Friday, May 25, 2018

The Myth of Healthy Drinking


Another meta-study demolishes decades of wishful thinking.


Vox notes that "an impressive new meta-study involving 600,000 participants, published recently in The Lancet, suggests that levels of alcohol previously thought to be relatively harmless are linked with an earlier death. What’s more, drinking small amounts of alcohol may not carry all the long-touted protective effects on the cardiovascular system."

Readers of Addiction Inbox will not be surprised by this finding. Back in 2014, I wrote a blog post entitled "Alcohol and Your Heart: Health benefits of moderate drinking come under fire." The post referenced studies suggesting that recent findings were bringing “the hypothesized cardioprotective effect of alcohol into question.”

Also in 2014, I published a report with the headline "Single Bout of Binge Drinking Linked to Immune System Effects."

It's not at all surprising that research touting alcohol's health benefits has been heavily pushed by the alcohol industry. See my post, "Alcoholic Deception: Big Alcohol Wants a Piece of the Health Market".

In the end, the myth about the health effects of moderate drinking made its way into the public consciousness for one obvious reason: People very much wanted it to be true.



Tuesday, May 8, 2018

Do Alcoholic Women Want Women-Only Treatment?


It's complicated. 


In an article appearing in the June 29 edition of the journal Addiction, researchers ask women what they think about it:

"Women‐only addiction services tend to be provided on a poorly evidenced assumption that women want single‐sex treatment. We draw upon women's expectations and experiences of women‐only residential rehabilitation to stimulate debate on this issue."

Full text available HERE.

Monday, January 22, 2018

New Study Casts Doubt on Current "Despair" Models of Addiction



The recent Hari/Hart/Lewis hypothesis that addiction is not primarily metabolic or genetic, but rather the result of "despair" or "sociological conditions" or "flawed learning," takes a major hit in a new report appearing in The National Bureau of Economic Research. The study suggests that "changes in economic conditions account for less than one-tenth of the rise in drug and opioid-involved mortality rates." 

Jason Schwartz at Addiction & Recovery News does a deep dive into the flawed thinking behind the new (old?) sociological views of addiction here.

Sunday, January 7, 2018

Alcohol and Cancer, Explained


"Alcohol and endogenous aldehydes damage chromosomes and mutate stem cells"

Juan I. Garaycoechea, Gerry P. Crossan, Frédéric Langevin, Lee Mulderrig, Sandra Louzada,  Fentang Yang, Guillaume Guilbaud, Naomi Park, Sophie Roerink, Serena Nik-Zainal, Michael R.
Stratton & Ketan J. Patel

    Nature doi:10.1038/nature25154

This pay-walled article, published in "Nature," presents fresh evidence that alcohol can damage chromosomes and cause mutations. If you don't have a zillion dollars to spare, The American Cancer Society has put together a layman's version of the subject here.

Here's an explainer from Britain's National Health Service. And here's an interview with one of the authors, published in "Genetic Engineering and Biotechnology News." Suffice to say that among the many health problems alcohol can cause, the one that all too often goes unmentioned, namely cancer, is not a trivial side effect.

Tuesday, December 26, 2017

Alcohol Should Be More Expensive




Without a doubt, the alcohol you're drinking this Holiday Season is too damn cheap.

By all means check out the new piece by German Lopez at Vox: "The case for setting a minimum price on alcohol."

Friday, August 4, 2017

Corey Booker's Statement on Marijuana Legalization


Sen. Booker's petition would remove marijuana from the list of controlled substances.


 "For decades, the failed War on Drugs has locked up millions of nonviolent drug offenders, especially for marijuana-related offenses. This has wasted human potential, torn apart families and communities, and squandered massive sums of taxpayer dollars.

"That's why I introduced the Marijuana Justice Act on Tuesday to call for the legalization of marijuana at the federal level. Will you sign my petition and call on your senators to join me in moving this critical legislation forward?

"If passed into law, this would have an immediate impact on our criminal justice system, on policing, on our communities, and even on the economy. This legislation would remove marijuana from the list of controlled substances, making it legal at the federal level.

"The bill would also incentivize states to change their marijuana laws if those laws are shown to disproportionately affect low-income individuals and/or people of color. The Marijuana Justice Act would be applied retroactively for those already serving time for marijuana-related offenses, providing for a judge's review of marijuana sentences. That means we could reduce our prison population, a goal that Democrats and Republicans alike have claimed to support.

