Some teens smoke pot for their health

Numerous studies and surveys show that adults sometimes use marijuana as relief from medical symptoms. It appears teenagers may occasionally do the same. A study published today found one-third of the adolescents interviewed said they don't smoke pot to get high but to treat health problems.

The study was small -- only 63 teenagers in Canada -- but it raises the question of whether kids smoke pot only to act out or to get high. The researchers, from the University of British Columbia, conducted in-depth interviews with adolescents who said they used marijuana. Twenty of the teens said they used it to relieve or manage health problems, such as emotion problems (depression or stress), sleep difficulties, problems concentrating or pain.

Many of the teens had unsatisfactory experiences with the healthcare system. For example, some had been prescribed medications for sleep problems or attention disorders but didn't like how the drugs made them feel or felt they weren't helpful. The teenagers said they were not worried about using marijuana for their health problems and said they did not use it excessively. In general, they were "thoughtful and prescriptive with their marijuana use," according to the researchers.

"They were adamant and confident that marijuana provided relief from their health problems," the authors wrote. "The decision to smoke marijuana was stated in a straight-forward fashion (e.g. 'I started it to make myself feel better') and justified because they had a 'reason for it.' "

Parents and doctors need to consider whether teenagers with health problems feel standard medical care is helping them. These teens said they felt they had little recourse for help with their health problems. Regular use of marijuana puts people at risk, the authors note, something that the adolescents in the study seemed to be unaware of. For example, smoking pot to alleviate depression actually increases the risk for depression.

The paper is published today in BioMed Central's open access journal Substance Abuse, Treatment, Prevention, and Policy.

 -- Shari Roan

 Photo credit: Don Bartletti / Los Angeles Times

Brain drugs won't go away, so best give them some thought

If pills can make us better mentally -- and it seems clear they can -- it's time to answer the question of whether we should let them. 

For some people, the question is already moot. In the April 27 issue of the New Yorker, writer Margaret Talbot explores the issue of brain medications in "Brain Gain: The underground world of 'neuroenhancing' drugs."

She writes: "In recent years Adderall and Ritalin, another stimulant, have been adopted as cognitive enhancers: drugs that high-functioning, overcommitted people take to become higher-functioning and more overcommitted."

She tells her story in some part through a recent Harvard graduate named Alex. He makes a compelling case for what can be accomplished with a little help.

Some neuroscientists and ethicists have already answered the bigger question among themselves. Says a recent blog post from Times staff writer Melissa Healy: "Pop a smart pill? Why not, says a group of neuroethicists"

-- Tami Dennis

Photo: Ritalin -- the little helper for people with attention deficit hyperactivity disorder and overworked, over-stressed students -- is going mainstream.

Credit: Keith Beaty/Toronto Star/ZUMA Press

Fetal development and the flu, epilepsy, meth exposure ...

As researchers learn more about in utero exposure and the effects on the unborn, pregnant women could be excused for trying to shut themselves off from the rest of the world. Sometimes, that might not even seem like an overreaction. In this week's news alone:

From UPI: Prenatal Hong Kong flu linked to lower IQ

The story states: "The intelligence scores of men born in July through October of that year, 6-9 months after the main outbreak of the Hong Kong flu in Norway, were lower than the mean values for those born in the same months during the preceding and following years." Here's the abstract from the Annals of Neurology.

From WebMD, among others: Epilepsy drug linked to babies' lower IQ

The story states: "Women with epilepsy who took the drug valproate ( Depakote) during pregnancy gave birth to children whose IQ at age 3 averaged up to 9 points lower than the scores of children exposed to other epilepsy drugs, according to a new study." Here's the abstract from the New England Journal of Medicine.

And from Reuters: Prenatal meth exposure may harm baby's brain

The story states: "Brain scans on a group of 3- and 4-year-old children showed abnormal development in the white matter, which carries messages across the brain, compared with children who did not have prenatal exposure to the drug, often called 'meth.' " Here's the abstract, from Neurology.

For a broader look at the issue of in utero exposure, check out these stories from Times staff writer Shari Roan:

Living for two: Mounting evidence suggests that fetuses are surprisingly susceptible to outside influences such as food, environmental pollutants, even stress.

Poor nutrition in utero, heavy child tomorrow?

-- Tami Dennis

Photo: An infant is fitted for a ventilator mask.

