Can Your Brain Size Indicate Risk for Addiction?

March 29, 2018 by  
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77490Researchers are continuously on the search for biomarkers that can identify a potential risk to develop a particular type of mental illness or mental disorder.

A biomarker is a physical or biological difference in a particular group that identifies them from other groups [1]. For example, researchers have identified specific biomarkers that can indicate an increased vulnerability of certain women to develop breast cancer.

A biomarker does not necessarily indicate that the person will develop a particular disorder, just that the person is at a higher risk to develop the disorder in question. Biomarkers are extremely hard to identify for psychiatric problems such as depression, bipolar disorder, addictions, and very few have been identified even though there is quite a bit of research that attempt to locate them [1].

However, if reliable biomarkers could be identified for disorders such as addiction these would be extremely useful in identifying people who are more vulnerable to developing a specific type of addiction and then implementing early forms of intervention. A recent study investigated the potential for specific brain biomarkers to identify an increased likelihood of addiction to stimulants [2].

Using Brain Scans to Predict Addiction Vulnerability

The researchers looked at two samples of occasional users of amphetamine-type stimulants to determine if any particular differences in the brain volume of the individuals would be associated with the transition from occasional use to more chronic, addictive-type usage. The participants in the study underwent structural brain imaging and then were monitored after 12 and 24 months to assess their level of drug use. The researchers found that individuals who went from occasional use to more chronic addictive type use displayed smaller volumes in the brain areas associated with decision-making at the beginning of the study, particularly in the areas of the prefrontal cortex and the amygdala [2]. These areas of the brain are involved in such things as decision-making, the ability to control one’s actions, monitoring fear or anxiety, and memory [1].

The researchers hypothesized that the findings suggest that smaller brain volumes in these particular regions may be associated with greater impulsivity and poor decision-making. This might make an individual more susceptible to transitioning from occasional amphetamine use to more chronic or addictive usage.

Challenges of the Study

However, even though this particular study found the relationship between brain volume and later behavior, there are a number of issues here. First, the research is correlational research and therefore it cannot demonstrate that having smaller brain volume is in these particular areas causes one to develop an addiction.

Secondly, the sample in this study could not be used to generalize people outside of the study. Far more research with different and more participants would is needed.

Moreover, the findings suggest that such things as a tendency towards impulsivity may be related to later chronic drug use. Thus, behavioral measures of impulsivity would be better predictors of later proneness to addiction than brain scans would be and these also would be quite a bit less expensive.

Finally, these types of studies are notorious for their inability to replicate. Quite a bit of follow-up research is needed to indicate the reliability of these findings.

References

[1] Hatfield, R. C. (2013). The everything guide to the human brain. Avon: MA: Adams.

[2] Becker, B., Wagner, D., Koester, P., Tittgemeyer, M., Mercer-Chalmers-Bender, K., Hurlemann, R., … & Daumann, J. (2015). Smaller amygdala and medial prefrontal cortex predict escalating stimulant use. Brain, awv113.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

STUDY: The “Love Drug” Oxytocin May Keep You Sober

December 28, 2017 by  
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98468Oxytocin is a hormone that is produced by the hypothalamus in the brain and then secreted by the posterior pituitary gland. Oxytocin is a neuromodulator, which means that it is a substance that is released by one neuron in the brain that can affect populations of neurons. It is known that oxytocin is produced in large amounts during acts of sex as well as other acts of intimacy such as cuddling, holding hands, gazing into a loved one’s eyes, and even giving birth and nursing young children. Oxytocin interacts with the reward system in the human brain in much the same way that drugs such as alcohol and cocaine do [1]. Thus, many brain researchers think that the reason why human beings like to touch each other is because these behaviors lead to higher levels of oxytocin in the brain. But, can this hormone have an effect drug use?

Oxytocin and Drug Use

It is well-known that even in a small or moderate amounts, alcohol has a profound effect on motor impairment (e.g., staggering walk, lack of coordination, etc.). The effects of alcohol are linked to how alcohol affects GABA neurotransmitters, the major inhibitory neurotransmitter of the brain [1]. Researchers in Australia decided to look at the effects of giving oxytocin to rodents who were also given alcohol [2]. When the researchers were able to introduce oxytocin directly into the brains of rodents who had been given moderate levels of alcohol the rodents did not display the types of coordination difficulties and other motor difficulties commonly seen during intoxication. Rodents given the same doses of alcohol without the oxytocin were seriously impaired.

The researchers hypothesized based on their findings that giving oxytocin to humans would most likely leave a person’s thinking and speech patterns less impaired after they drink alcohol. There have been no empirical studies that have looked at how the hormone affects motor impairment in humans who drink, but the researchers report that that will be their next order of investigation.

A Solution to Drunkenness?

Before you get really excited about these findings there are couple of things that you should understand.

