All posts by pjdhanoa

Childhood Anxiety Disorder Linked to Earlier Drug Use


Kathleen Louden

May 06, 2013

CHICAGO — Among teenagers with substance abuse, those who also have social anxiety disorder are significantly more likely to start using marijuana at an earlier age than those without the anxiety disorder, new research shows.

Teenagers with social anxiety disorder, also known as social phobia, start using marijuana at a mean age of 10.6 years, an average of 2.2 years earlier than other adolescents with substance use disorders, according to a study conducted by investigators at Case Western Reserve University School of Medicine, Cleveland, Ohio.


“This finding surprised us,” said principal investigator Alexandra Wang, a third-year medical student at the university, in an interview with Medscape Medical News. “It shows we need to start earlier with prevention of drug and alcohol use and treatment of social phobia [in children].”


Wang presented the research as a scientific poster here at the American Society of Addiction Medicine (ASAM) 44th Annual Medical-Scientific Conference.


Which Comes First?


The researchers conducted the study to determine associations between anxiety disorders and substance use disorders, and which disorder started first in adolescents with this comorbidity.


The study included 195 youths (102 girls, 52%), aged 14 to 18 years, who met the current diagnosis of substance use disorder and had received medical detoxification if needed. Participants had no major health conditions requiring hospitalization.


Alexandra Wang


Assessment involved semistructured interviews, medical chart review, and reports from the adolescent, parent, and clinician. Using the Mini–International Neuropsychiatric Interview, the investigators assessed the participants’ history of drug and alcohol use and their history of any of 3 anxiety disorders: social anxiety disorder, panic disorder, and agoraphobia. A clinician verified the participants’ recalled age at onset of symptoms or substance use in 83% of cases, according to the poster. Each participant received $25 for completing the interview.


The drug most often used was marijuana. Of the 195 participants, 92% had marijuana dependence, with a mean age at onset of use of 13 years, the investigators reported; 61% were alcohol dependent, having started to drink at 13.5 years on average.


Teenagers with either social anxiety disorder or panic disorder were significantly more likely to have marijuana dependence (for each, P < .01, logistic regression), Wang said. Both of these disorders reportedly were likelier to occur before marijuana dependence (P < .01).


Approximately 80% of adolescents with social anxiety disorder and 85% with panic disorder had symptoms of that disorder before the onset of their substance abuse, the poster data showed.


In addition, panic disorder tended to start before alcohol dependence (P < .05) and occurred in 75% of alcohol-dependent adolescents.


There was no clear pattern as to whether agoraphobia preceded or followed either marijuana use or the first drink, according to the authors.


The investigators also evaluated whether presence of substance abuse lowered the age at onset of an anxiety disorder, but they noted no significant difference.


Rule, Not the Exception


A limitation of the study, according to the research team, was that 128 (66%) of the particpants were juvenile offenders who had received court-referred treatment of their substance abuse. In their poster, the authors wrote that their findings might not generalize to a less severely addicted population.


Still, coinvestigator Christina Delos Reyes, MD, told Medscape Medical News that interventions to reduce social anxiety might help prevent adolescents’ marijuana use.


“We need to treat these young patients initially with nonpharmacologic means, such as cognitive behavioral therapy or mindfulness meditation,” said Dr. Delos Reyes, a psychiatrist specializing in addictions at University Hospitals Case Medical Center, in Cleveland.


Asked to comment by Medscape Medical News, Patrick Bordeaux, MD, a child and adolescent psychiatrist in Quebec, Canada, said it is well known that “comorbidities tend to be the rule in adolescents, not the exception.”


“Adolescents are more likely to have social and mental disorders that make them more likely to use drugs,” said Dr. Bordeaux, who was not involved with the study.


Grants from the National Institute on Alcohol Abuse and Alcoholism and from the John Templeton Foundation in West Conshohocken, Pennsylvania, partly funded this study. Alexandra Wang and Dr. Delos Reyes disclosed no relevant financial relationships.


American Society of Addiction Medicine (ASAM) 44th Annual Medical-Scientific Conference. Poster 4. Presented April 26, 2013.

Recovery Ride Spin Class 5-13-13!


Today’s ride was excellent!

