IMAGEN -An Ongoing Teen Study

A European study being conducted at multiple sites is an ongoing study of over 2,000 teenagers using genetic neuroimaging (MRI) to determine why some kids are drawn to risk-taking behaviors and whether such a tendency may be linked to substance abuse. The study, called the IMAGEN project has already made some interesting discoveries. For example, an MRI study which examined 266 adolescents who enjoy high-risk activities but have no reported substance abuse issues at present, found a lower bilateral activation of certain reward centers in the brain. The participants were given a task (Cambridge Gamble Task) specially designed to create an anticipation of reward. Researchers discovered that markedly higher risk scores corresponded to notably lower activity in the left ventral striatum – a reward center in the brain.

The IMAGEN study findings most recently published compared 14 year olds without substance abuse issues to other 14 year olds who were classified as potentially problematic substance users. The term potentially problematic meant that the teens were either habitual smokers, had risk factors for alcohol abuse or had already tried illicit substances such as marijuana, cocaine, or heroin among others. The teen groups were made up almost equally of male and female participants to rule out gender influences.

Teens May Be Seeking to Kick-Start the Brain’s Reward Center

Data points to a predilection for risk-taking activities and drug abuse as both are having connection to reduced activity in a teen’s neural reward center. This means that it is likely that teens who engage in high risk behaviors may be attempting to stimulate more activity in their brain’s reward system. Past research bears out the link between risk-taking, addiction and reduced responsiveness in the reward centers of the brain. Teens with a lethargic reward activation could be far more vulnerable to activities which offer short-term euphoria – activities like taking psychotropic drugs for example.

The study goes a long way toward making a teen’s propensity for risk-taking to being a vulnerability factor in predicting whether a teen will go on to abuse substances at some point in the future. Follow-up studies are being planned which should give data at the point of young adulthood that could verify these current findings. For the present, parents of teens who tend toward high-risk behaviors should be warned of the potential link to substance abuse and can be encouraged to direct their teen toward healthy and positive outlets for their reward stimulation. High adventure sports or even traveling to exotic locales may satisfy the teens’ craving.

At the same time, stimulants and inhalants are more likely to be used among this group and once drugs enter the mix, physical and psychological dependence is more likely.

Girls in this age range using drugs are also at more risk sexually than boys. Research findings suggest that adolescent girls consuming alcohol more than five times per month are less likely to use condoms or other birth control during sexual intercourse. The use of marijuana also increases the risk of unprotected sex.

With the data suggesting female adolescents are at a higher risk for substance abuse and unprotected sexual activity, prevention programs aimed specifically at girls should be readily available – yet it is lacking in some areas.

Studies examining prevention programs aimed at both boys and girls report response levels higher among girls as compared with boys. When prevention programs are not gender-specific, they tend to be less effective for girls than boys. One Palinkas et al. study focused on testing social network and skills training and restructuring for female adolescents among multiple ethnic groups.

The study determined the female-specific programs that focus on these skills proved ineffective and are even potentially counterproductive in terms of substance abuse outcomes. Another program launched by Weiss et al. instead focused on empowerment and leadership development, producing outcomes with lower drinking rates among adolescent girls less likely to use substances compared with those in the comparison group.

Elliot et al. focused on a program involving team sports that focused on drug abuse prevention and the promotion of healthy nutrition and exercise. Girls taking part in the program increased their knowledge of the effects of substance abuse and were less likely to use harmful drugs.

It is important that policymakers be provided with up-to-date information about trends in drug and alcohol use among different segments in the population. This helps communities plan adequate resources for treatment, education and prevention. The National Institute on Alcohol Abuse and Alcoholism provides periodic reports on the state of drug and alcohol use in the United States.

The National Institute on Alcohol Abuse and Alcoholism is a division of the National Institutes of Health. It recently released a report detailing information about trends in hospitalizations for drug and alcohol-related problems. The report found that between 1999 and 2008 there was a significant increase in hospitalizations related to alcohol and drug overdose for those aged 18 to 24 years.

The decade-long study found that the percentage of drug and alcohol overdoses and combinations of drug and alcohol overdoses increased by 25 percent, 56 percent and 76 percent, respectively.

