Replacing Addiction with a Healthy Obsession, By Jacque Wilson, CNN

In his memoir, “The Long Run,” Mishka Shubaly chronicles his journey from “irreverent young drunk” to ultra-runner. The author sobered up by running five miles at a time, then 10, then 50.  It was Shubaly’s editor who first suggested he write about his road to recovery.  “I told him point-blank, ‘No one wants to hear me cry about how I f***ed up my own life,’ ” Shubaly said. “And I was totally wrong.” When “The Long Run” was published on Amazon’s Kindle Singles list in 2011, it hit No. 1, bumping Stephen King out of the top spot.

The book’s popularity may have been a surprise to Shubaly, but experts know he’s not alone in using exercise to overcome addiction. Groups have been popping up around the country to help people stay sober by staying active.

“It’s a great way to introduce people into something that then later becomes … sort of their coping mechanism, as opposed to picking up a drink or a drug,” said Scott Strode, one of this year’s top 10 CNN Heroes. Strode’s nonprofit, Phoenix Multisport, provides free athletic activities and a sober support community to thousands of people in Colorado.

In 2008, the National Institute on Drug Abuse pledged $4 million to research the effect of physical activity on drug use. Preclinical research has provided evidence that exercise can help treat — and even possibly prevent — addiction, and now human trials are taking place.

According to the National Institute on Drug Abuse, abuse of illicit drugs and alcohol contributes to the death of more than 100,000 Americans every year. While intervention and treatment programs have improved, relapse rates range from 60% to 90% in the first year of sobriety, the institute said.

“Habits play an important role in our health,” the institute’s director, Dr. Nora Volkow, said in a National Institute of Health newsletter. “Understanding the biology of how we develop routines that may be harmful to us, and how to break those routines and embrace new ones, could help us change our lifestyles and adopt healthier behaviors.”

Psychology professor Mark Smith researches the effects of exercise on addiction in laboratory rats. One of his first preclinical studies on the subject showed lab rats that had access to an exercise wheel in their cage were much less likely to self-administer cocaine than their sedentary counterparts.

He and his colleagues have also completed several follow-up studies, duplicating the results with male and female rats; with low, medium and high doses; with heroin; and with different models of substance binges and relapses.

“I was amazed at how consistent the effects of exercise were,” Smith said.

Other researchers have published animal studies with similar results. For example, a 2009 study in Pathophysiology Journal showed treadmill exercise reduced morphine use in male rats. And in 2011, a study in the journal Current Neuropharmacologydemonstrated animals’ preference for saline over amphetamines when they exercised.

“These results lead us to conclude that a previous practice of regular physical activity may help in preventing amphetamine addiction,” the study’s authors wrote.  While evidence mounts that exercise may help prevent and treat addiction, scientists are trying to figure out why.  To get clean, addicts often give up their past social lives, including any friends who use. During their recovery, they have a lot of free time and not a lot of support.

To get clean, addicts often give up their past social lives, including any friends who use. During their recovery, they have a lot of free time and not a lot of support.

By Jacque Wilson, CNN

Adolescent Drinking May Be As Important a Risk Factor For Criminal Activity As Illicit Drug Use, Medical News Today

 

Alcohol use has often been linked to criminal activity on the part of both perpetrators as well as victims. While this relationship has been well documented among adults, fewer studies have explored this relationship among adolescents. A new study has found a strong relationship between drinking during adolescence and the commission of crimes, and criminal victimization, for both genders.

“This issue is extremely important because adolescents who are criminally active are significantly more likely to be adult criminals,” said Michael T. French, professor of health economics at the University of Miami and corresponding author for the study. “Although adolescents often commit less serious crimes than adults – for example, vandalism and shoplifting – these behaviors can quickly escalate into a criminally active lifestyle without effective interventions. Understanding how alcohol use among adolescents may contribute to criminal activity is therefore a logical and policy relevant area for research.”

