Showing posts with label addiction. Show all posts
Showing posts with label addiction. Show all posts

Tuesday, October 13, 2015

Substance Use and Beliefs in Middle School Influence Risk of Driving Under the Influence: A Concerning Set of Longitudinal Survey Data

By: Lewis First, MD, MS; Editor-in-Chief     

          Risk-taking behaviors are certainly high on our anticipatory guidance radar when we see adolescents for health maintenance visits.  Even though we are concerned that a risk-taking behavior in early adolescence can portend other risk-taking behaviors in later adolescence—has it ever really been demonstrated?  Ewing et al. (doi: 10.1542/peds.2015-1143) have done just that using surveys of over 1100 teens given at ages 12 and 14 looking at alcohol and marijuana use as well as beliefs about their use and then compared these results to how often these same teens at age 16 drive under the influence (DUI) or ride with someone else who is drinking and driving (RWDD).  Even beginning at age 12, if a teen felt positively about marijuana use, let alone by age 14 was using it or drinking alcohol—there is a dramatic higher risk of DUI AND RWDD in these teens. 
Do you broach these risk-taking behaviors at age 12?  Do you wait until teens are older?  If the latter, you may be too late in offering the education these teens need to make better choices when confronted by peers with risk-taking opportunities for substance use and abuse.  How early do you begin to discuss marijuana and alcohol use with preteens and have you found talking to preteens is making a difference in a positive sense?  Share with us your thoughts on this interesting, but sad look at early adolescence through a response to this blog, an e-letter or posting a comment on our Facebook or Twitter sites.

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Monday, August 31, 2015

Use of Marijuana and Alcohol among Youth with Chronic Illness, Especially Those Non-Adherent to Treatment

By: Lewis First, MD, MS; Editor-in-Chief 

          Adolescent risk-taking is something we all work hard to talk about and prevent with our teen patients during routine health maintenance visits.  But how often do we focus on risk-taking prevention in our teens with chronic illness such as cystic fibrosis, diabetes, inflammatory bowel disease and others? 
      Weitzman et al. (doi: 10.1542/peds.2015-0722) share with us the results of a cross-sectional study of more than 400 chronically ill preteens and teens ranging from 9 to 18 years who completed a self-administered survey that enabled correlation of risk-taking behaviors with disease knowledge and treatment adherence behaviors while controlling for possible confounders like mental health co-morbidities.  
      The results are concerning and show high school aged teens with chronic illness demonstrating more usage of alcohol and binge drinking as well as marijuana use than you might expect and things get even worse in those teens who forget or skip their routine medications.  There’s lots more to be learned and then shared with your patients with chronic illness with the hope of curbing their risk-taking so at no risk—read this article and learn more.   
     Are you finding your non-adherent teen patients with chronic illness are similar to those in this study when it comes to risk-taking behaviors?  Share your thoughts with us by responding to this blog, sending us an e-letter or posting on our Facebook site or Twitter.

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Monday, June 1, 2015

The Effect of State-level Alcohol Policies on Youth Drinking Behaviors

By: Lewis First, MD, MS; Editor-in-Chief       
       States have different policies when it comes to preventing access to drink alcohol—but do these policies result in different prevalence statistics of alcohol use in teens?  Xuan et al. (doi: 10.1542/peds.2015-0537) looked at strength of alcohol policies and the responses of high school students who participated in the national Youth Risk Behavior Survey from 1999 through 2011. 
       It is important to read that states with the stronger policies affecting access to alcohol for whole populations rather than just youth are the ones that have the lowest rate of youth drinking.  So how strict are your state’s alcohol policies—and do you think they do make a difference in reducing youth alcohol use?  Share your thoughts with us by responding to this blog, sending an e-letter, or posting your thoughts on our Facebook or Twitter sites.

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Thursday, September 5, 2013

Coffee and Mental Health

Associate Editor Dr. William V. Raszka offers insight into topics in the news. This week, he reflects on recently reported mental health disorders associated with coffee consumption: 

I begin each day with at least one large cup of coffee (usually two), and I often have one more cup mid-morning. While I do not think I have a “problem,” I do occasionally wonder what would happen if I suddenly stopped all caffeine consumption.

According to the latest version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, coffee consumption is associated with two – and possibly three – mental health disorders. Coffee intoxication and coffee withdrawal are mental health disorders when they impair function, and caffeine use disorder – now a research diagnosis requiring further study – is diagnosed when a coffee drinker complains of adverse effects and cannot quit.

As reported in The Wall Street Journal (Your Health: June 10, 2013), such designations were not without controversy. Some argue that clinically significant side effects of coffee withdrawal are uncommon and labeling an individual experiencing them as having a mental health disorder is excessive. Others argue that individuals in many studies report withdrawal symptoms, and that health care professionals need to include the possibility in the differential diagnosis and be able to manage it.

The diagnosis of caffeine withdrawal is supported if an individual reports at least three of following symptoms within a day of discontinuing caffeine consumption: headache, poor concentration, nausea or muscle pain, irritability or decreased mood, and fatigue or drowsiness. Symptoms may occur at different times, as the half-life of caffeine ranges from two to eight hours, and tend to last two to nine days. In patients who have experienced withdrawal symptoms, some recommend stopping cold turkey, but most seem to recommend tapering caffeine consumption over a few weeks.

As for me, I do not think I will attempt to see what happens, but continue to savor freshly brewed coffee in the morning with my wife.

*This filler excerpt can be found in the August 2013 Pediatrics print journal p. 289, or online here.