CHICAGO (AP) — A study of Australian twins and marijuana bolsters the fiercely debated “gateway theory” that pot can lead to harder drugs.

The researchers located 311 sets of same-sex twins in which only one twin had smoked marijuana before age 17. Early marijuana smokers were found to be up to five times more likely than their twins to move on to harder drugs.

They were about twice as likely to use opiates, which include heroin, and five times more likely to use hallucinogens, which include LSD.

Earlier studies on whether marijuana is a gateway drug reached conflicting conclusions. The impasse has complicated the debate over medical marijuana and decriminalization of pot.

Because this study involved twins, the findings would suggest that genetics play a subordinate role in drug use.

The study appears in Wednesday’s Journal of the American Medical Association and was funded in part by the National Institutes of Health.

It does not answer how marijuana, or cannabis, might lead to harder drugs.

“It is often implicitly assumed that using cannabis changes your brain or makes you crave other drugs,” said lead researcher Michael Lynskey, “but there are a number of other potential mechanisms, including access to drugs, willingness to break the law and likelihood of engaging in risk-taking behavior.”

Lynskey is a senior research fellow at Queensland Institute of Medical Research in Brisbane and a visiting assistant psychiatry professor at Washington University in St. Louis, where some of the research was done.

Lynskey and colleagues acknowledged the study has several limitations, including relying on participants’ reporting of their own experiences,

In an accompanying editorial, Denise Kandel of Columbia University’s psychiatry department said the study does not explain “whether or not a true causal link exists” between marijuana and hard drugs.

“An argument can be made that even identical twins do not share the same environment during adolescence,” she said.

Study participants were age 30 on average when they were asked about their teenage drug use. They included 136 sets of identical twins, who share the same genetic makeup.

About 46 percent of the early marijuana users reported that they later abused or became dependent on marijuana, and 43 percent had become dependent on alcohol.

Cocaine and other stimulants were the most commonly used harder drugs, tried by 48 percent of the early marijuana users, compared with 26 percent of the non-early marijuana users. Hallucinogens were the second most common, used by 35 percent of the early marijuana twins versus 18 percent of the others.

WASHINGTON (AP) — To wake parents up to the importance of snoozing, sleep experts warned Tuesday that seemingly energetic children who dodge bedtime for other activities are more prone to injury, poor school performance and crankiness.

“A tired child is an accident waiting to happen,” said Dr. Carl Hunt, director of the National Center on Sleep Disorders Research at the National Institutes of Health.

Many children with chronic sleep deprivation may not seem tired and may even appear to be overactive.

Hunt said injuries on bicycles and on playground equipment are more likely to occur when a child is sleep-deprived, and if poor sleeping habits continue as kids grow older, “the stakes get higher.”

“It turns into the teenager who is drowsy and driving a car,” he said.

Research shows that bad sleep habits for children can carry over into poor health for adults — causing heart ailments, respiratory problems and obesity, said Dr. Claude Lenfant, director of NIH’s National Heart, Lung and Blood Institute.

Children ages 7 to 11 require at least nine hours of sleep each night on a regular basis to do their best in school and extracurricular activities, NIH said.

Inadequate sleep results in difficulties with focused attention, irritability, easy frustration and difficulty controlling emotions.

NIH estimates that more than 70 million Americans of every age are sleep-deprived.

“Unfortunately in this 24-7 society we’re living in these days, it creates many distractions and obstacles to getting a good night’s sleep,” said Hunt. “We’re living in a society that doesn’t value sleep enough.”

Besides increased extracurricular activities and homework, things that are getting in the way of a good night’s sleep for a child are television, the Internet, cell phones and e-mail — with many of those distractions located in children’s bedrooms.

“These give children lots of opportunity to do other things besides sleep,” Hunt said.

To address health problems associated with sleep deprivation, NIH launched its Star Sleeper educational campaign to raise family awareness to the problem.

On Tuesday, it announced three winners of its “How I Get a Heap of Sleep” contest in which children described their tactics for getting nine hours of sleep each night. One winner was Danielle Wodka, 7, of Lemont, Ill. Her sleep strategies included taking a warm bath and saying her prayers.

Other winners — including Amanda Davol of Somerset, Mass., and Qian Wang of Fort Thomas, Ky. — said they listened to soothing music or read a book to lull them into sleep.

Getting children in the mood for bedtime is half the battle, says Danielle’s mother, Chris Wodka, of Lemont, Ill.

