Alcohol Use Disorder and the Loss of a Spouse

According to a recent study, the loss of a spouse due to divorce or death might be associated with an continuing risk of alcohol use disorder (“AUD”). According to the report’s authors, Kenneth Kendler, M.D., of Virginia Commonwealth University and colleagues:

“The pronounced elevation in AUD risk following divorce or widowhood, and the protective effect of both first marriage and remarriage against subsequent AUD, speaks to the profound impact of marriage on problematic alcohol use and the importance of clinical surveillance for AUD among divorced or widowed individuals”

The report is based on the records of close to a million married persons in Sweden. The study found a association with both a risk of a first AUD occurrence as well as AUD relapse, with a higher correlation in families with an AUD history, among other things. It also found a substantial decline in first AUD occurrences after divorce followed by a remarriage.

Widowhood also increased AUD risk in both sexes (hazard ratio of 3.85 in men and 4.10 in women). In women, widowhood had a stronger association with risk for future AUD if the spouse did not versus did have a lifetime history of AUD (hazard ratio of 3.69).

“These results suggest that it is not only the state of matrimony and the associated social roles that are protective against AUD. Rather, they are consistent with the importance of direct spousal interactions in which one individual monitors and tries to control his or her spouse’s drinking. A non-AUD spouse is likely to be much more effective at such control than a spouse with AUD.”

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SAMHSA Celebrates 25 Years of National Recovery Month and Releases Data on Substance Abuse

This past week, mental health experts and those recovering from mental illness, including substance use disorders, gathered at the National Press Club in Washington, D.C., to celebrate the 25th anniversary of National Recovery Month, which is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA).“[For] a quarter of a century, we have been illuminating, defining, validating, and shaping a concept into a fact that people do recover from addiction and mental illness,” said SAMHSA Administrator, Pamela Hyde, J.D., in addressing the audience (photo above). “[Today] we acknowledge and celebrate that reality.”

As part of the celebration, SAMHSA released some of the data from its 2013 National Survey on Drug Use and Health (NSDUH). “An estimated 24.6 million Americans 12 years and older were current drug users,” Hyde reported, emphasizing that means more than 9% of the U.S. population acknowledged drug use at the time of the survey. Marijuana was the most commonly used illicit drug, with 19.8 million individuals saying they used it in the month prior to the survey. The next most common example of illicit drug use was nonmedical use of prescription pain relievers, used by 4.5 million individuals. Alcohol use was estimated to be prevalent in about half (52.2%) of the U.S. population aged 12 and older, with 60.1 million individuals acknowledging binge drinking. SAMHSA reported that of the people who needed treatment for a substance use disorder or alcohol use disorder, only 11% received help.

The latest NSDUH survey also found that drug use is up slightly from last year. Hyde stated that the alarming rates of drug use, especially marijuana use, may be a result of a growing perception that the use of one drug is less harmful than another. “‘Social norms’ have to change,” said Hyde, “or else we are going to keep meeting here every fall and sharing the same problem. We will be watching [these trends] closely over the next few years.”

To view available data from the 2013 National Survey on Drug Use and Health, click here. For information on the risk perception of certain illicit drugs, see the Psychiatric News article, “News Is Mixed on Teenagers and Substance Use.”

NIDA Summarizes Research on Negative Health Consequences of Marijuana Use

English: one high-quality "bud " nug...

English: one high-quality “bud ” nugget of marijuana (Photo credit: Wikipedia)

A recent comprehensive research review published this week in the New England Journal of Medicine reports that marijuana use is linked to several adverse effects—particularly in youth. The review was conducted by scientists at the National Institute on Drug Abuse (NIDA) who compiled data from previous studies highlighting the adverse consequences of marijuana use among teenagers. The NIDA review showed that teenage marijuana use was associated with impaired critical thinking and memory functions that last up to days after drug use, impaired driving, and lowered IQ scores into adulthood. The review also suggested that risks for adverse effects are increase when the drug is used along with alcohol.
The authors noted that because older studies are based on the effects of marijuana containing lower levels of THC—the primary psychoactive chemical in cannabis—stronger adverse health effects may occur with the use of today’s more potent marijuana. They emphasized that more research must be done on the potential health consequences of second-hand marijuana smoke, the long-term impact of prenatal cannabis exposure, and effects of marijuana legalization policies on public health.

“It is important to alert the public that using marijuana in the teen years brings health, social, and academic risk,” said lead author and NIDA Director Nora Volkow, M.D. “Physicians in particular can play a role in conveying to families that early marijuana use can interfere with crucial social and developmental milestones and can impair cognitive development.”