The report showed that in 2008, a third of hospitalizations for overdoses for young adults were due to excessive alcohol consumption. Also in 2008, there were 29,000 hospitalizations for alcohol overdoses recorded for those aged 18 to 24 years. In addition, the report measured that there were 114,000 drug overdoses resulting in hospitalization, with another 29,000 caused by combined overdoses.

There was also a significant increase in hospitalizations for opioid pain medication overdose. The report recorded a 122 percent increase for overdoses of opioid pain medications that resulted in hospitalizations. In one of five of these poisonings, alcohol overdose was also a factor.

The authors of the report noted that the increases were not only observed in this particular age group, but that hospitalizations for drug and alcohol overdoses are growing in other age groups as well. However, the results shown for this age group may indicate a significant problem at an important time of life, when young adults are transitioning into a career and beginning to get married and start families.

The data for this report was collected from the Nationwide Inpatient Sample. The data stems from project that collects a 20 percent sample from U.S. hospitals, conducted by researchers from the U.S. Agency for Healthcare Research and Quality.

Dr. Timothy Wilkens followed 500 children with ADHD for ten years, and found they were one and a half times more likely to abuse drugs or alcohol, and had more than double the risk of smoking cigarettes than others without the disorder.

"Since anywhere from six to nine percent of the children in this country have ADHD, the notion that they are at increased risk for substance abuse becomes a very important educational piece, and prevention and early intervention component of their treatment," said Dr. Wilkens, a foremost expert in addiction.

Having ADHD was a greater risk factor for substance abuse than having problems in cognitive processes and learning, or having a family history of substance abuse.

"It is not the cognitive style or attentional component that seems to be driving the substance use," Dr. Wilkens explained. "It seems to be the dysregulation of mood or affect and the behavior that seems to be driving it."

This study appears in Current Opinion in Psychiatry.

Multiple surveys conducted all across the country were interpreted into a range of estimates. Youth from grades 7 to 12 were surveyed, but the most notable abuse of alcohol and cannabis was seen in those in Grade Twelve. Forty-one percent to 52 percent of 12th grade students reported having five or more alcoholic drinks on a single occasion within the last month. Twelve percent to 20 percent reported having two or more drinks within an hour before they got behind the steering wheel.

The statistics for the use of cannabis are only slightly lower, but still excessive and dangerous. In the last month, 15 percent to 27 percent of those surveyed used cannabis, and 3 percent to10 percent of those youth used it every day or close to every day. Fourteen percent to 21 percent reported using cannabis within the hour before they got behind the steering wheel – a higher percentage than those who used alcohol within an hour before driving.

The author of the study, Dr. Matthew Young, a Senior Research and Policy Analyst at the Canadian Centre on Substance Abuse, is concerned that some teens have a false sense of security that their driving is not impaired after they have used cannabis. This lack of knowledge could lead to more lives lost in automobile accidents. From 2000 to 2007, over half of drivers age 19 and younger who were fatally injured had drugs and/or alcohol in their system. Cannabis was one of the most common psychoactive substances found in these drivers.

Driver fatalities aren’t the only concern surrounding teen abuse of alcohol and marijuana. Dr. Young posed concerns that the abuse of these substances could lead to poor academic performance and a higher risk of mental health disorders.

Some interesting and encouraging information from the report: A large percentage of youth in grades 7 through 9 aren’t using drugs or alcohol at all. This information will hopefully influence teens in junior high, letting them know that their peers aren’t using these substances and there is no peer pressure to start substance abuse. Rather, by drinking and using cannabis at this age, they will be seen as the odd one.

This national picture of alcohol and cannabis use among Canada’s youth will help to serve the country in finding out the realities of alcohol and cannabis use among those in junior and senior high. This information can help map a plan to get knowledge and support to the age groups in need the most. Besides helping students and their families, the CSA and SDUS Working Group hopes that this report will help guide jurisdictional and national policy as well as initiatives in treatment, prevention and further research.

According to the CDC researchers, many teenagers are affected by chronic sleep deprivation due to several variable factors, including employment, academics, social, economic, and recreational pressure, as well as biological and family issues. Additionally, sleep deprivation is a common symptom in several mental health conditions, such as major depression and suicidal ideation. In their study, published in the scientific journal Preventive Medicine, lead research Lela McKnight-Eily and colleagues evaluated the prevalence of sleep deprivation among high school students and its correlations to other significant health-risk factors.

