News – Medical

Tougher alcohol laws for adults may also lower teen drinking – reports article

parentsprovidingJune 1, 2015 (HealthDay News) — New research suggests that as a state’s alcohol laws get tougher, teen drinking rates drop — even if the laws are targeting adults and not teens.

“Nobody’s ever looked to see how policies explain big differences between kids’ drinking among different states,” said study co-author Dr. Timothy Naimi, an alcohol epidemiologist at Boston Medical Center. “There’s a strong overall relationship between [alcohol] policies and teen drinking, but if you account for the difference in youth-specific policies, you find the adult-oriented policies have an equal or greater effect on teen drinking.”

Naimi’s team considered policies such as alcohol taxes, restricting alcohol sales to certain hours, not selling alcohol on Sundays, banning happy hours and restrictions on how many places sell alcohol, he said. “Things that reduce excessive drinking are things that keep the price up and keep alcohol a bit more inconvenient to get,” he said.  The findings were published online June 1 in the journal Pediatrics.

The researchers came up with a scoring system to assess how strong alcohol-related policies were in each of the 50 states. The system was based on 29 alcohol-related laws, the likely effectiveness of those laws and how well they were implemented.  Then they compared the overall score they derived for each state to the rates of teen drinking and binge drinking in each state, based on surveys by the U.S. Centers for Disease Control and Prevention from 1999 to 2011.

After considering other factors that may influence teen drinking, the researchers found that for every 10 additional percentage points in a state’s overall score of stronger alcohol-related laws, teens had 8 percent lower odds of drinking and 7 percent lower odds of binge drinking.  Even when the researchers made calculations only for alcohol-related legislation that targeted adults, the odds of teen drinking dropped 6 percent and the odds of teen binge drinking dropped 4 percent.

“Taking into consideration the power of adult influence upon youth behaviors, it is not surprising that the findings show polices that target adults have an impact on teen behaviors,” said Mayra Mendez, program coordinator at Providence Saint John’s Child and Family Development Center in Calif. “There is a relationship between youth drinking patterns and adult drinking patterns, both for positive and negative behaviors.”

Adult drinking may influence teen drinking through modeling and imitation, which is a strong form of learning. “Some research suggests that the role parents play is important. Parents might never drink, but if they allow supervised drinking of their teenager, it still validates the behavior for the teenager.”  Naimi also suggested that laws aimed at adults might also have a trickle-down effect of sorts on teens.

“Some of these adult-oriented policies, such as taxes, might have a direct effect on youth because they tend not to have a lot of disposable income,” Naimi said, and taxes increase the price of alcohol. “We also know that adults provide youth with most of the alcohol they consume.”  Policies that restrict alcohol access or increase its price can reduce the indirect negative effects of alcohol on nondrinkers, too, Naimi said.

Dr. Oz from TV says: Curb teen binge drinking; Teens watch parents habits; Be aware of alcohol marketing; and make you teens feel special

You may think the toga party thrown by Bluto (John Belushi) and his Delta Tau Chi pals in the 1978 movie “Animal House” was an exaggeration of adolescent drinking habits for riotously comic effects. But a new report makes us wonder, and worry. Interviewing more than 16,000 high-school seniors, researchers found that 20 percent downed five or more drinks in a row in the past two weeks; 10 percent say they slammed down 10 or more; and almost 6 percent admitted to 15 or more in one long binge. And it’s not just the boys; now 20 percent of girls are doing it, too.

Excessive drinking damages teens’ still-developing brain, memory and motor skills, while putting them at risk for lethal alcohol poisoning, being victims of violent crime, traffic accidents, and depression and anxiety. Plus, they may have high-risk sex and develop alcohol problems as adults. But you can do a lot as a parent or significant adult in your favorite teen’s life to help a kid avoid all that.

• Explain (calmly) the risks. And DO NOT overindulge yourself. If teens see you do it, they assume it’s OK for them too.

• Talk about how alcohol marketing targets them, so they can understand that drinking isn’t actually so cool.

• Don’t drink with your kids or supply them with alcohol. That signals a go-along-to-get-along attitude that’s a slippery slope.

• Make your kids feel that they’re special and their future is bright, so they understand doing anything (alcohol or drugs) that compromises them is heartbreaking to you and a waste for them.

Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is chief wellness officer and chair of the Wellness Institute at Cleveland Clinic.  Read more here:

Binge drinking/your brain: Raising risk of dependence

Yale News – 03/08/2013 – The brains of chronically heavy drinkers have twice the capacity of those of light drinkers to consume a chemical that may add to impairment and some other effects of alcohol, Yale School of Medicine researchers have found. This added capacity may also increase the vulnerability to alcohol dependence, according to the study, which appears in the Journal of Clinical Investigation.

Researchers studied 14 drinkers. Half of them were what would be considered heavy drinkers, many of them “binge drinkers.” They regularly consumed at least eight drinks a week, and at least four drinks on one of those days. The rest were light drinkers, who consumed less than two drinks per week.

All 14 subjects were given the chemical acetic acid (also called acetate). Normally the body has very little acetate, but when we drink, the liver converts the alcohol to acetate, The chemical is released into the blood and reaches the brain, which uses it for fuel.

The researchers found that the brains of the heavy drinkers were twice as able as those of the light drinkers to consume the acetate, creating a situation where heavy drinkers may adapt to the use of the acetate and have a harder time reducing drinking or quitting.

Normally, the brain relies on blood sugar for fuel, but it can also use other things like acetate. Binge drinking on an empty stomach can drop a person’s blood sugar acutely, and the acetic acid can fill in for the missing fuel, which creates more incentive to keep drinking. Habitual heavy drinkers have an even greater ability to get that extra energy. The acetate effects of binge drinking on the brain may promote dependence, because if people stop drinking, they lose not only the alcohol, but also the acetate. If the brain has adapted to having that chemical around, the drinker may suffer withdrawal symptoms, explain the researchers.

Senior author Graeme Mason, professor at Yale School of Medicine, says that this sets up a dangerous situation. “Acetate as fuel for the brain may sound like a good thing, but heavy drinkers’ brains may adapt to that supply of energy and so have a harder time reducing or quitting drinking.”

“Another potential adaptation also provides a danger for dependence,” Mason added.  “When the brain uses acetate for fuel, it creates another chemical called adenosine, which causes drowsiness. Adaptation to that extra adenosine may also make it more difficult to stop drinking.

Mason says that this new understanding of the cycle of tolerance and withdrawal may provide valuable insight not just into addiction, but into possible therapeutic interventions that can facilitate detoxification. “For the foreseeable future, nothing is going to make it easy to stop drinking. My hope is that we can add to the current measures to make it safer and less uncomfortable to get sober,”said the Yale scientist.

The study was supported by grants from the National Institutes of Health ; The Yale Clinical and Translational Science Award Grant; and components of the National Institutes of Health and NIH roadmap for Medical Research.

Perhaps more than alcohol outlet density and crime rates, neighborhood demographics predict incidence, severity, and for traumatic injury reports 2010 study

Unintentional injury leads all other causes of death for those 1 to 45 years old. The expense of medical care for injured people is estimated to exceed $406 billion annually.

Given this burden on the population, the Centers for Disease Control and Prevention consistently refers to injury prevention as a national priority. We postulated that exposure to crime and the density of alcohol outlets in one’s neighborhood will be positively associated with the incidence of hospitalization for and mortality from traumatic injuries, independent of other neighborhood characteristics.

Methods: We conducted a cross-sectional study with ecological and individual analyses.

Patient-level data for traumatic injury, injury severity, and hospital mortality due to traumatic injury in 2010 were gathered from the Dallas-Fort Worth Hospital Council Foundation. Each case of traumatic injury or death was geospatially linked with neighborhood of origin information from the 2010 U.S.

Census within Dallas County, Texas. This information was subsequently linked with crime data gathered from 20 local police departments and the Texas Alcoholic Beverage Commission alcohol outlet dataset.

The crime data are the Part One crimes reported to the Federal Bureau of Investigation.

Results: The proportion of persons 65 years old or older was the strongest predictor of the incidence of hospitalization for traumatic injury (b = 12.64, 95% confidence interval (CI) 8.73 to 16.55). In turn, the incidence of traumatic injury most strongly predicted the severity of traumatic injury (b = 0.008, 95% CI 0.0003 -0.0012).

