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EXTRACTS FROM OTHER JOURNALS RELATING TO CHILDREN, YOUTH AND FAMILIES — IN THE FIELDS OF HEALTH, SUBSTANCE ABUSE, EDUCATION, PSYCHOLOGY, SCIENCE

October 2001

For Heavy Ecstasy Users, "Memories May Be Things of the Past"
Among illegal drugs, marijuana (cannabis) and Ecstasy (MDMA) have reputations as being the kinds of gentle, happy-making substances that give users a sense of relaxed closeness with others as well as a mean hankering for carbohydrates. But this reputation leaves out one of the important side effects that heavy users of these drugs can face--memory loss. Now, two new studies in the journal Archives of General Psychiatry are starting to give us a clearer picture of just how that memory loss presents itself in a scientific setting.
In the study on pot, the researchers studied people aged 35-55 years and placed them in three groups. One group, which consisted of 63 current heavy users, had smoked pot at least 5,000 times and still smoked daily. Another group, 45 former heavy users, had also smoked at least 5,000 times but had smoked fewer than 12 times recently. The last group, 72 control subjects, had smoked no more than 50 times in their lives.
All the people underwent a 28-day washout period during which they smoked no pot. On days 0, 1, 7, and 28, these people were given a neuropsychological battery of tests to assess general intellectual function and the ability to have abstract thoughts, to sustain attention, to speak well, and to learn and recall new information.
At days 0, 1, and 7, current heavy users scored significantly below control subjects on recall of word lists. But here’s the good news: By day 28, there were no significant differences among the groups on any of the test results, and no significant associations between cumulative lifetime pot use and test scores.
"What we saw was that cannabis has a clear effect on cognitive function while it is in use," says Deborah Yurgelun-Todd, PhD, director of the Neuropsychology and Cognitive Brain Imaging Center and an associate professor at Harvard Medical School in Boston, Massachusetts. "But even very heavy users return to baseline levels seen in . . . [people in the control group] when drug use stops."
The Ecstasy picture was not quite so rosy. In the second study, led by Liesbeth Reneman of the Academic Medical Center in Amsterdam, The Netherlands, researchers made brain scans and tested memory function of current and former Ecstasy users. The drug causes huge amounts of the brain chemical serotonin to be released. Heavy use of the drug has been associated with a kind of burnout of the cells that make serotonin, which may leave heavy users in danger of developing untreatable depression.
They found that even people who had stopped using Ecstasy for more than a year--as well as those who were still using it--were "less able than nonusers to recall words during tests." The group of current users also showed a marked decline in the number of serotonin-producing cells in their brains, while the former users’ serotonin levels seemed to recover slightly.
Roneman said that she and her colleagues’ findings suggest that Ecstasy’s damage to serotonin cells may be reversible, but the memory damage may not be.
These "findings of impaired verbal memory are cause for concern and underscore the need for longitudinal studies in MDMA users to evaluate the persistence of functional deficits," wrote Mark Molliver, MD, a professor in the Departments of Neuroscience and Neurology at Johns Hopkins University School of Medicine in Baltimore, Maryland in an editorial that accompanied the study.
October issue of the Archives of General Psychiatry.

Poor Choose Cigarettes Over Food
A new report found that people living in the world's poorest nation often choose to spend their scant earnings on cigarettes rather than food, Reuters reported Oct. 11.
A study of people living in Bangladesh revealed that most men spend a portion of their $24 a month earnings on tobacco products, rather than food, clothing, and housing for themselves and their families.
"An estimated 10.5 million people currently malnourished could have an adequate diet if money on tobacco were spent on food instead," said Dr. Debra Efroymson of PATH Canada in Dhaka, Bangladesh.
In surveying 32,000 Bangladesh households, Efroymson and colleagues found that men aged 35 to 49 had the highest prevalence of tobacco use, with 70.3 percent being smokers. Women's smoking rates were much lower.
Furthermore, the researchers discovered that the rate of smoking increased as income decreased. For instance, among men with a household income below $24 a month, 58.2 percent smoked. Of the men whose household incomes were higher than $118 per month, 32.3 percent smoked.
"Average male cigarette smokers spend more than twice as much on cigarettes as per-capita expenditures on clothing, housing, health, and education combined," the researchers noted.
To encourage people to spend less on tobacco, the researchers recommended that Bangladesh increase taxes on tobacco products and distribute educational information on the dangers of smoking.
"From our research, we conclude that tobacco use is a neglected issue in poverty reduction and that poverty is a neglected issue in tobacco control," wrote Efroymson's team. "A further benefit of tobacco-control measures could be decreased expenditure on non-essential goods and a concurrent improvement in the health and well-being of the poor."
The report is published in the October issue of the journal Tobacco Control.