“It’s a struggle with Game Boy and the TV shows,” said Wodka

LONDON (AP) — Children growing up in single-parent families are twice as likely as their counterparts to develop serious psychiatric illnesses and addictions later in life, according to an important new study.

Researchers have for years debated whether children from broken homes bounce back or whether they are more likely than kids whose parents stay together to develop serious emotional problems.

Experts say the latest study, published this week in The Lancet medical journal, is important mainly because of its unprecedented scale and follow-up — it tracked about 1 million children for a decade, into their mid-20s.

The question of why and how those children end up with such problems remains unanswered. The study suggests that financial hardship may play a role, but other experts say the research also supports the view that quality of parenting could be a factor.

The study used the Swedish national registries, which cover almost the entire population and contain extensive socio-economic and health information. Children were considered to be living in a single-parent household if they were living with the same single adult in both the 1985 and 1990 housing census. That could have been the result of divorce, separation, death of a parent, out of wedlock birth, guardianship or other reasons.

About 60,000 were living with their mother and about 5,500 with their father. There were 921,257 living with both parents. The children were aged between 6 and 18 at the start of the study, with half already in their teens.

The scientists found that children with single parents were twice as likely as the others to develop a psychiatric illness such as severe depression or schizophrenia, to kill themselves or attempt suicide, and to develop an alcohol-related disease.

Girls were three times more likely to become drug addicts if they lived with a sole parent, and boys were four times more likely.

The researchers concluded that financial hardship, which they defined as renting rather than owning a home and as being on welfare, made a big difference.

However, other experts questioned the financial influence, saying Swedish single mothers are not poor when compared with those in other countries, and suggested that quality of parenting could also be a factor.

“It makes you think that what you’re seeing is just the most dysfunctional families having these problems, rather than the low income. The money is really an indicator of something else,” said Sara McLanahan, a professor of sociology and public affairs at Princeton University, who was not involved in the study.

“If you really thought that it was the income that makes the difference, you would think that Swedish lone mothers would do a lot better than the British or those in the U.S., but they look very similar,” she said.

Other experts agreed.

In the last 20 to 30 years, poverty has been greatly reduced everywhere in Europe, but psychiatric problems in children have not, said Dr. Stephen Scott, a child health and behavior researcher at the Institute of Psychiatry in London, who also was not involved in the study.

He said that in previous studies, once researchers have adjusted their results to eliminate the influence of bad parenting, any increased risk of emotional problems shrinks markedly. This, he said, indicates it is not so much single parenthood but the quality of parenting that is at issue.

“The kind of people who end up as single parents might not have done well by their kids, even if they hadn’t ended up alone. They tend to be more critical in their relationships, more derogatory toward other people,” Scott said, adding that it is also harder to be a warm, non-critical parent when you’re bringing up a child alone.

However, he noted that there are plenty of children from single-parent families who don’t end up with serious emotional problems.

There may also be a genetic element: More irritable people are more likely to become separated, but they are also more likely, whether they are separated or not, to have more irritable children, Scott said.

“The whole field is highly debated. This is another piece in that debate that makes several important points — firstly that there really is an increased risk in young adulthood of pretty bad things. It also indicates it’s not all about the money, but may be about the people themselves,” McLanahan said.

(AP) — High school athletes who suffer the mildest of concussions — in which obvious symptoms disappear within 15 minutes — often have memory problems and other latent difficulties days after the injury, according to a new study.

The study from the University of Pittsburgh Medical Center Sports Medicine Concussion Program shows that coaches and doctors should be cautious in deciding when an athlete can return to a game after a concussion, said researcher Mark Lovell, a neuropsychologist and director of the concussion program.

Now, coaches and trainers often allow an athlete to return to the game or to practice if the obvious symptoms of a concussion, such as disorientation and uncoordinated hand-eye movements, disappear within 15 minutes of the injury.

“Because on-the-field symptoms disappear within a few minutes and the athlete reports he or she is fine and appears to the sports medicine team to be fine, mild concussions often are unrecognized, overlooked or considered a trivial injury,” said Dr. Michael Collins, a neuropsychologist and the assistant director of the concussion program.

The study published in the February edition of the Journal of Neurosurgery evaluated 64 male and female high school athletes who sustained mild concussions.

Researchers evaluated the players on the field. Then, using a computer program that administers a battery of memory and reaction tests, researchers evaluated the athletes at periods of 36 hours, four days and seven days after the injury.

Headaches, dizziness and nausea seemed to disappear within four days, but some athletes had memory problems seven days after they received a concussion, the study found.

