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Alcohol harder on teen brains than thought

Katy Butler | 09.07.2006 22:46 | Analysis | Health | Social Struggles | World

He said in an interview that he had no way of knowing exactly how drinking affected his overall brain function. But on one point, he is clear.

Studies note neurological degradation
Studies note neurological degradation

Middle-class girls taking to drink
Middle-class girls taking to drink

Kids and booze
Kids and booze

Studies note neurological degradation

Teenagers have been drinking alcohol for centuries. In pre-Revolutionary America, young apprentices were handed buckets of ale. In the 1890s, at the age of 15, Jack London regularly drank grown sailors under the table.

For almost as long, concerned adults have tried to limit teenage alcohol consumption. In the 1830s, temperance societies administered lifelong-abstinence pledges to schoolchildren. Today, public health experts regularly warn that teenage drinkers run greatly increased risks of involvement in car accidents, fights and messy scenes in Cancun.

But what was once a social and moral debate may soon become a neurobiological one.

The costs of early heavy drinking, experts say, appear to extend far beyond the time that drinking takes away from doing homework, dating, acquiring social skills and the related tasks of growing up.

Mounting research suggests that alcohol causes more damage to the developing brains of teenagers than was previously thought, injuring them significantly more than it does adult brains. The findings, though preliminary, have demolished the assumption that people can drink heavily for years before causing themselves significant neurological injury. And the research even suggests that early heavy drinking may undermine the precise neurological capacities needed to protect oneself from alcoholism.

The new findings may help explain why people who begin drinking at an early age face enormous risks of becoming alcoholics. According to the results of a national survey of 43,093 adults, published on Monday in Archives of Pediatrics & Adolescent Medicine, 47 percent of those who begin drinking alcohol before the age of 14 become alcohol dependent at some time in their lives, compared with 9 percent of those who wait at least until age 21. The correlation holds even when genetic risks for alcoholism are taken into account.

The most alarming evidence of physical damage comes from federally financed laboratory experiments on the brains of adolescent rats subjected to binge doses of alcohol. These studies found significant cellular damage to the forebrain and the hippocampus.

And although it is unclear how directly these findings can be applied to humans, there is some evidence to suggest that young alcoholic humans may suffer analogous deficits.

Studies conducted over the last eight years by federally financed researchers in San Diego, for example, found that alcoholic teenagers performed poorly on tests of verbal and nonverbal memory, attention focusing and exercising spatial skills like those required to read a map or assemble a precut bookcase.

"There is no doubt about it now: There are long-term cognitive consequences to excessive drinking of alcohol in adolescence," said Aaron White, an assistant research professor in the psychiatry department at Duke University and the co-author of a recent study of extreme drinking on college campuses.

"We definitely didn't know five or 10 years ago that alcohol affected the teen brain differently," said White, who has also been involved in research at Duke on alcohol in adolescent rats. "Now there's a sense of urgency. It's the same place we were in when everyone realized what a bad thing it was for pregnant women to drink alcohol."

The hippocampus, a structure in the brain, is crucial for learning and memory. In 1995, White and other researchers placed delicate sensors inside living brain slices from the hippocampus of adolescent rats and discovered that alcohol drastically suppressed the activity of specific chemical receptors in the region.

Normally, these receptors are activated by the neurotransmitter glutamate and allow calcium to enter neurons, setting off a cascade of changes that strengthen synapses by helping to create repeated connections between cells, aiding in the efficient formation of new memories.

But at the equivalent of one or two alcoholic drinks, the receptors' activity slowed, and at higher doses, they shut down almost entirely. The researchers, led by Scott Swartzwelder, a neuropsychologist at Duke and at the Veterans Affairs Medical Center in Durham, N.C., found that the suppressive effect was significantly stronger in adolescent rat brain cells than in the brain cells of adult rats.

As might be predicted, the cellular shutdown affected the ability of the younger rats to learn and remember. In other experiments, the team found that adolescent rats under the influence of alcohol had far more trouble than did tipsy adult rats when required repeatedly to locate a platform submerged in a tub of cloudy water and swim to it.

