1. Study links abnormal startle-reflex responses to higher risk of alcohol problems

    May 20, 2017 by Ashley

    From the Research Society on Alcoholism press release:

    The startle response, often recorded as an eye-blink reflex, is a defensive measure believed to reflect emotional processing. Patients with alcohol use disorders (AUDs) show abnormal startle-reflex responses to alcohol-related stimuli. This study examined startle-reflex responses to various visual stimuli among heavy drinkers, and assessed whether certain patterns predict the development of AUDs four years later.

    Researchers measured the startle-reflex responses of 287 men recruited from public health-care centers in Spain: 239 non-dependent, heavy-drinking men and 48 healthy men who comprised the control group. All participants were exposed to four types of pictures: alcohol-related, aversive, appetitive, and neutral. The participants were subsequently examined four years later to determine the predictive value of their startle response on drinking status.

    The researchers found that a reduced startle-reflex response to alcohol-related and aversive pictures predicted AUD status in previously heavy drinkers. At follow-up, among the participants who were heavy drinkers initially, 46% met DSM-IV criteria for alcohol abuse or dependence. The authors suggested that a diminished startle-reflex response to alcohol-related and aversive stimuli may reflect a greater reward motivation among vulnerable drinkers and can serve as a clinical marker to predict the future development of AUDs.


  2. Study looks at socioeconomic aspects of drinking

    May 19, 2017 by Ashley

    From the University of Washington press release:

    Neighborhoods with greater poverty and disorganization may play a greater role in problem drinking than the availability of bars and stores that sell hard liquor, a University of Washington-led study has found.

    While there is evidence for the link between neighborhood poverty and alcohol use, the new twist — that socioeconomics are more powerful environmental factors than even access to the substance itself — suggests that improving a neighborhood’s quality of life can yield a range of benefits.

    “Is there something about the neighborhood itself that can lead to problems? As we learn more about those neighborhood factors that are relevant, then this might point to population-level strategies to modify or improve the environments where people live,” said Isaac Rhew, a research assistant professor in the Department of Psychiatry & Behavioral Sciences.

    A common way to think of such broader changes is the “broken windows” theory of maintaining neighborhoods to deter crime. In other words, implementing programs, services or clean-up efforts to improve a neighborhood could help attain another goal: reducing problem drinking.

    The UW study was published online May 8 in the Journal of Urban Health.

    In examining the combination of multiple neighborhood factors on alcohol use, UW researchers turned to an ongoing research study of adults the university’s Social Development Research Group has followed for decades. They interviewed more than 500 of the adults in the study, who were first identified as fifth-graders in Seattle elementary schools and now live throughout King County. In this neighborhood study, 48 percent of participants were women; people of color made up nearly 60 percent of respondents.

    Researchers determined the U.S. Census Block Group (a geographic area of roughly 1,000 people) of each participant’s residence, along with demographic data tied to that area and the number of locations that sold hard alcohol there. Participants also answered a series of questions about their alcohol consumption and their perceptions of their neighborhood.

    This information allowed researchers to classify neighborhoods according to poverty level, alcohol availability (location of bars and liquor stores) and “disorganization,” which included factors such as crime, drug selling and graffiti.

    The ability to consider a number of neighborhood characteristics simultaneously and to identify patterns of how these characteristics grouped together to form distinct neighborhood types made this study different from others that might focus on the impact of, say, poverty alone, Rhew said.

    And while poverty and disorganization often are assumed to go hand-in-hand, that’s not always the case, added study co-author Rick Kosterman, a research scientist in the UW School of Social Work. A socioeconomically disadvantaged neighborhood might also be highly organized, with strong leaders, a sense of identity and various programs and services for residents. At the same time, a low-poverty neighborhood might be highly disorganized, with a lack of resources or sense of community, or a few streets with more trouble than others.

    In this study, researchers found that residents of neighborhoods primarily characterized by high poverty and disorganization tended to drink twice as much in a typical week as those in other types of neighborhoods. Binge-drinking — generally defined as more than four drinks at a time for women, five for men — occurred in these high-poverty, highly disorganized communities about four times as frequently as in other types of neighborhoods. These findings are consistent with previous research indicating that people in lower income neighborhoods may be at greater risk for alcohol-related problems, Rhew said.