First, giving the rodents oxytocin after alcohol reduced their issues with motor control; however, this does not reduce one’s blood alcohol level. So if a method to use the hormone were developed for humans, it would not keep people from getting drunk nor could someone using the hormone drink significantly more than they can normally tolerate.

Secondly, oxytocin is known to reduce alcohol consumption and craving for alcohol in both humans and animals [1]. The reason for this is that the hormone works on the same aspects of the reward system in the brain that alcohol and other drugs affect. In the experiment, the rats were infused with alcohol and with the hormone. If a drug or medication were to be developed for humans, its use would also reduce alcohol consumption in individuals and directly reduce alcohol cravings in individuals trying to achieve sobriety. The goal of this type of research is to develop a clinical use for oxytocin for treating alcohol and drug abuse and not to allow people with addictions to indulge in their destructive behaviors. Thus, these findings are not going to lead to people drinking more if a drug is developed for humans based on this research.

Other Implications

Interestingly, there is plenty of research indicating that many individuals with substance abuse problems begin to recover on their own once they get in a serious relationship, have children, or have some other significant event in their life that they embrace [3]. However, we can all point to instances where drug use ruined a relationship, led to neglect of children, ruined a career, etc. It may very well be that there are subjective differences in the way that we feel things that may be based on experience and on our physical makeup that drive how such things as relationship status affect addiction. At this time, it is impossible to determine if increased levels of oxytocin in the brain as a result of life changes such as getting in a relationship or giving birth may have assisted in recovery for some people, but that certainly is a possibility. Thus, perhaps love is the drug that can keep you sober after all.

References

1. Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.

2. Bowen, M. T., Peters, S. T., Absalom, N., Chebib, M., Neumann, I. D., & McGregor, I. S. (2015). Oxytocin prevents ethanol actions at δ subunit-containing GABA A receptors and attenuates ethanol-induced motor impairment in rats. Proceedings of the National Academy of Sciences, 112(10), 3104-3109.

3. Heyman, G. M. (2009). Addiction: A disorder of choice. Harvard University Press.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

Substance Abuse and Mental Illness

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There are many reasons why alcohol use and having a mental health issue do not mix.This article explores the top 10 reasons why alcohol and mental illness do not mix.

People who have a mental illness also have a higher risk of having a substance abuse problem [1]. Alcohol is one of the most commonly misused substances and high rates of alcoholuse disorders occur in people with diagnose mental illnesses. There are many reasons why individuals were diagnosed with a mental illness, even something as common as depression, should not drink alcohol.

  1. Alcohol interferes with the mechanism by which most medications used in treating mental illness work. Drinking alcohol typically nullifies the effects (if any) from psychotropic medications.
  2. Alcohol use interferes with the process of learning and memory. This relationship is such that the more alcohol one uses the more the process is disrupted. Someone in a treatment program for mental illness or substance abuse drinks heavily will not process, encode, and retain information as well as if they did not drink at all.
  3. Alcohol can be dangerous and even lethal when used in combination with certain medications such as anti-anxiety medications.
  4. Alcohol use contributes to increased impulsivity in people. People with mental illness are at risk for acting impulsively and irrationally. Drinking alcohol makes this all the worse.
  5. Heavy alcohol use leads to poor decision-making that can intensify guilt, shame, depression.
  6. Alcohol is a central nervous system depressant. What this means is that it dampens the firing of certain neurons in the brain. For people prone to depressive reactions alcohol use can actually intensify their depression and increase thoughts of self “” harm.
  7. Heavy alcohol use may initially reduce a person’s anxiety; however, it also leads to something known as rebound anxiety where the person will experience more anxious symptoms as they withdraw from alcohol use.
  8. Alcohol use is known to increase recall for negative events such as traumatic experiences that occurred when one was using alcohol. This can lead to increased shame, depression, etc.
  9. Regular alcohol use disrupts sleep patterns and REM sleep. Disrupting one’s sleep can lead to more issues with fatigue, anxiety, depression, etc.
  10. Alcohol use is associated with other substance abuse, especially in individuals diagnosed with some form of mental health issue or mental illness. This can lead to more distressed, increased legal issues, and issues in recovery and treatment.

The bottom line is this: If you are diagnosed with a mental health issue DO NOT drink alcohol at all unless you are instructed to do so by your physician (this last situation would be VERY rare).

There are many reasons why alcohol use and having a mental health issue do not mix.This article explores the top 10 reasons why alcohol and mental illness do not mix.

People who have a mental illness also have a higher risk of having a substance abuse problem [1]. Alcohol is one of the most commonly misused substances and high rates of alcoholuse disorders occur in people with diagnose mental illnesses. There are many reasons why individuals were diagnosed with a mental illness, even something as common as depression, should not drink alcohol.