Unfortunately, French added, much of the research has focused only on illicit drugs and criminal activity. Second, quality data are hard to come by. The health survey data set used in this study, he said, is one of the few longitudinal datasets with excellent measures for alcohol use and criminal activity.

He and his colleagues used data from four waves (n=20,746; n=14,738; n=15,190; n=9,576) of the National Longitudinal Study of Adolescent Health to examine alcohol-use patterns and criminal activity from adolescence through to young adulthood. They were interested in several questions: Does alcohol use have different effects on being a victim or being a perpetrator of a crime? Is the likelihood of committing a property crime for drinkers relative to non-drinkers greater than that of being involved in other types of crime? How do these relationships differ for males and females? Are frequent binge drinkers more likely to be involved in criminal activity compared to occasional drinkers or abstainers?

“We found that for both adolescent males and females, more frequent alcohol consumption is associated with a greater probability of committing a property crime, committing a predatory crime, and being a victim of a predatory crime,” said French. “While we were not necessarily surprised that these relationships existed for both genders, the strength of the relationships was a bit unexpected as well as the fact that they were robust to numerous sensitivity tests.”

The key message, he noted, is that frequent alcohol use by adolescents may be as important a risk factor for criminal activity as illicit drug use. “Educators, parents, clinicians, and others who interact with adolescents can use these findings as an incentive to be vigilant about underage alcohol use as this behavior could be linked with current criminal activities or a least a precursor to future illegal acts,” he said. “Early intervention is probably the best defense in this case.”

However, French cautioned, while these findings may inform public-policy measures designed to reduce drinking among adolescents with the goal of reducing criminal activity and delinquency, it would be incorrect and misguided to conclude from these findings that all frequent-drinking adolescents are associated with criminal acts, either as a perpetrator or victim. “However,” he said, “this study demonstrates that frequent alcohol consumption is an important risk factor that should not be easily dismissed as normal adolescent behavior.”

Medical News Today

Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, “Alcohol Use and Crime: Findings from a Longitudinal Sample of U.S. Adolescents and Young Adults,” were: Ioana Popovici in the Department of Sociobehavioral and Administrative Pharmacy of the College of Pharmacy at the Nova Southeastern University; Jenny F. Homer of the Health Economics Research Group of the Sociology Research Center at the University of Miami; and Hai Fang of the Department of Health Systems, Management, and Policy in the Colorado School of Public Health at the University of Colorado Denver. The study was funded by the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Drug Abuse. This release is supported by the Addiction Technology Transfer Center Network at http://www.ATTCnetwork.org.

Marijuana – Its negative impact on adolescent development, Journal of Abnormal Psychology

Recreational marijuana use remains very popular among U.S. teens and young adults.  This is nothing new, as pot has been a prominent part of popular culture for decades.  But some important things have changed.  First, the levels of THC (the primary psychoactive ingredient in marijuana) in confiscated marijuana have risen markedly over the years, from about 1-2% in the late 1970s, to roughly 10% in 2009.  Although more potent strains of marijuana have always been available, they are far more common now. This means that today’s pot smokers are exposed to a far stronger version of the drug, and this adds to concerns about both the immediate effects of a single dose and the long-term effects of repeated use.  Secondly, we now know that there are specific receptors in the brain to which THC molecules can bind and change the functioning of nerve cells.  This means that there is a natural, internal (“endogenous”), and delicate cannabinoid system in the brain that can be powerfully stimulated by marijuana.

Importantly, we also now know that the adolescent brain is far more sensitive than the adult brain to some of the effects of THC.  Most of the recent research has focused on the ability of THC to impair learning and learning-related brain function. In our laboratory, we have shown that THC disrupts learning performance in adolescent animals far more potently than it does in adults, and that this difference in sensitivity can be traced all the way down to the level of individual neurons in the hippocampus.  These are striking findings because they indicate some very fundamental differences in how the adolescent and adult brain function and react to THC.  Like with alcohol, it is now possible to have a conversation with an adolescent about marijuana that is based on facts and not emotions or power struggles.  It might not seem fair, but for better or worse the adolescent brain is simply more susceptible to learning impairments by marijuana.  And in studies of adolescent marijuana users, higher levels of use are associated with more significant learning deficits.While the impairments that marijuana causes in learning and memory appear to improve some with abstinence, deficits in attention, a fundamental ability involved in nearly every facet of daily life, are still evident for at least three weeks after a teen stops using. Further, like with alcohol, it appears that the earlier one initiates use of marijuana the bigger the deficits produced by the drug. In one recent study comparing adolescent chronic marijuana users who began before or after the age of 15, those who began earlier showed larger deficits in attention and memory.