    What’s different, Rhew and Kosterman agreed, is the fact that neighborhoods characterized by greater alcohol availability showed no increased alcohol use among residents — suggesting that socioeconomic factors may pose a greater risk for substance abuse.

    “On its face, the connection between poverty and disorganization and alcohol use may not be all that surprising, but when you find that this connection may be even more important than the location of bars and liquor stores, then it’s those characteristics of a neighborhood that we want to pay attention to,” Kosterman said.

    Researchers pointed to an important change that has occurred since their original data was collected: the passage of a state law in 2011 privatizing liquor sales. The availability of liquor went from a little more than 300 state-run stores to some 1,500 pharmacies, grocery stores and warehouse clubs.

    “Prior to privatization, locations of stores that sold hard liquor were more controlled by the state, so now a neighborhood that had one store that sold liquor could have several,” said Rhew. But the evidence is mixed in terms of the impact that nearby alcohol outlets have on alcohol use, he added. People who purchase alcohol in one location, for instance, may live in another.

    “People who utilize the outlets aren’t just people from the neighborhood. We see stronger evidence of the link between where alcohol is sold and other problems such as violence, crime, and drinking and driving, but not necessarily consumption,” he added.

    The ability, thanks to recent funding, to overlay neighborhood data with the longitudinal Seattle Social Development Project — the study of 808 individuals begun in 1985 — presents opportunities for future analyses of a variety of behaviors and circumstances, the researchers said.


  3. Bullying’s lasting impact

    May 14, 2017 by Ashley

    From the University of Delaware press release:

    A new study led by the University of Delaware found that kids who are bullied in fifth grade often suffer from depression and begin using alcohol and other substances a few years after the incidents.

    “Students who experienced more frequent peer victimization in fifth grade were more likely to have greater symptoms of depression in seventh grade, and a greater likelihood of using alcohol, marijuana or tobacco in tenth grade,” said the study’s leader, Valerie Earnshaw, a social psychologist and assistant professor in UD’s College of Education and Human Development.

    The study involved researchers from universities and hospitals in six states, who analyzed data collected between 2004 and 2011 from 4,297 students on their journey from fifth through tenth grade. The findings were published online in the medical journal Pediatrics.

    The students were from Birmingham, Alabama; Houston, Texas; and Los Angeles County, California. Forty-four percent were Latino, 29 percent were African American and 22 percent were white.

    Although peer victimization is common during late childhood and early adolescence and appears to be associated with increased substance use, few studies have examined these associations longitudinally — meaning that data is gathered from the same subjects repeatedly over several years — or point to the psychological processes whereby peer victimization leads to substance use.

    “We show that peer victimization in fifth grade has lasting effects on substance use five years later. We also show that depressive symptoms help to explain why peer victimization is associated with substance use, suggesting that youth may be self-medicating by using substances to relieve these negative emotions,” Earnshaw said.

    Impacts and interventions

    Peer victimization leads to substance use, and substance use can harm adolescent development with implications for health throughout the lifespan, Earnshaw said. Alcohol and marijuana use may interfere with brain development and can lead to injuries. Tobacco use may lead to respiratory illness, cancer and early death.

    “Youth who develop substance use disorders are at risk of many mental and physical illnesses throughout life,” Earnshaw said. “So, the substance use that results from peer victimization can affect young people throughout their lives.”

    Among the study’s findings, boys, sexual minority youth and youth living with chronic illness reported more frequent peer victimization in fifth grade. Age, obesity, race/ethnicity, household educational achievement and family income were not related to more frequent peer victimization.

    Twenty-four percent of tenth graders in the study reported recent alcohol use, 15.2 percent reported marijuana use, and 11.7 percent reported tobacco use. Sexual minority status was more strongly related to alcohol use among girls than boys; it was also related to marijuana and tobacco use among girls but not boys.

    Earnshaw used structural equation modeling — a form of statistical analysis — to examine the multiple variables across time and to test if there were relationships among them. She started working with the data in summer 2015 and finalized the model in fall 2016 in her office in UD’s Alison Hall.