Credit: Associated Press

Marijuana use and testicular cancer

Young men who began using marijuana as adolescents or who smoked pot at least once a week were twice as likely as those who never used the drug to develop testicular cancer, according to researchers at Fred Hutchinson Cancer Research Center in Seattle.

The association was strongest with nonseminoma, an aggressive, fast-growing subtype of testicular cancer that typically strikes men between ages 20 and 35.

"It's not just that you develop testicular cancer, but you develop a worse type of testicular cancer," said Dr. Glen Justice, director of the cancer center at Orange Coast Memorial Medical Center in Fountain Valley, who was not involved with the study.

About 40% of testicular cancers are nonseminomas. The rest are slower-growing seminomas, which tend to occur a decade or two later, when men are in their 30s and 40s. Since the 1950s, both kinds have increased by 3% to 6% a year in the United States, Europe, Australia and New Zealand.

Various studies have looked for environmental or lifestyle changes that could account for the increase. The study published online today in the journal Cancer was the first to look at marijuana, its authors said.

Researchers interviewed 371 men aged 18 to 44 who had been diagnosed with testicular cancer. They interviewed an additional 979 men of the same age group and from the same three Washington counties who did not have cancer.

The researchers found a 70% higher risk of testicular cancer in those who were using pot at the time of diagnosis, with an even higher risk associated with younger age at first use and frequency of use. Hormonal changes during puberty are thought to make that a particularly vulnerable period for environmental influences.

The findings were independent of known risk factors such as undescended testes and a family history of testicular cancer, and adjusted for cigarette smoking and alcohol use.

The senior author of the study, epidemiologist Janet R. Daling, got the idea to look at marijuana after learning that the testes, like the brain, have receptors for tetrahydrocannabinol, or THC, the chemical component of the marijuana high.

The researchers did not know why the association was seen with nonseminoma but not seminoma, because both subtypes have increased. In the U.S., the rise in seminoma has outpaced that in nonseminoma, but the opposite is true in the Netherlands.

Whether slow-growing or aggressive, testicular cancer is highly curable, Justice said, especially when detected early.

--Mary Engel

Photo credit: Robert Durell / Los Angeles Times

Poll finds teen smoking rate at all-time low

Abuse of prescription drugs continues to be a major problem among teenagers although fewer of them are smoking cigarettes, according to the 2008 Monitoring the Future survey released today.

The survey, which has been conducted for 33 years, found that nearly 10% of high school seniors reported nonmedical use of Vicodin and 4.7% reported abusing OxyContin. Both are strong opioid pain pills. Seven of the top 10 drugs abused by high school seniors were prescription or over-the-counter medications. The high rates of abuse of prescription drugs is a reminder to parents to keep medications out of the reach of minors. "While the long-term general decline (in drug abuse) is encouraging, especially for cigarettes and alcohol, some of the other findings this year amplify our concerns for potential problems in the future -- especially the nonmedical use of prescription drugs," said Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, which funds the study. Monitoring the Future is conducted by researchers at the University of Michigan.

The survey also found that marijuana use has leveled off after a decade-long decline. About 11% of eighth-graders, 24% of 10th-graders and 32% of 12th-graders reported using marijuana in the last year.

Cigarette smoking, however, is at its lowest point since the survey began. Still, more than 1 in 10 high school seniors say they smoke daily and 5.4% smoke more than a half a pack a day.

Alcohol use continues to decline in all grades. This year's survey showed a significant drop among 10th-graders for all categories of alcohol use, such as lifetime use, use in the last month and binge drinking.

The nationwide survey, which can be found on the Monitoring the Future website, included more than 46,000 students from public and private high schools.

-- Shari Roan

Photo: OxyContin is a drug for pain relief that is used as a drug-of-abuse among some teenagers. Credit: Lawrence K. Ho / Los Angeles Times

Girls medicated for ADHD are less prone to substance abuse

On college campuses and in high school corridors, there's a lively market for Ritalin and other stimulant medication prescribed to those diagnosed with Attention Deficit and Hyperactivity Disorder, or ADHD. And studies have long shown that kids with ADHD are much more likely than kids without attention problems to experiment with drugs recreationally.

So, is it the stimulant medication or is it ADHD -- a disorder frequently accompanied by problems of impulse-control -- that makes a kid more likely to abuse illicit substances? Do attention problems make these kids more likely to engage in risk-taking behavior such as substance abuse? Or does the fact that they are likely to take a widely abused prescription drug make these kids more open to abusing other drugs?

