Drug use falls, except among older adults

Youngsters are using fewer illegal
drugs but a spike in use has been seen among older adults,
perhaps because a few aging baby boomers have clung to their
rebellious ways, according a U.S. substance abuse report
published on Thursday.

Just 6.8 percent of teenagers aged 12 to 17 said they used
marijuana in 2005, down from 8.2 percent in 2002, according to
the annual survey done by the Substance Abuse and Mental Health
Services Administration.

Overall illicit drug use also fell, from 11.6 percent in
2002 who said they had used drugs in the past month to 9.9
percent in 2005, the report said.

"Something important is happening with American teens,"
said John Walters, Director of National Drug Control Policy.

"They are getting the message that using drugs limits their
futures, and they are turning away from the destructive
patterns and cruelly misinformed perceptions about substance
abuse that have so damaged previous generations," he said.

But baby boomers, now entering their 50s and 60s, are
apparently not all tuning in to the message.

The rate of current illicit drug use increased from 2.7
percent among adults aged 50 to 59 in 2002 to 4.4 percent in
2005.

"Could kids be rejecting drugs because it's some lame thing
that old people do?," asked Tom Riley, a spokesman for the
White House National Office of Drug Control Policy.

"To what extent is boomer 'recreational' use now more
accurately understood as 'dependency'?"

The illegal use of alcohol fell among teens, with 16.5
percent of 12- to 17-year-olds saying they were drinkers and
9.9 percent reporting binge drinking -- defined as having five
or more drinks in a row. Both are down more than a full
percentage point from 2004.

FUNDAMENTAL SHIFT IN TEEN DRUG USE

"The news today is there is a fundamental shift in drug use
among young people in America," said Assistant Surgeon General
Eric Broderick, who is SAMHSA Acting Deputy Administrator.

"We first saw this shift toward healthier decisions when
rates of tobacco use among young people began to go down. Now,
we see a sustained drop in rates of drug use. We will see if
the decline in drinking among 12-to 17-year-olds becomes a
continued pattern as well," he said.

But certain dangerous patterns of alcohol use did not
change -- nearly 23 percent of all people aged 12 and older
admitted to binge drinking.

"This translates as about 55 million people, comparable to
the 2004 estimate," SAMHSA said in a statement. "The binge
drinking rate among young adults ages 18-25 was 41.9 percent,
and the heavy drinking rate was 15.3 percent."

Close to 89 percent of people who said they had tasted
alcohol for the first time were under the legal drinking age of
21, the survey found.

About 6 percent of people said they had smoked or eaten
marijuana in the past month, and 2.6 percent said they had
abused prescription drugs.

About 4 percent of people surveyed said they had used
methamphetamine. Just about 1 percent said they had used
cocaine, about the same as in past years, while about 0.1
percent used heroin, also not much of a change.

The survey found that 71.5 million Americans ages 12 and
older used tobacco. Just over 29 percent of people said they
had smoked or chewed tobacco in the past month.

Among children aged 12 to 17 tobacco use fell to 10.8
percent in 2005 from 13 percent in 2002.

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Taking preventive medications curbs diabetes risk

Individuals at risk for
developing type 2 diabetes who are prescribed the drug
metformin should stick with it, doctors say. In a large study,
individuals who adhered to a metformin-based diabetes
preventive strategy had a reduced risk of developing diabetes,
they report.

The Diabetes Prevention Program (DPP) investigated the
value of intensive lifestyle intervention (diet and exercise)
or metformin in delaying or preventing type 2 diabetes in
high-risk individuals with impaired glucose tolerance, a
precursor to full-blown diabetes.

Dr. Elizabeth A. Walker, of George Washington University,
Rockville, Maryland, and colleagues examined medication
adherence and health outcomes in the metformin and placebo arms
of the DPP.

A total of 2155 subjects who were randomly assigned to
either the metformin or placebo treatment arms were included in
the analysis.

The overall adherence rates -- that is, the proportion of
patients taking at least 80 percent of the prescribed dose --
were 71 percent in the metformin group and 77 percent in the
placebo group.

Compared to patients who were adherent to placebo, those
adherent to metformin had a 38.2 percent reduced risk of
developing diabetes, the investigators report. In this study,
"the level of medication adherence predicted the primary
outcome of diabetes," they write in the journal Diabetes Care.

Among patients taking metformin, older subjects were more
adherent than younger subjects.

Walker's team reports that the most commonly reported
barriers to taking the medication as prescribed were forgetting
to take doses (22 percent), adverse effects (8 percent), and
disruption of routines (8 percent). Overall, 15 percent of
women and 10 percent of men reported adverse effects in the
metformin group.