    An expert in stigma research, Earnshaw wants to understand why people treat other people poorly and how this poor treatment leads to poor health, including through substance use behaviors. She hopes this latest study will enlighten pediatricians, teachers, parents — anyone in a position to help students facing peer aggression.

    “We urge pediatricians to screen youth for peer victimization, symptoms of depression and substance use,” says Earnshaw. “These doctors can offer counsel to youth and recommendations to parents and youth for approaching teachers and school staff for support. Moreover, youth experiencing depressive symptoms and substance use should be offered treatment when needed.”

    The research team’s messages also extend to teachers.

    Peer victimization really matters, and we need to take it seriously — this echoes the messages educators already have been receiving,” Earnshaw says. “This study gives some additional evidence as to why it’s important to intervene. It also may give teachers insight into why students are depressed or using substances in middle and high school.”


  4. Study suggests gender differences in effects of alcoholism on the brain’s reward system

    April 25, 2017 by Ashley

    From the Massachusetts General Hospital press release:

    A collaborative study between researchers at Massachusetts General Hospital (MGH) and Boston University School of Medicine (BUSM) has found evidence implying that alcoholism may have different effects on the reward system in the brains of women than it does in men.

    In their paper published in Psychiatry Research Neuroimaging, the team reports that reward system structures are larger in alcoholic women than in nonalcoholic women, and their report confirmed earlier studies that found the same structures were smaller in alcoholic men than in nonalcoholic men. The study, which enrolled currently abstinent individuals with a history of long-term alcohol use disorder, also found a negative association between the length of sobriety and the size of the fluid-filled ventricles in the center of the brain, suggesting possible recovery of the overall brain from the effects of alcoholism.

    “Until now, little has been known about the volume of the reward regions in alcoholic women, since all previous studies have been done in men,” says co-author Gordon Harris, PhD, of the 3D Imaging Service and the Center for Morphometric Analysis in the Martinos Center for Biomedical Imaging at MGH. “Our findings suggest that it might be helpful to consider gender-specific approaches to treatment for alcoholism.”

    The brain’s reward system is a group of structures – including the amygdala and the hippocampus – that reinforce beneficial experiences, are involved in memory and complex decision-making and have been implicated in the development of substance use disorders. Since there are known difference between the psychological and behavioral profiles of women and men with alcoholism – women tend toward having higher levels of anxiety, while men are more likely to exhibit anti-social characteristics – the current study was designed to investigate whether the alcoholism-associated reward system differences previously observed in men would also be seen in women.

    The study enrolled 60 participants with histories of long-term alcoholism – 30 women and 30 men – and an equivalent group of nonalcoholic volunteers. The alcoholic participants had been abstinent for time periods ranging from four weeks to 38 years. Participants completed detailed medical histories and neuropsychological assessments with the BUSM researchers before having MRI brain scans at the Martinos Center that were analyzed both in terms of the total brain and of the structures in the reward network.

    Replicating the results of earlier studies, the average sizes of reward region structures of alcoholic men were 4.1 percent smaller than those of nonalcoholic men, but the average sizes of the same structures were 4.4 percent larger in alcoholic than in nonalcoholic women. While factors such as the duration and intensity of heavy drinking appeared to reinforce these gender-specific effects, the research team notes that the current study cannot determine whether these differences preceded or resulted from the development of alcoholism. Among participants with alcoholism – both women and men – each year of sobriety was associated with a 1.8 percent decrease in the size of the ventricles, suggesting recovery from the damaging effects of alcoholism on the brain.

    “We’re planning to take a more detailed look at the impact of factors such as the severity of drinking and the length of sobriety on specific brain structure, and hope to investigate whether the imaging differences seen in this and previous studies are associated with gender-based differences in motivational and emotional functions,” says co-author Marlene Oscar-Berman, PhD, a professor of Psychiatry, Neurology, and Anatomy & Neurobiology at BUSM.


  5. Study suggests heavy drinking impacts performance over time

    April 21, 2017 by Ashley

    From the Veterans Affairs Research Communications press release:

    Heavy drinkers develop behavioral tolerance to alcohol over time on some fine motor tasks, but not on more complex tasks, according to a study led by a Veterans Affairs San Diego Healthcare System researcher. While heavy drinkers showed less impairment than light drinkers on a rote fine motor test over time, they did not perform better on a test involving more short-term memory, motor speed, and more complex cognitive processing.