"States have, so far, led the way in reforming our failed drug policy and in beginning to fix our criminal justice system. Unfortunately, the federal government isn't doing its share—and Attorney General Jeff Sessions, among his many offenses, is working actively to undermine the progress in this area. We can't let Sessions roll back our progress, criminalize more Americans, and terrorize our communities by doubling down on failed policy."

Monday, April 10, 2017

Marijuana, Sleep, and Dreams


The indica vs. sativa debate, continued. 

[First published July 13, 2015.]

Anyone who has smoked marijuana more than a couple of times knows that cannabis can alter how you sleep. The effect of cannabis on sleep is even part of the never-ending debate over Cannabis indica vs. Cannabis sativa, the two major species of the marijuana plant. Indica smokers typically report a marijuana high that is body-intensive and often soporific, sometimes leading to the condition aptly known as “couch lock.” Whereas sativa smokers, according to marijuana lore, experience a more cerebral, energetic “head high,” with fewer somatic effects. Not surprisingly, hybrid strains incorporating the alleged characteristics of both indica and sativa strains are popular in the medical marijuana community.

Although there is no official sanction for it in the medical community, marijuana is often dispensed medically for sleep problems. One piece of common wisdom holds that the higher the THC content of marijuana, the more helpful it will be in promoting sleep and improving poor sleep. The stronger the better, in other words. Similarly, indica strains are assumed to promote sleep more than sativa strains.

In an effort to clear the air, so to speak, a group of researchers, writing in Addictive Behaviors, sought to “document naturalistic choice of particular medical cannabis types among individuals who self-report using cannabis for the treatment of sleep problems…. Little research has documented species or cannabinoid concentration preferences among individuals who use medical cannabis for particular conditions…. We also evaluated the interaction between the type of cannabis used and diagnosis of cannabis use disorder among study participants.”

The researchers recruited participants from a medical cannabis dispensary in California under procedures approved by the VA and Stanford University review boards. 163 people with a mean age of 40, who used cannabis twice a day on average, provided self-reported information on their cannabis use for the study. 81 participants reported using cannabis for the management of insomnia, and another 14 reported using cannabis to reduce nightmares. (Frequent smokers insist they dream less. THC does appear to decrease the density of REM cycles, leading to more restful, dream-free sleep, according to some studies.)

So what did they find?

—“Individuals who reported using cannabis for nightmares, compared to those who did not, preferred sativa to indica.” (Small effect.)

Indica, considered the “heavier” high, might have seemed the likely choice here.

—"Individuals who self-report using cannabis to treat symptoms of insomnia and those with greater self-reported sleep latency reported using cannabis with significantly higher concentrations of CBD.” (Large effect.)

Again, a somewhat counterintuitive finding, since it is widely believed that CBD conduces toward a more wakeful state than THC alone.

—“Individuals who used sleep medication less than once/week used cannabis with higher THC concentrations than those who used sleep medication at least once a week.” (Large effect.) “There were no differences in THC concentration as a function of self-reported sleep quality, or use for insomnia or nightmares.”

Pretty straightforward finding: THC makes you sleepy. It is not clear, however, that above a certain threshold, more THC makes you even sleepier. In fact, some researchers would consider this finding unexpected, given that high THC concentrations have been shown to have a stimulating effect.

—“Older individuals were less likely to have cannabis use disorder compared to those younger….

No surprise about the older folks, since prior studies show a decrease in the prevalence of cannabis use disorders with age.

—“Individuals who preferred sativa or primary sativa hybrid strains were less likely to have cannabis use disorder compared to those who preferred indica or primary indica hybrid strains.” (Small effect.)

If replicated, this finding could have significant implications; both in strengthening programs to reduce marijuana smoking among the very young, and it warning consumers that some evidence suggests indica strains may be more addictive than sativa strains in plants with similar THC/CBD levels and ratios.

—“Neither concentration of THC nor CBD were associated with cannabis use disorder.”

Common sense, but useful to remember. In other addictive behaviors, such as heroin and alcohol abuse, the relative strength of the drug is not the primary determinant of its addictive potential.

Caveats and design limitations: The survey relied on retrospective reports of sleep quality and pot preferences. Also lacking is an examination of additional variables such as PTSD and co-occurring substance abuse.
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