It's a question that's long worried parents and sparked furious debate among those who research and treat ADHD, which is believed to affect 8% of all American school kids, as well as among skeptics of psychopharmacology: Does medicating a kid for ADHD make it more or less likely that he or she will abuse illegal substances? As the first generation of kids to be diagnosed and medicated in large numbers grows into adulthood, answers are becoming clearer.

A study published in the Archives of Pediatric and Adolescent Medicine takes the latest crack at the controversy, and finds that for girls with ADHD, being medicated for the condition makes substance abuse less likely. The study builds on recent findings -- by the same group of researchers at Massachusetts General Hospital -- suggesting that medicating boys who have the condition will help, at least, to delay their decision to try illegal substances.

The study followed 114 girls between the ages of 6 and 18 -- 94 of them medicated for ADHD and 20 of them not -- for five years. Those medicated for the condition were about half as likely to smoke cigarettes, drink alcohol or take illicit drugs as those who had the condition but were not medicated, found MGH psychopharmacologist Dr. Timothy Wilens and colleagues. Wilens says it's unclear that the protective effect of ADHD medications would follow the girls into adulthood, when the majority of kids diagnosed early tend to abandon the medications. But as long as girls with ADHD were "successfully treated," they were less likely to try cigarettes, alcohol or drugs.

-- Melissa Healy

Energy drinks can cause caffeine intoxication

Energy drinks have been popular for years, and the market keeps expanding. Some people drink them like they would soda -- during breakfast, lunch, dinner and as snacks. But there is such a thing as too much energy. A study published today in the journal Drug and Alcohol Dependence delivers a stern warning about the possibility of caffeine intoxication from energy drinks.

"The caffeine content of energy drinks varies over a 10-fold range, with some containing the equivalent of 14 cans of Coca-Cola, yet the caffeine amounts are unlabeled and few include warnings about potential health risks of caffeine intoxication," said one of the study's authors, Roland Griffiths of Johns Hopkins Medical Institutions.

A regular 12-ounce cola drink has about 35 milligrams of caffeine. A 6-ounce cup of brewed coffee has 80 to 150 milligrams of caffeine. The Food and Drug Administration imposes limits on how much caffeine food products can contain (71 milligrams for each 12-ounce can). But energy drinks are designated as dietary supplements, not food products. Thus, manufacturers of energy drinks can load their products with caffeine. Moreover, says Chad Reissig, another of the study's authors: "It's notable that over-the-counter caffeine-containing products require warning labels, yet energy drinks do not."

Caffeine intoxication is a recognized clinical syndrome. It is described as nervousness, anxiety, restlessness, insomnia, gastrointestinal upset, tremors, rapid heartbeat, restlessness and pacing. In rare cases, caffeine intoxication can cause death. See this Mayo Clinic report on caffeine side effects and this L.A. Times story on energy drinks that was written by a doctor.

The authors of the study have called for labeling on energy drinks to inform consumers of what they are getting. Advertising for energy drinks is aimed at teens and young adults and promotes the drinks as performance enhancers. Recently, however, some manufacturers have applied a harder edge to their marketing. One product is named Cocaine, and another product, a powdered energy drink sold in a vial, is named Blow. The makers of both products have received warning letters from the FDA about misleading advertising.

But occasional hand-slaps from the FDA are not enough. Besides caffeine intoxication, the use of energy drinks along with alcohol can be dangerous, the Johns Hopkins researchers say. A recent survey found that 27% of college students said they had mixed energy drinks and alcohol at least once a month. There is even some evidence, says Griffiths, that energy drinks may serve as a "gateway" product leading to more serious drug abuse.

- Shari Roan

Photo credit: PR NewsFolo/Rexam

Problem parents contribute to teen drug use

A survey on substance abuse among teens was released this morning that really lowers the boom on parents. The annual survey from the National Center on Addiction and Substance Abuse at Columbia University calls out parents for contributing to drug and alcohol use among kids ages 12 to 17. Some parents fail to monitor their children's activities, do not safeguard medications at home that can be used for abuse, and do not set good examples for their kids, the report said. Almost half of the teens surveyed -- a nationally representative sample of 1,002 teens and 312 of their parents -- said they leave the house to hang out with friends on school nights. Among those teens, half who come home after 10 p.m. said they had been drinking alcohol, smoking marijuana or doing other drugs. Just under 30% of those who come home between 8 and 10 p.m. said they had been drinking or using drugs. In contrast, only 14% of the parents said their teens leave the house to hang out with friends on school nights.