  1. Alcohol interferes with the mechanism by which most medications used in treating mental illness work. Drinking alcohol typically nullifies the effects (if any) from psychotropic medications.
  2. Alcohol use interferes with the process of learning and memory. This relationship is such that the more alcohol one uses the more the process is disrupted. Someone in a treatment program for mental illness or substance abuse drinks heavily will not process, encode, and retain information as well as if they did not drink at all.
  3. Alcohol can be dangerous and even lethal when used in combination with certain medications such as anti-anxiety medications.
  4. Alcohol use contributes to increased impulsivity in people. People with mental illness are at risk for acting impulsively and irrationally. Drinking alcohol makes this all the worse.
  5. Heavy alcohol use leads to poor decision-making that can intensify guilt, shame, depression.
  6. Alcohol is a central nervous system depressant. What this means is that it dampens the firing of certain neurons in the brain. For people prone to depressive reactions alcohol use can actually intensify their depression and increase thoughts of self “” harm.
  7. Heavy alcohol use may initially reduce a person’s anxiety; however, it also leads to something known as rebound anxiety where the person will experience more anxious symptoms as they withdraw from alcohol use.
  8. Alcohol use is known to increase recall for negative events such as traumatic experiences that occurred when one was using alcohol. This can lead to increased shame, depression, etc.
  9. Regular alcohol use disrupts sleep patterns and REM sleep. Disrupting one’s sleep can lead to more issues with fatigue, anxiety, depression, etc.
  10. Alcohol use is associated with other substance abuse, especially in individuals diagnosed with some form of mental health issue or mental illness. This can lead to more distressed, increased legal issues, and issues in recovery and treatment.

The bottom line is this: If you are diagnosed with a mental health issue DO NOT drink alcohol at all unless you are instructed to do so by your physician (this last situation would be VERY rare).

 

References:

[1] American Psychiatric Association. (2013). Diagnostic and statistical manual for mental disorders (5th ed.). Washington DC: Author.

[2] Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

 

Government-backed Messages to Kids Regarding Drinking

December 29, 2016 by  
Filed under People and Culture

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Unless you have been living in a cave you have probably noticed the many government and state sponsored advertisements and messages designed to curb alcohol, tobacco, and drug use in young people. Do they work?

Large campaigns often target younger people because it is believed that if drug abuse and addiction can be addressed at an early age the problem with abuse and addiction will be rectified. What does the research say about the effectiveness of these large campaigns? Read on.

1. D.A.R.E.

The conclusion of the U.S. General Accounting Office was that D.A.R.E. was ineffective despite spending millions. A new allegedly more effective program was launched in 2014.

In the United Kingdom there are over 1.2 million hospital admissions annually related to alcohol use, over 15,500 deaths related alcohol abuse, and the cost of alcohol abuse in Britain runs into the billions of British pounds. Binge drinking among younger people is a big issue in the UK and a recent study in Great Britain investigated governmental attempts to tackle and reduce excessive binge drinking by British youth [1].

2. Say NO!

A saying popularized by Nancy Reagan was found to have no effect on drug use in US youth

Researchers from four UK universities looked at the effects of government-sponsored anti-binge drinking messages directed at younger individuals. The researchers looked at data from over 200 alcohol advertisements and their effects on young people between the years 2004 through 2007. They found that the government-sponsored advertisements were generally ineffective because these advertising campaigns actually increased the notion that sensible drinking is boring and conformist in nature, whereas binge drinking is reactionary, nonconformist, and even fun.

The researchers concluded that government officials and government employees who design these campaigns actually ignore the reasons that many of the British youth enjoy drinking. The researchers also concluded that the funding for these campaigns, which runs into the millions of British pounds, is simply being misused because the messages invoke a reactionary response by young binge drinkers or are considered irrelevant to them [1].

3. This is your brain on drugs.

This was a large-scale US anti-narcotics campaign by Partnership for a Drug-Free America that used two televised public service announcements. While amusing they were generally ineffective.

The United States has a long history of government-sponsored anti-drinking and anti-drug campaigns.Of course the most infamous government intervention against alcohol use is Prohibition which outlawed alcohol possession nearly all together and ran from 1920 to 1933. The program failed miserably. Government sponsored programs designed to reduce use of other drugs came to fruition with the Harrison Narcotics Act, passed in 1914, as the first federal drug policy.  This act restricted the manufacture and sale of marijuana, cocaine, heroin, and morphine.  It too was highly unsuccessful in curbing drug use and simply fostered the development of large criminal organizations that specialized in manufacturing and delivering these drugs to users [2].  

4. Potheads

Advertisements have recently attempted to target specific groups of young people. Ads targeting marijuana use are notoriously ineffective.

More recent government that sponsored programs such as the “Just say no!” slogan, D.A.R.E. and others have been equally ineffective and many researchers have suggested that these programs often produce what is known as a “boomerang effect” with drugs like alcohol, tobacco, and marijuana where the more young people are exposed to these campaigns the less effective they are.

Independent research on the US Government’s National Youth Anti-Drug Media Campaign has also found it to be generally ineffective [4].Moreover, there is research that suggests in response to these large campaigns many at-risk younger people tend to romanticize the use of these drugs and see their use as rebellious and as a means to develop a personal identity [3]. These findings are consistent with the recent findings from the UK [1].