    The study offers new insight into the changes and problems that accompany excessive drinking. As the researchers explain, “The results have implications for our understanding of alcohol-induced impairments across neurobehavioral processes in heavy drinkers and their ongoing risks for alcohol-related consequences over time.”

    Lead researcher Dr. Ty Brumback adds, “The most important thing about the study is that despite heavy drinkers’ extensive experience with alcohol, increased speed of metabolism, and lower self-perceived impairment, we show that on a more demanding task they are just as impaired as light drinkers.”

    Brumback is a postdoctoral fellow in addiction treatment with VA and the University of California, San Diego.

    The study results were published in a March 2017 issue of the journal Psychopharmacology.

    Many studies have measured how consuming alcohol impairs both cognitive function and motor coordination. Researchers have also observed that people with histories of heavier prolonged drinking often show greater tolerance to alcohol than lighter drinkers. While research has shown that more experienced drinkers are less impaired by alcohol on some performance measures, the degree to which this tolerance changes over time has not been clearly shown.

    This study sought to answer this question as part of the Chicago Social Drinking Project, led by Dr. Andrea King at the University of Chicago. One-hundred fifty-five young adult volunteers were tested on two cognitive and motor coordination tests at the beginning of the study and again five years later.

    The study defined a heavy drinker as a person who drank between 10 and 40 alcoholic drinks per week for at least the past two years at the initial testing. This involved consuming more than five drinks at one time for men and more than four for women. Light drinkers were those who had fewer than six drinks per week. Participants maintained these drinking habits across the five years between initial testing and follow-up.

    Participants completed two psychomotor tasks. In the Grooved Pegboard Test, they were timed moving, inserting, and rotating pegs into slotted holes on a board. This test measures fine motor skills. In the Digit Symbol Substitution Test (DSST), participants were given a legend with different symbols corresponding to numbers. They then had 90 seconds to fill in the correct symbols on a sheet with numbers. The test is designed to assess not only fine motor skills, but also short-term memory and cognitive processing.

    Brumback explains that a real-world activity such as using keys to unlock a door is similar to manipulating a peg on the Pegboard Test. The DSST is akin to more complex tasks such as remembering directions to a novel location or driving a car.

    Before each test, participants were given a dose of alcohol that was calculated based on their body weight to bring them to a specific breath alcohol concentration. They were then tested at 30, 60, 120, and 180 minutes after the drink.

    As expected, all the participants performed worse on both tests when impaired by alcohol. In a prior report, the authors showed that light and heavy drinkers showed similar levels of impairment on both tasks during the initial testing. At the five-year follow-up, both groups showed improvement on both tasks compared with how they had done when tested years earlier, which the authors attribute primarily to practice effects.

    Heavy drinkers also showed evidence of chemical tolerance to alcohol. Their breath alcohol concentrations decreased faster after drinking at the five-year retest versus the initial test. The result lends support to the idea that heavy drinkers absorb and metabolize alcohol faster than light drinkers.

    While both groups did better at the follow-up, heavy drinkers showed less impairment on the pegboard than light drinkers relative to their initial testing scores. This did not hold true on the DSST, however. Both heavy and light drinkers showed similar levels of impairment during the follow-up testing.

    All in all, the results show that sustained heavier drinking may lead to less impairment in simpler fine motor skills relative to lighter drinking, but this tolerance does not help performance on tasks involving more complex motor processing and short-term memory. Thus, faster metabolization of alcohol in heavy drinkers did not lead to better performance on the more complex task.

    Heavier drinkers may develop behavioral tolerance for several reasons, say the researchers. Repeatedly drinking to intoxication leads to cellular adaptation within the brain, changing the sensitivity to alcohol. Contextual factors also play a part: When people learn a task while drunk, they adapt to performing that task while under the influence.

    A key point the researchers highlight is that heavy drinkers reported lower self-perceived impairment than light drinkers. They suggest that, for heavy drinkers, lower perceived impairment and higher sensitivity to the stimulating and rewarding effects of alcohol could make the habit more dangerous for them. They may engage in more potentially risky behaviors while drunk because they see their impairment level as lower.

