The Sara Bellum Blog

Since the death of Michael Jackson in 2009, “propofol” has been mentioned often in the news.  The substance was found to be the cause of his death and was the center of the highly publicized trial of his doctor.

So, it’s no surprise there is a lot of curiosity about propofol.   NIDA received questions about it during last year’s Drug Facts Chat Day.

During Chat Day, Cam from California asked about the basics—

Is propofol a drug?

Yes.  Propofol is a common type of anesthetic—a drug that doctors use to “put people to sleep” for surgery. It is given to patients through an “intravenous drip,” (called an “IV” for short) that goes through a special needle into a patient’s vein, so the medicine goes directly into the bloodstream.

Doctors who give patients propofol are generally known as “anesthesiologists” and have special training. These experts set up the IV, make sure the patient is “sleeping” comfortably, and then carefully monitor vital signs (like heart rate, breathing, etc.) while the patient has surgery.

Doctors like using propofol because it leaves the body very quickly, which allows the patient to wake up after surgery more rapidly, without bad side effects.  Propofol can be a useful drug when it’s given by people who are properly trained. But like many prescription drugs, it can be very harmful if used inappropriately.  Propofol should be given only in a hospital setting where the patient can be closely monitored.

A Lost Legend

Michael Jackson died of acute propofol intoxication.  Additional drugs found in Michael’s system were the depressants midazolam and diazepam, the painkiller Lidocaine, and the stimulant ephedrine.  His doctor, Conrad Murray, was convicted of causing the singer’s death by giving Michael the propofol that caused him to stop breathing.   By helping Michael abuse drugs—even if it was to “help him sleep”—he contributed to the loss of a legend.  Michael’s untimely death was mourned by millions of people.

More people understand now the harmful effects that smoking has on the body as well as the addictive effects of nicotine. The good news is that teens seem to be getting the message—SBB recently reported that smoking rates among 8th-, 10th-, and 12th-graders are at an all-time low.

But many teens are still smoking—according to the 2011 Monitoring the Future Study, 19 percent of high school seniors reported smoking in the past month.

New NIDA research gives yet another reason for teens to avoid lighting that first cigarette—nicotine may “prime” the brain to enhance cocaine’s effects, making it a very dangerous “gateway drug.” That means it could open the door to other drug use.

Science Suggests that Nicotine Changes the Brain

Evidence shows that most people who tried drugs like cocaine were first  tobacco or alcohol users. This concept of “gateway drugs” has been controversial, mostly because people question whether prior use of drugs like nicotine, alcohol, or marijuana actually leads to later drug use. Before now, studies have not been able to show a biological reason why smoking or other nicotine use could increase a person’s chances of using illegal street drugs.

That changed when NIDA researchers found that mice exposed to nicotine in their drinking water for at least 7 days showed an increased response to cocaine.

Why did this happen? Researchers recognized that nicotine actually changes the structure of your DNA, it reprograms how certain genes are expressed—in particular a gene that has been related to addiction—and ultimately, it enhances the response to cocaine.

Moving on from mice, researchers looked at statistics in humans—in particular at when people began nicotine use and their degree of cocaine dependence: Among cocaine users who smoked cigarettes before starting cocaine, the rate of cocaine dependence was higher compared with  those who tried cocaine first (before smoking cigarettes).

The study doesn’t mean that every person who smokes cigarettes will eventually become addicted to cocaine. But it does suggest that if a person who smokes cigarettes tries cocaine, their brains may have been changed by nicotine to make it more likely that they will become addicted to cocaine.

Need help quitting smoking? Take a look at these resources from the Centers for Disease Control and Prevention.

Why do adults seem to blame “raging hormones” for many things teens do? Beyond causing acne and a sudden interest in dating, are hormones responsible for changes in behavior or emotional response?

The answer is yes. The hormones that change around puberty—starting between age 8 and 14—and last until the early 20s when adolescence ends may affect you in more ways than you realize.

NIDA defines a “hormone” as “a chemical substance formed in glands in the body and carried in the blood to organs and tissues, where it influences function, structure, and behavior.”

In preteen and teen years, many new chemicals move around inside your body, transforming you from a child to a teen to an adult.

Growing on the Outside: What’s Happening on the Inside?

During puberty, your brain releases various hormones that help your body to mature by producing testosterone (in boys) and estrogen (in girls).  Resulting changes can go beyond physical development to include emotional and mood changes—although some researchers think mood swings may relate more to changes in the teen brain than to hormonal spurts.