5. Controversy

Many of the government advertisements targeting youth have stirred controversy after shifting the blame to the victim.

The British researchers suggested that smaller, targeted, and practical interventions at specific groups might be more effective than mass campaigns promoted by the government and the media [1]. Many individuals in the United States have suggested legalization for illicit drugs like marijuana and cocaine or more specific practical and interventions/messages as opposed to the overall negative messages directed at younger audiences, much in line with the suggestions of the researchers in the UK [2, 3].

References

[1] Hackley, C., Bengry-Howell, A., Griffin, C., Szmigin, I., Mistral, W., & Hackley, R. A. (2015). Transgressive drinking practices and the subversion of proscriptive alcohol policy messages. Journal of Business Research.

[2] Lise, W. (2012). War on Drugs. Publications Oboulo. com.

[3] van Wormer, K., & Thyer, B. A. (Eds.). (2009). Evidence-based practice in the field of substance abuse: A book of readings. Sage.

[4] Hornik, R., & Jacobsohn, L. (2007). The best laid plans: Disappointments of the National Youth Anti-Drug Media Campaign. LDI issue brief, 14(2), 1-4.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

Increasing Use of ADHD Medication on College Campuses

November 17, 2016 by  
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Group of people silhouettes

The pressure to get good grades in college often leads college students to take excessive steps or to find shortcuts to success. There had been several studies performed on different college campuses that suggest that the misuse of stimulant drugs, especially drugs like Ritalin and Adderall, is becoming more common by college students looking to get an edge. Ritalin and Adderall are Schedule II controlled substances which places them in the same legal category as methamphetamine, cocaine, etc. Moreover, these drugs are designed specifically for the treatment of Attention Deficit Hyperactivity Disorder. A recent study has indicated that the practice of using these stimulant medications by college students is increasing at an alarming rate [1].

The researchers of the study used a statistical technique known as meta-analysis which allows researchers to pool together the results from many different studies. The researchers looked at 30 different studies that met fairly stringent criteria to determine the rates of use of these stimulant medications for ADHD on college campuses. The results of the studies indicated that about 17% of college students misuse stimulant medication for ADHD by either taking the medication without a prescription or taking a much larger amount than prescribed. Students who are able to get the medication without a prescription often purchase it from individuals who have a prescription for the medication or from other sources that sell it at increased prices. The primary reason given by students for taking the medication was to improve academic performance; however, there actually is no empirical evidence that taking stimulant medications improves memory or learning ability. What the stimulant medications do is allow students to stay awake longer and to cram or study longer. The medication does not increase their ability to learn material.

Other Complications from Stimulant Abuse

The researchers found that there were several variables that identified stimulant medication misusers from nonusers. These included having issues with alcohol use disorder and marijuana use disorder, belonging to a fraternity or sorority, poorer than average academic performance, and a past history of substance abuse. There are many adverse health effects that can result from misuse of these drugs such as serious cardiovascular complications (e.g. heart attack or stroke), the development of paranoia or extreme hostility, and of course an increased risk for addiction. In addition, a recent study also found that even casual users of stimulant medications designed to treat ADHD demonstrate significant changes in their brain function compared to nonusers [2]. Moreover, because these medications are actually classified as Schedule II drugs individuals who do not have a prescription for them and are caught with them risk some serious legal problems.

Alternatives to Using Stimulant Medication

Interestingly, there is no evidence to suggest that the use of these medications improves academic performance. As mentioned above students that use this medication often use it during finals when they feel the need to study around the clock. There are a few simple principles of learning and memory that would be much more effective:

(A). There is plenty of research that indicates that studying material bit by bit or for short periods of time at a consistent level is much more efficient than cramming or what learning researchers call “mass practice” [3]. Instead of waiting until the night before test or a final to study volumes of material students would be much more efficient in learning by reviewing and studying specific material for an hour or so a day on a consistent schedule.

(B). For reasons this writer could never understand many students study in areas with lots of distractions such as radios playing music, TVs on, other people talking, at sporting events, etc. This practice is highly inefficient. Learning academic material and reading textbooks becomes much more efficient when done in areas that are distraction free.

(C). Students should only take what they absolutely need with them when they are studying. Typically this is means textbooks, notes, and other class materials or study materials such as flashcards. Taking a computer, leaving your cell phone on, etc. only produce more distractions.

(D). Writing and rewriting notes is an efficient way to help learn. Using outlines, flashcards, etc. helps to organize material. Instead of highlighting text in the textbook is more efficient to rewrite it and summarize it then use the summary notes as flashcards or memorization aids.

(E). It is extremely important to make a schedule that you can stick to and then stick to that schedule. Again, regular practice at regular intervals always is more efficient than cramming or mass practice. It is important to set goals for each study session and keep tabs on where you are in relation to what it is you need to know for the upcoming exam. It is also extremely important to understand the expectations for each class and chart your progress towards these.

