Social Work Today E-Zine

Children who grow up with a parent with a drinking problem have been shown to suffer from depression, anxiety, acting out, and academic and social difficulties. Some of these problems begin as early as age 2; however, the few prevention programs that exist for children of alcoholic parents are typically aimed at students in middle school or older.

Andrea Hussong, PhD, a clinical psychologist at the University of North Carolina at Chapel Hill, hopes to change that. Along with her colleagues in the UNC College of Arts and Sciences’ psychology department, Hussong is developing an early prevention program called Families First, designed for families of preschool-age children who are living with a parent with a drinking problem.

The preschool years are an ideal developmental period for intervention because risk behaviors such as aggression may become more difficult to change if they are not addressed before children enter elementary school, Hussong says.

“Many of the young children with whom I have worked in community mental health care were struggling to find ways to cope with parent alcoholism and problem drinking before they entered school,” Hussong says. “Our goal is to work with families one on one to address issues common to healthy family development for all of us—promoting positive relationships with children, effective discipline practices, and healthy emotional and social development.”

“We know that signs of emotional distress in early childhood predict greater risk for substance use in adolescence and young adulthood,” Hussong says. “My work has been aimed at connecting the dots along this developmental pathway to identify and evaluate whether there is an ‘internalizing pathway’ to substance use disorders.”

— Source: University of North Carolina at Chapel Hill

Flavored alcoholic beverages—or alcopops—are becoming more popular, especially among young people, and it’s raising people’s concerns about underage drinking. According to a recent report, 52% of adults believe definitely or probably that alcopops encourage underage drinking. The report also finds that because these often fruity, fizzy, pop-like drinks can be easily confused with nonalcoholic beverages, 92% of adults strongly support the use of warning labels on alcopops. Most adults also support greater restrictions on advertising that focuses on youth.

“Alcopops are sweet drinks made to taste like cola or soda pop or punch or lemonade,” says Matthew Davis, MD, director of the C.S. Mott Children’s Hospital National Poll on Children’s Health. “Typically, alcopops have between 5% and 8% alcohol content, which is a little bit more than most beers, and they’re marketed to look like familiar drinks to kids.”

What many people may not know is that most alcopops contain distilled alcohol but are classified in most states as “malt beverages” similar to beer. This designation allows alcopops to be marketed more widely, including online and in magazines, and sold in a greater number of retail locations.
“We also found in this poll that about 75% of adults in the United States are concerned underage drinking is a problem,” Davis says. “Underage drinking in the U.S. is pretty common. About 20% of 8th graders and 40% of 12th graders drink.”

The National Poll on Children’s Health also found that among adults 84% support banning alcopops ads from youth Web sites; 80% from youth magazines; 75% from billboards within 500 feet of a school or park; 59% from ads during primetime television; 58% support prohibiting alcopops sponsoring college sporting events; and 57% support limiting alcopops ads during televised sporting events.

“There is a lot of action in state legislatures regarding alcopops or flavored alcoholic beverages,” Davis says. “Many states are considering legislation and some have enacted legislation to limit advertising and otherwise change how alcopops are presented to the public.”

— Source: University of Michigan Health System

A new Web site (http://rethinkingdrinking.niaaa.nih.gov) and booklet from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) could help many people reduce their risk for alcohol problems. Called Rethinking Drinking, the new materials present evidence-based information about risky drinking patterns, the alcohol content of drinks, and the signs of an alcohol problem, along with information about medications and other resources to help people who choose to cut back or quit drinking. The Web site also features interactive tools, such as calculators for measuring alcohol calories and drink sizes.

Based on results of a NIAAA survey of 43,000 U.S. adults, Rethinking Drinking presents single-day and weekly low-risk limits for men and women. For men, these limits are no more than four drinks on any single day and 14 drinks per week, and for women, no more than three drinks on any day and seven per week. Among people who exceed these limits, about one in four already has alcoholism or alcohol abuse, and the rest are at increased risk for these and other problems.

"People can still have trouble drinking within these limits, especially if they drink too quickly, have certain medical conditions, or are older," says NIAAA Acting Director Kenneth Warren, PhD. He adds that Rethinking Drinking presents information previously released in the NIAAA Clinician's Guide in a comprehensive, user-friendly way for the general public, so that anyone who chooses to drink alcohol can evaluate their individual risk.

— Source: The National Institute on Alcohol Abuse and Alcoholism

Menthol cigarettes are harder to quit, particularly among African American and Latino smokers, according to researchers at the University of Medicine and Dentistry of New Jersey (UMDNJ) in a study that examined the effects of menthol on quit rates among a diverse group of nearly 1,700 smokers attending a Tobacco Dependence Clinic at the UMDNJ-School of Public Health, which is published in The International Journal of Clinical Practice.

“We previously found that menthol cigarette smokers take in more nicotine and carbon monoxide per cigarette. This study shows that menthol smokers also find it harder to quit, despite smoking fewer cigarettes per day,” says study author Kunal Gandhi, MBBS, MPH, a researcher in the division of addiction psychiatry.

Jonathan Foulds, PhD, director of the Tobacco Dependence Program, adds: “More than 80% of the African American smokers attending our clinic smoke menthols, and they have half the quit rate of African Americans who smoke nonmenthol cigarettes.”