To read more about the use of marijuana among teens and legislation concerning marijuana use in this population, see the Psychiatric News articles, “News Is Mixed on Teenagers and Substance Use” and “Marijuana Legalization and Young Brains: Time for Serious Study.”

Further Research on Substance Abuse and Severe Mental Illness

A new article at the Huffington Post by Sarah Peters (Research Links Severe Mental Illness and Substance Use) reiterates the observation that mental illnesses and substance-abuse disorders appear to be strongly connected, and points to new data supporting those observations, as well as further insights being examined in connection with the new data.

Specifically, the University of Southern California and Washington University School of Medicine St. Louis conducted a joint study of nearly 20,000 individuals, collecting data over a 5-year period.  “What we are learning is that this overlap of mental illness with addictive disorders is not random,” said the National Institute on Drug Abuse Deputy Director Wilson Compton. The organization, part of the National Institute for Heath, provided the funding for the study.

The study examined nicotine, alcohol, marijuana and recreational drug use in mentally healthy test subjects and psychiatric patients diagnosed with schizophrenia, bipolar disorder or schizoaffective disorder, finding that 30% of those with a severe mental illness engaged in binge drinking, for instance, compared to 8% in the mentally healthy population.

“This kind of work is particularly important for the psychiatric community and treating clinicians. For far too long psychiatry has ignored the problems related to substances while they focused on the mental illness of their patients.”

“Putting this on the radar as such a huge problem in this population of people with severe mental illness will help us both with the clinical treatment of the comorbidity and it will also help us researchers begin to understand the overlap,” lead author for the article and Washington University researcher Sarah Hartz said. “When people come in for severe mental illness, we need to also treat the substance abuse. We can’t treat them independent from each other.”

For the full Huffington Post article CLICK HERE.

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Quitting Smoking Helps Mental Health According to Study

From Psychiatric News Alert, March 24, 2014: Stopping smoking is associated with significant improvements in anxiety, depression, stress, positive affect, and psychological quality of life. And the strength of the association appears to be similar for both the general population and clinical populations, including those with psychiatric disorders, according to findings from a meta-analysis reported in the British Medical Journal by Paul Aveyard, a professor of behavioral medicine at the University of Oxford in England, and colleagues.

The meta-analysis included 26 studies that measured subjects’ mental health before and after they quit smoking. The studies examined six measures of mental health: anxiety, depression, mixed anxiety and depression, positive affect, psychological quality of life, and stress. Eleven of the studies were cohort studies, 14 were secondary analyses of cessation interventions, and one was a randomized trial.

“This study illustrates the importance of providing tobacco-cessation treatment to individuals with behavioral health conditions, to help with both improvement in symptoms of mental illness and overall physical health,” Lori Raney, M.D., told Psychiatric News. “Psychiatrists have an important role to play in assisting in this treatment and can provide guidance and support to patients and in helping our colleagues in other medical settings.” In addition to being medical director of Axis Health System in Durango, Colo., Raney has a special interest in the relationship between smoking cessation and mental health.

More information about the importance of smoking cessation for patients with mental illness can be found in the Psychiatric News articles “Decline in Smoking Lags Among Patients With Mental Illness” and “Smoking Cessation for Patients Called an Urgent Priority.”

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Open Mind Lecture March 4: Clean with David Sheff

The next installment of the Open Mind Lecture series hosted by the Semel Institute for Neuroscience and Human Behavior will be a presentation by author David Sheff and Dr. Timothy Fong.

David Sheff, author of the critically acclaimed book, Clean, and the New York Times best-selling memoir, Beautiful Boy: A Father’s Journey through His Son’s Addiction, will discuss new approaches to treating and preventing addiction and addressing the mental illnesses that commonly accompany addiction.

Dr. Fong, Director of the UCLA Addiction Medicine Clinic, will provide information about the latest scientifically-proven treatment strategies for addiction, as well as insight into how addictive disorders affect patients, family and society.

The Semel Institute is a world-renowned multidisciplinary research institute dedicated to the study of mind, brain and behavior. Since its founding, the Institute has assembled more than 370 physicians, clinical researchers and scientists to work collaboratively in studying psychiatric and neurological disorders and to develop new, effective treatments that improve lives.

The Open Mind Lectures are free to attend, but registration is required. For questions call Patty Evans at 424-214-3851 or patty@friendsofsemelinstitute.org. Parking for this event available in Sunset Village.

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