There are many suspected side effects to an all work and no play lifestyle. The stereotypical workaholic has tattered family relationships, a nonexistent exercise regimen and lives on fast-food meals. While this lifestyle is often portrayed in the media, researchers are exploring whether there are connections between work hours and health issues.

A new study published in the January 2012 issue of the journal Addiction explores the connection between work hours and alcohol related problems during the early years of adulthood. The study was conducted by Sheree J. Gibb, David M. Fergusson and Jon Horwood at the University of Otago in New Zealand.

To examine the association between work hours and alcohol use, the researchers conducted a longitudinal analysis of a birth cohort from Christchurch, New Zealand. The participants were all born in 1977 and were followed to the age of 30.

The sample included a total of 1,919 participants. The data included information about working hours and alcohol-related problems collected at the age of 25 or 30.

The researchers measured data relating to frequent alcohol use, the number of symptoms identified as criteria for alcohol abuse or dependence, a diagnosis of alcohol abuse or dependence and the number of weekly hours spent working in paid employment.

The team also adjusted associations identified between alcohol-related problems and work hours using measures of personality and behavior, academic achievement and IQ, mental health problems, recent life events, parental and family background, and current partner and family situations.

The researchers discovered that longer work hours showed a significant association with more frequent alcohol use. Longer work hours were also associated with higher rates of alcohol abuse and dependence and a greater number of symptoms of alcohol abuse or dependence.

The associations were adjusted with several different confounding factors. Even with accounting for these factors there was a significant connection between working hours and alcohol-related problems. Those who worked more than 50 hours a week were 1.8 to 3.3 times more likely to have an alcohol-related problem than those who did not work. The results did not differ when gender was considered.

While the study does not seek to establish a causal relationship between working hours and increased alcohol use, the results call for further study. Additional research may provide evidence that there is a connection that indicates that increasing work hours is a risk factor for the development of alcohol-related problems. Additional research may also help to identify whether certain types of employment are connected with increased alcohol use when compared with others.

Comorbidities are illnesses which co-exist. Understanding what connects two conditions for patients could prove instrumental in not only treating those conditions but in the development of new preventative measures and interventions.

Anxiety Linked to Substance Abuse

In a study published in the Archives of General Psychiatry, a Journal of the American Medical Association, researchers sought to untangle the connection between self-medication for anxiety and future instances of substance abuse. The study involved 34,653 adult Americans considered to be representative of the general population. The study was conducted over a period of three years with an initial reporting in 2001/02 and the follow-up reporting taking place in 2004/05.

Participants in the study were divided into three categories:

1. people who did not self-medicate;
2. those who self-medicated with alcohol; and
3. those who self-medicated with drugs.

A significant number (13 percent) in the first sampling said they had used alcohol or drugs as a way to handle anxiety in the past year. Even more (25 percent) said that they had taken prescription medications for the same reason.

During the first sampling to establish baselines, some participants were diagnosed with substance abuse. Of those, 23.3 percent abused alcohol and 32.7 percent were diagnosed as abusers of drugs. Among the roughly 23 percent diagnosed with alcohol abuse there was a 5.7 percent to 9.9 percent comorbidity for anxiety disorder. Incidences of anxiety disorder which presented in those diagnosed with drug use disorder ranged from 8 percent to 13.5 percent.

The study results confirmed long-held expectations that those who suffer from anxiety disorders are at increased risk for substance abuse. The study results demonstrated that those with anxiety disorders who self-medicate are two to five times likelier than those that do not self-medicate to experience substance abuse problems in three years. Those who demonstrated anxiety symptoms but who were not diagnosed with the disorder at the beginning of the study experienced were more likely to be diagnosed with a social phobia by the completion of the three years if they had been self-medicating.

Alternatives to Substance Abuse

While not everyone who enjoys a glass of beer or wine at the end of a workday or work week needs to worry that they are on the road to alcoholism, everyone can read the study as a cautionary tale. Those who struggle with anxiety should avoid settling for the short-term fix that alcohol or drugs provide. Short-term solutions do not address the underlying problem and the long-term consequences of that combination are risky.

Anxiety disorders are highly treatable. Finding a counselor is a long-term solution with a great promise of success. Those who do not struggle with anxiety issues should also consider how often substances are being used to self-medicate in difficult situations. When anxiety is present, instead of drinking or self-medicating, consider taking a long walk, a hot bath or calling a good friend for a long phone chat. Some things work better together than others.