Using the 2007 national Youth Risk Behavior Survey (YRBS), the researchers analyzed the responses of 12,154 public and private high school students from across the nation regarding their personal health and behaviors. Based on the report’s findings, the researchers discovered that the majority of high school students (nearly 70%) are not receiving the recommended eight hours of sleep per school night. These sleep-deprived students were also more likely than those who reported sufficient sleep to engage in multiple risky behaviors. Students with insufficient sleep reported higher rates of current alcohol use, current cigarette use, current marijuana use, current sexual activity, experiencing serious suicidal thoughts, experiencing sad or hopeless feelings, and getting into one or more physical fights per year. In addition, sleep-deprived students reported higher rates of physical inactivity and unhealthy eating habits.

According to McKnight-Eily and her team, sleep-deprived students have a higher propensity toward risky behaviors due to a decreased ability to comprehend the consequences of negative behaviors as well as an increased receptiveness to peer pressure. Likewise, the combination of sleep deprivation and substance use can significantly hinder motor skills like concentration, alertness, and coordination. This negative combination puts these adolescents at greater risk of further risky behaviors, including heightened recklessness, sexual activity, and injury.

Based on the study’s results and the prevalence of insufficient sleep among teenagers, the researchers assert that more awareness needs to be placed on adolescents’ healthy sleeping habits in order to encourage healthier lifestyles during their crucial developmental years.

BIBLIOGRAPHY:

McKnight-Eily, Lela R., Danice K. Eaton, Richard Lowry, Janet B. Croft, Letitia Presley-Cantrella, and Geraldine S. Perry. 2011. Relationships between hours of sleep and health-risk behaviors in US adolescent students. Preventive Medicine, ISSN 0091-7435, Corrected Proof (August 5). DOI:10.1016/j.ypmed.2011.06.020. http://www.sciencedirect.com/science/article/pii/S0091743511002878.

http://www.cdc.gov/media/releases/2011/a0926_insufficient_sleep.html

http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/28747
 

The link was significant.

For example, teens who used such websites were three times more likely to drink (26% compared to 9%), five times more likely to smoke (10% vs. 2%), and twice as likely to use marijuana (13% vs. 7%) compared to teens who do not spend any time on social websites.

The CASA researchers found another important link, this time between viewing pictures of other teens drunk, passed out, or using drugs and doing such behaviors yourself. Teens who saw such pictures were three times more likely to use alcohol and four times more likely to smoke marijuana.

Joseph Califano, CASA chairman, said that operating such websites is "electronic child abuse."

The owners of the sites were quick to defend themselves, saying that their policy is to prohibit depictions of illegal drug use, and to remove them if someone reports it.

"We recommend that people think before they post and that they report content that may violate our policies," said spokespeople for Facebook. "Nothing is more important to us than the health and safety of the people who use our service, especially the many teens who use Facebook."

The CASA researchers interviewed over 1,000 teens and half their parents. Over 64% of the adults did not believe that using the websites put their children at risk, even though 90% believe that teens who spend time on them are more likely to drink and use drugs.

Critics of the study pointed out that there were flaws in its methodology and how the results were interpreted.

"The other possibility is the other side, that if you use drugs and alcohol, you are more likely to use a social networking site," said Amanda Lenhart, director of the Pew Internet and American Life Project’s research on teenagers.

The study is considered significant because previous research indicates that people who do not experiment with drugs or alcohol before they are 21 years old are the ones least likely to develop addictions.

The survey of parents conducted by the University of Michigan C.S. Mott Children’s Hospital found that their top concerns are drug abuse, childhood obesity, smoking, and teen pregnancy. This year for the first time in the five years the poll has been conducted, concern about drug abuse is at the top of the list and slightly outranks obesity, probably because teen drug abuse is on the increase. Black and Hispanic parents were more likely to be concerned about pregnancy and violence; white parents were more likely to worry about internet safety and bullying, but all racial groups ranked drugs, smoking and obesity as their top concerns.

The irony is that a new report from Columbia University, issued the same week as the Michigan survey, indicates that teen addiction begins in the toddler years when children watch their parents drink, smoke and take drugs. Most drug and alcohol abuse begins before a person enters adulthood, and children who have such parental role models are at a high risk of developing addictions themselves.

According to the researchers, teen addiction "is the largest preventable and most costly public health problem in the United States today."

