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September 2, 2013 Alcoholism & Drug Abuse Weekly "7

Breaking news

DOJ to allow marijuana ballot initiatives to go forward

The Department of Justice (DOJ) on August 29 said it would allow states to go ahead with marijuana taxation and licensing initiatives, abandoning federal enforcement of possession of personal use amounts in states that have legalized recreational marijuana use. While still holding that marijuana is a dangerous drug, the federal government will focus only on possession by mi- nors, distribution by drug gangs, drugged driving, and several oth- er areas such as growing mari- juana on public lands. Project SAM (Smart Approaches to Mari- juana) tells treatment providers and public health officials to be prepared for negative conse- quences of marijuana use as a result. "In Colorado, we've seen an explosion of consequences among kids as a result of the new industry that emerged around so- called medical marijuana after 2009," said Christian Thurstone, M.D., medical director of STEP, the adolescent treatment pro- gram of Denver Health, and a SAM Board Member. "We now have to prepare the floodgates." For the DOJ memo, go to www. j u s t i c e . g o v / i s o / o p a / r e s o u r c e s / 3052013829132756857467.pdf

NIAAA: Chronic alcohol use changes brain, leading to habitual use

Chronic use of alcohol causes brain changes that move behavior control away from complex deci- sion-making and toward the area as- sociated with habit formation, ac- cording to an animal study conducted by scientists at the Na- tional Institute of Alcohol Abuse and Alcoholism (NIAAA). The study, published online August 20 in the

Proceedings of the National Acade- my of Sciences, helps explain why people can't stop drinking, and why they become dependent on alcohol. The prefrontal cortex controls emo- tion and decision-making, while the dorsal striatum plays a role in moti- vation and habit formation, accord- ing to the NIAAA. Previous research found that people dependent on al- cohol have problems with impulse control and other skills mediated by the prefrontal cortex; they also have exaggerated response in the dorsal striatum to alcohol-related cues. Led by Andrew Holmes, Ph.D., of NIAAA's Laboratory of Behavioral and Genomic Neuroscience, re- searchers measured how mice's brains' changed as a result of chron- ic exposure to alcohol vapors. The dorsal striatum of these mice showed an expansion of the nerve cell den- drites that conduct signals between cells — changes that are also seen with exposure to amphetamine. "The changes we observed suggest that the manner in which the dorsal striatum signaled and adapted to en- vironmental information has been altered by alcohol," said Holmes. "The findings imply that chronic drinking may set up a concerted set of adaptions in this key brain region that produce a bias for striatal con- trol over behavior." Drug abuse doesn't just impair brain functions; it reduces the function of some brain regions while increasing the func- tion of others, the findings suggest, said Holmes. In fact, chronic alcohol improved the ability of the mice to learn to make choices, he noted. "Improved performance on learning tasks that we know depend on the dorsolateral striatum is particularly

interesting because it suggests that alcohol could prime the brain to fa- vor other dorsal striatal behaviors — including things like habit forma- tion, which may foster addictive patterns of behavior."

SAMHSA: Abuse of prescription opioids raises risk of heroin use

A new report from the Sub- stance Abuse and Mental Health Services Administration (SAMHSA) shows that using prescription opi- oids for nonmedical reasons raises the risk of initiating heroin use. The report, released on August 22, be- gins to answer some of the ques- tions that have been raised by anec- dotal reports of the increase in heroin use: in particular, as prescrip- tion opioids have become less avail- able due to successful crackdowns on pill mills, have people dependent on those opioids turned to heroin? Are they turning to heroin as a less costly alternative when prescription opioids become too expensive due to increased amounts as a result of tolerance? While the report, which is based on the National Survey on Drug Use and Health (NSDUH), does not answer these questions, it lays the groundwork by showing that people aged 12 to 49 who who had used prescription pain relievers nonmedically were 19 times more likely to have initiated heroin use re- cently (within the past 12 months of being interviewed) than others in that age group (0.39 percent versus 0.02 percent). The report also shows that four out of five recent heroin initiates (79.5 percent) had previ- ously used prescription pain reliev- ers nonmedically. "Prescription pain

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Correction There was an error in the article on recovery coaches in the August 26

issue ("Recovery coaches — new standards for volunteers only?"). There is no separate New York credential for recovery coaches in medication- assisted treatment. Medication Assisted Recovery Support (MARS) does have a special half-day training about medication-assisted treatment for recovery coaches. We regret the error.

Alcoholism & Drug Abuse Weekly DOI: 10.1002/adaw A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com

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