Marijuana nearly doubles risk of collisions

We hear a lot about the hazards of drunk driving, but here's something else to put on your radar: A study in the British Medical Journal found that marijuana nearly doubles the risk of vehicle collisions.

Researchers conducted a systematic review of nine studies on the subject of marijuana and driving accidents, which incorporated almost 50,000 participants.

Alcohol impairs drivers' speed and reaction time, while cannabis affects spatial location, said Mark Asbridge, associate professor in the Department of Community Health and Epidemiology at Dalhousie University in Halifax, Nova Scotia.

Among impaired drivers, fatally injured drivers, and motor vehicle crash victims, marijuana is the most prevalent illegal drug that has been detected, according to the U.S. National Institute on Drug Abuse.

Drivers who have recently smoked marijuana may follow cars too closely, and swerve in and out of lanes, Asbridge said.

People who are impaired by alcohol often recognize that they're impaired by alcohol, but "people under the influence of cannabis often deny feeling impaired in any way," Asbridge noted.

It's not unusual for young people to go to a party and give the "designated driver" responsibility to the person who uses marijuana, Asbridge said.

"There clearly is a lot of misconception about the extent to which cannabis impairs performance," he said. "People just don't believe it."

As with alcohol, cannabis has different effects on different people. People metabolize cannabis in different ways. Some inhale more than others.

The effects of cannabis tend to wear off within three to four hours, whereas alcohol can mess your thinking up longer. Depending on how much you drank, you may not be able to drive for up to 12 hours after you finish drinking.

If the driver is 35 or younger, there's a higher likelihood of marijuana consumption leading to collisions, previous research has found.

There's not enough information known about the effects of marijuana doses on collisions - in other words, what level of cannabis in a person's system correlates most with crashes.

And Asbridge's conclusions are based on observational studies, meaning there were no controlled conditions imposed to look at the effects of marijuana.

One problem in some of the existing research is that there was no measurement of cannabis within two to three hours of driving. Inactive metabolites of THC, a chemical found in marijuana, can be present in urine for weeks or even a month after usage; marijuana usage so long ago would not affect driving performance or collisions. So Asbridge's group looked only at studies where there was a recent measurement. They also looked at studies that looked at both drivers who used marijuana and those who did not to compare the collision rate.

To deter marijuana usage just before driving, there is roadside testing for cannabis in Australia, western Europe and the United States, Wayne Hall of the University of Queensland in Australia said in an accompanying editorial.

Hall called for further research to evaluating the impact of roadside drug testing on preventing driver deaths connected to vehicle accidents and cannabis use.

Post by: Elizabeth Landau - CNN.com Health Writer/Producer
Filed under: Drug Safety

Protecting our children from underage drinking

From Marilyn Belmonte, of Burlington Drug and Alcohol Task Force & www.drugabuserecognition.com......

Recently, a parent attending one of my substance abuse prevention workshops in a nearby community asked my opinion on allowing her 17 year-old daughter to drink alcohol at home. The mother stated that she was very concerned about her daughter going off to college and becoming very intoxicated for the first time without any parent supervision.

The mother hoped that under her watchful eyes, her daughter would learn that alcohol consumption in large quantities can make her very sick. Perhaps she could even teach her daughter to drink responsibly. Then when her daughter is a college freshman, she will not participate in typical binge drinking activities.

The question is, does this practice work as a deterrent? Does allowing your teenager to drink freely at home deter them from getting drunk outside of the home?

It is impossible to say whether this parenting practice is beneficial for any individual adolescent but the science tells us that it will not work for the majority of teens. Numerous research studies show us that maintaining strict rules and consequences about underage drinking is most protective against teen alcohol use. Parents who use harm-reducing strategies such as allowing their high school teens to drink under their supervision, have a higher risk of those teens getting drunk outside of the home without parental permission than teens who are not allowed to drink at home.

Also, allowing your teen to experience alcohol in high school with parent supervision does not reduce alcohol use at college. Studies of college freshman show that heavy drinking occurs with a majority of students regardless of whether they started drinking alcohol in high school.

So the next question is, why bother trying to prevent high school drinking if it has little effect on college drinking?

It is well documented that underage drinking increases risk of adult alcohol disorders. In fact, the younger a person starts drinking alcohol, the greater that risk. Therefore, postponing the initiation of drinking as long as possible is a worthwhile effort for parents. The more years we can postpone the start of drinking, the more protected our children are from a lifelong alcohol addiction.

The last question is, how do parents postpone the onset of drinking?

Parental communication about their disapproval of underage drinking has been proven to help reduce the risk. Studies show that parents who are “soft” on teen drinking, are more likely to have teens who drink heavily.