If coaches and others evaluating an athlete miss subtle signs such as a slow memory, headaches and dizziness, players could return to a sport before their brain has had time to heal, increasing the chance of more serious brain damage, Lovell said.

Successive concussions could cause long-term memory loss and other problems, Lovell said. In rare cases, young athletes can suffer from “second-impact syndrome,” in which an impact can cause a fatal brain hemorrhage, he said.

“The concern is that concussion symptoms are not always straightforward and not always reported by the athlete,” said Dr. Joseph Maroon, a study investigator. “On-the-field evaluation of the injury’s effects and knowing when it is safe to return the athlete to play can be difficult to objectively measure.”

The UPMC concussion program’s study confirms what “clinicians have known in their hearts,” said Gregory O’Shanick, medical director of the Arlington, Va.-based Brain Injury Association of America.

“Clinicians who have seen many people with concussions have believed that a history of concussions of whatever degree does count in the cumulative effect of concussions,” said O’Shanick, who did not participate in the study.

But Lovell’s study and the UPMC concussion program’s research is important and meaningful because researchers are studying student athletes’ memories and reaction times before and after they receive a concussion, O’Shanick said.

Many researchers in the past have evaluated people with concussions retroactively, with no idea of their memory or reaction times before their head injury, and the research can be “fraught with error,” he said.

When Joseph Perry, the athletic director of Keystone Oaks High School in suburban Pittsburgh, started coaching 35 years ago, he often allowed football players to return to the game minutes after they received a mild concussion, telling them “they just got their bell rung,” he said.

Now, his high school uses a computer program called the Immediate Post-Concussion Assessment and Cognitive Testing system, or ImPACT. It was developed by the UPMC concussion program and tests athletes’ memory and reaction skills before and after a concussion.

Lovell said neurocognitive testing such as ImPACT is the best way to evaluate an athlete’s condition after a concussion.

“We don’t leave it to guesswork anymore because my intuition could be wrong,” Perry said. “There are speed, eye-coordination and thought-process tests in there. It’s pretty hard to fake.”

By TIM WEINER

ENSENADA, Mexico — Ryan Fraidenburgh was 14 when he was brought here shackled, kicking and screaming.

Two men carrying handcuffs and leg irons came for him at his mother’s home in Sacramento, Calif., shoved him into a van and bound him hand and foot. They drove him 12 hours south, over the Mexican border, into a high-walled compound near here called Casa by the Sea.

“It was nighttime,” Ryan recalled. “I look around and I see kids sleeping on cement. I was really, really scared. The big honcho, Mauricio, said, `You don’t speak English here.’ I didn’t know how to speak Spanish.”

Ryan quickly learned the rules: stay silent, be compliant, don’t look up, don’t look out the window, don’t speak unless spoken to. The punishments for breaking the rules included solitary confinement, lying on the floor in a small room, nose to the ground, often for days on end.

Ryan was not a criminal. He was only skipping school, his parents said in telephone interviews. But in August 2000, they said, in the middle of a bitter divorce and custody battle, they decided to send him away to Casa by the Sea, which calls itself a “specialty boarding school” for behavior modification.

Like hundreds of other parents, the Fraidenburghs made their choice largely on the basis of a glossy brochure and a call to a toll-free number in Utah. They came to regret their choice.

The idea of sending a child to such a program in Mexico was unheard of a decade ago. But in the United States, behavior-modification programs and boarding schools for troubled youths have faced increasing legal and licensing challenges over the past few years.

More and more are moving abroad — some to Mexico, Central America or the Caribbean — where they operate largely under the regulation radar and where some employ minimum-wage custodians more than teachers or therapists, say government officials, education consultants and clinical psychologists.

The behavior-modification business is booming at Casa by the Sea, on Mexico’s Pacific Coast, the largest of 11 affiliated programs with roughly 2,200 youths, about half of them in Mexico, Costa Rica and Jamaica. The programs are run by a small group of businessmen based in St. George, Utah, under the banner of the World Wide Association of Specialty Programs and Schools, or Wwasps, and Teen Help, the programs’ main marketing arm.

Over the past seven years, local governments and State Department officials have investigated Wwasps-affiliated programs in Mexico, the Czech Republic and Samoa on charges of physical abuse and immigration violations. The Mexican program, in Cancún, and the Czech program closed, and their owners left those countries saying they feared unjust charges. The Samoan program cut its affiliation with Wwasps.