The tract-level unemployment rate was associated with a 5% increase in the odds of hospital mortality among hospitalized trauma patients.

Conclusions: Several neighborhood characteristics were associated with the incidence, severity, and hospital mortality from traumatic injury. However, crime rates and alcohol outlet density carried no such association.

Prevention efforts should focus on neighborhood characteristics such as population density, mean age of the residents, and unemployment rate, regardless of crime rates and alcohol outlet density.

Author: Alan CookJennifer GonzalezBijal A Balasubramanian
Credits/Source: Injury Epidemiology 2014, 1:23 

NIH study finds missed opportunities for underage alcohol screening by physicians

Physicians often fail to ask high school-aged patients about alcohol use and to advise young people to reduce or stop drinking, according to a study led by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health.

In a random survey of more than 2,500 10th grade students with an average age of 16 years, researchers from NIAAA and the Eunice Kennedy Shriver National Institute of Child Health and Human Development found that 34 percent reported drinking alcohol in the past month. And 26 percent said they had binged, defined as five or more drinks per occasion for males, and four or more for females. While more than 80 percent of 10th graders said they had seen a doctor in the past year, just 54 percent of that group were asked about drinking, and 40 percent were advised about alcohol harms,” says lead author Ralph W. Hingson, Sc.D., M.P.H.  He adds that, among students who had been seen by a doctor in the past year and who reported drinking in the past month, only 23 percent said they were advised to reduce or stop drinking. The findings are now online in the February issue of Pediatrics.

Studies have shown that screening and brief interventions by health care providers — asking patients about alcohol use and advising them to reduce risky drinking – can promote significant, lasting reductions in drinking levels and alcohol-related problems among adults. Accumulating evidence supports the use of alcohol screening among adolescents.

In 2011, NIAAA and the American Academy of Pediatrics released a two-question screening tool designed to help clinicians overcome time constraints and other common barriers to youth alcohol screening.    Examples of these questions, which vary slightly for elementary, middle, and high school ages, include:

  • “Do you have any friends who drank beer, wine, or any drink containing alcohol in the past year?”
  • “How about you — in the past year, on how many days have you had more than a few sips of beer, wine, or any drink containing alcohol?”

“Alcohol is by far the drug of choice among youth,” says NIAAA acting director Kenneth R.
Warren, Ph.D. “The findings reported by Dr. Hingson and his colleagues indicate that we must redouble our efforts to help clinicians make alcohol screening a routine part of patient care for young people in the United States.”

Alcohol and Marijuana? Not My Kids!

By | Parenting – Fri, Sep 16, 2011

No parent wants to believe their kid is a party animal at the age of 13, 15 or even 17. But, is it naive to think that your teenager hasn’t had a drink?In a new, national poll conducted by C.S. Mott Children’s Hospital at the University of Michigan, only 10% of parents said they believe their teenagers (ages 13-17) have used alcohol in the last year. Even fewer, 5 percent, thought their kids had used marijuana during that same time period.

Compare that to what teenagers admit and it’s a wake-up call. In the latest study by Monitoring the, 52% of 10th graders reported drinking in the last year and 28% reported using marijuana.

“There’s a clear mismatch between what parents are reporting in terms of their children’s possible use of substances and what teenagers report themselves,” says Bernard Biermann, M.D., Ph.D., Assistant Professor in the Department of Psychiatry and Medical Director of the Child/Adolescent Inpatient Unit at the University of Michigan.

Related: Teen Drinking– Important Lessons for Parents

Another very interesting finding, at least 40% of parents believe other teenagers are more likely to drink and smoke pot than their own.

“…If parents acknowledge the possibility – and in fact, the likelihood – that their child may have experimented with or used alcohol or marijuana, they can begin to talk to them more about it, provide some guidance, and allow their kids to ask questions,” says Biermann.

Are Some Teenagers Wired for Addiction?

By Robert Lee Hotz
The Wall Street Journal — April 30, 2012, 1:00 PM

In the largest imaging study of the adolescent brain ever conducted — involving 1,896 14-year-olds — scientists report in Nature Neuroscience that some teenagers may be more inclined to experiment with drugs and alcohol, simply because their brains work differently, making them more impulsive.

