Free e-book: Concussions, CTE and Football

From the Introduction:

When You Watch Your Next Football Game...

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From high school to college to professional levels, football dominates American sports and exposes millions to head traumas on practically every play.

It is a paradox of wide proportions. From opening day in September to the Super Bowl in February, the National Football League (NFL) dominates American sports and wins television ratings far beyond any other program--sports or otherwise.

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Increasingly, though, discussions of football (and other sports) include the medical terms concussion and chronic traumatic encephalopathy (CTE), a long-term degenerative and incurable brain disease. Although military personnel and others are vulnerable to the disease, the highest risk is among athletes involved in contact sports in which hits to the head are considered “part of the game.”

Ten years ago, few would have predicted that the movie “Concussion” starring Will Smith would be made. Fewer would have predicted that brain injuries would one day dominate the sports headlines. When former NFL star Junior Seau committed suicide in May 2012, the media focused almost entirely on whether the thousands of head blows he endured during his 19-year career as a middle linebacker were a contributing factor.

More than 3,000 former NFL players sued the league for allegedly misleading them about the risks of brain injury. The players and the league settled for more than $1 billion in damages. New policies and studies aimed at protecting the brains of athletes seem to be announced every week. But it’s not just professional athletes who are the focus of attention. No fewer than 40 states have passed laws requiring athletes in schools and recreational programs to schedule a doctor’s appointment when a concussion is suspected.

A progressive, degenerative brain disease, CTE can present itself  in athletes and others with a history of repetitive brain trauma months, years, or even decades after injury. Memory loss, confusion, depression, aggression, impaired judgment or impulse control, and, eventually, progressive dementia may result.

With this increasing awareness about the dangers of concussion, parents face tough choices about which sports their children should be allowed to play. Some of the more

New rules have since been designed to lessen brain trauma; but with every new horror story that emerges on the sports pages, parents worry even more.

dangerous sports for the brain, such as football, soccer, ice hockey, and lacrosse, are also the most popular. Although everyone agrees that brain trauma may have lasting and debilitating effects, and science continues to make slow progress toward understanding the disease, we cannot yet entirely quantify those effects. As a result, parents and even medical professionals are left to search their hearts and scour Web sites for answers. But a decade’s worth of research has made one thing clear: We need to find better ways to protect the brains of athletes.

Difficult to Measure

Concussions suffer from a perception problem. On the surface, they might not seem to have a lasting, serious impact. (In fact, sports programs and commentators continue to celebrate the most impactful “hits,” using euphemisms such as “getting your bell rung.”) They are an invisible injury: There is no blood, there are no displaced bones, and the patient rarely complains. Even when an athlete is knocked unconscious and observers react with panic, the concern quickly fades. Ninety-nine percent of concussed athletes wake up in seconds or minutes and then seem fine. When symptoms persist beyond the day of injury, in the vast majority of cases they dissipate within a month. The injury seems as if it is gone forever, leaving no scars or overt indication that it ever happened.

Children at Risk

Most brain trauma in the industrialized world occurs in children playing sports. Since participation is voluntary, and the rules of recreational sports are malleable, it seems reasonable to make every effort to reform each individual sport....

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Large declines seen in teen substance abuse, delinquency

Surveys over a decade indicate positive behavioral shifts

Summary:

In recent years, teens have become far less likely to abuse alcohol, nicotine and illicit drugs, according to researchers. Teens also are less likely to engage in behaviors like fighting and stealing, and the researchers believe the declines in substance use and delinquency are connected.

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More than a decade of data indicates teens have become far less likely to abuse alcohol, nicotine and illicit drugs, and they also are less likely to engage in delinquent behaviors, such as fighting and stealing, according to results of a national survey analyzed by researchers at Washington University School of Medicine in St. Louis.

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Learn about how the brain governs our health.

The data come from the National Survey on Drug Use and Health, an annual survey of 12- to 17-year-olds from all 50 states that is sponsored by the Substance Abuse and Mental Health Administration, an agency of the U.S. Department of Health and Human Services. The data include information from 2003 through 2014, the last year for which survey numbers are available. A total of 210,599 teens -- 13,000 to 18,500 each year -- were part of the study.
The findings are reported Oct. 25 in the journal Psychological Medicine.

The researchers found that the number of substance-use disorders among 12- to 17-year olds had declined by 49 percent over the 12-year span, along with a simultaneous 34 percent decline in delinquent behaviors, such as fighting, assault, stealing, selling drugs or carrying a handgun.

The drop in substance abuse among teens parallels findings in other recent surveys, but until now no one has looked at how the drop-off may be linked to other behavioral issues.