Ken Kay, the president of Wwasps, would not allow a reporter to visit Casa by the Sea; Dace Goulding, the program’s director, declined to answer any questions. But Mr. Kay, responding to inquiries in writing from his office in Utah, said no charge of abuse had ever been proven against any of the programs in any court.

“We are about getting families back together,” he said in a written statement. “We are not for everyone, and there are very few but vociferous critics of not just us but any youth intervention.” He described many of the program’s critics as parents who feel they have been “manipulated, brainwashed or duped” or who are battling through divorce and taking their anger out “by making us look terrible.”

In telephone interviews, eight teenagers who were formerly in Casa by the Sea described a system in which the youths try to ascend six “levels” through a system of rewards and punishments, including being sent to “R and R,” a small, bare isolation room, often for days on end. Discipline, not education, was the rule, they said.

For Laura Hamel, 17, of Vienna, Va., who counts herself as a success story, it was a slow two-year ascent to graduation in March. She said she was demoted from Level 3 back to Level 1 after giving a weeping, lonely friend a hug and a kiss on the cheek at Thanksgiving. Affection of that kind is forbidden.

A youth who rises to Levels 4, 5 and 6 can become a “junior staff member” and “participate in the discipline process” against lower-level youths, Casa’s contract with parents says.

“The authority is in your hands,” said Ryan Pink, 19, of El Paso, who reached Level 5 at Casa. “You can discipline kids. The younger kids — they were constantly being restrained, being punished, put in R and R for four or five days. Nose to the wall. Or nose to the ground. And at night you sleep in the hallways.”

Many parents and youths say the behavior-management system of discipline and punishment scares youths into sobriety and obedience. Others — parents and youths formerly enrolled, education experts, government authorities and a former Wwasps program director — say the programs profit from struggling parents unable to handle their depressed, delinquent, defiant or drug-abusing children.

“Their goal is not to help teens in crisis or their families,” according to a former director of one Wwasps-affiliated program, Amberly Knight. “It is to make millions of dollars.”

The financial success of Casa by the Sea is evident. Its enrollment has nearly tripled, from about 200 youths when it opened in 1998 to more than 570 today, almost all American teenagers. Already among the biggest programs of its kind outside the United States, Casa by the Sea has just spun off another program for those 18 and over.

Tuition and fees at Casa by the Sea run about $30,000 a year, half of what some United States-based programs cost. Its staff members “do not need and may not necessarily have” teaching credentials, Casa’s contract with parents plainly states.

Lon Woodbury, publisher of Woodbury Reports, which rates schools and programs for troubled teenagers inside and outside the United States, said one reason that American programs have moved abroad is “to avoid the laws and regulations of the States.” He added, “They can hire minimum-wage staff and still charge stateside prices.”

Profit margins and growth within the programs run by Wwasps appear solid. Teen Help, the affiliation’s main marketing arm, was the single biggest corporate campaign contributor in the state of Utah in the 2002 election cycle, donating $215,290 to Republican campaigns, according to online federal election records posted in March.

Mr. Kay, the Wwasps president, said that the proof of the programs’ success is the way in which “behavior of students generally changes drastically.” The organization’s internal surveys, he said, proved that “more than 98 percent of the schools’ parents are completely satisfied.” He wrote, “No wonder these are the fastest growing Schools of their kind in the world!!!”

The overseas “specialty boarding school” industry is growing so fast that United States consular officials in overseas embassies say they have no idea how many such programs exist.

“No authorities in Mexico control these institutions,” said Elisa Ledesma, a lawyer at the American Consulate in Tijuana. Consular officers demanded and received access to several such programs in Mexico, one official said, after they “heard horror stories from parents.”

The consular officers have the power, under the Vienna Convention, to visit overseas programs to check on the well-being of American citizens under 18.

In January, after several such visits, the State Department issued a notice on “behavior modification facilities” in Mexico, Costa Rica and Jamaica. The programs may “isolate the children in relatively remote sites” and restrict their contact with the outside world, it said.

At least seven programs in Utah, Montana, South Carolina and New York are Wwasps affiliates, according to the organization’s Web site; at least three have faced legal challenges. Utah state officials say they are reviewing the license of the flagship Wwasps program, Cross Creek Manor, and that a second program, Majestic Ranch, is operating without a proper license.

Six weeks ago, according to the state attorney general’s office in Utah, a director of Majestic Ranch entered into a court agreement to have no unsupervised contact with children after he was charged with misdemeanor child abuse.

Attorneys for both programs contest the licensing challenges. South Carolina officials have fined a third Wwasps program, Carolina Springs Academy, $5,000 for operating without a license.