Self-Poisoning Risk Highest Among Adolescent Girls
Despite an overall decline in poisonings among children and adolescents, teenage girls remain at risk of suicide from overdoses of drugs, such as pain relievers and antidepressants, study findings reveal.
The findings underscore the need for targeted suicide prevention efforts that include parents, teachers and doctors, according to Dr. F. Gauvin of the University of Washington in Seattle and colleagues.
Their report, published in the October issue of the Archives of Pediatric and Adolescent Medicine, documents a decrease in the number of hospitalizations caused by poisonings among children from birth to 18 years of age in Washington state from 1987 to 1997.
Among those hospitalized, teenagers accounted for about three quarters of patients, and teenage girls were 2.5 times more likely than boys to be admitted to a hospital because of poisoning.
Attempted suicide was the most common cause of poisoning, accounting for 47% of cases, according to hospital data. "Because female teenagers continue as the highest risk group for a suicide attempt by ingestion of pharmacologic agents, prevention efforts should be targeted to this population," Dr. Gauvin and colleagues write.
The investigators found that pharmaceutical agents were used by 80% of teenagers hospitalized for poisoning. Pain relievers were used in roughly one third of teenage poisonings, followed by antidepressants and drugs, such as tranquilizers and sedatives.
Younger children were more likely to ingest non-pharmaceutical substances such as cleaning fluids and solvents, the report indicates.
According to the researchers, preventive measures and the creation of poison centers have resulted in a sharp decline in the number of child and teenage deaths caused by poisoning over the past 50 years. In 1950, more than 800 US children died from accidental or intentional poisonings compared with fewer than 50 in 1997.
"Nevertheless, acute intoxication remains an important cause of illness in children," Dr. Gauvin's team concludes.
Arch Pediatr Adolesc Med 2001;155:1105-1110.

Teens' Peers Strongly Influence Choices About Sex
Young teens who believe that their friends disapprove of sexual activity among their peers are less likely to have sex themselves, according to the results of a recent study. These teens, as well as their sexually active counterparts, may rely on their friends' behavior and beliefs to shape their own, researchers suggest.
``Human immunodeficiency virus (HIV (news - web sites)) and pregnancy prevention programs should emphasize peer influences in both the initiation of sexual intercourse and the use of safer sex practices among sexually active adolescents,'' according to lead study author Dr. Colleen DiIorio of Emory University in Atlanta, Georgia, and her colleagues.
The programs should also emphasize ``personal attitudes about consequences to self and confidence in negotiating safer sex practices with one's partner,'' the researchers report in the September issue of the Journal of Adolescent Health.
For the study, DiIorio's team interviewed 405 teens aged 13 to 15, almost 30% of whom reported having had sexual intercourse.
The investigators found that adolescents who said they never had sex were more likely to have friends who disapproved of sexual intercourse among youth in their age group.
The reason for this may be because these teens chose friends and maintained friendships with individuals who shared their views about sex or because their ``friends' behaviors and verbal statements helped them form their own perceptions,'' the authors speculate.
Furthermore, the non-sexually active teens reported having more positive expectancies about not having sex--such as feeling more responsible about themselves and knowing that they will not get AIDS (news - web sites)--than did their sexually active peers. They also scored high on a scale that measured their ability to resist pressure to have sex.
In contrast, among sexually active teens, those who said they used condoms were more likely to report that their friends also used condoms. Condom users also reported greater confidence in refusing sex, wearing condoms and discussing their partner's sexual history than did their non-condom using peers.
The study was supported by funding from the Centers for Disease Control and Prevention (news - web sites) in Atlanta, Georgia.
SOURCE: Journal of Adolescent Health 2001;29:208-216.

Some Television May Positively Affect Child Development
It has been suggested that watching television may do more harm than good to a child's developmental skills. But a new study says that it all depends on what children watch — some educational programs on TV can actually enhance children's intellectual development.
Until now, television viewing has been blamed consistently for having a negative effect on children's developmental skills. But the authors of a new study, which was published in the September/October issue of Child Development, argue that not all television programs are created equal.
"All TV is not alike," says co-author Aletha Huston, PhD, professor of child development at the University of Texas at Austin. "Educational television can have a very positive impact on young children."
For the study, researchers recruited more than 200 children in the Kansas City area who were from low- to moderate-income families. About 40% of the children were African-Americans, and the rest were Hispanic and Caucasian Americans. During the 3-year study, which followed children from ages 2 to 4 years, researchers tested the children and visited their homes every year. The tests included reading, vocabulary, math, and school readiness.
"Children who watched educational programming — particularly at age 2 and 3 — performed better on tests of school-related skills than children who did not watch educational television," says Huston. "Watching a lot of general audience programming was related to poor skills."
After controlling for the family environment, which included parents' education and family income, researchers found that watching educational programs on television may indeed translate to better skills.
Daniel Anderson, PhD, professor of psychology at the University of Massachusetts at Amherst, says that the findings highlight the importance of the type of content that is viewed.
"What children watch on television is the key," says Anderson. "When the television programs are designed to teach, children learn good things. If they are not designed to teach, and especially if they include violence, children learn things that end up being bad for their behavior."
Anderson points out that for children from low- to moderate-income families, such educational programming is filling in parts of their childhood experience that they might not otherwise get.
"These children very often don't have other educational resources available in their homes, such as age-appropriate books, and parents often don't understand the importance of reading to their children and encouraging their children to read," says Anderson.
Researchers say that it is heartening to see that educational programming has become a regular, if small, part of broadcast offerings. Children can learn cognitive and social skills from such programs if parents supervise what they watch.
"Television is a powerful tool to teach things good or bad," says John Murray, PhD, professor in the school of family studies and human services at Kansas State University.
But he cautions that too much television for school-aged children may have the opposite effect. "The rule of thumb is two hours per day," says Murray. "Watching too much television takes away time children spend on exercise and other school-related activities."
A related study, released this week in the September issue of Ambulatory Pediatrics, found that easy access to television, such as having a TV in a child's room, leads to more time spent in front of the tube. The study author, Jean Wiecha, PhD, says her study backs up that 2-hour rule.
"Parents should limit the time children spend watching television," says Wiecha, deputy director of the prevention research center on nutrition and physical activity at the Harvard School of Public Health in Boston. "More than 2 hours of viewing time may have health consequences for children, such as obesity."
Monogr Soc Res Child Dev 2001;66(1):I-VIII, 1-147. Ambulatory Pediatr. 2001;1(5):244-251

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