(F). It is also extremely important to allow schedule breaks during studying. However, during the break it would be counterproductive to engage in an activity that will affect your studying goals in a negative manner such as going out a getting a beer or other activities that lead to distraction from the goal of learning.

(G). Some people work better in groups and some people work better alone. It is important to know where you stand on this issue. If you study with a group it is also important to study with a group that is focused in learning the material as opposed to socializing and engaging in activities that will distract you from your goal of learning the material.

 

References:

[1] Benson, K., Flory, K., Humphreys, K. L., & Lee, S. S. (2015). Misuse of Stimulant Medication Among College Students: A Comprehensive Review and Meta-analysis. Clinical child and family psychology review, 18(1), 1-27.

[2] Harlé, K. M., Shenoy, P., Stewart, J. L., Tapert, S. F., Angela, J. Y., & Paulus, M. P. (2014). Altered neural processing of the need to stop in young adults at risk for stimulant dependence. The Journal of Neuroscience, 34(13), 4567-4580

[3] Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

People Who Drink Heavily May Have Lower I.Q.

October 13, 2016 by  
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There has been quite a bit of research that has attempted to link people’s drinking habits with their intelligence. For the most part, the research has been inconclusive such that there is no clear, consistent, relationship found between a level of the person’s intelligence and their drinking habits. Research performed in Sweden looked at the drinking habits of over 49,000 men who had been in the Swedish military from 1969 to 1971. These subjects at all had brief IQ tests and had provided information on their alcohol usage, tobacco usage, psychiatric symptoms, their upbringing, and any medical conditions [1]. The researchers were interested in finding if there was an association between intelligence and total alcohol intake in adolescence, intelligence and patterns of drinking in adolescents, and if so does this association persist into adulthood.

The overall findings indicated that lower scores on the IQ tests were associated with a higher consumption of alcohol and risky drinking behaviors such as binge drinking. Moreover, lower social economic status, history of emotional problems, and issues with upbringing were also associated with more risky alcohol consumption. This story was picked up by many of the major news providers. Cruising many of the Internet science reporting sites one can see headlines based on the study that appeared to indicate that heavy drinkers are less intelligent than light or nondrinkers, that drinking alcohol makes you less intelligent, etc. One must remember that these headlines are designed to draw traffic to the sites and are not designed to be objective, accurate, and realistic. The type of research applied in this study is useful in understanding general principles as well as trends/associations in data sets, but it also has a number of inherent problems that limit the types of generalizations that can be made. A few of these issues are discussed next.

Correlational Research

First, this study is a type of study that is known as correlational research, which is the most common form of research done in social sciences. Correlational research basically looks at how things are associated with one another. This type of research is unable to make any type of cause and effect inference based on the associations found in the research (the old “correlation does not equal causation” saying that you’ve heard many times in school). In fact, it would be unethical and impossible to perform a true experiment on people that could determine if drinking alcohol causes them to score more poorly on IQ tests (see [2] and [3] for a discussion on this). So any research study performed on people that looks at intelligence and alcohol usage cannot make the claim that drinking alcohol makes a person less intelligent. In the case of specific deficits associated with long-term chronic alcohol usage there are some studies indicate that chronic heavy alcohol usage over a period of years is associated with specific cognitive deficits; however, in normal populations studies such as this one the researchers are able to make a “drinking more alcohol causes you to be less intelligent” claim.

Second, the types of intelligence tests used in this study are not the standardized intelligence tests that would be used in a clinical study or to provide a clinically useful IQ score. Moreover, the method of data reporting and the measures of drinking behaviors use of this study are not reliable and valid and would be problematic if used in a more controlled study.

Third, there is a complex relationship between social economic status, health “” related behaviors, and how groups of individuals perform on various cognitive tests. The researchers themselves note that there are a number of different explanations that could explain their findings including heavier drinkers having more emotional and social issues, heavier drinkers often belong to more socially/economically disadvantaged groups, and people who score low on IQ test are just less health-conscious than people who tend to score higher on IQ “” type tests.

The researchers state quite unequivocally that for most of us our level of intelligence is actually fairly well established before they begin to drink and that it is a person’s level of intelligence that probably moderates their health-related habits including such things as drinking and smoking. As stated above it is well-established that people who score higher on IQ tests or intelligence tests are as a group more health-conscious than people that score lower on these tests. So, despite the claims of many of the news services that covered this particular study, the study did not produce evidence that drinking “causes” people to be less intelligent, but instead reaffirms older notions that social background, emotional distress, and intelligence interact with people’s behavior such as their alcohol usage.