Swartzwelder said it was likely that in human teenagers, analogous neural mechanisms might explain alcohol "blackouts" -- a lack of memory for events that occur during a night of heavy drinking, without a loss of consciousness. Blackouts were once thought to be a symptom of advanced adult alcoholism, but researchers have recently discovered just how frequently it occurs among teenagers who drink, as well.

In a 2002 e-mail survey of 772 Duke undergraduates, White and Swartzwelder found that 51 percent of those who drank at all had had at least one blackout in their drinking lifetimes; they reported an average of three blackouts apiece.

These averages barely suggest the frequency of blackouts among young adults at the extreme end of the drinking scale. Toren Volkmann, 26, is a graduate of the University of San Diego who, at 14, started drinking heavily almost every weekend and at 24 checked himself into a residential alcohol-treatment program.

"It was common for me to basically black out at least once or twice every weekend in late high school and definitely through college, and it wasn't a big deal to me," said Volkmann, a co-author, with his mother, Chris, of "From Binge to Blackout: A Mother and Son Struggle With Teen Drinking," to be published in August. "I wouldn't even worry about what happened, because I wouldn't know."

Blackouts are usually brief, and once they are over, the capacity to form new memories returns. But younger rats subjected to binge drinking also displayed subtler long-term problems in learning and memory, the researchers found, even after they were allowed to grow up and "dry out."

In experiments conducted by the Duke team, the reformed rat drinkers learned mazes normally when they were sober. But after the equivalent of only a couple of drinks, their performance declined significantly more than did that of rats that had never tippled before they became adults. The study was published in 2000 in the journal Alcoholism: Clinical and Experimental Research. Other research has found that while drunken adolescent rats become more sensitive to memory impairment, their hippocampal cells become less responsive than adults' to the neurotransmitter gamma-amino butyric acid, or GABA, which helps induce calmness and sleepiness.

This cellular mechanism may help explain Jack London's observation, in "John Barleycorn: Alcoholic Memoirs," that when he was a teenager he could keep drinking long after his adult companions fell asleep.

"Clearly, something is changed in the brain by early alcohol exposure," Swartzwelder said in an interview. "It's a double-edged sword, and both of the edges are bad.

"Teenagers can drink far more than adults before they get sleepy enough to stop, but along the way they're impairing their cognitive functions much more powerfully."

Alcohol also appears to damage more severely the frontal areas of the adolescent brain, crucial for controlling impulses and thinking through consequences of intended actions -- capacities many addicts and alcoholics of all ages lack.

In 2000, Fulton Crews, a neuropharmacologist at the University of North Carolina, subjected adolescent and adult rats to the equivalent of a four-day alcohol binge and then autopsied them, sectioning their forebrains and staining them with a silver solution to identify dead neurons.

All the rats showed some cell die-off in the forebrain, but the damage was at least twice as severe in the forebrains of the adolescent rats, and it occurred in some areas that were entirely spared in the adults.

Although human brains are far more developed and elaborate in their frontal regions, some functions are analogous across species, Crews said, including planning and impulse control. During human adolescence, these portions of the brain are heavily remolded and rewired, as teenagers learn -- often excruciatingly slowly -- how to exercise adult decisionmaking skills, like the ability to focus, to discriminate, to predict and to ponder questions of right and wrong.

"Alcohol creates disruption in parts of the brain essential for self-control, motivation and goal setting," Crews said, and can compound existing genetic and psychological vulnerabilities. "Early drinking is affecting a sensitive brain in a way that promotes the progression to addiction.

"Let's say you've been arrested for driving while drunk and spent seven days in jail. You'd think, 'No way am I going to speed and drive drunk again,' because you have the ability to weigh the consequences and the importance of a behavior. This is exactly what addicts don't do."

In another experiment, published this year in the journal Neuroscience, Crews found that even a single high dose of alcohol temporarily prevented the creation of new nerve cells from progenitor stem cells in the forebrain that appear to be involved in brain development.

The damage, far more serious in adolescent rats than in adult rats, began at a level equivalent to two drinks in humans and increased steadily as the dosage was increased to the equivalent of 10 beers, when it stopped the production of almost all new nerve cells.