While some dissatisfied parents have sued Wwasps and its programs, the contract that parents sign with Casa by the Sea sets high hurdles for them. It states plainly that the program “does not accept responsibility for services written in sales materials or brochures” or promises made by “staff or public relations personnel” and that any dispute between a parent and the program must be settled in a Mexican court, not in the United States.

The Wwasps programs market themselves under a multitude of interlinked Web sites. Their sales personnel offer thousands of dollars in incentives to adults who recruit new youths or host Web sites advertising the programs.

Some parents said in interviews that they enrolled their children in programs they had never visited after browsing Web sites, brochures and videotapes depicting happy children in a wholesome setting.

“I sent him there sight unseen,” said Patti Reddoch, of Sweeny, Tex., who considered Dundee Ranch for her son, Edmund Brumaghin, now 17, but chose Casa by the Sea instead. “The music he was listening to started getting darker and he was getting more into the drugs, and that’s when I decided I needed to do something.

“So I went on the Internet and started searching around and found the Wwasp program. I contacted them and made the arrangements, and that’s pretty much it. It didn’t take me any time at all.”

Mrs. Reddoch, speaking by telephone, said she then hired an “escort service” familiar with Casa by the Sea to handcuff and transport her son away at 5 a.m. one Sunday last September.

That morning, her son cursed her bitterly, but now his attitude is changing, she said.

“I am very pleased with the school,” said Ms. Reddoch, who said she visited Casa by the Sea once, for a weekend, last January. “I’ve started putting out brochures for referrals. I would recommend Casa to anyone.”

Reality may differ from the brochures, however. “Everyone has a shaved head,” Michael Zieghelboim, who was formerly enrolled at Casa by the Sea, said in a telephone interview. “They walk around like zombies. Most of the staff have no training.”

“Casa by the Sea was the scariest thing that ever happened to me,” said Mr. Zieghelboim, who now lives with his father in El Salvador.

He said that despite falling behind in his education at Casa by the Sea — at 17, he is now in the 10th grade — he rates himself a success. “If I had never gone there, I’d probably still be doing cocaine,” he said.

This kind of tough discipline is an attraction for many exasperated parents.

The program runs “a very tight ship,” said Virginia Day, of Redmond, Wash., who sent her son, Gabriel, 15, to the program in July.

“The staff that works most closely with the kids are not necessarily professionals, and I know that this is an issue,” said Ms. Day, who called herself a very satisfied customer. “This is not a school that specializes in a therapeutic component.”

Carol Maxym, an educational consultant in Maryland, said: “What they are looking for at Casa is compliance. Compliance is easy, if you break the kid down enough. And compliance is cheap.” She added, “The parents often don’t realize what’s going on.”

Youths and staff at other overseas Wwasps programs have described harsh conditions. One was Aaron Kravig, now 19. He said he contracted scabies, untreated for six months, ate meals of watery porridge and fish entrails, and was schooled almost solely with “emotional growth” videos at Tranquility Bay, the Wwasps-affiliated program in Jamaica, according to a transcript of sworn testimony he gave last year at a Virginia state court hearing.

In Costa Rica, Ms. Knight, the former director of the Wwasps-affiliated Academy at Dundee Ranch, resigned in August after sending a letter to the national minister of child welfare calling for the program to be shut down.

The letter said the program was “hiring unqualified, untrained, staff” and providing “the bare minimum of food and living essentials.” It said the program “takes financial advantage of parents in crisis, and puts teens in physical and emotional risk.”

The speed with which some parents choose an overseas behavioral-modification program for their children baffles some educational consultants.

“I find it incredible that parents would send their kids off to some place they’ve heard about on the Internet,” Mr. Woodbury said.

Ms. Maxym, author of “Teens in Turmoil: A Path to Change for Parents, Adolescents and their Families” (Viking Penguin, 2000) said, “I find it interesting that parents will spend less time finding a school for their child than buying a new car.”

Ryan Fraidenburgh’s father, Bob, an aerospace engineering executive, said he had only glanced at Casa by the Sea’s “brochures that looked like Club Med.” He said he removed Ryan from the program by himself in January 2001 after deciding he had been too hasty.

“We made a huge mistake,” he said. “Until the day I die I’ll regret that.”

Ryan’s mother, Carolyn, said: “We were expecting treatment, not a minimum-wage person to watch over your kid like he was an animal in a cage.”

 

(The Associated Press) — Cocaine-addicted rats experience bursts of brain chemical activity just before seeking out their next fix, scientists report in a finding that could open a new avenue for treating human addicts.

