Thursday, July 29, 2010

Giving Kids Booze, Medicines Can Be Child Abuse

US News & World Report

The malicious use of alcohol and medicines is an under-recognized form of child abuse, according to a new report.

The U.S. study reviewed cases of pharmaceutical-related child abuse reported to the National Poison Data System between 2000 and 2008. The cases included the use of alcohol, painkillers, cough and cold medicines, sedatives, sleeping pills and antipsychotic medicines.

The findings are scheduled to be published in an upcoming issue of the Journal of Pediatrics.

The review included over 1,400 cases, and nearly 14 percent led to moderate or major consequences for children, including death. In about half of the cases, children were given at least one sedative. On average, 160 cases of pharmaceutical abuse, including two deaths, were reported each year.

Motives for this type of child abuse included punishment, amusement, or a desire for a break from childcare responsibilities, the researcher pointed out in a news release from the journal's publisher.

The findings highlight a serious problem, according to study author Dr. Shan Yin, of the University of Colorado and the Rocky Mountain Poison and Drug Center at Denver Health.

"The malicious administration of pharmaceuticals should be considered an important form of child abuse," Yin stated in the news release.

Pediatricians and emergency medical personnel should be on alert for this type of child abuse, and comprehensive drug screening should be used for children who are suspected victims of abuse, Yin added.

Thursday, July 22, 2010

The Science Behind Drinking: Testing for Alcohol Consumption and Abuse

Health News Digest

As actress Lindsay Lohan now knows, there are a variety of ways to test a person’s bodily fluids for alcohol consumption, both before and after an arrest for driving under the influence and to monitor adherence during rehabilitation. During her recent probation for DUI, Ms. Lohan found herself in a special ankle bracelet that uses Breathalyzer technology to sample the sweat on the skin every half hour to determine if an individual violates probation by drinking alcohol. In Ms. Lohan’s case, the device was triggered several times, prompting the judge to consider these violations when sentencing her to 90 days in jail.

In most cases where individuals are suspected of driving under the influence, breath analyzers are used to determine blood alcohol concentration, but according to Dr. Amitava Dasgupta, Director of Clinical Chemistry, Toxicology and Point-of-Care Services at Memorial-Hermann Hospital, Texas Medical Center in Houston, not all breath analyzers are created equal. ”Most people don’t know that there are two types of blood alcohol breath analyzers and the results from only evidentiary breath analyzers can be used to prosecute people accused of driving under the influence,” he said. Additionally, interferents such as mouthwash, hand sanitizers and energy drinks can skew the results of a breath analyzer, and test administrators must take these factors into consideration.

Measuring alcohol use and abuse goes far beyond just testing DUI suspects, and during a morning presentation titled “Role of the Laboratory in the Science of Drinking: From Blood Alcohol Levels and Markers of Alcohol Abuse to Pharmacogenomics,” on Monday, July 26, both Dr. Dasgupta and Dr. Loralie Langman, Associate Professor of Pathology and Laboratory Medicine at the Mayo Clinic in Rochester, will outline the complex and changing role labs are playing not only in measuring and interpreting blood alcohol levels, but also in measuring biomarkers of alcohol abuse and researching genetic variations that can provide insight into why individuals metabolize alcohol in different ways. These presentations will be offered during AACC’s 2010 Annual Meeting, which is being held at the Anaheim Convention Center.

Both Dasgupta and Langman point out that monitoring alcohol consumption and alcohol abuse long-term is much more complicated than taking snapshots of blood alcohol concentrations. In such a scenario, clinicians need to continue measuring traditional biomarkers for alcohol consumption and abuse, such as liver enzymes, mean corpuscular volume (MCV) and carbohydrate-deficient transferrin, mainly because these markers stay elevated for a longer period of time and have the potential to help determine recent alcohol intake versus chronic alcohol consumption, as well as alcohol abuse versus moderate drinking.

Genetic researchers have discovered that there are some genetic factors that cause alcohol sensitivity in people of certain ethnic origins. “Certain populations are genetically predisposed to be more sensitive to alcohol than others,” explains Langman. “Individuals who are sensitive to alcohol can be drunk with a blood alcohol level of .03, and these are the people who should probably not drink.” However, testing individuals for certain genetic polymorphisms related to alcohol abuse or addiction is complicated and there is still much research that must be done before such tests can be offered clinically.

Tuesday, July 20, 2010

Protein Regulator Shows Promise Against Addiction

US News & World Report

Little things can make a big difference in the brain. Case in point: A tiny snippet of RNA may help guard cocaine-using rats against addiction to the drug, a new study shows.

The minuscule molecular guard is a hairpin-shaped piece of RNA known as a microRNA. Raising levels of a microRNA called miR-212 in the brains of cocaine-using rats led the animals to take less of the drug than rats with normal microRNA levels, researchers report in the July 8 Nature. Similarly, blocking the microRNA’s action increased the rats’ cocaine use.

If the results hold true in people, researchers may be able to develop new therapies for treating addiction to cocaine and other drugs of abuse. “Once you get out of whack, this is something that might help bring you back,” says Yale neuroscientist Marina Picciotto, who was not involved in the study.