"We've known that teens overall are becoming less likely to engage in risky behaviors, and that's good news," said first author Richard A. Grucza, PhD, a professor of psychiatry. "But what we learned in this study is that the declines in substance abuse are connected to declines in delinquency. This suggests the changes have been driven more by changes in adolescents themselves more than by policies to reduce substance abuse or delinquent behavior."

Other researchers have found that teens are delaying sex and using seat belts more often than their parents and grandparents. Grucza's team focused on substance-use disorders -- involving alcohol, nicotine, marijuana, opioids and the abuse of other prescription drugs or nonprescription drugs -- and delinquent behaviors.

"It's not clear what is driving the parallel declines," Grucza said. "New policies -- including things like higher cigarette taxes and stricter anti-bullying policies -- certainly have a positive effect. But seeing these trends across multiple behaviors suggests that larger environmental factors are at work. These might include reductions in childhood lead exposure, lower rates of child abuse and neglect, and better mental health care for children."

Although heroin and opioid abuse have become epidemic in many areas of the United States, the use among teens has fallen, according to the survey data.
"Opioid problems continue to increase among adults," he said. "But among the 12- to 17-year-old population, we saw a drop of nearly 50 percent."

Based on the survey data, Grucza and his team estimated that in 2014 there were nearly 700,000 fewer adolescents with substance-use disorders than in 2003. And because it's possible for a person to be addicted to nicotine while abusing alcohol or marijuana, the researchers estimate the total number of substance-use disorders among adolescents declined by about 2 million.

Source:

Washington University School of Medicine

Alcohol: The Forgotten Drug of Abuse

Parents have critical role in preventing teen drinking

Source:

University of Adelaide

Summary:

Fewer Australian teenagers are drinking alcohol but more needs to be done to curb the drinking habits of Aussie students, based on the findings of the latest study.

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Fewer Australian teenagers are drinking alcohol but more needs to be done to curb the drinking habits of Aussie students, based on the findings of the latest study by Adelaide researchers.

The results of the study, now published in the journal BMC Public Health, provide a snapshot of the prevalence of alcohol consumption among students, and the factors that most influence their drinking behaviour. This research has been supported by Cancer Council SA and SA Government.

"Harmful alcohol use is a serious problem in Australia, and drinking patterns are often first set in adolescence," says lead author Jacqueline Bowden, behavioural scientist and Manager of Population Health Research at SAHMRI, and researcher with the School of Psychology, University of Adelaide.

"With alcohol contributing to four of the top five causes of death in young people, and a leading cause of cancer in our community, it's important for us to better understand drinking behaviour among young people so we can help to prevent or delay it.

"One of the major messages from our study is that parents have more influence on their teenagers' decisions regarding alcohol than they probably realise. Parental behaviour and attitudes towards alcohol really do make a difference, and can help prevent children from drinking at an early age."
The study found:

• By age 16, most students had tried alcohol
• A third of students reported that they drank alcohol at least occasionally
• Only 28% of students were aware of a link between alcohol and cancer
• Across all ages, students were less likely to drink if their parents showed disapproval of underage drinking
• Those aged 14-17 were less likely to drink if they knew about the link between alcohol and cancer
• Smoking and approval of drinking from friends were more likely to result in drinking
• Once young people have become regular drinkers, the main predictor for drinking is the perceived availability of alcohol
• Cashed up students are more likely to drink.

Lincoln Size, Chief Executive Cancer Council SA, says: "The evidence is clear that alcohol use is a cause of cancer. Any level of alcohol consumption increases the risk of developing an alcohol-related cancer; the level of risk increases in line with the level of consumption.

"This latest evidence highlights the need to educate young people about the consequences of alcohol consumption and for parents to demonstrate responsible drinking behaviour. We need to get the message through that what may be considered harmless fun actually has lifelong consequences.

"We know that alcohol causes cancers of the mouth, pharynx, larynx, esophagus, bowel in men and breast among women. There is also probable evidence that alcohol increases the risk of bowel cancer in women, and liver cancer.

Ms Bowden says we need to address the issue of supply to teenagers. "Many parents believe providing their children with alcohol in the safe environment of their home teaches them to drink responsibly. However, the weight of evidence suggests that this increases consumption, and is not recommended.

"Our results also found that those adolescents who thought they could buy alcohol easily were more likely to drink regularly. The issue of availability -- including price -- and marketing of alcohol in the community is a major hurdle to be overcome.

"Alcohol is more affordable in Australia than it has been in the past 30 years, and the number of premises selling alcohol in Australia has increased substantially in the past 15 years. Throw advertising and sports sponsorship into the mix and we have some very strong messages that alcohol is the norm," Ms Bowden says.

