SMOKING - Blog

Study reveals ‘huffing’ household chemicals connected to teen suicide

Girls who ‘huff’ are at higher risk of suicidal thoughts and behaviors

With suicide as the third leading cause of death among adolescents in the United States, a new University of Denver (DU) study reveals inhaling or “huffing” vapors of common household goods, such as glue or nail polish, are associated with increased suicidal thoughts and attempts.

Of the study’s participants,

• 33 percent reported having inhaled volatile solvents,
• 25 percent had attempted suicide, and
• 58 percent reported suicidal thoughts.

Stacey Freedenthal and Jeffrey M. Jenson of DU’s Graduate School of Social Work joined researchers from Chapel Hill and the University of Pittsburgh in a study of 723 incarcerated youth. “Inhalant Use and Suicidality among Incarcerated Youth” appeared in the September 2007 issue of the academic journal Drug and Alcohol Dependence. The study was the first work to categorize both levels of severity of inhalant use and gender in relation to suicidal ideas and suicide attempts.

The investigators found a significant increase in suicidal thoughts and attempts with higher use of volatile solvents.

Researchers did not determine which problem came first, the huffing or the suicidal behavior, but showed that the two are undeniably connected, even when accounting for numerous other factors.

Freedenthal warns parents to be aware of the possibility of suicidal thoughts in children who have been caught inhaling household chemicals.

“Inhalant use has many serious, physiological consequences, including death,” says Freedenthal. “Now we are learning ever more strongly that they are also linked to suicidal thoughts and behaviors.”

The study found the correlation between huffing and suicidality greater in girls than boys. More than 80 percent of girls who abused inhalants revealed a history of suicide attempts, while less than 60 percent of boys showed the same history. The study also indicated that suicidal thoughts were much higher for girls than boys. Suicidal thoughts and attempts were considered two separate issues, since thoughts do not always lead to attempts, and attempts are not always preceded by much thought.

The study involved 723 participants incarcerated by the Missouri Division of Youth Services, 629 boys and 94 girls at an average age of 15. Participants were asked if they huffed any of the 35 common household substances, such as;

• paint,
• paint thinner,
• shoe polish,
• spot remover,
• floor polish,
• kerosene,
• gasoline,
• antifreeze,
• permanent markers,
• nail polish remover,
• mothballs,
• waxes,
• lighter fluid, and others.

Harmful effects of alcohol on sexual behaviour in a New Zealand university community.

The prevalence of hazardous drinking among university students in New Zealand is very high, but the impacts on sexual behaviour are largely unknown.

The aim of this study was to estimate the prevalence of alcohol-related risky and unwanted sexual experiences.

We conducted a web-based survey of a random sample of university students, asking about specific experiences resulting from their own drinking or the drinking of others, and some beliefs about drinking.

A total of 1564 students responded (82%) and the following were reported as the result of drinking, by women and men, in the last 3 months:

• unprotected sex, women 11% and men 15%;
• sex they were not happy with at the time, women 6% and men 7%;
• sex later regretted, women 16% and men 19%.
• Also, 34% of women and 25% of men reported unwanted sexual advances in the past 4 weeks as a result of other people’s drinking.

These experiences were all associated positively with Alcohol Use Disorders Identification Test (AUDIT) scores of the respondents, certain types of living arrangements and specific attitudes to drinking.

In addition, 1% of women and 0.5% of men reported sexual assault in the past 4 weeks.

Cashell-Smith ML, Connor JL, Kypri K. Harmful effects of alcohol on sexual behaviour in a New Zealand university community. Drug Alcohol Rev 2007; 26(6): 645-51.

Drug and alcohol nurses are to be stationed at two of New Zealand’s busiest police stations by January in a bid to help addicts before their offending reaches the point where they have to be jailed [New Zealand Herald]

Aim: To compare the effects in alcohol-dependent patients ofthree pharmacotherapies, disulfiram (DIS), naltrexone (NTX),and acamprosate (ACA), when used with a brief manual-based cognitive-behaviouralintervention. Method: We conducted a randomized, open label,multicentre naturalistic study in two phases; first, a 12-weekcontinuously supervised medication, followed by targeted medication(TM) up to 52 weeks in addition to a 67-week follow-up period;altogether 119 weeks (2.5 years), in 243 voluntary treatment-seekingalcohol-dependent adult outpatients. Subjects were randomized1:1:1 to receive supervised NTX, ACA or DIS, 50, 1998, or 200mg, respectively, per day, plus a brief manual-based cognitive-behaviouralintervention. The patients were met in the second and sixthweeks, and then after 3, 6, and 12 months. The primary outcomemeasures were the time (days) to first heavy drinking day (HDD),and time during the first 3 months to the first drinking dayafter medication started. Secondary variables were abstinentdays/week (0 drinks/day), average weekly alcohol intake, AlcoholUse Disorder Identification Test (AUDIT), Severity of AlcoholDependence Data (SADD), and quality of life (QL) measures. Results:All three study groups showed marked reduction in drinking,from baseline to the end of the study. During the continuousmedication phase, treatment with DIS was more effective in reducingHDDs and average weekly alcohol consumption, and increasingtime to the first drink, as well as the number of abstinentdays. During the TM period, there were no significant differencesbetween the groups in time to first HDD and days to first drinking,but the abstinence days were significantly more frequent inthe DIS group than ACA and NTX. There were no differences betweenthe NTX and ACA groups in either phase of the study of drinkingoutcomes. However, SADD scores improved more in the NTX groupthan the ACA group. Conclusions: Patients allocated to ACA,NTX and DIS combined with brief manual-based cognitive behaviouralintervention significantly reduce their alcohol consumptionand report improved QL. Supervised DIS appeared superior, especiallyduring the continuous medication period, to NTX and ACA.