Other important hormones also come into play in the teen years. Melatonin is a hormone that helps your body regulate sleep cycles by making you feel sleepy after the sun goes down. Melatonin levels in adolescents don’t start to rise until about 10:30 p.m., which might explain why many teens want to stay up late despite their parents’ wishes. Research shows that for adolescents, melatonin levels remain high, even after they wake up, which is why teens may feel sleepy in the morning.

Our bodies also release something called “stress hormones,” such as cortisol.  The stress hormone cortisol governs how well someone responds to or recovers from stressful experiences. Increased stresses in adolescence can cause cortisol levels to rise, which can affect teens’ ability to function calmly and reasonably.

So, while teen bodies are a bundle of changes, the good news is that eventually your body adjusts, and the “raging” hormones calm down as you move into adulthood.

In October 2011, the coroner who conducted Amy Winehouse’s autopsy declared that the Grammy-winning singer “died by misadventure.” Translation: Amy died of accidental alcohol poisoning.

Amy famously battled an addiction to drugs and alcohol, and had returned to rehab only months before her death. She gave up drugs after receiving treatment in 2008 but had trouble staying away from alcohol—in fact, Amy had just resumed drinking a few days before her death after 3 weeks of abstinence from it. Sadly, she drank a lethal amount of alcohol—nearly five times the British drunk-driving limit.

What Is Alcohol Poisoning?

Alcohol poisoning is when a person has extremely high levels of toxic alcohol in his or her system.

According to the National Institute on Alcohol Abuse and Alcoholism, the liver converts toxic alcohol—from beer, wine, or hard liquor—to nontoxic energy at a rate of approximately one drink per hour, depending on factors like gender, size, age, medical conditions (e.g., heart disease), and whether other drugs were used in addition to alcohol.

Rapid consumption of a lot of alcohol can overload the liver’s ability to keep up, causing the blood alcohol concentration to rise rapidly. High blood alcohol concentration can lead to slurred speech and lack of muscle coordination. It also “numbs” the part of the brain that controls the heart and lungs, which can lead to coma or death.

How Many People Die From Accidental Alcohol Poisoning?

It’s actually pretty rare to die from alcohol poisoning alone—about one in a million people. What’s more common is for people to die from combining alcohol and other drugs, which can lead to dangerous medical issues, suicide or self-injury, accidental drowning, or car accidents.

Usually when we say someone is “one in a million,” it means that they’re special and talented in a way most people dream of. Amy Winehouse was certainly special and talented for writing and performing her music. Unfortunately, at age 27, Amy Winehouse was also an unlucky “one in a million.” Rest in peace, Amy.

The Government banned cigarette commercials on television in 1970 after the 1964 Surgeon General’s report found that smoking cigarettes increased your chances of getting lung cancer.  This was a big deal, considering the strong smoking culture in the United States at the time.  However, this ban didn’t stop smoking on television. Forty-years later, characters on television shows continue to smoke.

And, what if we told you that teens are one of the primary audiences for some of those shows?

Researchers from Columbia University and Legacy (formerly the American Legacy Foundation), an anti-tobacco group that produces the “Truth” anti-smoking ad campaign, teamed up to find out how often tobacco use shows up on TV shows popular with teens.  The shows included:

“Gossip Girl,” “Heroes,” “American Dad,” “Desperate Housewives,” “Family Guy,” “House,” and “The Simpsons.” They also looked at reality shows like “America’s Next Top Model” to measure depictions such as smoking, or even showing a pipe or pack of cigarettes on screen.

TV Shows Still Smokin’

Researchers watched every episode of the season. Of the 73 episodes in the analysis, 40 percent contained at least one depiction of tobacco (mainly cigarettes), double the rate from a similar study 10 years earlier. In all, there were 271 depictions, which worked out to an average of 4.4 depictions an hour.

Published in February 2011, the researchers concluded in their study:

Substantial tobacco use was observed in television shows popular among youth. It is projected that almost 1 million youth were exposed to tobacco depictions through the programming examined. Tobacco use on television should be a cause for concern, particularly because of the high volume of television viewing among younger audiences.

Other research on the connection between hours spent watching TV and young people taking up smoking, it was found that tweens and teens who watched 5 or more hours of TV each day were almost six times more likely to take up smoking than those who watched less than 2 hours.

Why Does It Matter?