It’s unlikely that the research will lead to gene therapy to raise levels of microRNAs in people’s brains. But small-molecule drugs that mimic the microRNA’s action might be helpful.

Just 21 to 23 RNA units long, microRNAs are major regulatory molecules that govern part of the process by which instructions contained in DNA are transformed into proteins. The molecules generally block protein production. So it was a surprise to find levels of a protein called CREB increase with rising levels of miR-212, says Paul Kenny, a neuroscientist at the Scripps Research Institute in Jupiter, Fla.

CREB has been found to help fight addiction by decreasing the rewarding experience of taking cocaine, sometimes to the point that rats actually develop an aversion to the drug. It took Kenny and his colleagues years to work out exactly how cocaine use boosts miR-212 production and how the microRNA, in turn, increases production of CREB protein. The process involves several steps and intermediate proteins, including a protein called Raf1 that had never before been shown to be involved in the response to drugs.

The miR-212 microRNA blocks an inhibitor of Raf1 in the striatum, a part of the brain involved in learning habits like driving a car and learning to avoid making the same mistake twice. With its inhibitor in check, Raf1 is free to stimulate CREB production, Kenny and his colleagues show in the new study.

Protecting against cocaine addiction may be a side benefit of mir-212’s normal job of regulating CREB production and other biochemical processes in the brain, Kenny says. The microRNA helps set the correct level of CREB production to keep it from getting too low, which leads to addiction and anxiety, or too high, which leads to depression.

Any therapy targeting CREB would have to strike this delicate balance as well, he says. “Obviously there could be some very profound side effects,” Kenny says.

The researchers are investigating how mir-212 is regulated and whether it is protective against other drugs, such as nicotine and alcohol addiction.

Wednesday, July 7, 2010

Pat O'Brien to Address Alcoholism and "Unfortunate Scandal" in Memoir

Seattle Post

Former Access Hollywood and The Insider anchor Pat O'Brien intends to write a tell-all detailing his struggle with alcohol addiction and his "unfortunate scandal," in which he left slurred sexually graphic voicemail messages on a woman's phone, he tells the New York Post.

O'Brien, who will co-write the memoir — tentatively titled I Love Your Work — with biographer Andrew Morton, will also address his 2004 divorce from his wife, Linda, which occurred a year before his voicemails leaked.

In the voicemails, O'Brien asked an unidentified woman to join him for drugs and sex. He subsequently entered drug rehab before returning to The Insider. He did another stint in rehab in March 2008 and six months later was fired from The Insider after writing e-mails to co-workers that insulted co-host Lara Spencer.

"I was not in total recovery or in alcoholics anonymous at the time. I was still messed up," O'Brien, 62, told the Post's Page Six.

O'Brien, who says he's been sober for more than 600 days, is considering a multiyear radio deal.

I Love Your Work is scheduled to hit shelves from St. Martin's Press in fall 2011.

Thursday, July 1, 2010

San Francisco Eyes Alcohol Tax to Recover Health Costs

San Francisco Chronicle

San Francisco would be the first local government in the state to impose a booze fee intended to recover health care costs associated with alcohol addiction treatment now covered by taxpayers.

The fee, expected to generate more than $15 million a year, would cover such expenses as ambulance transport to the emergency room for public inebriates, unreimbursed hospital and clinic services for alcohol-related accidents and diseases, and Department of Public Health-funded programs aimed at preventing and treating alcoholism.

The idea, said Supervisor John Avalos, who proposed the fee legislation Tuesday, is to make the targeted businesses pay "for the harm of alcohol consumption on the people of San Francisco and the city and county of San Francisco."

The fee is focused on wholesalers. The rate would be 0.076 cents per ounce of alcohol sold. Avalos estimated that the added cost to a standard drink would be a little less than a nickel.

A similar statewide bill was killed this year in the Legislature amid opposition from the alcoholic beverage industry.

Eric Potashner, a spokesman for California Beer and Beverage Distributors, said the Avalos legislation was still being analyzed by the trade group, "but it would be safe to say they're opposed to it."

Mayor Gavin Newsom has not taken a position on the proposal, said his spokesman, Tony Winnicker. But, he noted, "It's the kind of fee that would impact every hotel, restaurant, retailer and hundreds of thousands of people and would require careful scrutiny and public outreach" to uncover any potential unintended consequences.

The mayor's health director, however, backs the proposal.

"We support it," said Dr. Mitch Katz, director of the Department of Public Health. "Alcohol rehab and abuse has a tremendous cost on the health care system. It seems to me that a fee should be added to the cost of alcohol."

On Avalos' behalf, the city controller's office commissioned an independent study that looked at how much money the cash-strapped city spends on unreimbursed alcohol-related expenses. Among those identified: The Fire Department spends nearly $4 million for emergency medical response; San Francisco General Hospital spends $1.8 million caring for patients; and the city's community substance abuse treatment program spends another $10 million.

The money also would be used to cover the costs of fee collection, investigation and enforcement.

Fees, which unlike taxes do not have to go before voters for approval, are tied to cost recovery.

Avalos hopes the fee would be enacted effective in January. Litigation is expected if it is adopted.