    Brumback provides an example of how this could play out in the real world, “Say a heavy drinker is out at a restaurant and becomes intoxicated. When it comes time to leave, this person has only internal and external cues to help make the decision whether to drive home or call a cab. So, if this person tends to perceive herself as less impaired, she gets up from the table and walks to the door, pushes the door open, and walks to her car. These simple motor functions may not provide sufficient feedback for her to decide she is too drunk to drive. Furthermore, when she gets to her car and unlocks the door and even puts the car in gear, she may not be perceiving impairment in these simple tasks. However, once she begins to drive, the cognitive and psychomotor demands increase significantly but the decision to drive has already been made based on the earlier simple tasks.”

    In scenarios such as this, alcohol tolerance may in fact lead heavy drinkers to judge that they are not impaired and attempt more difficult tasks.

    “Overall, there is a common belief among heavy drinkers that they can ‘handle their alcohol’ and that many common daily tasks may not be affected by their alcohol use,” says Brumback. “The take-home message here is that tolerance to alcohol is not equal across all tasks and is not ‘protective’ against accidents or injuries while intoxicated, because it may in fact lead the heavy drinker to judge that they are not impaired and attempt more difficult tasks. Making such decisions in the moment is highly risky, because it is based on faulty information.”


  6. Risky alcohol consumption can increase at time of retirement

    April 9, 2017 by Ashley

    From the University of Turku press release:

    Of retiring employees, 12 percent increased their risky drinking at the time of retirement. However, for most people, there was no change in risky level alcohol consumption around the time of retirement: 81 percent sustained healthy drinking during the follow-up, and in 7 percent of the participants risky drinking was constant, although they experienced a slow decline in risky level alcohol consumption after retirement. In the study, the levels for risky drinking were 24 units per week for men and 16 units for women, or passing out due to extreme alcohol consumption.

    Increase in risky drinking was more common in smokers, men and those who reported depression, says Senior Researcher, Docent Jaana Halonen from the Finnish Institute of Occupational Health. These are known risk factors for substantial alcohol use.

    Retirement is a major transition in life and, in the light of these results, it also involves a risk of adopting an unhealthy lifestyle.

    • As baby boomers retire, approximately 70,000 Finns retire each year, so it is a significant social phenomenon. The increase in free time and the changes in the social networks related to retirement can have either adverse or positive effects on public health, says Academy Research Fellow, Docent Sari Stenholm from the University of Turku.
    • Occupational health care and employers could develop operational strategies that could prepare employees for retirement and the changes it can cause. This way, unhealthy changes in lifestyle could be prevented, suggests Jaana Halonen.

    Nearly 6,000 Employees from Public Sector Participated in the Study

    The study followed 5,800 employees who participated in the Finnish Public Sector (FPS) study and had retired due to old-age between 2000 and 2011. Each participant answered questions on alcohol consumption before and after retirement.


  7. Research reveals how family history can affect your memory of hangovers

    March 30, 2017 by Ashley

    From the Keele University press release:

    People with a family history of alcoholism are already known to be at a greater risk of developing a drinking problem, but new research led by Psychologist Dr Richard Stephens at Keele University has found they are also more likely to hold onto the painful memory of hangovers.

    Dr Stephens’ latest research paper, “Does familial risk for alcohol use disorder predict alcohol hangover?,” involved two studies focusing on hangover frequency and severity.

    According to the National Institute on Alcohol Abuse and Alcoholism people with a family history of alcoholism are four times more likely to develop a drinking problem. Based on this, Dr Stephens’ research explores whether hangovers — unpleasant effects felt the morning after drinking alcohol — impact on this.

    In the first study, 142 individuals, including 24 who had a family history of problem drinking, were asked to complete a survey about their hangovers from the last 12 months. The study found those with alcoholism in their family background recollected more frequent hangover symptoms than those who didn’t have any family history of problem drinking, taking account of alcohol consumption levels.

    In the second study, a group of 49 participants, including 17 who had a family history of alcoholism, were interviewed the morning after a night of drinking when any hangover symptoms would be present. The alcohol consumption levels were again controlled, but the participants with a family history of alcoholism did not show any greater signs of hangover symptoms compared to participants without any family background of problem drinking.