Moreover, different brain networks appear to be involved in the self-control problems of substance abuse among teenagers than those associated with attention deficit hyperactivity disorder, or ADHD, even though both problems stem, in part, from a failure to inhibit behavior, the scientists report.

“The behavior might look the same but there may be different brain regions contributing to that behavior,” says neuroimaging expert Dr. Robert Whelan at the University of Vermont, who was the study’s lead author. The study is part of a larger project funded by the European Union that is conducting a systematic neural, genetic and behavioral assessment of teenagers in Ireland, England, France, and Germany.

Whelan and his colleagues used functional magnetic resonance imaging, which tracks the changes in blood flow between neurons associated with mental activity. They monitored brain responses as the teenagers moved one hand in response to a stream of commands, a widely used research protocol called the “stop-signal task” that is much like a game of Simon Says.  Periodically — and unpredictably — the volunteers would be ordered to stop moving their hands. The researchers identified seven neural networks active when the teenagers could stop themselves and six other brain circuits active when they could not.

Generally, the researchers found that the adolescents with ADHD symptoms, which is the most common neurodevelopmental psychiatric disorder, and those who had used drugs or alcohol had an equally hard time handling the task.

Among those with a history of alcohol, cigarettes, and illegal drug use, however, they found that the impulse control problem was associated with diminished activity in a brain region called the orbitofrontal cortex. The researchers found an entirely separate set of impulse-control networks connected with the symptoms of ADHD, which were distinct from those associated with adolescent substance abuse.

“Our study lends credence to the idea that ADHD and substance abuse are not intrinsically linked together,” Whelan tells the Health Blog. “There appear to be different regions associated with different kinds of impulsivity.”


Government eyes popular malt liquor Four Loko

By JENNIFER C. KERR  The Associated Press –  Thursday, March 1, 2012

WASHINGTON — A carbonated brew guzzled on college campuses is the focus of an intense write-in campaign urging federal regulators to take some buzz out of a sweet alcoholic drink sometimes referred to as “blackout in a can.”

The Federal Trade Commission is looking at a wave of complaints about the popular fruit-flavored malt liquor Four Loko. Under review: the amount of alcohol in the brightly colored, supersized cans and how they are marketed.

The drink gained national attention in 2010 following the hospitalization of college students in New Jersey and Washington state. Some states banned the drink, worried about the caffeine in Four Loko and its potential to mask how much alcohol one could safely consume. Amid a crackdown by the Food and Drug Administration, the drink’s makers removed the caffeine and started selling Four Loko without the energy kick but with plenty of alcohol.

The FTC charges that the drink’s creator, Chicago-based Phusion Projects, has implied in ads that its 23.5-ounce can is equal to one or two regular 12-ounce beers. The agency says the can, which contains up to 12 percent alcohol, is really more like four to five beers and shouldn’t be consumed in one sitting.

Under a deal the agency brokered late last year with Phusion, new labels would be required on its products with more alcohol than 2-1/2 regular beers, and they would have to state how much alcohol, compared with a regular beer, is in the drink. Before a final vote to implement the settlement, the FTC asked the public to offer comments. Sentiment has been overwhelmingly against the deal.

More than 200 opposing comments were received, many saying the deal doesn’t go far enough and some wanting a ban on the product — something the FTC does not have the authority to do. About a dozen comments expressed support for the agreement.

Julie Bos of the Van Buren/Cass District Health Department in Michigan, wrote: “In light of the evidence about the dangers of supersized alcopops, especially with underage drinkers, this agreement is unacceptable. Please withdraw this agreement and require much stronger changes from Phusion Products and other alcopop producers to protect public safety and health.”

The American Medical Association is also opposed, as is the Beer Institute, an industry lobbying group that says it would be unprecedented in U.S. alcohol-labeling history to compare the alcohol content of one product with the alcohol content of another.

What the commission can do, Evans said, is regulate how alcohol is marketed to prevent deception about alcohol content.

Phusion said it could not comment on the pending settlement. The company has maintained that its packaging does not contain statements or graphics that are misleading or intended to attract underage drinkers. A final decision from the FTC on the settlement — whether to approve it or change it — is expected in the next couple of months.

