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38 Million American Adults are Binge Drinkers, CDC Says

The Centers for Disease Control and Prevention (CDC) say 38 million American adults are binge drinkers, and most of them are ages 18 to 34. In a new report, the CDC says that while binge drinking is more common among young adults, those age 65 and older who binge drink do so more often — an average of five to six times a month.

 Binge drinking is defined as men who have five or more drinks in one sitting, and women who have four or more drinks at one time, HealthDay reports.

 Binge drinking is responsible for more than half of the 80,000 alcohol-related deaths each year in the United States, and accounts for about three-fourths of the more than $200 billion in costs from alcohol abuse, according to the CDC.

 “Binge drinking causes a wide range of health, social and economic problems and this report confirms the problem is really widespread,” CDC Director Thomas R. Frieden, M.D., M.P.H. said in a news release. “We need to work together to implement proven measures to reduce binge drinking at national, state and community levels.”

 The CDC found binge drinking is more common among people with household incomes of $75,000 or more. However, binge drinkers with household incomes of less than $25,000 have the largest number of drinks per sitting—an average of eight to nine drinks.

 Researchers Seek to Predict Stress-Induced Substance Abuse Relapse

With more than two thirds of people relapsing after starting treatment for substance use disorders, researchers are looking for ways to predict a person’s susceptibility to return to drug or alcohol use. Researchers at the Yale Stress Center in New Haven, CT, are developing biological markers of recovery to predict who will relapse, and when.

 Having validated markers to measure a person’s risk of relapse could help doctors better predict who is at highest risk and tailor treatments for them, says Rajita Sinha, PhD, Director of the Yale Stress Center. For instance, a doctor might recommend an extended stay in residential treatment, or more intense behavioral treatment for patients who are likely to relapse.

 While much is known about the effects of stress on addiction, much less is understood about how stress affects a person’s risk of relapse and jeopardizes recovery, according to Dr. Sinha. “When the regions of the brain involved in regulating stress are not working well, it increases a person’s vulnerability to relapse,” she says. “We want to find those neural and biological measures that predict whether this will occur.”

 She and her colleagues are testing a number of biological measures of stress in people with various substance use disorders, including cocaine addiction and alcoholism. They are studying patients who are discharged from inpatient substance abuse treatment, to see if and when they relapse. The researchers are looking for links between relapse and biological markers including high levels of the chemical cortisol and high blood levels of a protein called brain-derived neurotrophic factor (BDNF), as well as brain atrophy in specific regions of the brain.

 In a recently published study in the Archives of General Psychiatry, Dr. Sinha found several markers of increased risk of alcohol relapse, including high morning levels of the hormone corticotrophin. Another recent study, published in Biological Psychiatry, found high levels of BDNF in cocaine-dependent patients was predictive of an early relapse.

 Dr. Sinha’s lab is also studying treatments to reduce stress-induced substance abuse. One recent pilot study found an older drug for hypertension called prazosin appears to decrease stress-induced alcohol craving. “We are also identifying newer drugs that could help those most susceptible to stress,” she notes. “But first we need to validate biological markers so we know who will benefit from these treatments.”

 Prescription Drug Abuse Results in One Death Every 19 Minutes in U.S.

One person dies every 19 minutes from prescription drug abuse in the United States, according to the Centers for Disease Control and Prevention (CDC). An estimated 27,000 unintentional drug overdose deaths occurred in 2007, UPI reports.

 The rise in unintentional drug overdose deaths has been driven by an increase in use of opioids, the CDC notes in the Morbidity and Mortality Weekly Report. For every unintentional overdose death linked to opioids, nine people are admitted for substance abuse treatment, 35 people go to the emergency room, 161 report drug abuse or dependence, and 461 report non-medical uses of opioids.

The rate of opioid misuse and overdose deaths are highest among non-Hispanic whites, men ages 20-64, and poor and rural populations.

The National Response to this Crisis

 At the national level, the White House Office of National Drug Control Policy establishes policies, priorities, and objectives for the nation’s drug control program to reduce illicit drug use, manufacturing, and trafficking; drug-related crime and violence; and drug-related health consequences. In May 2010, President Obama released the National Drug Control Strategy, which outlined the Administration’s science-based public health approach to drug policy. In 2011, the strategy was expanded to place special focus on certain populations, such as service members and their families, college students, women and children, and persons in the criminal justice system.