Crews added, however, that adult alcoholics who stop drinking are known to recover cognitive function over time.

The same may hold true for hard-drinking teenagers. In 1998, Sandra Brown and Susan Tapert, clinical psychologists at UC San Diego and at the Veterans Affairs Medical Center there, found that 15- to 16-year-olds who said they had been drunk at least 100 times performed significantly more poorly than their matched nondrinking peers on tests of verbal and nonverbal memory.

The teenagers, who were sober during the testing, had been drunk an average of 750 times in the course of their young lives.

"Heavy alcohol involvement during adolescence is associated with cognitive deficits that worsen as drinking continues into late adolescence and young adulthood," Tapert said.

Two MRI scan studies, one conducted by Tapert, have found that hard-drinking teenagers had significantly smaller hippocampi than their sober counterparts. But it is also possible, the researchers said, that the heavy drinkers had smaller hippocampi even before they started to drink.

Teenagers who drink heavily may also use their brains differently to make up for subtle neurological damage, Tapert said. A study using functional-MRI scans, published in 2004, found that alcohol-abusing teenagers who were given a spatial test showed more activation in the parietal regions of the brain, toward the back of the skull, than did nondrinking teenagers.

When female drinkers in the group were tested in their early 20s, their performance declined significantly in comparison with nondrinkers, and their brains showed less activation than normal in the frontal and parietal regions.

Tapert hypothesized that when the drinkers were younger, their brains had been able to recruit wider areas of the brain for the task.

"This is a fairly sensitive measure of early stages of subtle neuronal disruption, and it is likely to be rectifiable if the person stops drinking," Tapert said.

The good news is that the brain is remarkably plastic, she added, and future studies may show that the teenage brain, while more vulnerable to the effects of alcohol, is also more resilient.

She pointed to test results from the original group of teenagers, recruited from substance-abuse treatment centers and brought into the lab when they were 15 by Brown. When Tapert retested the teenagers eight years later, those who had relapsed and who continued to get drunk frequently performed the worst on tests requiring focused attention, and those who reported the most hangovers performed the worst on spatial tasks.

On the other hand, the relative handful of teenagers and young adults in the group who stayed sober -- 28 percent of the total -- performed almost as well, at both the four-year and the eight-year mark, as other San Diego teenagers who had rarely, if ever, had a drink.

Volkmann, the University of San Diego graduate, was not part of Tapert's study. While in college, Volkmann said, he thought he drank for the fun of it. His moment of truth came in the Peace Corps in Paraguay, when he began waking up with sweats and tremors. He discovered he could not control his drinking even when he wanted.

Volkmann spent a month in a residential treatment program and six months in a halfway house. He has since returned to San Diego.

He said in an interview that he had no way of knowing exactly how drinking affected his overall brain function. But on one point, he is clear.

"My memory is definitely better now," he said. "Every day now, I can count on the fact that when I think back to the night before, I know what happened."


Middle-class girls taking to drink

New study highlights big increase in alcohol abuse by teenagers from well-off families
Click on image for a larger version

Teenagers from affluent homes are the most likely to drink frequently and behave while drunk in a way that they will regret, according to a new study which also finds that girls typically drink more than boys.

The survey of 11 to 16 year olds shows that, while girls start drinking regularly later than boys, their intake increases significantly at around 13 and they outstrip boys by the time they are 14 or 15.

The independent study of almost 2,500 children from 300 state schools across England and Wales finds that fathers' drinking habits particularly influenced children's behaviour, although there was a strong link between the intake of both parents and that of their offspring.

'Middle-class children who have two working parents and are living in affluent areas or rural communities are significantly more likely to have tried alcohol than any other group,' said Steve Barrett, editor of the magazine Young People Now which, with the Office of the Children's Commissioner, ordered the study from pollsters Ipsos/Mori.

Overall children today are almost twice as likely to drink as those who were a similar age four years ago, with 'three out of four 11 to 16 year-olds having tried alcohol and one in five claiming to be regular drinkers', said Barrett.

Almost three out of four children living in affluent areas have drunk alcohol, the survey found, compared with fewer than two in three of those in poorer communities. Young white people were twice as likely to be regular drinkers as those from black or Asian backgrounds.