When the rats merely heard or saw cues associated with cocaine, their brains pumped out extra doses of the same reward-related chemical that helps produce the euphoria that human users feel.

The rats’ brain activity may explain the intense cravings human addicts experience when something reminds them of the drug.

“They’re having a miniature high before they even get there,” said Anna Rose Childress, a professor of psychiatry at the University of Pennsylvania’s School of Medicine.

“It acts like a salty potato chip, or the smell of the brownie across the room, the chocolate croissant in the window — it’s a primer, it’s a seductive pull.”

The new work may help scientists find drugs that can dampen drug cravings in people who have quit cocaine, said Childress, who was not involved in the research.

She said the findings could also apply to other drugs such as amphetamines, heroin, opium, nicotine and possibly even alcohol.

The rat study is presented in Thursday’s issue of the journal Nature by psychologist Regina M. Carelli and chemist R. Mark Wightman of the University of North Carolina in Chapel Hill.

They detected the dopamine pulses in rats using a new technique that makes rapid “real-time” measurements of changes in rat’s brain chemicals.

The scientists made the rats addicted to cocaine, then implanted an electrode in a portion of a rat’s brain associated with drug use. The rodents could receive cocaine by pressing a special bar which activated a pump implanted in them that injected cocaine into their system.

The drug delivery was accompanied by a tone that sounded and a light that turned on in the area where the experiment was unfolding.

When the rats were presented with the light and the tone was sounded, the researchers detected rapid pulses of dopamine in the rodents’ brains. Dopamine levels also rose as the rats approached and pushed the bar to receive their fix.

In contrast, rats that had not been addicted to cocaine showed no comparable increase in dopamine levels when exposed to the same cues. That indicates that the dopamine levels increased in response to cues the rats learned to associate with cocaine, Carelli said.

She said the rodent findings may explain bursts of brain activity seen in human addicts when they crave cocaine or see paraphernalia associated with it.

“People had suspected for some time that just the anticipation of receiving cocaine could cause rapid increases in dopamine levels, but no one had been able to accurately measure it,” Carelli said.

Roy Wise, chief of behavioral neurosciences at the National Institute on Drug Abuse, said although the studies were conducted in rats, rodents have proven to be a good predictor of how humans respond to drugs. “The same thing is almost certainly happening in humans,” he said.

Michael Kuhar, a professor of pharmacology at Emory University in Atlanta, called the research “a technical tour de force” that will refine models of how the brain acts in cocaine addicts.

Copyright 2003 The Associated Press. All rights reserved.

 

NEW YORK (CNN) –A survey released Monday found a major gap between the number of teenagers who admit having used the psychoactive drug Ecstasy and the number of parents who think their kids have tried it.

Only 1 percent of the more than 1,200 parents surveyed nationwide by the Partnership for a Drug-Free America said they believe their children may have tried the club drug Ecstasy.

By contrast, the February study found that 12 percent of teens said they had tried the drug.

The survey of parents also found that 92 percent said they had heard of Ecstasy, but 49 percent did not know what effect the drug has on users.

And 41 percent felt it is difficult for children to obtain; only 26 percent of the kids interviewed agreed with that sentiment.

The drug has been largely perceived as harmless by teens, a mistake once made with cocaine, said Stephen Pasierb, the partnership’s president and CEO.

“We’re at the front end on Ecstasy,” Pasierb told a news conference. “We’ve got the example of cocaine. And if parents take this information, if kids think about this drug differently, we can avert a problem five years, 10 years, 20 years down the road.”

The partnership also released a new series of public service announcements to inform people about the harmful effects of Ecstasy, known scientifically as 3,4 methylenedioxymethamphetamine, or MDMA.

The Partnership for a Drug-Free America is a broad coalition of media companies dedicated to helping kids reject substance abuse.

 

Press Release
RAND
1700 Main Street | P.O. Box 2138
Santa Monica, CA 90407
www.rand.org

Children who are drinking alcohol by 7th grade are more likely to suffer employment problems, abuse other drugs, and commit criminal and violent acts once they reach young adulthood, according to a RAND Health study released today.

Following a group of young people from 7th grade through age 23, researchers found that youthful drinking was not only associated with an increased likelihood of people having academic and social problems during their teenage years, but was associated with a heightened risk of behavior problems at least through their early 20s.

