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Older Americans and The Changing Scope of Substance Abuse

A recent study by the Substance Abuse and Mental Health Services Administration (SAMHSA) revealed that since 1992 the number of older Americans being admitted into substance abuse treatment has nearly doubled. And even though alcohol remains the top reason for admission among this age group, the study showed a sharp rise since 1992 in the illicit drug abuse involving admissions and this older age group (ages 50 and older).

Among this age group, admissions since 1992 due to heroin abuse more than doubled, cocaine abuse quadrupled, and prescription drug abuse rose from 0.7 percent to 3.5 percent. The study also found that admissions involving abuse of multiple substances nearly tripled from 13.7 percent to 39.7 percent since 1992. (Medical News Today)

While over three quarters of these admissions involved a primary use of a substance beginning by age 25, there was a significant increase in the proportion of admissions that involved a substance introduced within five years prior to admission. In 2008, cocaine abuse is an example of a leading cause of admission that older Americans reported having begin use within five years prior to admission. Prescription drug abuse was second.

Researchers for the study explained the findings as indication of “the changing scope of substance abuse problems in America.” It also raises new wellness concerns for the health and social services already providing assistance to seniors.

The study is also an example of the indiscriminate nature of substance abuse, and the need to de-stigmatize addiction in order to best treat those suffering and at-risk.

Icing: A Disturbing Trend

On June 8, 2010, The New York Times ran an article about a new drinking game trend that encourages binge drinking, icing, that’s spread from college campuses across the U.S. to social networking sites, such as Twitter and Facebook, to blogs. It has become the first viral drinking game.

two glasses clinking“Icing” involves the malt beverage Smirnoff Ice. The premise of the game is that at any social gathering a friend might hand another friend a Smirnoff Ice (typically a warm one), and the receiver has to drink all of it at once while kneeling on one knee. However, if the receiver is carrying a bottle of Smirnoff Ice himself (the game is more popular among men than women), then the initial giver must drink both of the bottles, all at once, while kneeling on one knee. Most of the participants describe Smirnoff Ice as an unpleasant drink, which heightens the aspect of losing and reinforces the carrying of defense Ice. It’s no surprise that the sales of Smirnoff Ice has skyrocketed.

Many have questioned Smirnoff Ice’s involvement in the viral ad campaign, but Smirnoff has denied all accusations. Some young adults who documented the spread of the game said that many would stop Icing “if it turns out that they’re being used to market a drink they don’t really like.”

Smirnoff Ice and its parent company released a statement that read: “Icing is consumer-generated, and some people think it is fun. We never want under-age ‘icing’ and we always want responsible drinking.” However, the very nature of the game, through it’s encouragement of the dangerous act of binge drinking, is irresponsible. Whether involved or not, it seems the responsible thing for Smirnoff Ice to do at this point would be discourage such games as “Icing” and to remind its consumers about the dangers of binge drinking. They should not be reiterating the game as something that people think is ‘fun’.

No matter under-age or of-age, making a game of binge drinking is always dangerous.
Here are some health problems associated with binge drinking:

  • Alcohol poisoning.
  • Liver disease.
  • High blood pressure, stroke, and other forms of cardiovascular disease.
  • Neurological damage.
  • Sexually transmitted diseases.
  • Unintentional pregnancy.
  • Fetal Alcohol Syndrome (if pregnant women binge drink).
  • Unintentional injuries (such as car accidents, falls, etc.).
  • Intentional injuries (such as injuries from firearms, domestic violence, etc.).

In addition, studies have shown that the younger one begins drinking, the more likely they are to develop alcohol dependence.

Substance Abuse: The American Adolescent’s Average Day

A recent report released by the Substance Abuse and Mental Health Services (SAMHSA) provided a startling look at the drug and alcohol activities of American adolescents on an average day. The report found that on an average day: 508,000 adolescents, ages 12-17, drink alcohol; 641,000 use illicit drugs; and more than 1 million smoked cigarettes. This substance abuse trend is alarming. (Medical News Today)

SAMHSA conducted and analyzed a national survey for the study, “A Day in the Life of American Adolescents: Substance Use Facts Update,” which presented a bleak look at the daily toll that substance abuse has on America’s youth. The efforts are a part of a larger initiative, “designed to create an integrated data strategy that provides key public health information on a wide range of behavioral health issues.”

The report found that on any given day, 563,000 adolescents used marijuana, nearly 37,000 used inhalants, 24,000 used hallucinogens, 16,000 used cocaine, and 2, 800 used heroin.

Many addiction specialists see the report as a wake up call to the extreme extent that America’s youth is engaging in risky and illegal behavior. The young age of exposure to drugs and alcohol leave these adolescents more vulnerable and at-risk of developing severe addictions.

Some of facts of the study included first-time drug and alcohol use for adolescents on an average day, and found: approximately 7,500 adolescents drank alcohol for the first time; approximately 4,360 adolescents used an illicit drug for the first time; around 3,900 adolescents smoked cigarettes for the first time; nearly 3,700 adolescents used marijuana for the first time; and approximately 2,500 adolescents abused pain relievers for the first time.

The study also looked at substance abuse treatment and treatment admission patterns among those under the age of 18, and found: more than 76,000 in outpatient treatment; more than 9,000 in non-hospital residential treatment; and more than 700 in hospital inpatient treatment. There were about a quarter of a million drug-related emergency hospital visits among this age group, of which 170,000 visits involved the use of illicit drugs, alcohol or abuse of prescription drugs.