Another factor that has been shown to decrease college freshman drinking is internal or “Intrinsic Motivation”. This is self-motivation driven by interest and enjoyment rather than external pressure, threat of punishment, or reward such as good grades, a trophy or money. The stress and pressure from external forces can actually drive heavy drinking. But one’s internal desire to achieve helps us to make healthier choices.

So encourage your teens to do their best at the activities they enjoy. Help them find areas of study that they are passionate about. Guide them in making goals for the future that excite them because postponing underage drinking is a worthwhile effort.

Teen dies after smoking synthetic pot

Teen dies after smoking synthetic pot
AP,
Thu Oct 27, 5:02 PM EDT

PITTSBURGH — A 13-year-old in the U.S. who became ill after smoking synthetic marijuana and had a double lung transplant has died.

Tonya Rice tells the Pittsburgh Tribune-Review newspaper that her 13-year-old son, Brandon, died Thursday morning at a hospital in Pennsylvania.

The boy smoked the fake marijuana out of a plastic candy dispenser and suffered chemical burns to both lungs. He was put on a respirator in June and had a double lung transplant in September.

The boy's mother says anti-rejection drugs he's taken since the transplants weakened his immune system and made him unable to fight off a recent infection.

Gov. Tom Corbett signed a law outlawing such substances a few days after the boy became ill. The ban took effect in August.

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Alcohol Marketing to Minors

The Latest News Update 10/25/11 From Marilyn Belmonte of the Burlington Drug and Alcohol Task Force: re: Alcohol Marketing to Minors on Facebook:

Much of the alcohol-related content on Facebook is available to underage Facebook members, according to a study conducted by the Marin Institute. There are guidelines requiring age restrictions on Facebook but the study found that content promoting alcohol and binge drinking was accessible by underage members in advertisements, pages, applications, events, and groups.
Alcohol companies can buy ad space that allows them to access a user’s profile. The Marin study found that one out of every eight ads contained alcohol and all alcohol-related ads were displayed to under-21 users.
Facebook pages and groups allow members to become fans and therefore stay in touch with their discussions, photos and events. At the time of the study, the ten top beer brands had 93 pages with more than 1.1 million fans. But only 50% of these pages restricted access due to the member’s age. Once a member becomes a fan of these pages, they receive marketing messages on their own Facebook page. None of the Facebook groups about alcohol had age restrictions.
Facebook applications allow users to play games, take quizzes and send special messages to their friends. There are over 500 Facebook applications associated with alcohol. 66% of the alcohol applications are accessible to underage members. These applications allow underage members to send virtual “mixed drinks” or “shots” to other Facebook friends.
According to the Distilled Spirits Council of the United States Code of Responsible Practices for Beverage Alcohol Advertising and Marketing, Facebook violates the industry’s advertising guidelines. Responsible Placement Guideline #2 states “Beverage alcohol products should not be advertised or marketed in any manner directed or primarily appealing to persons below the legal purchase age”. Guideline #3 states “Beverage alcohol advertising and marketing should be placed in broadcast, cable, radio, print, and internet/digital communications only where at least 71.6 percent of the audience is reasonably expected to be of legal purchase age”.
According to the Center on Alcohol Marketing and Youth at Johns Hopkins Bloomberg School of Health, numerous studies prove that a greater exposure to alcohol advertising contributes to an increase in drinking among underage youth effect by influencing expectations, attitudes, and creating an environment that promotes underage drinking.
Parents can not assume that websites such as Facebook are going to follow guidelines designed to protect our children. We also can not monitor every step they take on the internet. But we can take the responsibility of talking with our teens about the problems related to underage drinking. Studies prove that parental guidance during adolescence has a major impact in reducing drinking. Parents can offset pro-drinking messages just by having thoughtful discussions with their teens.

Kudos to Family Circle…for great, real life articles for parents & teens! Aug 2011

If you are wondering about teens, underage drinking, tobacco and drug use, check out these articles with advice from the experts at www.familycircle.com:

Q&A: My Usually Good Teen Was Caught with Drugs
http://www.familycircle.com/teen/advice/rosalind/abusing-prescription-drugs/

My Teen Told Me His Friend Smokes Pot. Now What?
http://www.familycircle.com/teen/advice/rosalind/friend-smokes-pot/

Hard Candy: New Ways Kids Get High
http://www.familycircle.com/teen/drugs/new-ways-kids-get-high/

Q&A: Is My Teen Selling His Prescription Drugs?
http://www.familycircle.com/teen/advice/rosalind/selling-prescription-drugs/

How to Plan a Teen Party
http://www.familycircle.com/teen/activities/teen-party/

What should I say to my child about “field parties,” that involve lots of drinking?
http://www.familycircle.com/teen/school/back-to-school/solutions-to-back-to-school-problems/