    Dr Stephens, from Keele University, said: “We started off this research by questioning whether hangovers might impact on problem drinking, either positively by providing a natural curb on excessive drinking, or negatively should some drinkers feel compelled to drink through a hangover, known as “the hair of the dog” drinking.

    “Taken together with findings from prior research it appears that people who are predisposed to develop problem drinking are no more susceptible to developing a hangover after a night of alcohol than people who are not predisposed. However, we found that such people appear to remember their hangovers more lucidly.

    It may be possible to exploit this lucid memory for hangovers to curb excessive drinking. Reminding problem drinkers of the negative consequences of incapacitating hangover, for example, letting down family members due to abandoned plans, may help them to manage their alcohol consumption.”


  8. New study links opioid epidemic to childhood emotional abuse

    March 24, 2017 by Ashley

    From the University of Vermont press release:

    A study by researchers at the University of Vermont has revealed a link between adult opioid misuse and childhood emotional abuse, a new finding that suggests a rethinking of treatment approaches for opioid abusers.

    To uncover the link to emotional abuse, the study, published in the current issue of Addictive Behaviors, analysed and cross referenced the results of a series of psychological tests administered to a sample of 84 individuals with a history of problem opioid use who had also suffered childhood trauma.

    Earlier research has found that a high percentage of adults who abuse substances were maltreated in a variety of ways as children. But few previous studies have investigated the causes of opioid addiction specifically, and no earlier ones narrowed the link among opioid users to emotional abuse.

    Emotional abuse was much more strongly correlated with survey participants’ problem opioid use than childhood sexual and physical abuse or other kinds of maltreatment such as neglect.

    The study found that children who had been emotionally abused were more likely to engage in rash, risky behavior in adolescence and to suffer posttraumatic stress disorder (PTSD) as adults. Opioid use offered a refuge from PTSD for this group — while causing a host of new problems. The severity of the PTSD was directly linked to the severity of their opioid-related problems.

    “If a person is being physically or sexually abused, it’s easier to put the blame on the person doing the abuse,” said Matthew Price, assistant professor in Department of Psychological Science at the University of Vermont, and the paper’s senior author.

    “With emotional abuse, the abuser is saying ‘You are the problem.’ Being called names, being told you’re not good enough, being told no one cares about you undermines your ability to cope with difficult emotions. To protect themselves from strong emotions and from trauma cues that can bring on PTSD symptoms, people with this kind of childhood experience frequently adopt a strategy of avoidance, which can include opioid use.”

    New treatment approaches

    The findings suggest why some opioid abusers don’t respond to substance abuse counseling or PTSD treatment and point the way toward potentially more productive therapies. Drug addiction and mental health issues are often treated separately by different kinds of specialists, Price said. “Mental health counselors will frequently say, ‘Deal with your drug issues first, then come to see me.'”

    The study suggests “we should really start to explore more integrated treatment,” Price said. “If a patient has had severe emotional abuse and they have a tendency to act out when they’re feeling upset, and then they turn to opioids to deal with the resulting PTSD, it makes sense to address the emotional component and the drug problems at the same time.”

    In the study, participants were interviewed about their childhood experiences and then given a battery of psychological tests that measured the type and extent of any maltreatment they had experienced as children, the extent to which their opioid use was causing life problems, the severity of their addiction, the extent of their impulsive behavior, and the extent and severity of their PTSD.

    The researchers used a sophisticated statistical method known as structural equation modeling, or SEM, to make connections between the data sets each of the individual tests brought to light, which illuminated the pathway from childhood emotional abuse to rash adolescent behavior to PTSD to opioid abuse.


  9. Giving up cigarettes linked with recovery from illicit substance use disorders

    March 22, 2017 by Ashley

    From the Columbia University’s Mailman School of Public Health press release:

    Smokers in recovery from illicit drug use disorders are at greater risk of relapsing three years later compared with those who do not smoke cigarettes. Results of the study by researchers at Columbia University’s Mailman School of Public Health and the City University of New York appear online in The Journal of Clinical Psychiatry.

    Most adults who have illicit drug use disorders also smoke cigarettes. Yet while treatments for substance use disorders traditionally include and require concurrent treatment for addiction to all substances — including treatment for and required abstinence from alcohol and any other illicit substance use — treatment for nicotine dependence has not routinely been part of treatment for illicit substance use problems.