The researches hope that the report will lead to better preventative strategies and more effective ways of promoting emotional health among American adolescents.

Teens More Sensitive to Dopamine Release?

A small study at the University of California, Los Angeles, found that risk-taking tendencies (and sometimes high-risk activities) in teenagers, including the use of drugs or alcohol, may be largely driven by what scientist refer to as a “hypersensitivity” to the brain’s release of dopamine (a powerful, pleasure/ motivator chemical in the reward center of the brain).

Using three age groups: children ages eight to 12, teenagers 14-19, and adults ages 25-30, the researchers had the volunteers perform reward-incentive tasks while a functional magnetic resonance imaging scanner (fMRI) measured the blood flow in their brains. The tests revealed that the striatal area of the brain, which is sensitive to dopamine, lit up more strongly among the teenagers than the adults or children when receiving a reward.

A lead researcher further explained that the study shows “that when adolescents get a reward that they’re not expecting, their brains are more responsive to that reward.”

This understanding of the adolescent brain is particularly important when understanding how susceptible they may be to drug or alcohol abuse and addiction that directly targets the reward center of the brain. Such knowledge reiterates the need for delaying the use of drugs or alcohol among teens, as well as possible age-specific prevention tactics, early intervention, and rehabilitation.

According to LoveToKnow.com, here are some warning signs of possible alcohol abuse:

  • Daily or frequent use of alcohol. “I need a drink to calm me down“ or “There’s nothing like two stiff drinks after a hard day at the office.”
  • Solitary drinking. If an individual displays a distinct preference for solitary drinking, especially on a daily or frequent basis, there may be cause for concern.
  • Making excuses to drink. If you find someone simply waiting for an excuse to drink, however trivial or frivolous it may seem to others, it is time to start the alarm bells ringing.
  • Secretive behavior. Telling lies about their whereabouts, spending large amounts of time away from family, covering up on the amount of drinking–all of these are warning signs.
  • Hostility when directly questioned. Substance abusers are often hostile or aggressive when confronted about their drinking.
  • Work-related difficulties. Underperforming relative to ones abilities, not getting the job done, problems with professional relationships, not delivering, unexplained absences, and tardiness are often present with alcohol abuse.
  • Financial negligence and/or distress.
  • Arrest, DUI or other trouble with the law. DUIs, near misses, and accidents are common with alcohol abuse. Fights and other forms of violence are also warning signs.
  • Blackouts. Not remembering what happened while drinking is a sign that there is a problem.

 

Gene Variant, A Key to Prevention?

Researches at the National Institute on Alcohol Abuse and Alcoholism (NIAA) recently found a genetic variation in receptor sites known as the mu-opioid in the brain’s reward system that appear to influence the release of dopamine and may be key to addiction prevention. This also affects the degree of pleasure that individuals get from drinking. As reported by Join Together, the study was published in the journal Molecular Psychiatry.

It’s known that alcohol consumption causes the brain to release the neurotransmitter dopamine (responsible for pleasure, motivation, etc.), but science is beginning to understand how genes may influence the degree to which the brain responds to drinking. Ultimately, this may determine more effective methods for substance abuse prevention and rehabilitation.

Specifically, individuals who possess the 118G variant of the mu-opioid receptor may experience more pleasurable effects from alcohol. This puts them at greater risk for developing alcohol abuse and dependence. This may also explain why individuals with this genetic variant benefited the most from treatment that directly targeted the dopamine receptors.

Further understanding of this gene variant, its relationship to dopamine, and the ability to detect the gene variant in individuals could become a powerful means of prevention and early intervention.

Science Solidifying the Neurobiology of Addiction

A team at The Scripps Research Institute has found significant evidence regarding the neurobiology of addiction that a specific neurotransmitter system, the endocannabinoid system that includes the most common CB1 receptors, is active in the brain region that plays an important role in appetite, memory, mood/ emotion, and addiction. The study, which was recently published in Neuropsychopharmacology, also found that endocannabinoid system can inhibit the effects of alcohol, thus offering promise for future prevention and rehabilitation strategies.

According to a professor of the neurobiology of addiction at Scripps Research, this is the first study to show a “direct cellular interaction between endocannabinoids and alcohol in the brain.” (Science Daily)

The study abates a paper published in 2001 in the Journal of Neuroscience, in which a European group asserted that endocannabinoid receptors (CB1 receptors) did not exist in the brain region known as the central amygdala (which is part of the limbic / reward system of the brain). This paper’s conclusions were widely accepted by the the field. However, the scientists at The Scripps Research began to suspect that the presence of CB1 receptors in the central amygdala had somehow been missed. Especially since, as many of the scientists at Scripps, said that they began studying the endocannabinoid system in the central amygdala because of addiction. And they found that CB1 receptors are very abundant throughout the brain.

One of the scientists reiterated that there has been numerous behavioral studies on substance abuse, but a very limited amount on the physiology of addiction. And aside from the 2001 study, even less on the physiology in the central amygdala (a region of the brain that is key in understanding the drug and alcohol abuse).

Using electrophysiological techniques in brain slices to test the response of brain cells from the central amygdala in rats, the scientists found compelling evidence that CB1 receptors were active there. They also determined that alcohol and CB1 agonists have opposing effects on GABA (which is a main inhibitory neurotransmitter in the brain that fine-tunes signaling throughout the nervous system. GABA plays a key role in alcohol dependence and other addictions.) The scientists concluded that because there is such a wide presence of CB1 receptors, there is a greater possibility of inhibiting the effects of alcohol.

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