When developing a national approach to address prescription drug overdose, any policy must balance the desire to minimize abuse with the need to ensure legitimate access to these medications, and its implementation must bring together a variety of federal, state, local, and tribal groups. The Administration’s plan for addressing prescription drug abuse, Epidemic: Responding to America’s Prescription Drug Abuse Crisis, which was released in April 2011, includes four components: education, tracking and monitoring, proper medication disposal, and enforcement.

The majority of health-care providers receive minimal education regarding addiction and might be at risk for prescribing an addictive medication without fully appreciating the potential risks. Therefore, the first component of the plan calls for mandatory prescriber education. This would require prescribers to be trained on appropriate prescribing of opioids before obtaining their controlled substance registration from the Drug Enforcement Administration (DEA). Parents and patients also must be educated about the dangers and prevalence of prescription drug abuse and how to use prescription drugs safely. To achieve this, the plan calls for a public/private partnership to develop an educational campaign directed at parents and patients.

The second component of the plan calls for prescription drug monitoring programs to be operational in all states and mechanisms to be in place for data sharing. As of May 2011, 35 states had operational monitoring programs, and 13 additional states had passed enacting legislation.

The third component, proper medication disposal, is essential because the public lacks a safe, convenient, and environmentally responsible way to dispose of medications that are no longer needed. DEA is drafting rules to provide easier access to drug disposal. In support of medication disposal efforts, DEA held National Prescription Drug Take-Back Events in 2010 and 2011. During the first two such events, approximately 309 tons of drugs were collected at over 5,000 sites across the country.

The fourth component calls on law enforcement agencies to help decrease prescription drug diversion and abuse. The majority of prescribers are responsible, but unscrupulous persons continue to operate outside of legitimate medical practice. These persons must be held accountable, and the plan outlines specific actions the federal government can take to help law enforcement agencies effectively address pill mills and doctor shopping.

The CDC says the two main groups at risk for prescription drug overdose are the nine million people who report long-term medical use of opioids, and the roughly 5 million who have used opioids without a prescription or medical need in the past month.

 Family History of Alcoholism May Affect Teens’ Decision-Making

A family history of alcoholism may affect teenagers’ decision-making, researchers at Oregon Health and Sciences University have found. They discovered these adolescents have a weaker brain response during risky decision-making compared with teens without such a family history.

 The researchers studied 31 teens ages 13 to 15. Of these, 18 had a family history of alcoholism. All of the teens’ brains were scanned using functional magnetic resonance imaging, to examine responses during an activity that mimicked the TV show Wheel of Fortune. The game presented risky and safe probabilities of winning different sums of money.

 In the teens with a family history of alcoholism, the researchers noted that two areas of the brain responded differently, UPI reports. These brain areas are important for executive functioning, which guide complex behavior through planning, decision-making and response control. This group of teens showed weaker brain responses during risky decision-making, compared with teens who did not have a family history of alcoholism.

 The researchers conclude in the journal Alcoholism: Clinical & Experimental Research, “Atypical brain activity, in regions implicated in executive functioning could lead to reduced cognitive control, which may result in risky choices regarding alcohol use.”

 Many States Receive Failing Grades in Lung Association Report on Anti-Tobacco Efforts

Many states received failing grades on the latest American Lung Association report card rating tobacco control efforts. Forty-three states and the District of Columbia earned an “F” for funding smoking-prevention programs at less than half the levels recommended by the Centers for Disease Control and Prevention (CDC).

 Alaska was the only state that funded tobacco programs at the CDC’s recommended levels, Bloomberg Businessweek reports. Overall, states’ collective spending on anti-smoking programs dropped 11 percent last year, and only Vermont and Connecticut raised cigarette taxes. Eight states rejected cigarette tax proposals, while New Hampshire decreased its cigarette tax 10 cents per pack, according to the report, the State of Tobacco Control.

 “At a time when our country is trying to get a handle on health-care spending, this is an enormous expense that could be avoided by investing in effective tobacco-prevention and cessation programs and policies,” said American Lung Association President and Chief Executive Officer, Charles Connor.

 The report covered four policy areas: cigarette taxes, smoking bans, tobacco-prevention spending and cessation coverage. Four states—Delaware, Hawaii, Maine and Oklahoma—received passing grades in all four areas, while six states—Alabama, Mississippi, Missouri, South Carolina, Virginia and West Virginia—failed in all four categories.

 The federal government made some progress in tobacco control, by beginning to offer comprehensive smoking cessation benefits to millions of federal employees and their families, the report noted. The federal government also announced it will give states partial reimbursement for smoking cessation counseling services for Medicaid enrollees through state toll-free phone quitlines.