Co-lead author Shelly B. Flagel, Ph.D., a research investigator at the U-M Medical School’s Molecular and Behavioral Neuroscience Institute, said they were able to answer the question of what role the neurotransmitter dopamine plays in the reward center of the brain.

To get some perspective, think about a rat learning to associate a lever with the appearance of food. Until now, scientists hadn’t figured out whether dopamine was released in the rats’ brains at the sight of the lever itself or when the rats accurately predicted the appearance of food. With this study, the researchers found that the answer depends on the rat’s genes. 

Flagel said to think about a sign for an ice cream store. Some people will see the sign and think of it as an indicator that ice cream is available. Other people, however, will have a stronger reaction to the sign, and they’ll hurry over to the store, unable to resist the opportunity. 

The researchers studied rats that were bred for certain personality traits, including increased risk for drug addiction. Rats that were more prone to substance abuse tended to focus their attention on the lever, whereas the other rats focused on the area where the food appeared.

The researchers used a method called fast-scan cyclic voltammetry to measure the dopamine responses in the rats’ brains, and found that the rats that were more susceptible to drug abuse experienced a reward just from seeing the lever, whereas the other rats did not. Even when the food was removed, the drug-prone rats’ desire for the lever continued.

The study also measured the rats’ ability to learn when the reward feelings (dopamine) were blocked, and repeated the experiments with rats that had not been selectively bred.

The researchers, including co-lead author Jeremy J. Clark, Ph.D., of the University of Washington, hope their study will help scientists discover my some people are much more influenced by environmental cues and are at a higher risk for compulsive behavior such as addiction.

Source: Science Daily, Unlocking the Secrets of Our Compulsions, December 8, 2010

The study, published in the Journal of the American Academy of Child and Adolescent Psychiatry and led by Dr. Patricia Conrod, looked at 2,506 adolescents with a mean age of about 14, and asked questions that assess risks for substance abuse with regards to impulsive behavior, sensitivity to anxiety, feelings of hopelessness, and sensation seeking. Of the students, 1, 159 were identified as being at high risk for substance abuse. Of these students, 624 went through an intervention, and 384 did not receive an intervention.

The interventions were two 90-minute group sessions that were held by education professionals who underwent a rigorous 3-day workshop and supervision. Although the interventions, called the Adventure Trial, are designed to analyze mental health symptoms, academic achievement, and substance abuse over a two-year period, the authors focused on six-month outcomes of binge drinking and alcohol-related problems.

Study author and trial coordinator Maeve O’Leary-Barrett said that the interventions significantly decreased the risk of drinking alcohol after six months. Those who didn’t receive the interventions were 1.7 times more likely to drink alcohol than those who received the intervention.

Those who received the interventions also reported lower binge-drinking rates among those who initially reported alcohol use. Compared with those who didn’t receive the interventions, participants were 55% less likely to binge drink after six months. Those who were at high risk for substance abuse reported less alcohol use and fewer alcohol-related problems compared to those who didn’t receive interventions.

The authors conclude that their study suggests that school-based interventions may help youth who are at risk for substance abuse. This study is the first to look at the efficiency of personality-targeted interventions delivered by teachers.

Source: Science Daily, School-Based Intervention Successfully Lowers Drinking Rates in at Risk Children, August 30, 2010

Erica Weintraub Austin, director of the Murrow Center for Media and Health Promotion at Washington State University and lead author of the study, and her colleagues found that a two-week course helped third, fourth, and fifth graders reduce their intentions to try alcohol and tobacco, and increased their belief that they could resist the substances. 

Austin said that people underestimate children’s ability to understand advertising messages, as well as the fact that marketing methods can affect their decisions later in life. If children associate smoking with popularity and maturity, they might want to try cigarettes when they’re older. Marketing specialists tend to make their messages appealing to young people, so it’s important that children understand that some of these messages may not be in their best interest.

The researchers found that people internalize or reject advertising messages through a partly logical, partly emotional process. By teaching children that advertisers want them to react emotionally, they can learn to react more logically.

North Carolina-based Innovation Research Training, Inc. conducted the study, in which elementary schools either received the Media Detective program or were part of a control group. The 344 children who received Media Detective lessons were less interested in alcohol merchandise than the 335 children in the control group. Students in the Media Detective group who had already used alcohol or tobacco said their intentions to use the substances were lower, and they believed they had a better ability to refuse the substances than children in the control group. The researchers found that the lessons were most helpful to boys.