“Early drinkers do not necessarily mature out of this problematic lifestyle once they become young adults,” said Phyllis Ellickson, a RAND researcher and the study’s lead author. “Early alcohol use is a signal that someone is likely to have more problems as they transition into adulthood.”

Researchers say the findings suggest that adolescents who drink are at high risk and should be targeted early with intervention programs that focus not only on alcohol, but also cigarette smoking, use of illicit drugs, and perhaps other problem behaviors. The study appears in the May issue of the medical journal Pediatrics.

Underage drinking is a major national problem, with estimates suggesting that by the 8th grade one-fourth of all adolescents have consumed alcohol to the point of intoxication. In addition, adolescent drinking plays a key role in the four leading causes of death among teens–car accidents, accidental injuries, homicides and suicides.

The RAND findings are from a study that followed about 3,400 youths who were recruited in 1985 from 30 socially and economically diverse schools in California and Oregon when they were enrolled in 7th grade. Participants were surveyed during the 7th grade, 12th grade and at age 23 about their current use of alcohol, tobacco and other drugs, and about a number of behavioral issues.

At the outset of the study, about three-quarters of the 7th graders had used alcohol. Researchers labeled 46 percent as “experimenters” (had consumed alcohol, but fewer than three times in the past year and not within the past month) and 31 percent as “drinkers” (three or more alcoholic drinks within the past year or any drinking in the past month). Nondrinkers (those who had never drunk alcohol) accounted for 23 percent of the 7th graders.

Students who used alcohol by the 7th grade were far more likely than nondrinkers to report using other substances, stealing and having school problems. For example, the drinkers were 19 times more likely to be weekly smokers or hard drug users, and 4.5 times more likely to have stolen items in the past year when compared with nondrinkers. Experimenters reported fewer problems, but were still 2.5 times more likely to have used hard drugs and twice as likely to have stolen when compared with nondrinkers.

The differences remained at the 12th grade, although they were less pronounced. Compared with nondrinkers, drinkers were 5 times more likely to be weekly marijuana users, 3 times more likely to use hard drugs or experience several drug-related problems in the past year, twice as likely to have been suspended or dropped out of school, and about twice as likely to engage in violent or criminal behavior in the past year.

Experimenters were about twice as likely to be weekly marijuana users, use hard drugs, and have multiple drug problems, 1.2 to 1.7 times more likely to engage in violent or criminal behavior, and 1.5 times more likely to commit a felony or be suspended from school.

“Early drinking clearly is associated with other problems that develop in school and in many other settings,” said Joan S. Tucker, a RAND psychologist and another author of the report. “Differences between drinkers and nondrinkers show up early and persist over time.”

At age 23, those identified in 7th grade as drinkers still showed significantly more behavior problems than those who had been nondrinkers. The drinkers were 2 to 3 times more likely to use hard drugs, experience multiple drug problems, or have undergone alcohol or drug treatment, 3 times more likely to have been arrested for drunk driving, twice as likely to engage in violent or criminal behavior in the past year, and nearly 1.5 times more likely to report missing work for no reason.

The differences were smaller for the group identified as experimenters in 7th grade. Compared with nondrinkers, experimenters were twice as likely to have multiple drug problems, 1.6 times as likely to engage in criminal behavior, use hard drugs, or have undergone alcohol or drug treatment, and nearly twice as likely to have been arrested for drunk driving.

“These results suggest that drinking in early adolescence may be among the most important risk factors for a wide variety of behavior problems during the transition to young adulthood,” Tucker said. “Preventing drinking initiation before Grade 7 may help reduce these later problems.”

Researchers say it is not clear what mechanisms link early alcohol use to behavior problems later in life. It may be that alcohol disrupts the development of adequate social and academic skills that are needed to succeed later in life. Or early alcohol use may signal that an individual is predisposed to use drugs and develop other behavioral problems.

The research was supported by the National Institute on Alcohol Abuse and Alcoholism. The project also included RAND researcher David J. Klein.

RAND Health is the nation’s largest independent health policy research organization, with a broad research portfolio that focuses on medical quality, health care costs and delivery of health care, among other topics.

 

May 16, 2003 LONDON (AP) — An epilepsy drug offers significant promise in helping alcoholics quit drinking and appears to be more effective than drugs now in use for the problem, a new study shows.

Half of the 55 alcoholics who took the anti-seizure drug topiramate either quit drinking altogether or cut back their drinking sharply.

Researchers found that those given the medication were six times more likely than those on a dummy pill to abstain from alcohol for a month, according to the report published Friday in The Lancet.