High Season: Teens and Marijuana Use http://www.familycircle.com/teen/drugs/teen-marijuana-use/

Video: Teens and the Dangers of Binge Drinking
http://www.familycircle.com/teen/drugs/teens-and-binge-drinking-dangers/

Back from the Brink: One Teen’s Struggle with Alcoholism
http://www.familycircle.com/teen/drugs/teens-alcoholism-struggle/?page=1

Q&A: Is My Teenager’s Friend on Drugs?
http://www.familycircle.com/teen/advice/rosalind/teen-friend-on-drugs/

Rethinking Addiction’s Roots, and Its Treatment

http://www.nytimes.com/2011/07/11/health/11addictions.html
By DOUGLAS QUENQUA
Published: July 10, 2011

There is an age-old debate over alcoholism: is the problem in the sufferer’s head — something that can be overcome through willpower, spirituality or talk therapy, perhaps — or is it a physical disease, one that needs continuing medical treatment in much the same way as, say, diabetes or epilepsy?
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Dr. Christine Pace helps Derek Anderson manage his heroin addiction at Boston University Medical Center. With the help of medication, Mr. Anderson has been clean for six years.
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Increasingly, the medical establishment is putting its weight behind the physical diagnosis. In the latest evidence, 10 medical institutions have just introduced the first accredited residency programs in addiction medicine, where doctors who have completed medical school and a primary residency will be able to spend a year studying the relationship between addiction and brain chemistry.

“This is a first step toward bringing recognition, respectability and rigor to addiction medicine,” said David Withers, who oversees the new residency program at the Marworth Alcohol and Chemical Dependency Treatment Center in Waverly, Pa.

The goal of the residency programs, which started July 1 with 20 students at the various institutions, is to establish addiction medicine as a standard specialty along the lines of pediatrics, oncology or dermatology. The residents will treat patients with a range of addictions — to alcohol, drugs, prescription medicines, nicotine and more — and study the brain chemistry involved, as well as the role of heredity.

“In the past, the specialty was very much targeted toward psychiatrists,” said Nora D. Volkow, the neuroscientist in charge of the National Institute on Drug Abuse. “It’s a gap in our training program.” She called the lack of substance-abuse education among general practitioners “a very serious problem.”

Institutions offering the one-year residency are St. Luke’s-Roosevelt Hospital in New York, the University of Maryland Medical System, the University at Buffalo School of Medicine, the University of Cincinnati College of Medicine, the University of Minnesota Medical School, the University of Florida College of Medicine, the John A. Burns School of Medicine at the University of Hawaii, the University of Wisconsin School of Medicine and Public Health, Marworth and Boston University Medical Center. Some, like Marworth, have been offering programs in addiction medicine for years, simply without accreditation.

The new accreditation comes courtesy of the American Board of Addiction Medicine, or ABAM, which was founded in 2007 to help promote the medical treatment of addiction.

The board aims to also get the program accredited by the Accreditation Council for Graduate Medical Education, a step that requires, among other things, establishing the program at a minimum of 20 institutions. The recognition would mean that the addictions specialty would qualify as a “primary” residency, one that a newly minted doctor could enter right out of school.

Richard Blondell, the chairman of the training committee at ABAM, said the group expected to accredit an additional 10 to 15 institutions this year.

The rethinking of addiction as a medical disease rather than a strictly psychological one began about 15 years ago, when researchers discovered through high-resonance imaging that drug addiction resulted in actual physical changes to the brain.

Armed with that understanding, “the management of folks with addiction becomes very much like the management of other chronic diseases, such as asthma, hypertension or diabetes,” said Dr. Daniel Alford, who oversees the program at Boston University Medical Center. “It’s hard necessarily to cure people, but you can certainly manage the problem to the point where they are able to function” through a combination of pharmaceuticals and therapy.

Central to the understanding of addiction as a physical ailment is the belief that treatment must be continuing in order to avoid relapse. Just as no one expects a diabetes patient to be cured after six weeks of diet and insulin management, Dr. Alford said, it is unrealistic to expect most drug addicts to be cured after 28 days in a detoxification facility.

“It’s not surprising to us now that when you stop the treatment, people relapse,” Dr. Alford said. “It doesn’t mean that the treatment doesn’t work, it just means that you need to continue treatment.” Those physical changes in the brain could also explain why some smokers will still crave a cigarette 30 years after quitting, Dr. Alford said.

If the idea of addiction as a chronic disease has been slow to take hold in medical circles, it could be because doctors sometime struggle to grasp brain function, Dr. Volkow said. “While it is very simple to understand a disease of the heart — the heart is very simple, it’s just a muscle — it’s much more complex to understand the brain,” she said.