Prior studies by Austin and researchers with The Edward R. Murrow College of Communication’s Center for Media & Health Promotion found that programs such as Media Detective can help prevent substance abuse, teach sex education, and instill an interest in voting and public affairs among teens. The new study is the first to show that these programs can be helpful for children, as well.

Source: Science Daily, ‘Media Detective’ Tool Empowers Children to Skirt Alcohol and Tobacco Marketing Messages, August 24, 2010
 

When asked about losing his driver’s license in 2007 after he was found slumped at the steering wheel, he said: "For all the doctored pictures, every single breathalyzer test I’ve taken in my life has read 0.0, and I’ve never failed a sobriety test. I always preface this with, ‘I deserved to lose my license, I needed to lose my license.’" He admits that he had taken drugs that night, but insists he was capable of driving.

“I had a problem with sleeping pills for about a year and a half, and I (messed) up really badly. I got in the car twice when I’d forgotten I’d already downed something to try to get me to sleep. It doesn’t matter that it wasn’t deliberate—ultimately, I did it a second time, and I could have killed somebody. But the fact remains I was never accused of driving under the influence. I got done for exhaustion and sleeping pills,” he said.

Michael used to tell people that the worst thing about the stories in the papers was that 90 percent of them were true. Now, he says, hardly any are, and that the media takes advantage of him because they know he can’t afford to sue.

The most worrying report was that when he was arrested for engaging in anonymous sex with a man in a public restroom (referred to as “cottaging”), he was charged with possession of crack cocaine. When asked if he ever smoked crack, he defiantly said no and then admitted that he was smoking the drug on that occasion when pressed by Hattenstone.

"I mean, I’ve done different things at different times that I shouldn’t have done, once or twice, you know,” he admitted, adding, “I’m feeling more parental by the second.”

A few months ago Michael was involved in a serious accident with a truck. "He came into my lane, and I had nowhere to go and ended up being battered between him and the central reservation, and I have to say it’s amazing that I’m alive."

The accident made him reassess things. "If that juggernaut had killed me, I think I’d be perfectly happy with the amount of quality music I have left in the world. My ego is sated."

Hattenstone told Michael that the common perception is that Michael sleeps late, gets high, and goes cruising. "The handful of times a year it’s bloody warm enough, I’ll do it,” the singer admits. “I’ll do it on a nice summer evening. Quite often there are campfires up there. It’s a much nicer place to get some quick and honest sex than standing in a bar, (high on Ecstasy), shouting at somebody and hoping they want the same thing as you do in bed.”

Returning to his typical day, he said, "I normally get up about 10 am, my PA will bring me a Starbucks, I’ll have a look at my emails. At the moment I’ve got nothing that pressurized other than keeping an eye on the video they’re making for the Christmas single. Then, if I’m in the mood, I’ll come up to the office in Highgate, do some work, writing, backing tracks or whatever. Come home. Kenny (his boyfriend) will be here, the dogs are here. Maybe eat locally, hang out, and then probably go off and have a shag or have someone come here and have a shag." Laughing, he added, “It’s not typical—that’s probably a couple times a week."

Over the past few years, a number of stars have said they fear for Michael—notably Elton John, who is one of Michael’s heroes. "Elton lives on that. He will not be happy until I bang on his door in the middle of the night saying, ‘Please, please, help me, Elton. Take me to rehab.’ It’s not going to happen,” Michael responded, adding, “Look, if people choose to believe that I’m sitting here in my ivory tower, Howard Hughes-ing myself with long fingernails and loads of drugs, then I can’t do anything about that, can I?"

Michael recently received an advance from HarperCollins for his autobiography, but he is going to give it back, as he said the timing isn’t right and that he needs to make more progress before he can write well about himself. "There are things I need to resolve. And I think I’ll be a much better writer when I’ve got through those things. But it’s great to know that at 46 I’m still very much a changing person."

When asked if he likes the way he’s changed, he responded, “Well, yeah, thank Christ. Most visible traces of self-loathing have gone…I’m surprised that I’ve survived my own dysfunction, really."

Here are some tips for parents from the Oklahoma Department of Mental Health and Substance Abuse Services for preventing substance abuse among teens:

Provide a clear message. There should be no confusing language when discussing drug or alcohol use. Make sure your child knows the dangers of substance abuse, especially since his or her brain is still developing and can be damaged by alcohol and drug use.