Another serious consideration is that recent research indicates that some adolescents may be at risk for serious psychiatric problems, including delusions, hallucinations, and the emergence of schizophrenia later in life if they smoke marijuana regularly during their teens.  The research is new and there are many details to be worked out, but it does raise a red flag for caution.  We’ve known for some years that marijuana use by young people conveys a moderate statistical risk for the development of psychiatric illness, and the younger the age at which marijuana use is initiated, the greater the risk.  But the new work suggests that whether or not a person is at risk depends on the expression profile of a particular gene that gives rise to an enzyme in the brain called COMT (catechol-o-methyl-transferase) that regulates the activity of dopamine and several other neurochemicals that are important for mood and other functions.  People with a particular version of the gene may be far more likely to develop psychiatric illness than others.
Fortunately, marijuana does not share the profound impact alcohol has on vital reflexes, like gagging and breathing, which makes marijuana less deadly after one time use. However, marijuana can bring about death via its effects on the cardiovascular system, particularly in the first half hour or so after smoking it. It can also lead to death by causing people to do stupid things that seem really smart at the moment. According to data from the Drug Abuse Warning Network (DAWN), which tracks mentions of drug use recorded during visits to Emergency Rooms, marijuana-related visits have been on the rise over the last few decades, surpassing the number of Emergency Room visits attributed to heroin.

There is widespread misconception regarding whether marijuana use can lead to dependence.  An abundance of data from recent studies leaves little doubt that marijuana dependence is real and that quitting often brings about a very uncomfortable syndrome of withdrawal symptoms. In one recent study of 104 adolescents in treatment for marijuana dependence, 9 out of 10 reported experiencing withdrawal symptoms characterized by craving, irritability, restlessness, anxiety and depression. As with alcohol, there appears to be a genetic component to marijuana dependence. A recent study examined the DNA of kids with and without dependency on the drug, and found that there is a particular type of gene associated with dependence as well as another associated with use but no dependence. Around 12% of the sample had the putative dependence-risk-enhancing gene.

While research regarding the impact of marijuana on adolescent brain development and psychological development is, in many ways, still in its infancy, there is sufficient evidence to conclude that marijuana use during adolescents can lead to lingering deficits in basic cognitive abilities, like learning and attention, and that regular use of marijuana can lead to physical dependence and withdrawal. Studies regarding the direct effects of marijuana on the adolescent  braindo not yet paint a compelling story about changes marijuana produces, but do indicate that a long list of changes occurs. Several studies suggest reduced thickness of cortical gray matter layers in the cerebellum, which is involved in learning, balance and driving skills, in adolescent marijuana abusers. Other studies suggest increased thickness of gray matter layers in some areas of the frontal lobes and decreased thickness in others among chronic users. While we await a more definitive picture of the impact of marijuana on the teen brain, the existing research tells us that marijuana use during adolescence impairs cognitive skills, increases the risk for schizophrenia and other psychotic disorders, is associated with depression, and can lead to dependence and withdrawal. These reasons alone should be sufficient to motivate adults to do everything they can to delay or prevent the use of marijuana by teens.

Impact of adolescent drug use and social support on problems of young adults: A longitudinal study.  Newcomb, Michael D.; Bentler, Peter M.  Journal of Abnormal Psychology, Vol 97(1), Feb 1988, 64-75. doi: 10.1037/0021-843X.97.1.64