1. Standing On The Shore – Empire Of The Sun

2. European Me – Johnny Marr

3. Dilly – Band Of Horses

4. Inner City Pressure – Flight of The Conchords

5. Battle of Who Could Care Less – Ben Folds Five

6. There’s A Silence – Electric Soft Parade

7. Right Here, Right Now – Fatboy Slim

8. Stacy’s Mom – Fountains of Wayne

9. Do You Want To – Franz Ferdinand

10. Baby Got Back – Jonathan Coulton

11. California Gurls – Katy Perry

12. Dashboard – Modest Mouse

An Easy Asian Dish: Vietnamese Green Mango and Pork Salad – By Chef Rob


Posted: 07 May 2013 01:43 PM PDT

Here’s an easy recipe for a full-flavored Asian dish—Vietnamese green mango and pork salad—that requires no crazy cooking skills and no ingredients that you have to travel to Hanoi to buy. 

Feel free to substitute ground chicken or ground turkey for the ground pork. Fish sauce can be found in most standard supermarkets. The following recipe, accompanied with brown rice and a vegetable, should serve six.

2                Green (unripe) mangoes, peeled and diced
2 tsp.          Salt (preferably unrefined sea salt)
1/3 cup       Lime juice
2 Tbs.         Olive or high-quality canola oil
2 to 3 Tbs.  Garlic, thinly sliced

2 to 3 Tbs.  Shallots, thinly sliced
1 tsp.         Crushed red pepper flakes
1.5 lbs.       Ground pork
To taste      Fresh ground pepper
¼ cup         Fish sauce
2 Tbs.         Brown sugar
4 Tbs.         Peanuts, chopped (for garnish)
2 Tbs.         Cilantro or parsley (for garnish)

Recovery Ride Spin Class 5-6-13 !


99 problems                                                   Jay Z

Fantastic Voyage                                          Coolio

Virginia Plain                                                 Roxy Music

Nite Klub                                                         The Specials

All Apologies                                                   Nirvana

Plush                                                               Stone Temple Pilots

Rock and Roll                                                  Led Zepplin

Let it Rain                                                         Eric Clapton

Substitute                                                         The Who

American Girl                                                       Tom Petty

Rebel Rebel                                                        David Bowie

Peace Frog                                                         The Doors

Please, please let me get what I want                     The Smiths

Suicide Rate Among Middle-aged Americans Soars


Caroline Cassels

May 02, 2013

The suicide rate among middle-aged individuals in the United States has taken a major leap forward in the past decade, new research shows.

A report released today by the Centers for Disease Control and Prevention (CDC) reveals that the suicide rate among men and women aged 35 to 64 years increased by 28% — 32% for women and 27% for men — between 1999 and 2010.

Increases in suicide rates were also especially high among non-Hispanic whites and American Indians and Alaska Natives.

The increases were geographically widespread and occurred in states with high, as well as average and low, suicide rates, the authors report.

Increases in suicide rates among males and females were also observed from suicides involving hanging/suffocation, poisoning, and firearms. Suicide rates for individuals aged 10 to 34 years and for those aged 65 years and older did not change significantly during this period.

“Suicide is a tragedy that is far too common. The stories we hear of those who are impacted by suicide are very difficult. This report highlights the need to expand our knowledge of risk factors so we can build on prevention programs that prevent suicide,” CDC director Thomas Friedan, MD, said in a release.

The findings were published May 2 in the CDC’s journal, Morbidity and Mortality Weekly Report.

The report’s key findings include the following:

  • Suicide rates among those aged 35 to 64 years increased 28% (32% for women, 27% for men).
  • The greatest increases in suicide rates were among people aged 50 to 54 years (48%) and 55 to 59 years (49%).
  • Among racial/ethnic groups, the greatest increases in suicide rates were among white non-Hispanics (40%) and American Indian and Alaska Natives (65%).
  • Suicide rates increased 23% or more across all 4 major regions of the United States.
  • Suicide rates increased 81% for hanging/suffocation, compared with 14% for use of firearms and 24% for poisoning.
  • Firearms and hanging/suffocation were the most common suicide mechanisms for middle-aged men. Poisoning and firearms were the most common mechanisms for middle-aged women.

According to the report’s authors, one possible contributing factor for the rise in suicide rates among middle-aged Americans is the recent economic downturn. They point out that historically, suicide rates tend to correlate with business cycles, with higher suicide rates occurring during times of economic hardship.

In addition, the observed risk in intentional overdoses may be due to the increased availability of prescription opioids.