“This finding is a major scientific advance in the treatment of alcoholism,” said Dr. Domenic Ciraulo, head of psychiatry at Boston University, who was not connected with the research.

Three drugs are now available worldwide for combating alcoholism. One of them, disulfiram, sold as Antabuse, makes people feel sick when they drink.

“The problem with that drug is that people know that if you want to drink, all you have to do is throw the tablet away. It is not a treatment. All it does is punish you for drinking,” said Dr. Bankole Johnson, chief of alcohol and drug addiction research at the University of Texas at San Antonio and lead investigator in the latest study.

The other two drugs — acamprosate, available in Europe but not the United States, and naltrexone — are given to ward off relapses once an alcoholic has stopped drinking.

“What is good about topiramate is you can take it while you are still drinking,” Johnson said.

Scientists believe that the brain chemical dopamine is what provides the pleasure from alcohol and that topiramate, sold as Topamax by Johnson & Johnson, works by washing away the excess dopamine released by drinking alcohol.

Long-term studies in epileptic patients show no serious problems related to topiramate.

The study involved 103 hard-core alcoholics followed for three months. Many had already tried methods such as Alcoholics Anonymous, medication, psychotherapy and rehab clinics. When they enrolled in the study it had been at least six months since they had been in treatment and they were drinking the equivalent of two bottles of wine a day.

Fifty-five drinkers were given topiramate, while 48 were given a dummy pill. The dose of topiramate was gradually increased.

All the participants got regular counseling to encourage them to keep taking the drugs and refrain from drinking.

By the time the study ended, 13 out of the 55 in the topiramate group, or 24 percent, had abstained continuously for a month. That compares with two out of 48 people, or 4 percent, in the placebo group.

“This is continuous abstinence. This is the strictest way of looking at it. You are not including people who may have had the odd drink,” Johnson said.

The gap between the two groups was even wider when it came to binge drinking.

In the topiramate group, 28 out of 55, or 50 percent, did not binge in the final month, compared with 8 out of 48, or 16 percent, of those taking the fake pill. This means those taking the drug were nearly four times less likely to binge.

In the topiramate group, reported cravings were cut in half, compared to a 15 percent drop in the placebo group.

Ray Litten, chief of treatment research at the US National Institute on Alcohol Abuse and Alcoholism, said topiramate could be a significant advance in treating alcoholism.

“It does look like topiramate might be stronger than naltrexone or acamprosate,” Litten said. “It’s very promising and it certainly has potential, but this is only one study and more trials need to be done.”

Litten said a combination of drugs and psychological therapy is considered the best treatment.

“Alcoholism is a complex disease and there’s no magic bullet out there,” Litten said. “But just to get a menu of different treatments is a step in the right direction.”

Many experts say abstinence should still be the goal, but Johnson argues that treatments that help alcoholics cut down — say, from 10 drinks a day to two a day — is worthwhile.

“If you can make most people stop drinking at a hazardous level, you have done them a power of good. You are going to improve these people’s quality of life, help save their marriages, their jobs,” Johnson said.

 

Drinkers may feel sober a few hours after consuming alcohol, but new research finds that their cognitive functioning continues to be impaired, Health Scout News reported May 14.

In response to the study, Mothers Against Drunk Driving (MADD) said the findings confirm the group’s zero-tolerance position on drinking and driving.

“At MADD, we say don’t drink and drive. There is no safe level,” said James Fell, director of traffic safety and enforcement programs for MADD. “While we believe that 0.08 is the right level for the law, even at lower blood-alcohol levels, some people are affected.

“Appoint someone as your designated driver,” said Fell. “Or, if you plan to drink, don’t drink as much and make sure you wait long enough that your blood-alcohol content is down to zero.”

“People generally feel down or a little depressed as they’re sobering up, but they don’t feel drunk,” said study author Robert Pihl, professor of psychology and psychiatry at McGill University in Montreal, Canada. “Yet cognitive deficits are worse at that time.”

According to the study, alcohol continues to impact key cognitive functions, such as spatial reasoning, planning, and the ability to control behavior.

The study’s findings were the result of research involving 41 male college students. One group was given enough alcohol to get legally intoxicated, while the other group was given a mixture of orange juice and several drops of alcohol.

After giving six cognitive-functioning tests to all of the participants, the researchers found that the intoxicated volunteers had greater declines in cognitive functions, in particular spatial functioning, even many hours after drinking.

Pihl said people who drink heavily should wait at least five hours before driving.

The study was published in the May issue of the journal Alcoholism: Clinical and Experimental Research.