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Study highlights multiple factors of ADHD medication use

The findings also show that teens who start using stimulant medications for attention deficit hyperactivity disorder for a short time later in adolescence -- during middle or high school -- are at high risk of substance use.. The U-M research is believed to be the first national study to compare early-use and longer-duration stimulant medication therapy with nonstimulant therapy for ADHD . A large sample size of high school seniors also meant researchers could separate doctor-prescribed ADHD medication use by gender. The results show no gender differences in the overall associations between stimulant medication therapy for ADHD and risk of substance use, said Sean Esteban McCabe, a research professor at the U-M Institute for Research on Women and Gender. More than 40,000 individuals from 10 cohorts nationwide between 2005 to 2014, answered questions about ADHD medication use and recent substance use as part of the Monitoring the Future study. Among the findings: Nearly one...
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Recovery-oriented systems of care: Emerging approach to integrated treatment for people with substance use, mental health disorders

The special issue provides a "state of the discipline" look at the emerging role of ROSC to provide coordinated, patient-centered services of substance abuse and psychiatric disorders, including the critical role of primary care providers. The Guest Editors are Katherine Fornili, MPH, RN, CARN, of University of Maryland School of Nursing, Baltimore, and Mary D. Moller, DNP, ARNP , PMHCNS-BC, CPRP, of Pacific Lutheran University School of Nursing, Tacoma, Wash. Overcoming Obstacles, Experts Share Experiences with Recovery-Oriented Care The need for integrated treatment of substance use and psychiatric disorders is at an all-time high. An estimated 7.9 million Americans--three percent of the population -- have both a mental and a substance use disorder. "Combined with an extremely reduced addictions nursing and psychiatric-mental health workforce, it is clear that the ability of this population to access specialized care and achieve and sustain recovery requires a se...
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Trauma in childhood linked to drug use in adolescence

This is the first study to document these associations in a national sample of adolescents. The research, led by Mailman School of Public Health postdoctoral fellow Hannah Carliner and Associate Professor Silvia S. Martins, MD, PhD, found that childhood trauma experiences before age 11 increased the chances that teens would try marijuana, cocaine, prescription drugs used without a medical reason, other drugs, and multiple drugs. They also showed that a greater number of traumatic experiences were associated with an increase in risk for use of marijuana and other drugs. "Abuse and domestic violence were particularly harmful to children, increasing the chances of all types of drug use in the adolescent years," says Dr. Carliner. "We also found that trauma such as car accidents , natural disasters, and major illness in childhood increased the chances that teens would use marijuana, cocaine, and prescription drugs." Adolescents with a parent who misused alcohol...
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Six in ten adults prescribed opioid painkillers have leftover pills

The researchers, reporting June 13, 2016 in  JAMA Internal Medicine , also found that nearly half of those surveyed reported receiving no information on how to safely store their medications, either to keep them from young children who could accidentally ingest them or from adolescents or other adults looking to get high. Nor were they given information on how to safely dispose of their medications. Fewer than seven percent of people with extra pills reported taking advantage of "take back" programs that enable patients to turn in unused pain medication either to pharmacies , police departments or the Drug Enforcement Administration for disposal. "These painkillers are much riskier than has been understood and the volume of prescribing and use has contributed to an opioid epidemic in this country," says study leader Alene Kennedy-Hendricks, PhD, an assistant scientist in the Department of Health Policy and Management at the Bloomberg School. "It's not c...
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Addiction as a disorder of reward learning: New role for glial energy metabolism in addiction

However, glia, the non-neuronal supporting cells of the brain, have now been implicated in the consolidation of cocaine-related memories. Researchers, led by senior author Dr. Jie Shi, Professor of Clinical Pharmacology at Peking University in China, report these new findings in the current issue of Biological Psychiatry. Glia play a number of roles that support nerve cells. For example, they take up energy substrates, like glucose and acetate, and metabolize these chemicals into lactate, which they then release. Nerve cells absorb this lactate and use it to fuel many cellular functions. In their new paper, Shi and colleagues report that reactivation of cocaine memories in rats alters the expression of a protein that releases lactate from glia and enables nerve cells to take up lactate. The authors found that if they blocked lactate release by glia or uptake by nerve cells, they produced a long-lasting prevention of cocaine relapse in rodents. These data indicate that cellular...
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PET/CT reveals adaptations of the alcoholic brain

According to 2016 statistics from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), almost 7 percent of adults over the age of 18 had a drinking disorder in 2014. Alcohol-related deaths were deemed the fourth leading cause of preventable death, accounting for nearly 88,000 deaths in the same year. Images of the brain lit up like fireworks as people experience pleasure and reward are a familiar sight, but sometimes the reward needs to be taken away. In this groundbreaking study, researchers imaged the brains of recently recovering alcoholics and found an inverse and compensatory adaptation in a particular receptor involved in memory, learning, and the sensations of pain and anxiety. This receptor, called metabotropic glutamate receptor subtype 5 (mGluR5), is found throughout the central and peripheral nervous systems but, in certain areas of the brain, it is implicated in intense cravings and addictive relapse. It seems that the brains of recovering alcoholics have ada...
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Low-tech system overcomes barriers preventing doctor-patient chat about drinking habits

About 25 to 30 percent of the general U.S. population drinks alcohol at a level that, while not diagnosed as alcoholism, is high enough to qualify as unhealthy, says Gail Rose, Ph.D., a behavioral health researcher at the University of Vermont (UVM) and lead author on the study. And heavy drinking, she adds, has a strong influence on health, and can diminish the efficacy of some medications, among other negative effects. "But it's a stigmatized topic," says Rose, and since clinicians have so many topics to discuss with patients, drinking habits often fall off the list. In addition, some physicians don't view alcoholism as a medical problem. Previous research has shown that patients with drinking problems can benefit from even a short conversation with their physicians, but getting them to that point has been a challenge. In their study of more than 1,500 patients at eight internal medicine and family medicine practices affiliated with a university medical center...
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