One last thing to keep in mind about correlational research and research studies in general is that correlational research describes general associations and general trends among groups of people. These trends and relationships are never reported to be prefect relationships in the data. One can find obvious exemptions to the associations described in these types of studies, even in the data from which the research findings are drawn. So, even though this study found a general association between a lower score on an IQ test and higher alcohol consumption or more risky drinking habits, there were also small numbers of subjects in this study that demonstrated the opposite type of association (higher IQ scores and heavy drinking habits) as well as subjects in the study who demonstrated no such association. The overall finding and results are based on the overall trend in the data. We can all search our own experience and find exceptions to the findings; however, if we consider large groups of people instead of single cases these types of trends will be more evident.

References

[1] Sjölund, S., Hemmingsson, T., & Allebeck, P. (2015). IQ and Level of Alcohol Consumption””Findings from a National Survey of Swedish Conscripts. Alcoholism: Clinical and Experimental Research 39(3), 548-555.

[2] Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.

[3] Hatfield, R. C. (2014). The everything guide to coping with panic disorder. Avon, MA: Adams.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

What You Need to Know About Flakka

September 15, 2016 by  
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Alpha-PVP or flakka, as it is known by its street name, is a chemical relative to MDPV or “bath salts,” which has been illegal in the United States since 2011. The United States Drug Enforcement Administration has put a temporary ban on flakka since 2014 and it is believed that this ban will become permanent [1]. However, flakka is so potent and is extremely inexpensive (as low as five dollars per dose) that its use has grown in certain parts of the country. Recent research using established animal models of addiction have been performed to determine the addiction potential of flakka.

These animal models typically use rodents who are trained to press a lever to intravenously infuse small doses of the drug. Initially, a small number of lever presses are required for the rodent to get the drug and then the number of lever presses to receive another dose is gradually increased [2]. The research found that this particular drug was so addictive that the animals would press the lever hundreds of times to receive a single dose of this drug. Its addiction potential was almost identical to MDPV [1], another highly addictive drug recently banned by the DEA.

In addition, flakka administration boosted the physical activity of the rodents and drastically disrupted their body temperature, which are classic physical signs of stimulant use. The research indicates that flakka is one of the worst ever drugs on the market in terms of its physical addiction potential and rodents in laboratory conditions demonstrated much higher drug-seeking lever pressing to obtain flakka in rodents than other addiction trials did for crystal meth [1].

Like most abused stimulant drugs, individuals who initially use the drug and binge on it are at a much higher risk to develop addiction than do individuals who initially use the drug and are able to use just occasionally. However, as these designer drugs increase in their potency, it’s believed that their addiction potential also increases [1]. For instance, rodents in the laboratory trials that did not gradually increase their intake of the drug instead binged on as much as they could get during the initial sessions and demonstrated higher levels of addictive behavior (the tendency to press the lever for longer periods of time in order to get a single dose) than rodents that increase their usage gradually [1].

The issue with drugs like bath salts and flakka is that these drugs are not made in garages any longer but instead come from sophisticated chemistry labs that produce a particular drug and several different analogues of the drug. Once one particular drug gets banned, the manufacturers are able to release another one that is slightly chemically different, but just as potentially dangerous. Recent actions of individuals taking flakka and having hallucinations indicate that the drug is not only dangerous for the user, but potentially dangerous for individuals that interact with heavy users of the drug [3].

Sources:

[1] Aarde, S. M., Creehan, K. M., Vandewater, S. A., Dickerson, T. J., & Taffe, M. A. (2015). In vivo potency and efficacy of the novel cathinone α-pyrrolidinopentiophenone and 3, 4-methylenedioxypyrovalerone: self-administration and locomotor stimulation in male rats. Psychopharmacology, 1-11.

[2] Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.

[3]. Palm Beach County’s newest drug flakka being called “one of the worst roads ever.” http://palmbeachhealthbeat.blog.palmbeachpost.com/2015/05/18/palm-beach-countys-newest-drug-flakka-being-called-one-of-the-worst-drugs-ever/


 Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

New Fingerprint Test Can Determine Cocaine Use

July 22, 2016 by  
Filed under Health, Treatment and Recovery News

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Mass spectrometry analysis is a method of analysis that can measure specific types of chemicals in a sample. Researchers in the Netherlands and the United Kingdom used different types of mass spectrometry analyses to analyze the fingerprints of people who attended drug treatment programs [1]. They compared the fingerprints of the individuals to saliva tests in order to determine how the saliva tests and the mass spectrometry analysis tests were related.

When a person uses cocaine, they excrete traces of the chemicals benzoylecgonine and methylegonine as they metabolize the drug. Both of these chemicals show up in saliva tests and in other bodily fluid tests and, if present, indicate that a person has used cocaine because excreting these metabolites is impossible for someone who hasn’t used. However, previous tests that use fingerprint analysis and employ similar methods could only determine whether the person had touched cocaine””they’re unable to determine if the person had actually taken the drug internally. In this study the researchers were able to use an additional technique known as Desorption Electrospray Ionization to determine if these two particular chemicals that are metabolites of cocaine, benzoylecgonine and methylegonine were present in the fingerprint residue of individuals. If these chemicals are present, it would be certain that the person providing the fingerprint has used cocaine because they can only be present when the body metabolizes cocaine. The findings indicated that for people who had used cocaine these two chemicals are present in their fingerprint residue.