The researchers believe the cooling effect of the menthol makes it easier to inhale more nicotine from each cigarette and, therefore, to obtain a stronger and more addictive nicotine dose. “That may be part of the reason why African Americans have much higher rates of lung cancer,” Foulds says.

The researchers also are concerned that the tobacco industry may target its marketing of menthol cigarettes to groups with less cash to spend, such as youths, with the aim of getting them hooked even on fewer cigarettes per day, they say. Their study findings may have implications for future regulation of cigarettes. Recent legislation in New Jersey and pending federal legislation bans fruit- and candy-flavored cigarettes but allows menthol to be added.

— Source: University of Medicine and Dentistry of New Jersey

A new study found that adolescents were at the greatest risk of smoking when their parents began smoking at an early age and the parents' smoking quickly reached high levels and persisted over time. 
The study, published in Health Psychology, draws from the long-running Indiana University (IU) Smoking Survey and builds on previous research that suggests smoking behavior is influenced by both genetics and the environment.

"This particular study focuses more on the genetic influence in the specific case of a parent's smoking behavior impacting a teenage son or daughter's smoking," says Jon Macy, project director of the IU Smoking Survey in the department of psychological and brain sciences.

"The study findings suggest that the characteristics of early onset and high levels of long-term smoking are great candidates for behavioral and molecular genetic studies of the causes of smoking and how smoking behavior is passed from one generation to the next.

"Of course, environmental influences on adolescents such as parenting practices, availability of cigarettes in the home, and parents' attitudes about smoking are equally as important and can be addressed with effective public health interventions including family-based smoking prevention programs," he says.

"This study used a more informative description of parental smoking behaviors," Macy adds. "We've found that these descriptions might do a better job than current parental smoking status of predicting risk of their adolescent children starting to smoke."

— Source: Indiana University

Adolescents addicted to opioids who received continuing treatment with the combination medication buprenorphine-naloxone had lower rates of testing positive or reporting use of opioids compared with youths who went through a short-term detoxification program using the same medication, according to a study in The Journal of the American Medical Association.

“The usual treatment for opioid-addicted youth is short-term detoxification and individual or group therapy in residential or outpatient settings over weeks or months. Clinicians report that relapse is high, yet many programs remain strongly committed to this approach and, except for treating withdrawal, do not use agonist [a drug that mimics the action of a naturally occurring substance] medication,” the authors wrote.

George Woody, MD, of the University of Pennsylvania in Philadelphia, and colleagues conducted a study comparing outcomes of treating opioid addiction among adolescents with extended treatment using buprenorphine-naloxone vs. short-term detoxification. The study included 152 patients, aged 15 to 21. Patients in the 12-week buprenorphine-naloxone group were prescribed up to 24 milligrams per day for 9 weeks and then tapered to week 12; patients in the detox group were prescribed up to 14 milligrams per day and then tapered to day 14. All were offered weekly individual and group counseling.

The researchers found that overall, patients in the detox group had higher proportions of opioid-positive urine test results at weeks 4 and 8 but not at week 12. At week 4, 61% of detox patients had positive results vs. 26% of the 12-week buprenorphine-naloxone patients. At week 8, 54% of detox patients had positive results vs. 23% of 12-week buprenorphine-naloxone patients. At week 12, 51% of detox patients had positive results vs. 43% of buprenorphine-naloxone patients, who by that time had been tapered off their medication.

By week 12, 20.5% of detox patients remained in treatment vs. 70% of 12-week buprenorphine-naloxone patients. During weeks 1 through 12, patients in the 12-week buprenorphine-naloxone group reported less use of opioids, cocaine, and marijuana; less injecting; and less need for additional addiction treatment. High levels of opioid use occurred in both groups at follow-up.

“Taken together, these data show that stopping buprenorphine-naloxone had comparably negative effects in both groups, with effects occurring earlier and with somewhat greater severity in patients in the detox group,” the authors wrote.

— Source: American Medical Association

While many congregations of different faiths preach against drug abuse, it has been unclear whether a youth’s religious involvement has any effect on his or her risk of drug abuse. Now a new national study finds that religious involvement makes teens one half as likely to use marijuana. The study, published this week in the Journal of Drug Issues, settles a question scholars have disagreed on in the past.

"Some may think this is an obvious finding, but research and expert opinion on this issue have not been consistent," says Brigham Young University (BYU) sociology professor Stephen Bahr, PhD, an author on the study. "After we accounted for family and peer characteristics, and regardless of denomination, there was an independent effect that those who were religious were less likely to do drugs, even when their friends were users."

Two data sets were used in the study, 13,534 students who participated in the National Longitudinal Survey of Adolescent Health and 4,983 adolescents in a state-wide survey of Utah schools.

The study, coauthored by BYU sociologist John Hoffmann, PhD, also found individual religiosity buffered peer pressure for cigarette smoking and heavy drinking. The term religiosity as used in the study has to do with people's participation in a religion and not the particular denomination. Hoffmann says the protective effect of church and spirituality supplements the influence of parents.

"The power of peers is less among youths who are religious," Bahr says. "Meaning if you are religious, the pressure from peers to use drugs will not have as much effect."

— Source: Brigham Young University