also reported sharp increases in the number of calls relating to synthetic drugs.

By Join Together Staff

Teens Use Diverted Medical Marijuana

74 Percent of Teens in CO Substance Abuse Treatment Programs Used Diverted Medical Marijuana

Three-quarters of teenage patients in substance abuse treatment programs in Denver, Colorado said they used someone else’s medical marijuana, according to a new study.

The study revealed that 121 of 164 teenage patients (73.8 percent) have ever used medical marijuana prescribed to someone else.  Patients reported using diverted medical marijuana from one to 1,000 times, with a median of 50 times, suggesting that most adolescent patients have used medical marijuana on multiple occasions, according to Stacy Salomonsen-Sautel, PhD, a post-doctoral fellow at the University of Colorado Anschutz Medical Campus, Division of Substance Dependence. She reported the findings at the recent College on Problems of Drug Dependence, and the study appears online in the Journal of the American Academy of Child and Adolescent Psychiatry.

The study found that after adjusting for gender and race/ethnicity, teenage patients who used medical marijuana had an earlier age of regular marijuana use, more marijuana abuse and dependence symptoms, and more conduct disorder symptoms, compared with those who did not use medical marijuana.

As of the end of April 2012, Colorado has 48 registered medical marijuana users under the age of 18. Four of the 164 teenage patients in the study reported being evaluated for a medical marijuana card; however, only one teenage patient received a medical marijuana card. According to the Colorado Department of Public Health and Environment, 96,709 people in the state were registered as medical marijuana users as of April 30, 2012. This means 2.5 percent of the adults in Colorado are registered medical marijuana users, according to Salomonsen-Sautel.

“We don’t know what proportion of the marijuana they are using is medical marijuana,” Salomonsen-Sautel notes. She said the findings imply that there is substantial diversion from registered medical marijuana users. She and her colleagues say the results support the need for policy changes that protect against diversion of medical marijuana, and reduce teenager access to it.

From; The Partnership at Drugfree.org and Join Together

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.