Who is telling the truth? The report suggests that parents are pretty clueless about their kids' schedules and how they spend their free time.

"Every mother and father should look in the mirror and ask themselves if they are doing the parenting essential to help their child negotiate the difficult teen years free of tobacco, alcohol and drugs," said Elizabeth Planet, CASA's director of special projects.

CASA president and former U.S. Secretary of Health, Education and Welfare Joseph A. Califano said this:

"Preventing substance abuse among teens is primarily a mom and pop operation. It is inexcusable that so many parents fail to appropriately monitor their children, fail to keep dangerous prescription drugs out of the reach of their children and tolerate drug infected schools. The parents who smoke marijuana with children should be considered child abusers. By identifying the characteristics of problem parents we seek to identify the actions that parents can take -- and avoid -- in order to become part of the solution and raise healthy, drug-free children."

No one said parenting was easy, and parents in the survey said overwhelmingly that it's harder today to keep kids safe and raise them with good moral character than it was in previous generations. Resources to help and support parents are available, such as those that can be found on the CASA website. Also, try the National Institute on Drug Abuse and the National Youth Anti-Drug media campaign for more resources.

It would probably be helpful for all of us who are parents to get our heads out of the sand. Times change, and the culture kids are growing up in today is different from back in our day. For example, the survey also found these hair-raising trends:

• For the first time in the survey's 13-year history, more teens said prescription drugs were easier to buy than beer.
• 42% of the teens said they can buy marijuana in a day or less.
• One-quarter of teens said they know a parent of a classmate or friend who uses marijuana and 10% of those teens said this parent smokes marijuana with teens.
• Half of the teens ages 16 and 17 said that among their age group smoking marijuana is more common than smoking cigarettes.
• Of the teens who drink, almost 30% said their drink of choice was hard liquor mixed with soda or something sweet compared with 16% who said they prefer beer.

-- Shari Roan

Photo: Gary Freidman / Los Angeles Times

Driving while high, hard to prove

Any emergency room worker or highway patrol officer could tell you that illegal drug use and traffic accidents have a cause and effect connection. But proving it scientifically has been difficult.

Now, the National Institutes of Health has released research guidelines aimed at coming up with tests for drug abuse that are as quick and simple as using a Breathalyzer to test for alcohol use. The guidelines are published in the August journal Addiction. Experts hope that soon, someone suspected of driving under the influence of marijuana or cocaine might be asked to spit into a cup, just as suspected drunk drivers are asked to blow into a Breathalyzer.

What experts do know is scary enough. In 2001, according to a national survey, 3.6% of the U.S. population, or 8 million people, reported driving under the influence of illegal drugs. A Department of Transportation study found that marijuana alters a driver's perception of time, space and distance, and that cocaine use causes drivers to speed and change lanes without signaling.

Experts hope the new guidelines will lead to consistent ways to identify drugged drivers -- and keep them off the roads.

-- Susan Brink

California becomes 11th state to restrict salvia

Minors in California will no longer be able to buy the herb salvia legally. Gov. Arnold Schwarzenegger signed a bill Tuesday that forbids the sale or distribution of salvia to minors. California is the eleventh state to apply some restrictions on use of the drug.

Salvia, or Salvia divinorum, is an herb found in Mexico that was traditionally used by Mazatec Indians for healing. Dried salvia leaves can be smoked or chewed to produce a high that ranges from a minute to a half hour. Users report hallucinating, an out-of-body feeling and losing control over their movements. The fact that the herb can be purchased by anyone at tobacco shops and on the Internet has concerned some law enforcement and health officials who say the substance is dangerous. The Drug Enforcement Administration is studying whether to designate salvia as a controlled substance.

The ban in California will take effect on Jan. 1, 2009. The bill was sponsored by Assemblyman Anthony Adams (R-Hesperia), who said this morning: "This bill had a tremendous amount of backing, and I'm grateful the governor recognized the wisdom of signing the bill."

Salvia remains legal for adults, although it's not popular and many one-time users say they disliked the effects. The herb is also the subject of research to determine if it has legitimate therapeutic uses for the treatment of substance-abuse disorders, pain or depression.

-- Shari Roan

Photo: Ricardo DeAratanha/Los Angeles Times