Increasing interest in addiction medicine is a handful of promising new pharmaceuticals, most notably buprenorphine (sold under names like Suboxone), which has proved to ease withdrawal symptoms in heroin addicts and subsequently block cravings, though it causes side effects of its own. Other drugs for treating opioid or alcohol dependence have shown promise as well.

Few addiction medicine specialists advocate a path to recovery that depends solely on pharmacology, however. “The more we learn about the treatment of addiction, the more we realize that one size does not fit all,” said Petros Levounis, who is in charge of the residency at the Addiction Institute of New York at St. Luke’s-Roosevelt Hospital.

Equally maligned is the idea that psychiatry or 12-step programs are adequate for curing a disease with physical roots. Many people who abuse substances do not have psychiatric problems, Dr. Alford noted, adding, “I think there’s absolutely a role for addiction psychiatrists.”

While each institution has developed its own curriculum, the basic competencies each seeks to impart are the same. Residents will learn to recognize and diagnose substance abuse, conduct brief interventions that spell out the treatment options and prescribe the proper medications. The doctors will also be expected to understand the legal and practical implications of substance abuse.

Christine Pace, a 31-year-old graduate of Harvard Medical School, is the first addiction resident at Boston University Medical Center. She got interested in the subject as a teenager, when she volunteered at an AIDS organization and overheard heroin addicts complaining about doctors who could not — or would not — help them.

This year, when she became the in-house doctor at a methadone clinic in Boston, she was dismayed to find that the complaints had not changed. “I saw physicians over and over again pushing it aside, just calling a social-work consult to deal with a patient who is struggling with addiction,” Dr. Pace said.

One of her patients is Derek Anderson, 53, who credits Suboxone — as well as a general practitioner who six years ago recognized his signs of addiction — with helping him kick his 35-year heroin habit.

“I used to go to detoxes and go back and forth and back and forth,” he said. But the Suboxone “got me to where I don’t have the dependency every day, consuming you, swallowing you like a fish in water. I’m able to work now, I’m able to take care of my daughter, I’m able to pay rent — all the things I couldn’t do when I was using.”

A version of this article appeared in print on July 11, 2011, on page A11 of the New York edition with the headline: Medicine Adds Slots for Study Of Addictions.

Burlington targets those who buy alcohol for teens

WAY TO GO, MARILYN BELMONTE!!!

http://articles.boston.com/2011-05-22/news/29571882_1_young-adults-alcohol-task-force-poster

May 22, 2011|By John Laidler, Globe Correspondent

Burlington high schoolers designed the new…
The Burlington Drug and Alcohol Task Force is trying a new strategy to keep alcohol out of the hands of teenagers.

The group is undertaking a public education campaign this month targeting not teens or even their parents, but instead young adults who might be tempted to procure alcohol for underage siblings or friends.

The task force’s message to the 20-somethings, which is being conveyed through posters and flyers, is to refrain from that impulse.

“We have found that the most common way that high school students acquire alcohol is from older siblings and friends, so we wanted to reach that age group,’’ said Marilyn Belmonte, task force cochairwoman.

“Some of those in their 20s now may have had alcohol bought for them when they were in high school. So they might feel it’s the right thing to do the same for someone else,’’ she said.

Belmonte said the task force, a community organization that fights underage alcohol and illicit drug use, chose this month to deliver its message because this is the time of year when college students return home for the summer and when high schools hold their proms and graduations.

Designed by Burlington High School students, the posters are being placed in all of the town’s liquor stores and most of its pizza-serving restaurants, with the consent of those businesses.

Participating restaurants also agreed to attach the fliers — which are smaller versions of the poster — to their delivery boxes and place them in their take-out bags on Friday night and Saturday.

Belmonte got the idea for the initiative two years ago when she heard of a similar campaign that Weymouth’s substance abuse coalition was undertaking.

“I thought it was a great idea,’’ said Belmonte.

With the consent of the Weymouth coalition, the Burlington task force is employing the same slogan the South Shore group used: “Be the Designated Grown-up.’’ But Belmonte said that while the Weymouth campaign highlighted the criminal penalties young adults could incur procuring alcohol for a minor, the Burlington program is focused on the guilt they would feel if their younger sibling or friend became injured or got in trouble by consuming alcohol.

That theme came from an informal survey Belmonte conducted on Facebook last year in which she asked young adults what might deter them from buying alcohol for the underaged.

Strikingly, none said fear of criminal penalties would be a deterrent, Belmonte said.

“None of them felt that would ever happen,’’ she said of getting in trouble. “But each person said they would feel terrible if ‘something bad were to happen because I bought alcohol for my younger friend or younger brother or sister.’ ’’