    “The thinking in clinical settings has been that asking patients to quit cigarette smoking while they try to stop using drugs is “too difficult,” or that smoking may be helpful in remaining abstinent from alcohol and drugs, but it is not related whether or not one remains abstinent from illicit drug use over the long term,” said Renee Goodwin, PhD, of the Department of Epidemiology, Mailman School of Public Health, who led the research.

    The researchers studied data from 34,653 adults enrolled in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who were assessed at two time points, three years apart, on substance use, substance use disorders, and related physical and mental disorders. Only those with a history of illicit substance use disorders according to DSM-IV criteria were included in the final sample. Daily smokers and nondaily smokers had approximately twice the odds of relapsing to drug use at the end of the three-year period compared with nonsmokers. The relationships held even after controlling for demographics and other factors including mood, anxiety, alcohol use disorders, and nicotine dependence.

    Specifically, among those with remitted substance use disorders who were smokers at the beginning of the study, more than one in ten (11 percent) who continued smoking three years later relapsed to illicit substance use three years later, while only 8 percent of those who had quit smoking and 6.5 percent of never smokers relapsed to substance use three years later. Among those who were non-smokers, smoking three years later was associated with significantly greater odds of substance use disorders relapse compared to those who remained non-smokers.

    “Quitting smoking will improve anyone’s health,” says lead author Andrea Weinberger, PhD, an assistant professor in the Department of Epidemiology and Population Health, Albert Einstein College of Medicine. “But our study shows that giving up cigarettes may be even more important for adults in recovery from illicit substance use disorders since it may help them stay sober.”

    “If research continues to show a relationship between smoking and relapse to substance use among those in recovery, making tobacco treatment a standard part of treatment for illicit substance use disorders may be a critical service to provide to adults toward improving substance treatment outcomes over the long term,” suggested Dr. Goodwin.


  10. Aggression disorder linked to greater risk of substance abuse

    March 16, 2017 by Ashley

    From the University of Chicago Medical Center press release:

    People with intermittent explosive disorder (IED) — a condition marked by frequent physical or verbal outbursts — are at five times greater risk for abusing substances such as alcohol, tobacco and marijuana than those who don’t display frequent aggressive behavior, according to a new study by researchers from the University of Chicago.

    In the study, published Feb. 28, 2017 in the Journal of Clinical Psychiatry, Emil Coccaro, MD, and colleagues analyzed data from more than 9,200 subjects in the National Comorbidity Survey, a national survey of mental health in the United States. They found that as the severity of aggressive behavior increased, so did levels of daily and weekly substance use. The findings suggest that a history of frequent, aggressive behavior is a risk factor for later substance abuse, and effective treatment of aggression could delay or even prevent substance abuse in young people.

    IED affects as many as 16 million Americans, more than bipolar disorder and schizophrenia combined. It is often first diagnosed in adolescents, some of whom are as young as 11, years before substance abuse problems usually develop. IED runs in families and is thought to have a significant genetic component, although Coccaro said people tend to treat it as a social-behavioral issue instead of as a true neurobiological disorder.

    “People don’t see this as a medical problem. They think of it as simply bad behavior they have developed over the course of their lives, but it isn’t. It has significant biology and neuroscience behind it,” said Coccaro, who is the Ellen C. Manning Professor of Psychiatry and Behavioral Neuroscience at UChicago.

    Previous research has implied that aggressive behavior in IED is due to the presence of other psychiatric disorders, such as anxiety or depression. But the new UChicago study found no such relationship. While substance abuse, like excessive drinking, can clearly make aggressive behavior worse, the onset of IED almost always precedes the development of chronic substance abuse. Coccaro and his team found that IED preceded substance abuse in 92.5 percent of the cases where subjects developed both disorders.

    Coccaro emphasized that early psychological intervention, medication and cognitive therapy are the most effective treatments to prevent, or at least delay, substance abuse problems in adolescents diagnosed with IED.

    What you’re really treating is the emotional dysregulation that leads to aggression,” Coccaro said. “The earlier you treat this dysregulation, the more likely you are to offset other disorders that come later down the road.”