Significantly more girls than boys said they got into situations when drunk that they later regretted. A quarter said they had kissed someone they later wished they had not and a similar proportion had walked through dark places they would normally avoid. One girl in five had hurt herself while intoxicated, compared with just over 10 per cent of boys.

'Children living in London were the least likely to have tried alcohol, with 38 per cent having never drunk at all,' said Barrett. 'That is 20 per cent above the national average.'

'All children are progressively becoming more likely to try alcohol, but those most likely to be regular drinkers are living in the more affluent areas, with two working parents,' said Barrett.

'This might be because these young people are being educated by their parents to drink responsibly at a young age by having a supervised drink on special occasions but it might be because these young people have access to their parents' alcohol and money to buy it themselves. Those with two working parents have more spare time without parental supervision to drink without their parents' knowledge.'

More than a third of 15-year-old girls overall see themselves as regular drinkers compared with fewer than 30 per cent of boys the same age.

Gemma, 13, from north London, drank for the first time at 10. 'I live in a really nice house and both my parents work but that means I have lots of time to do things they never find out about,' she said. 'I had my first drink at Christmas. My dad gave me some of his champagne as a special treat. I didn't like it at first but both my parents drink pretty often, so there was always an open bottle of wine somewhere in the house, and I began taking little sips when they weren't looking.

'Now I like the taste and the way it makes me feel. I know alcohol can be bad for you, but I don't worry about that because I don't drink enough to be in danger. I find getting drunk scary; I've done some things I regret when I've been drunk, like saying stupid things to my friends, so I don't do it very often.'

The report found that those most likely to drink regularly have parents who enjoy alcohol. Two-thirds of children whose fathers drink frequently say they use alcohol at least once a week, while almost 60 per cent of those with a mother who drinks regularly say they have been influenced by her.

Parents who drink are most likely to give their children alcohol, but young people said it was easy to acquire it for themselves.

Kids and booze

? Almost a third of 14-year-olds and half of pupils aged 15 drink every week, the Ipsos/Mori study shows.

? Ninety-three per cent of children aged 10 to 15 had been sold alcohol illegally in pubs, clubs and shops.

? Illegal sellers can be jailed for six months or fined thousands of pounds.

? Up to one in four schoolchildren have drunk themselves unconscious. Some have their stomachs pumped in hospital.

? In 2004-5 nearly 5,000 people under 18 received hospital inpatient treatment for alcohol-related illnesses.

? Drinking by pupils accounts for a third of truancy in some parts of the UK.

? Sixty per cent of 14-year-old girls surveyed by Bliss magazine admitted to losing their virginity while drunk.


Dangers of kids drinking

A research team from Boston University analysed the results of a 2001-2002 survey of 43,000 adults and found that 47% of people who had started drinking before the age of 14 met criteria for alcohol dependence within 10 years, compared to 4% of those who started drinking at the age of 21.

People who start drinking alcohol before the age of 14 are likely to become alcoholics more quickly than those who start drinking later, according to new research.

And the study also shows that the younger drinkers also develop dependence on alcohol faster and face a longer struggle with alcohol throughout their lives.

A research team from Boston University analysed the results of a 2001-2002 survey of 43,000 adults and found that 47% of people who had started drinking before the age of 14 met criteria for alcohol dependence within 10 years, compared to 4% of those who started drinking at the age of 21.

It was found that people who started drinking early were 2.6 times more likely to have episodes of alcohol dependence lasting longer than a year and nearly three times as likely to have six to seven symptoms of alcohol dependence.

The researchers say the findings, published in the Archives of Pediatrics and Adolescent Medicine, underscore the dangers of early alcohol use.


Alcohol risk far greater for unborn babies' health: study

Fetal alcohol syndrome (FAS) is a serious health problem that tragically affects its victims and their families, but that is completely preventable. Causing a child to suffer from fetal alcohol syndrome is really nothing short of child abuse and it lasts for life. Babies born with FAS tend to weigh less and be shorter than normal.

Drug Action Week in Coffs Harbour

An open letter to parents & children - Drug Action Week.
Did you know that…….

Katy Butler


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