"Our evidence shows that that parents have a significant and substantial role to play, to help their kids develop a healthier relationship with alcohol early. Parents can set the boundaries and create clear expectations."
Ms Bowden says parents should:

• Discuss alcohol use with their children, and the fact that not everyone drinks
• Get to know upcoming activities, such as parties, and set expectations for behaviour
• Reconsider drinking in front of children, as most alcohol is consumed by adults at home
• Have alcohol-free events
• Avoid binge drinking
• Don't buy alcohol for adolescents or provide it at parties.

"We often forget that alcohol is the most widely used recreational drug in Australia and has an enormous cost on families. It is important that parents set the right example," Ms Bowden says.

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Story Source:
Materials provided by University of Adelaide.

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Depression among young teens linked to cannabis use at 18

Seattle-focused study suggests earlier intervention with depressed youths could reduce rate of cannabis-use disorder

Summary:

Young people with chronic or severe forms of depression were at elevated risk for developing a problem with cannabis in later adolescence, found a study looking at the cumulative effects of depression in youth.

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A study looking at the cumulative effects of depression in youth, found that young people with chronic or severe forms of depression were at elevated risk for developing a problem with cannabis in later adolescence.

Researchers used data from annual assessments when students were ages 12-15 and then again when they were 18. The results were published in the journal Addiction.

"The findings suggest that if we can prevent or reduce chronic depression during early adolescence, we may reduce the prevalence of cannabis use disorder," said lead author Isaac Rhew, research assistant professor of psychiatry and behavioral sciences at the University of Washington School of Medicine.

According to researchers, during the past decade cannabis has surpassed tobacco with respect to prevalence of use among adolescents. Cannabis and alcohol are the two most commonly used substances among youth in the United States. They pointed to one national study showing increases in prevalence of cannabis use disorder and alcohol use disorder in the United States, especially among young adults.

Longitudinal studies looking at the link between depression and later use of alcohol and cannabis, however, have been mixed. Some show a link. Others don't. But most studies have assessed adolescent depression at a single point in time -- not cumulatively, said the researchers. Further, there have been differences in how substance use has been measured ranging from the initiation of any use to heavier problematic forms of use.

The study oversampled for students with depressive and/or conduct problems. The researchers were surprised to see that the prevalence of cannabis and alcohol use disorder in this study was notably higher than national estimates with 21 percent meeting criteria for cannabis use disorder and 20 percent meeting criteria for alcohol use disorder at age 18.

What effect the easing of marijuana laws in Washington state had on the youth is unclear. Researchers said it would be informative to conduct a similar study in a state with more strict marijuana laws to understand whether the relationship between depression and cannabis misuse would still hold in areas where marijuana may be less accessible.

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Story Source:
Materials provided by University of Washington Health Sciences/UW Medicine. Original written by Bobbi Nodell.

Confused About Marijuana and the Law?

There’s been a lot of talk in the U.S. lately about legalizing marijuana. Maybe you’ve heard stories in the news about some states that have legalized weed (or are debating whether to do that) and wondered, what does that mean for you?

Recreational marijuana
First, let’s get the obvious out of the way: If you’re a teen, it’s never legal to use marijuana recreationally (that is, just to get high).

Marijuana is also still illegal under U.S. federal law, even in states that have passed laws to make it legal under state law.

Confused yet? Okay, so what about those state laws?

The District of Columbia and four states (Alaska, Colorado, Oregon, and Washington) allow adults to use marijuana recreationally. While the laws in these places vary, all of them prohibit people under the age of 21 from using marijuana recreationally.

Medical marijuana
Some research suggests that marijuana may have the potential to help treat some health conditions including pain, nausea, epilepsy, and others. But there hasn’t been enough research on the subject, and patients across the country are using marijuana strains and extracts that haven’t been fully tested or shown to be effective for their medical condition.

So far, 25 states and D.C. have passed laws to let people use marijuana with recommendations from their doctors (and sometimes by fulfilling other requirements, like having a medical marijuana license). The federal government has decided not to challenge those laws to any great extent. But people who buy marijuana in a state where it’s legal (for medicinal or recreational use) cannot take it across state lines into a state where it is not legal. So it remains a confusing issue.

Marijuana hasn’t been approved by the Food and Drug Administration (FDA), and that approval is necessary to grow and sell medicine in this country. But researchers are studying possible medical uses for marijuana and some of the chemicals it contains. The Drug Enforcement Administration (DEA), which enforces marijuana laws in the U.S., recently said it would increase the number of places allowed to grow the plant for research purposes in hopes of making it easier for more scientists to study marijuana.