Seeing other teens and young adults—celebrities, entertainers, and musicians—smoking can make it seem “cool” or popular. In fact, tobacco companies are counting on it and have invested a lot of time and money to find out the best places to reach teens. Just because the tobacco companies are banned from showing commercials on television doesn’t mean they can’t influence the content of TV shows in other, more subtle ways, or use other tools to influence smoking behavior.

Fortunately, NIDA’s latest Monitoring the Future survey of 8^th, 10^th and 12^th graders found that smoking is decreasing to historically low rates among teens, so it appears most young people are smarter than the tobacco marketers had hoped.

Which Program Had the Most Smoking-Related Depictions?

Meanwhile, can you guess which primetime program that the Columbia University and Legacy researchers studied showed the highest incidence of smoking-related depictions? Was it (a) “Gossip Girl,” (b) “Heroes,” or (c) “America’s Next Top Model”? If you picked (c), the reality-based show “America’s Top Model,” you got it right.

Kind of ironic that a show about being beautiful and glamorous shows young girls using an addictive product that eventually will make their teeth yellow, cause premature wrinkling, and possibly lead to cancer, emphysema, or heart disease—none of which is very glamorous!

What do you think about depictions of smoking on TV? To answer the question, you can either write your response in the “Leave a Reply” box below or send us a message. As always, we read all comments and consider all feedback! We look forward to hearing from you.

To learn more about the effect of product placement on teens, check out Drugs: Shatter the Myths.

How Many Teens Actually Smoke, Drink, or Do Drugs?

It’s natural to be curious about your peers—especially when it comes to things that we know can be dangerous, like alcohol and drug use. You’ve probably heard rumors of kids drinking beer at a party or may have a friend who smokes cigarettes.

You may wonder how many teens actually smoke, drink, or do drugs. It’s a question we hear frequently from teens. During NIDA’s 2011 Drug Facts Chat Day, students from the around the country asked NIDA scientists questions such as:

• “How many teens smoke every year?”
• “Has the number of people who abuse drugs increased or decreased in the past 5 years? And why?”
• “What percent of teens has tried drugs?”
• “How many kids are doing drugs?”

Nora D. Volkow, M.D., Director of NIDA, announcing the release of the 2011 Monitoring the Future survey results.

In December 2011, NIDA released the 2011 Monitoring the Future Study, and it seems that more teens are making better decisions when it comes to smoking and alcohol use, but not so much when it comes to using marijuana and abusing prescription drugs.

Here’s a glimpse at the most recent trends in teen drug and alcohol use.

Cigarette and Alcohol Use at Historic Low

Teen smoking has declined in all three grades included in the study—grades 8, 10, and 12. Still, almost 19 percent of 12th graders reported current (past-month) cigarette use.

This decline shows that more teens realize the harm smoking does to your body and are making the decision not to start. Also, teens’ attitudes about smoking have changed. They increasingly prefer to date nonsmokers and believe smoking to be a dirty habit.

Likewise, among nearly all grades, trends over the past 5 years showed significant decreases in alcohol use—including first-time use, occasional use, daily use, and binge drinking. As with smoking, this decline may be the result of more teens understanding the risk of drinking alcohol and disapproving of this behavior.

Marijuana Use Continues To Rise

Unlike cigarettes and alcohol, marijuana use is increasing. Among 12th graders, 36.4 percent reported using marijuana at least once in the past year, up from 31.5 percent 5 years ago. This accompanies a decrease in the number of 12th graders who perceive that smoking marijuana is harmful. For example, only 22.7 percent of high school seniors saw great risk in smoking marijuana occasionally, compared to 25.9 percent 5 years ago.

Of course, we know the risks: marijuana can affect memory, judgment, and perception, and it can harm a teen’s developing brain.

Prescription Drug Abuse Remains Steady

Prescription drug abuse hasn’t changed much since 2010. Abuse of the opioid painkiller Vicodin and the nonmedical use of Adderall and Ritalin, stimulants meant to treat ADHD, remained about the same as last year. Also, the abuse of the opioid painkiller OxyContin remained steady for the past 5 years across all 3 grades surveyed.

To drive this trend downward, NIDA recently launched PEERx, a prescription drug abuse awareness campaign that gives teens science-based information about the harmful effects of prescription drug abuse on the brain and body.

When teens understand the health risks of abusing drugs, they do it less. So, tell us, how would you convince your peers that marijuana use and prescription drug abuse are harmful?

These estimates come from the Monitoring the Future Study’s national surveys of approximately 47,000 students in about 400 secondary schools each year. The survey was conducted in classrooms earlier this year. View all of the 2011 data.