This type of test has some pretty interesting implications. For example, drug testing is used mainly by the courts, probation departments, prisons, law-enforcement, etc. Traditional drug testing methods that use a person’s urine, saliva or other bodily fluids are often limited by the need for special training, specific storage and disposal methods, off-site analysis of samples, can be vulnerable to tampering, and can be potentially hazardous to individuals doing the testing. This particular technique circumvents all of these issues. In addition, fingerprint analysis is much more difficult, if impossible, to fake.

At the current time this technology is not available for practical use; however, the researchers believe that in the future law-enforcement agencies and other interested in agencies could have a number of portable fingerprint drug tests available to them. These fingerprint analysis techniques would be able to specifically determine if an individual had used cocaine and also are infallible in their ability to identify that the sample comes from that particular person because everyone has a unique fingerprint.

References

[1] Bailey, M. J., Bradshaw, R., Francese, S., Salter, T. L., Costa, C., Ismail, M., … & de Puit, M. (2015). Rapid detection of cocaine, benzoylecgonine and methylecgonine in fingerprints using surface mass spectrometry. Analyst.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

Marijuana Contact Buzz: Myth or Not?

June 16, 2016 by  
Filed under Health, Treatment and Recovery News

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MJ_ContactHigh_PhotoHaving been involved in the treatment of substance abusers and also an active participant in substance abuse groups, I’ve has witnessed several individuals who tested positive for cannabis but claimed they did not use the drug. Most often these individuals swear that they were with someone who was smoking marijuana and that is why they tested positive. Typically, people will test positive for THC, the active ingredient in marijuana, for up to 30 days following using it. In my personal interactions with these individuals, it seemed that their employers and the court system did not consider this to be a viable excuse, and quickly consider anyone who tests positive for cannabis to have used it at some time in the past. However, recent research may indicate that this attitude needs to be re-examined.

Testing Positive for THC

In one study researchers exposed non-marijuana users who were drug-free to secondhand marijuana smoke in a sealed chamber for one hour. The potency of the marijuana cigarettes was varied from low (5.3% THC) to rather high (11.3% THC). No ventilation was available in the room in two of the conditions (5.3% and 11.3%). In a third condition ventilation was employed in the room (11.3%).

The non-smokers tested positive for rather small levels of marijuana concentrations in their blood and urine. Interestingly, there was an effect for room ventilation such that in the condition with the better ventilation the concentration of THC in the blood was markedly decreased. Moreover there was also a dose effect such that individuals who were exposed to secondhand marijuana smoke with higher levels of THC were more likely to test positive [1].

Feeling the Buzz

In a second study, individuals in the high potency condition were subjected to physiological, behavioral or cognitive measures, and self-report measures of their experience. As stated above, exposure to cannabis smoke in poorly ventilated conditions produced detectable amounts of THC in the blood and urine of these individuals. Moreover, the individuals in the poorly ventilated room condition self-reported sedative effects of secondhand smoke as well as produced and impaired performance on a cognitive task of one’s ability to think quickly, react quickly, and make decisions. These effects were not seen in the ventilated room condition [2].

The Bottom Line

The researchers suggest that secondhand marijuana smoke exposure does produce detectable levels of THC in the blood and urine of individuals when there is little or very poor ventilation. Moreover, there is both subjective and objective evidence to suggest that secondhand exposure to cannabis smoke in such conditions can produce what most refer to as a “contact buzz.” However, the conditions under which this occurred in the studies were only positive for extremely poor ventilated areas.

Of course, much more research would be needed to actually determine the parameters regarding exactly how much secondhand exposure produces detectable results. The researchers in these studies concluded that objective measures like blood and urine tests coming up positive as a result of secondhand exposure to marijuana smoke in the real world are probably very rare.

References

[1] Cone, E. J., Bigelow, G. E., Herrmann, E. S., Mitchell, J. M., LoDico, C., Flegel, R., & Vandrey, R. (2014). Non-Smoker Exposure to Secondhand Cannabis Smoke. I. Urine Screening and Confirmation Results. Journal of analytical toxicology, bku116.

[2] Herrmann, E. S., Cone, E. J., Mitchell, J. M., Bigelow, G. E., LoDico, C., Flegel, R., & Vandrey, R. (2015). Non-Smoker Exposure to Secondhand Cannabis Smoke II: Effect of Room Ventilation on the Physiological, Subjective, and Behavioral/Cognitive Effects. Drug and Alcohol Dependence.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

Medications to Curb Drinking Behaviors

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103036The medical response to treating most conditions, even psychiatric conditions, is to prescribe some form of medication. Can medication effectively treat alcoholism? An important study in the Journal of the American Medical Association looked at the current evidence.