These results, the team concludes, "lend support for future
development and evaluation of brief, practical medication
adherence interventions for primary care settings."

SOURCE: Diabetes Care, September 2006.

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Study: Impact of drugs on kids confusing

Finding out how prescription drugs affect children isn't easy, even for pediatricians, a new study says.

That's because very little research on children and drugs is
published in medical journals that help guide doctors on treatment. The
result is that some prescribe the wrong dose or use drugs that could be
harmful to kids.

"Ironically, some of the times when drugs do work (in children),
they're still not getting published," said Dr. Danny Benjamin, an
associate professor at Duke University who led the study and also works
for the U.S.

Food and Drug Administration.

He said an FDA program meant to encourage drug companies to test how
drugs affect children has led to hundreds of studies. The problem is
that about half the time, the results don't get published in
peer-reviewed medical journals, mainly because researchers and sponsors
don't submit them for publication, Benjamin said.

Drug companies that conduct or sponsor pediatric research are
motivated mostly to get their products on the market, "not to tend to
the public health concerns," Benjamin said.

Also, parents often are reluctant to let their children participate
in studies. So the research often involves many institutions with a few
children at each location, which complicates compiling data and
submitting them for publication, Benjamin said.

Examples the authors cited include unpublished data suggesting that
an anesthesia drug might increase children's risk of death when used
for sedation. Also, unpublished data has suggested that some steroid
creams used for skin rashes in adults could cause a hormone imbalance
in children.

"People slather this on children, particularly babies," said study
co-author Dr. Dianne Murphy, director of the FDA's office of pediatric
therapeutics.

In both cases, precautions are listed on the drug label but not in
much detail. They also appear on the FDA's Web site, but that's not
where doctors usually look for such information, the researchers said.

"We've just got to get the data out to people who are caring for children," Benjamin said.

His study appears in Wednesday's

Journal of the American Medical Association.

JAMA is among the top peer-reviewed journals but editor-in-chief Dr.
Catherine DeAngelis said few studies submitted to JAMA involve the
effects of medication on children.

The researchers studied the impact of 1997 legislation authorizing a
measure that grants drug companies longer patent protection when they
agree to study a medication's effects in children.

Between 1998 and 2004, 253 pediatric studies were submitted to the
FDA under this program but only 45 percent were published in
peer-reviewed journals, the researchers found.

Dr. Peter Lurie of the watchdog organization Public Citizen's Health
Research Group said drug companies and academics need to push harder to
publish.

"It really is like the tree falling in the woods. The study is of no
use whatsoever if it never reaches the practicing physician," Lurie
said.

Scott Lassman of Pharmaceutical Research and Manufacturers of
America, an industry trade group, said drug companies shouldn't be
faulted.

While he agreed publication in a peer-reviewed journal is "the gold
standard for getting information out," Lassman said companies often
present data at medical conferences and or post them in an online
industry database, http://www.clinicalstudyresults.org.

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Marijuana helps patients stay on medication

Recovering drug addicts who are
infected with hepatitis C virus may stick to their medications
better if they are allowed to use marijuana, U.S. researchers
reported on Wednesday.

Smoking or eating cannabis may help them tolerate the side
effects of the antivirals, which can clear the virus but often
cause fevers, chills, and muscle and joint aches, the
researchers said.

Diana Sylvestre and colleagues at the University of
California, San Francisco tested 71 recovering substance users
given interferon and ribavirin to treat their hepatitis C --
which is common among injecting drug users.

About a third of the patients also used marijuana.

Half of the marijuana users were successfully treated with
the antivirals, versus 18 percent of those who did not use
cannabis, the researchers reported in the European Journal of
Gastroenterology and Hepatology.

And just 14 percent of the cannabis users relapsed,
compared to 61 percent of non-smokers.

"It may in fact be an ironical truth that those persons who
contracted hepatitis C virus through a form of illicit drug use
may be aided in ridding themselves of this potentially fatal
virus by the use of another drug in addition to their HCV
therapy," Benedikt Fischer of the Center for Addictions
Research of British Columbia in Canada wrote in a commentary.

The hepatitis C virus damages the liver and can kill people
if not treated. A combination of interferon, to boost immune
response, and ribavirin, to attack the virus, can help clear it
from the liver, but it can take months.

"The majority of patients develop significant
treatment-related side effects, with almost 80 percent
experiencing an initial flulike syndrome that includes fevers,
chills, and muscle and joint aches," the researchers wrote.

They are often given a range of drugs to treat the side
effects, including medications to stop vomiting, analgesics,
antihistamines and sleeping pills.

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