So just to repeat, nothing in the law has changed for teens; using weed to get high is still illegal, wherever you live in the U.S. Depending on what scientists learn about marijuana’s value as medicine, it may (or may not) become legal for more people with certain health problems.

Trump Watch: Swatiskas, Slurs, Hate Epic Rise in Our Schools

The Southern Poverty Law Center has documented an alarming rise in hate crimes and language in our schools post-Trump. These incidents appear in The Trump Effect, just published by the SPLC. Read them and support A Thousand Moms' new publishing effort, Healing the Brain.

“Since the election, every single secondary school in our district has had issues with racist, xenophobic or misogynistic comments cropping up. In the week since the election, I have personally had to deal with the following issues: 1) Boys inappropriately grabbing and touching girls, even after they said no (this never happened until after the election); 2) White students telling their friends who are Hispanic or of color that their parents are going to be deported and that they would be thrown out of school; 3) White students going up to students of color who are total strangers and hurling racial remarks at them, such as, ‘Trump is going [to] throw you back over the wall, you know?’ or ‘We can’t wait until you and the other brownies are gone’; 4) The use of the n-word by white students in my class and in the hallway. Never directed towards a student of color (that I’ve been told yet), but still being casually used in conversation.” — MIDDLE SCHOOL TEACHER, INDIANA

“The slurs have been written on assignments. ‘Send the Muslims back because they are responsible for 9/11.’” — HIGH SCHOOL TEACHER, MINNESOTA

"’I hate Muslims.’ (Student blurted this while the class was learning about major religions.)” — MIDDLE SCHOOL TEACHER, WASHINGTON

“I’ve had a lot of students repeat the phrase ‘Trump that bitch’ in my class, and make jokes about Hispanic students ‘going back to Mexico.’” — HIGH SCHOOL TEACHER, GEORGIA

“A proud proclamation of racism was made by a student after the election: ‘Bet those black people are really scared now.’” — HIGH SCHOOL TEACHER, MICHIGAN

“White males have been overheard saying, ‘screw women’s rights, fag lover liberal, build the wall, lock her up.’ The rebel flag is draped on the truck of a popular student, and the p-word has been used very casually, citing Trump as the excuse.” — HIGH SCHOOL TEACHER, MICHIGAN

“Kids saying, ‘Trump won, you’re going back to Mexico!’ Boys grabbing girls, cornering girls against lockers. Kids yelling, ‘Trump won, so [there will] be less people here soon.’” — HIGH SCHOOL TEACHER, KANSAS

“Today I photographed vandalism in the boy’s bathroom that mentioned a specific black student (1 of 7 in a school of 200). It repeatedly mentioned the KKK, used the n-word and joining Jews. A student drew a swastika on my board a few days ago. A black female ran out of a room crying after being racially harassed by multiple students during two different classes. One student … reported asking two different Latina students if they were ready to move back to Mexico now that Trump is president. I have witnessed an increase in racist and sexist jokes by students who support Trump. I personally spent most of the day putting out fires related to these issues, including documenting and reporting them. Multiple white males also expressed anger over the school wanting to post signs stating we are a sanctuary school.” — HIGH SCHOOL TEACHER, OREGON

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Parents: How do your kids stay off drugs?

Parents worry whether their children can resist the temptation of drug addiction. What's at stake and what are the risk factors your children face? Read this excerpt from Healing the Brain:

Why is adolescence a critical time for preventing drug addiction?

As noted previously, early use of drugs increases a person’s chances of developing addiction. Remember, drugs change brains—and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks. If we can prevent young people from experimenting with drugs, we can prevent drug addiction.

Wikimedia Commons

In high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used.

Risk of drug abuse increases greatly during times of transition. For an adult, a divorce or loss of a job may lead to drug abuse; for a teenager, risky times include moving or changing schools. In early adolescence, when children advance from elementary through middle school, they face new and challenging social and academic situations. Often during this period, children are exposed to abusable substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used.

At the same time, many behaviors that are a normal aspect of their development, such as the desire to try new things or take greater risks, may increase teen tendencies to experiment with drugs. Some teens may give in to the urging of drug-using friends to share the experience with them. Others may think that taking drugs (such as steroids) will improve their appearance or their athletic performance or that abusing substances such as alcohol or MDMA (ecstasy or “Molly”) will ease their anxiety in social situations. A growing number of teens are abusing prescription ADHD stimulants such as Adderall® to help them study or lose weight. Teens’ still-developing judgment and decision-making skills may limit their ability to accurately assess the risks of all of these forms of drug use. Using abusable substances at this age can disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control.  So, it is not surprising that teens who use alcohol and other drugs often have family and social problems, poor academic performance, health-related problems (including mental health), and involvement with the juvenile justice system.

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