Let’s start with a quick primer on research methods.

Meta-Analysis

In statistics we refer to the term “power” as the ability to detect a significant effect when one is there. Certain types of different research approaches have more power than others. One particularly powerful approach in research methodology is a technique known as meta-analysis. Meta-analysis combines the effects of many studies to determine if the phenomenon being studied is indeed effective. For example, meta-analytic studies have been done in order to determine if medications like antidepressants or vaccines are effective, if different types of psychotherapy are effective at treating depression, etc. The basic idea behind meta-analysis is very quite simple. Being able to draw on the results of multiple studies would have more statistical power than just the results of a single study. So if meta-analytic studies suggest that a certain technique is effective in treating something, this is stronger evidence than the results of single studies.

Number Needed to Treat (NNT)

A particular statistic that comes out of epidemiology is called number needed to treat (NNT). The NNT basically represents the number of individuals that must receive the treatment in order for one person to be effectively treated by it. For example if the NNT is five, then five people need to get the treatment before one is successfully treated by it. If the NNT is one that means that everyone who gets the treatment is successfully treated (this almost never happens). The higher the NNT the less effective the treatment (or drug) is.

The Deal with Medications and Alcoholism

Alcohol use disorders are among the most common forms of addiction and treatment for alcoholism is difficult and often considered to be a lifelong process (Hatfield, 2013). Even with the development of many different types of medications to assist in the treatment of addiction less than 10% of the patients with alcohol use disorders receive medications to help them reduce their alcohol consumption. The results of a recent study may help increase the use of medications in assisting to treat people who suffer from alcohol use disorders.

A meta “” analytic study recently reported in the Journal of the American Medical Association included 122 randomized controlled trials and one other study that all were at least 12 weeks long to determine the effectiveness of several medications in treating alcohol use disorders (Jonas, Amick, Feltner, et al., 2014). Randomized controlled trials are the gold standard in research because the methodology used allows for the researcher to determine if the treatment actually caused the particular outcome, whereas other types of studies cannot determine cause-and-effect relations (see Hatfield, 2013 for a complete review of research methods).

Most of the studies in the meta-analysis looked at the medications naltrexone (common brand names Revia or Depade) or acamprosate (brand name Campral). Both of these medications block neurotransmitter systems that are associated with the development of cravings and are believed to be able to reduce the urge to drink in people that take these medications.

According to the meta-analytic findings by Jonas et al. the NNT for oral naltrexone for return to any drinking at all was 20 and for a return to heavy drinking patterns was 12. The NNT for the return to any drinking at all for treatment with acamprosate was 12. There were no significant differences found between the use of the two medications (the researchers could not find any statistical evidence to establish the superiority of either medication compared to the other). As a comparison, meta-analytic studies using psychotherapy typically find an NNT of between 7 “” 10 for psychotherapy and alcohol use disorder (e.g., Riper, Andersson, Hunter et al., 2014); however, psychotherapy has the added benefit of concurrently treating things like depression, anxiety, etc. whereas these medications are unable to do that.

Most of the readers of these articles are probably more familiar with the medication disulfiram (brand name Antabuse) for treating alcoholism. Disulfiram does not affect the urge to drink but instead results in the person developing a noxious reaction if they drink alcohol while on the medication. This results in the person getting very sick and hopefully will dissuade them from using alcohol in the future. The research on the effectiveness of disulfiram has never been positive because people taking this medication still get urges to drink and can often simply stop taking the medication for 48 hours before drinking with no ill effects at all (Jonas et al., 2014; Hatfield, 2013).

Thus, based on the current research findings it appears that these medications can be extremely helpful in treating alcoholism; however, it appears that combinations of medications, psychotherapy, group therapies such as AA, and other factors such as social support are needed to bolster treatment effectiveness.

Do you think that the use of medications has a place in treating addictive behaviors such as alcohol use disorder? Why or why not?

References

Hatfield, R. C. (2013). The everything guide to the human brain. Avon, MA: Adams.

Jonas, D. E., Amick, H. R., Feltner, C., Bobashev, G., Thomas, K., Wines, R. & Garbutt, J. C. (2014). Pharmacotherapy for Adults with Alcohol Use Disorders in Outpatient Settings: A Systematic Review and Meta-Analysis. JAMA, 311(18), 1889-1900.

Riper, H., Andersson, G., Hunter, S. B., Wit, J., Berking, M., & Cuijpers, P. (2014). Treatment of Comorbid Alcohol Use Disorders and Depression with Cognitive Behavioural Therapy and Motivational interviewing: A meta-analysis. Addiction, 109(3), 394-406.


Dr. Hatfield is a clinical neuropsychologist with extensive experience assessing and treating neurological and psychiatric disorders. His areas of expertise include neurobiology, behavior, dementia, head injury, addiction, abnormal psychology, personality disorders, statistics, rehabilitation psychology and research methodology.

 

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