“These results highlight the need for suicide prevention strategies that address mental health issues and the stresses and challenges that middle-aged adults are likely to face. Such stresses include economic challenges, dual caregiver responsibilities, and potential health problems,” the authors write.

MMWR. Published May 2, 2013.

Increased Number Of Drug-Related Deaths Increased Between 1999- 2010







U.S. drug-related deaths, over time

U.S. drug-related deaths, over time Katie Peek


Drug Week:  Popular Science

In 2010, there were 80,000 drug and alcohol overdose deaths in the U.S., according to the Centers for Disease Control and Prevention’s WONDER database. The database, maintained by the National Center for Health Statistics, keeps a tally of all the deaths listed on certificates nationwide. They’re classified by the ICD-10 medical coding reference system.Death reporting in the U.S. requires an underlying cause—the event or disease that lead to the death. This chart represents all those listed in the CDC database as “accidental poisoning,” “intentional self-poisoning,” “assault by drugs,” and “poisoning with undetermined intent.” In addition to the underlying cause, a death certificate has space for up to 20 additional causes. That’s where “cocaine” or “antidepressants” would show up. The subcategories are limited in their detail—many drugs are lumped together, like MDMA and caffeine, which are listed together as “psychostimulants.” And about a quarter of all overdose death certificates don’t have the toxicity test results listed at all, landing them in the “unspecified” stripe.

By adding all those sub-categories up, imperfect as they may be, it’s clear that the rate of reported overdoses the U.S. more than doubled between 1999 and 2010. About half of those additional deaths are in the pharmaceuticals category, which the CDC has written about before. Nearly three-quarters of the pharmaceuticals deaths are opioid analgesics—prescription painkillers like OxyContin and Vicodin. And while cocaine, heroin and alcohol are all responsible for enough deaths to warrant their own stripes on the chart, many popular illegal drugs—including marijuana and LSD—are such a tiny blip as to be invisible.

A few caveats about the statistics: if a person had multiple drugs listed on their death certificate, they’re being counted twice here. Also, the database doesn’t include nonresidents—either undocumented immigrants or U.S. citizens living abroad.

Peer Pressure – Worse in Middle School


Peer Pressure to Smoke Greater in Middle School Than High School: Study

By  | April 29, 2013

Parents’ smoking behavior influences their teens’ decisions about cigarette use throughout high school, a new study suggests. Peer pressure to smoke is greater during middle school than high school, according to researchers at the Keck School of Medicine of the University of Southern California.

The findings indicate smoking intervention programs designed to counteract peer pressure to smoke should be aimed at middle school students, instead of high school students, the researchers report in the Journal of Adolescent Health.

The findings on peer pressure were surprising to the researchers,HealthDay reports. “We thought friends would have more influence on cigarette use during high school than junior high school,” said study author Yue Liao. “But what we found was friends have greater influence during junior high school than high school. We think the reason may be that friends’ cigarette use behavior may have a stronger influence on youth who start smoking at a younger age,” she noted in a press release. “During high school, cigarette use might represent the maintenance of behavior rather than a result of peer influence.”

The study included 1,000 teens who were first questioned in seventh grade. They were reassessed after six months, and then annually until they were in twelfth grade. They answered questions about how many of their close friends and parents smoked, and how many cigarettes they themselves had smoked in the past month. They saw a large decrease in friends’ influence from eighth to ninth grade.

Breathing Test Device Used to Detect 12 Controlled Substances


Swedish researchers have found a commercially available breathing test device can be used to detect 12 controlled substances, including marijuana, cocaine, heroin and methamphetamine, US News reports.

The device was tested on 47 people who had taken drugs in the previous 24 hours and were recovering at a drug addiction emergency clinic, the researchers report in the Journal of Breath Research. The test correctly detected drug use in 87 percent of cases, and was as accurate as blood and urine tests.

Currently, police do not have a simple way to test drivers for drugs when they are suspected of driving under the influence (DUI), the article notes. Lead researcher Olof Beck of the Karolinska Institutet noted in a news release, “Considering the samples were taken 24 hours after the intake of drugs, we were surprised to find that there was still high detectability for most drugs.” Dr. Beck said police could use the test at the scene when DUI is suspected, and later confirm the findings with a blood test.

The researchers collected breath samples using a currently available breath test called SensAbues, which consists of a mouthpiece and micro-particle filter. When a person breathes into the mouthpiece, the device separates saliva and larger particles from the tiny particles that are measured. The micro-particles pass through and deposit onto a filter, which is sealed and stored. The particles are then analyzed using lab tests known as liquid chromatography and mass spectrometry.