"We turn a blind eye to a common and deadly epidemic that we can in fact prevent," said Susan Foster, vice present of the National Center on Addiction and Substance Abuse.

About 75% of today’s teens have tried cigarettes, alcohol, marijuana, cocaine, and other addictive substances, and over 19% have clinical substance abuse disorders. These numbers may be even higher because the Columbia researchers did not count teenagers who are incarcerated or high school drop-outs. This study found that substance abuse in general costs state, local and federal government $468 billion a year, or $1500 for every person in America.

Roughly half of the students completed the surveys up till they were 25 or 26 years of age. Students were questioned regarding alcohol, smoking, and drug use as well as their involvement in sports and exercise. Interestingly, involvement in sports did not curb alcohol use among youngsters. Those who played team sports were shown to drink more than their peers. And, those who drank earlier on were more likely to continue the habit into adulthood.

Researchers suspect that drinking may be seen as a social bonding activity amongst teammates. After all, major sporting events such as the Super Bowl, which define American culture, are laced with televised beer ads all throughout the game. There are many other possible reasons why athletes might be more prone to drink than those who do not exercise or participate in team sports. There might be peer pressure to drink in celebration of an evening’s win. Some kids might drink to deal with pressure from parents and coaches to perform. Others may just carry that same competitive spirit they have on the field to the party scene with friends.

Whatever the case may be, the study underscores the importance of alcohol education and prevention programs for those participating in sports. While particpating in sports is not a guarantee that a child will stay drug or alcohol free, it does improve chances he/she will live a healthy lifestyle overall. The results of the study were also fairly consistent with prior studies on the subject.

A 2000 study published in the journal, "Pediatrics and Adolescent Medicine," surveyed 14,000 U.S. high school students. Results from that study showed that those participating in sports were not as likely to be involved in experimenting in drugs as those not a part of sports. Their overall perception of drugs in general was also negative.

Researchers caution that data from the studies does not confirm a direct cause – effect relationship between playing sports and decreased drug use. There could be other factors that play into these results. Parental involvement, busy game schedules, and a focus on being healthy and in getting in shape might all have an effect on staying away from substance abuse.

In addition to avoiding drugs, the 2000 study notes that female athletes were also less likely to have engaged in sexual intercourse than their non-athletic peers in the prior three-month period. Both male and female athletes also reported eating more fruits and vegetables, important building blocks for a healthy diet. The study authors note that while drug use is the main focus of the study, the positive behaviors induced by sports are significant.

Researchers from Weill Cornell Medical College surveyed 264 teenagers between the ages of 13 and 17 living in the United States, and found that teens who reported drinking alcohol in the last months used a computer recreationally more hours per week than those who did not drink. Drinking was also associated with more time spent on social networking sites and downloading (and listening to) music. There was no distinct link between alcohol use and using the computer for educational purposes, nor was there a link between drinking and video games or drinking and online shopping.

Dr. Jennifer Epstein, public health researcher at Weill Cornell Medical College, said that it seems that adolescents are experimenting with drinking and activities on the Internet. Online exposure to alcohol advertising or peers who are drinking alcohol and sharing this information on social networking sites could influence more teens to drink. She added that children are exposed to computers and the Internet at younger ages, so it’s important for parents to be actively involved in monitoring their children’s computer use, as well as their exposure to alcohol.

Dr. Epstein explained that a national study by the Pew Internet and American Life Project found that more than half of parents of teenagers had installed filters on their children’s computers, blocking certain content; however, many parents did not monitor their children’s use of the Internet, especially among parents of older teens.

Dr. Epstein said she and her colleagues would like to collect more data on the association between teen drinking and computer use, including the amount of alcohol they tend to drink and the duration of their drinking habits.

Many adolescents start experimenting with alcohol at age 12 or 13, and risk factors for problem drinking include the lack of parental supervision and poor parental communication, conflict within the family, inconsistent or harsh discipline, and a family history of substance abuse.

Dr. Gil Botvin, professor of public health and chief of the Division of Prevention and Health Behavior at Weill Cornell Medical College, said that this study is important for understanding the potential influence that the Internet may have on today’s youth. He added that while the Internet provides many opportunities for intellectual and social enrichment, there is clearly also a negative side. He concluded that more research is needed to better understand these potential risk factors and how to avoid them.

Source: Medical News Today, Teenage Alcohol Consumption Associated with Computer Use, May 9, 2011