Alcohol is no ordinary commodity. It is a legal drug which brings health, personal, cultural and social benefits for many people around the world – yet causes significant mental, physical and social harms for many others. To effectively tackle this dilemma, the alcohol field in general needs to generate and embrace new ideas and more practical approaches.

Alcohol harm reduction can be broadly defined as measures that aim to reduce the negative consequences of drinking.

A comprehensive alcohol policy needs population-level interventions, which focus on the availability and accessibility of alcohol (such as taxation and restricted licensing hours). But it needs more than this - such measures alone will not reduce alcohol related harms. In the last 20 years there has also developed an increasing (but less promoted) interest in alcohol harm reduction interventions. These tend to focus on particular risk behaviours (such as drinking and driving, binge drinking), particular risk groups (such as pregnant women, young people) and particular drinking contexts (such as bars and clubs). These approaches have broadened the sphere of interest in alcohol related harms to include social nuisance and public order problems. Very often (but not exclusively) such interventions operate at the community level.

Examples of this approach in practice are:

• Campaigns against drinking and driving (including designated driver schemes and improved public transport in the evenings)
• Serving alcohol in shatter-proof glass to prevent injuries
• Training bar staff to serve alcohol responsibly
• Promoting the safer design of drinking environments (such as bars)
• Managing the ‘night-time economy’ and the ‘drinking environment’ in order to maximise pleasure and minimise violence and anti-social behaviour
• Brief interventions advising people on moderate or controlled drinking
• Education in schools and universities advising people on moderate or controlled drinking
• Providing shelters for homeless drinkers (known as ‘Wet Centres’)
• Providing shelters for heavily intoxicated individuals (known as ‘Sobering-Up Centres’)
• They do not exclude abstinence based programs.

The benefits of alcohol harm reduction approaches are as follows:

• They are practical approaches (so much so that many people deliver alcohol harm reduction on a regular basis without realising it)
• They are realistic approaches in that they (often) do not rely upon national consensus, funding, policies or legislation
• They can be designed and delivered by local communities and stakeholders to address specific local needs and contexts
• Their short-term aim is to minimise the impacts of drinking alcohol
• Their longer-term aim is to change drinking cultures – encouraging the benefits of responsible drinking and discouraging harmful drinking

http://www.ihra.net/alcohol

The International Harm Reduction Association (IHRA)

Smoked cannabis proven effective in treating neuropathic pain
October 25, 2007 -  Smoked cannabis eased pain induced in healthy volunteers, according to a study by researchers at the University of California, San Diego (UCSD) Center for Medical Cannabis Research (CMCR.) However, the researchers found that less may be more.

In the placebo controlled study of 15 subjects, a low dose of cannabis showed no effect, a medium dose provided moderate pain relief, and a high dose increased the pain response. The results suggest a "therapeutic window" for cannabis analgesia, according to lead researcher Mark Wallace, M.D., professor of anesthesiology at UCSD School of Medicine and Program Director for the UCSD Center for Pain Medicine.

The paper, to be published in the November issue of the journal Anesthesiology, is the second published study out of the CMCR. Headquartered at UCSD, the CMCR is collaboration between UCSD and UC San Francisco that was funded by a state-funded initiative in 1999 to rigorously study the safety and efficacy of medicinal cannabis in treating diseases.

The study used capsaicin, an alkaloid derived from hot chili peppers that is an irritant to the skin, to mimic the type of neuropathic pain experienced by patients with HIV/AIDS, diabetes or shingles - brief, intense pain following by a longer-lasting secondary pain. The subjects were healthy volunteers who inhaled either medical cannabis or a placebo after pain was induced. The marijuana cigarettes were formulated under NIH supervision to contain either zero, two, four or eight percent delta-9-tetrahydrocannabinol (THC.)

"Subjects reported a decrease in pain at the medium dose, and there was also a significant correlation between plasma levels of THC, the active ingredient in cannabis, and decreased pain," said Igor Grant, M.D., F.R.C.P.(C), professor and Executive Vice-Chair of the Department of Psychiatry, the director of the CMCR. "Interestingly, the analgesic effect wasn't immediate; it took about 45 minutes for the cannabis to have an impact on the pain," he said.

The results, showing a medium-dose (4% THC by weight) of cannabis to be an effective analgesic, converged with results from the CMCR's first published study, a paper by UCSF researcher Donald Abrams, M.D. published in the journal Neurology in February 2007. In that randomized placebo-controlled trial, patients smoking the same dose of cannabis experienced a 34% reduction in HIV-associated sensory neuropathy pain-twice the rate experienced by patients receiving a placebo.

"This study helps to build a case that cannabis does have therapeutic value at a medium-dose level," said Grant. "It also suggests that higher doses aren't necessarily better in certain situations - something also observed with other medications, such as antidepressants."

The researchers stated that more and larger studies need to be conducted to measure the efficacy of cannabis, noting that medical marijuana could play an important role in treating patients who don't respond well to the usual pain relievers or can't tolerate drugs such as ibuprofen or opioids used for severe pain.

"The results of this study might help guide others doing clinical research into pain management," said Wallace.

University of California - San Diego