Raise Taxes, Wyoming, I D.A.R.E. You


By Joe Schrank

Posted: 04/25/2013 4:14 pm

America has a long history of stubborn resistance to applying logic, science and just common sense to our intoxication problem. For more than 30 years the DARE program has been in 80 percent of school districts. Reagan, Bush, Clinton, Bush II and Obama have all had a “national DARE day” and yet, in 2001, Surgeon General David Satcher placed the DARE program in the category of “ineffective.” In 2003 the office went further and claimed it may even have a boomerang effect and increase drug use. As someone who sits many hours with each years new class of rehab kids, I have heard about the DARE program everything from “it was bullshit” to ‘it made me want to try what they were saying not to” even “I hated them because they kept saying what losers alcoholics were and my dad is an alcoholic.” Perhaps the most concerning thing I have heard was “the cop who taught it hit on me.” A decade after the proclamation from David Satcher, we still have the DARE program. It begs a 12 step culture cliché: when nothing changes, nothing changes.

At this point, we can safely accept that intoxication is part of the human condition, it has been since cavemen first fermented fruit and yet, year after year we try to give stern warnings to youth and expect that will do the trick that did nothing for the previous generation. So what does work?

There is growing evidence that taxation has a strong correlation to reducing the rates of use, underage, and binge drinking.

And when drinking goes down, so does: violence, vandalism, visits to the ER from uninsured, accidental pregnancy, and STD’s, the list goes on and on. It would make sense, since the data demonstrates that higher taxation works to try it, what is there to lose? While we all love the cute and cuddly (read: weird and creepy) DARE lion, why not use what is shown to work? More than likely, the alcohol lobby is at work here and they don’t want to see any tax hikes. They seem to know that if that were to happen, they would sell less of their product. The community would certainly benefit from more revenue and as an added bonus, people drink less and therefore cause less damage.

Many states have not raised taxes on alcohol in generations, the most egregious of these is Wyoming. Beer, the beverage of choice for the underage drinker and frat boy, is taxed .02/100 in Wyoming with the last tax raise in 1935. Think of it in these terms: Saturday night, 20 college kids and a keg of beer (15 gallons). Not hard to imagine something going wrong all of which is financed by the tax-payer because the state got .30/100 for that keg of beer. To be fair, Wyoming seems to have some decent programs for families and individuals plagued by alcoholism. They even have REACH high school, an innovative program to help youngsters in recovery. Governor Matt Mead seems to have a concern on the matter and sponsored many efforts to curb underage drinking and alcohol abuse. Curiously void from these efforts is what research says is the most effective; a tax hike. When asked about taxation in his state, Governor Matt Mead had this to say “Alcohol and substance abuse are serious problems across America including here in Wyoming. I believe we have come a long way in creating better prevention and treatment programs, but we should always look to improve. One area where I know we have room for growth is in programs for our youth. I support concepts that try to innovate and target teenagers. I will continue to look for collaborations to reduce alcohol abuse and underage drinking.”

I have a way to innovate governor, let’s ignore the alcohol lobby and raise taxes on beer in your state, with the revenue dedicated to treatment, recovery, and family services. Just for fun, let’s take all the kids at REACH high on a fun sober vacation. I’ll chaperone.

 — Joe Schrank

Party Drug Called “Benzo Fury” Presents Dangers, Rat Study Suggests



A party drug known as “Benzo Fury” can have dangerous consequences, a new study of rodents suggests. It has both stimulant and hallucinogenic effects, Reuters reports. The drug is a synthetic, laboratory-designed substance.

Benzo Fury can be purchased online, and is popular in Britain and the United States, the article notes. Researchers at Britain’s University of Roehampton found the drug produced an effect on the brains of rats that was similar to hallucinogenic, addictive drugs such as cocaine or amphetamines. It may lead to high blood pressure by constricting blood vessels, the researchers said.

“It’s in the combination of these stimulant and hallucinogenic properties that the greatest danger lies,” said lead researcher Jolanta Opacka-Juffry. She presented her findings at the British Neuroscience Association conference in London. She added, “It’s possible that the reason these drugs are so popular is because they are seen as safer than their illegal counterparts,” so it is “important to challenge such assumptions.”