Vodka, Malt Liquor Most Likely to Buy Trip to Emergency Room

WASHINGTON, November 2011

Vodka and malt beverages were the forms of alcohol most likely to have been consumed by patients who wound up at the emergency department seeking treatment for an injury, according to a small study.  In addition, more men than women presented to the ED with injuries after drinking (69% versus 31%), according to the study presented at the American Public Health Association’s annual meeting.

Men were also more likely than women to report drinking beer. However, women were more likely to have consumed spirits, wine, champagne, or flavored malt beverages, said lead author David Jernigan, PhD, of the Johns Hopkins Bloomberg School of Public Health.
Nearly a third of injury-related visits to emergency departments are alcohol-related,
said Jernigan, who is director of the institution’s Center on Alcohol Marketing and

Medical News: Vodka, Malt Liquor Most Likely to Buy Trip to…

Hard liquors were overrepresented among patients with injuries in the ED, considering that beer and other malt beverages have a far larger market share, the authors stated.  Liquors including vodka and gin made up about one-third of the total market for alcoholic drinks, but were responsible for nearly 70% of hospital visits. Vodka was by far the most common liquor to have been consumed by those surveyed, which wasn’t surprising, Jernigan said, because vodka makes up more than 90% of the spirits market.  Malt beverages were consumed by about 27% of the injury patients who had been drinking.

“The hidden crisis of binge drinking”

According to an article entitled, Binge Drinking Common Among Adults, “about one in every six U.S. adults binges on alcohol.”

According to the article, “binge drinking — defined as at least four drinks in one sitting for women and five drinks for men — carries substantial risks and high costs. It accounts for more than half of the estimated 80,000 annual deaths and three-quarters of the $223.5 billion in economic costs tied to excessive alcohol use.”

Not surprisingly, the article reports, “the rate of binge drinking was highest among 18-to-24-year-olds (28.2%), as was the intensity (9.3 drinks per occasion). Both figures decreased with age.  The frequency of binge drinking, however, was highest among respondents 65 and older (5.5 episodes per month).”

My patients prefer to call binge drinking by the more PC term, “social drinking.”  Mr. X is a 24 year old college grad, employed full-time as an accountant.  He lives with his roommate in Chicago and is actively dating several young women.

Me:        Mr. X, do you drink alcohol?
Mr. X:    Socially, on occasion.
Me:        On which occasions?
Mr. X:    On most weekends and occasionally during the work week.
Me:        How much do you drink on the occasions you drink?
Mr. X:    You know, a few on a weekday and a few more on weekends.
Me:        Can you be a little more precise?  How many is a few?
Mr. X:    Maybe 4-5 a night during the week and more on the weekend.

This young man who only drinks socially, having a “few” drinks on an “occasion,” is really a binge drinker, something he learned in college.  The problem is twofold.  Number one, he has no idea he is a binge drinker and therefore is unaware of the risks of his drinking.

The second and larger problem is that his friends are also binge drinkers and also fail to recognize the risk of binging.  These are responsible young men and women.  They do not drink and drive, arriving and leaving by taxi.  If they drive, they have a designated driver who mostly refrains from drinking.

So, what’s the harm?  According to the article, binge drinking “accounts for more than half of the estimated 80,000 annual deaths and three-quarters of the $223.5 billion in economic costs tied to excessive alcohol use.”  Just think about that.  Up to 40,000 deaths are related to binging!

In my 30 years of practice, I have been unfortunate enough to watch young souls destroy themselves with a “few” drinks on an “occasion.”  I have heard all the excuses.

“Doc, haven’t young people always partied with alcohol?  Didn’t you?”  “I make a good living and work hard.  I deserve to be able to party on the weekend.”  “We are very responsible drinkers.”  I have also seen many “wild and crazy” youths grow into responsible sober adults and raise “wild and crazy” binge drinkers of their own.  How do you know which binge drinkers will go on to become alcoholics, or worse, die.  Therein lays the conundrum.

If you or your children or friends fit the definition of a binge drinker, stop.  Since there is no way of knowing if you are destined to be one of the 40,000 fatalities, avoiding binging seems to be your only sensible choice.  Remember, the life you save may be your own.

Stewart Segal is a family physician who blogs at

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