Report underage drinking. Adults should always report underage drinking to the proper authorities, sending a clear message to youths.

Stay connected. Youths who have an open, honest relationship with their parents are far less likely to participate in underage drinking and substance abuse than those who don’t openly communicate with their parents or caretakers.

Maintain a zero-tolerance policy. Set and enforce expectations, such as not allowing any alcohol in the home and not allowing your child to attend parties where there might be alcohol. Always know who your child’s friends are, and communicate with his or her friends’ parents, making sure they know about your zero-tolerance policy.

Be aware of things that could place your teen at higher risk. Teens who have a family history of substance abuse, are depressed, are going through a transition such as moving or experiencing parental divorce, and have friends who abuse substances are at a much higher risk of developing a chemical dependency and are more susceptible to the consequences of substance abuse, such as health problems, unprotected sex, and driving while under the influence.

It’s extremely important to talk to your children and teens about substance abuse—one conversation could save a life.

Of those who attempt suicide, about half use alcohol or illegal drugs to do so. Of those who successfully take their own lives, 25 percent were abusing drugs and/or alcohol at the time of their death. For those who suffer from addiction, it’s important to understand that suicide rates increase among those who abuse alcohol and/or drugs, putting users at a greater risk of death. ] Studies show that 50 percent of teens that commit suicide have a history of alcohol and drug use.

Fortunately, suicide is preventable, according to Brian Mishara, president of the International Association for Suicide Prevention (IASP). In areas that are targeted with prevention campaigns, suicide rates do decline.

Suicide can also be triggered by depression, which often co-occurs with substance abuse disorders. This is why it’s so important to treat any co-occurring disorders that may arise among those suffering from substance abuse disorders. If you or someone you know is abusing alcohol or drugs and is having suicidal thoughts, it is imperative to seek help immediately.

Researchers from Addictions and the Humanities sought to determine whether people exposed to the World Trade Center attack in 2001 had different addiction-related outcomes as a result of their racial, ethnic or cultural backgrounds.

One study was conducted by Wu et al. (2006) in which researchers sought to study the effect of the World Trade Center attack on increased cigarette and alcohol use. To conduct this study, researchers drew a random sample of high school students in New York City and asked them to complete a survey about their exposure to cigarettes and alcohol after the attack.

Analysis of these surveys revealed that students who were directly exposed to the attack reported increased alcohol use after the World Trade Center attack. In comparing African Americans, Asian Americans and Hispanic Americans to their non-Hispanic White counterparts, researchers determined that these minority groups were protected from increased alcohol use after the attack.

The Odds Ratio (OR) for African American students was 0.4, for Asian American students the OR was 0.5, and for Hispanic American students the OR was 0.6.

The limitations of this survey include the fact that it was not longitudinal and therefore was impossible to determine if exposure to the World Trade Center attack precipitated the change in smoking and drinking behavior. In addition, since the study only examined high school students in New York City, the results are only relevant in situations where displacement is minimal.

The findings from this analysis are in fact in contrast to the results from the Youth Risk Behavior Surveillance System, which found higher alcohol use prevalent rates among Hispanic and non-Hispanic White students compared to African-American students.

Researchers acknowledge that certain cultural values could influence an individual’s likelihood to use or not use alcohol or drugs. At the same time, certain cultures may abuse other substances that are not measured in response to disasters.

To gain a better understanding of whether or not race or ethnic background plays a role in the way people cope with disasters, further studies must be completed. These studies should use comprehensive measures of substance use, focus on cultural differences and follow students over time.
 

She explains that trauma—whether it’s in the form of a plane crash, car accident, near-death experience or major life-alteration—presents an imbalance to our emotional and mental systems, and that a person’s response to trauma can result in intense fear, horror, or helplessness.

Although one can have a substance abuse issue prior to the traumatic event, trauma often “paves the way from abuse to addiction.” Bennett explains that addiction resulting from trauma is unlike other triggers where there is more of a “conscious intent on deliberately getting ‘high’ or intoxicated.”

We all experience varying degrees of trauma in our lives, and everyone handles it differently. Some people can experience “shock-wave shivers” when re-living the incident, while others almost have an out-of-body experience when memories of the event are conjured up. Bennett writes that similar to depression, “trauma can lead to self-medication (prescription or otherwise) to numb the pain in at attempt to dilute the reality of the occurrence; which in turn can lead to dependency and/or addiction.”

Bennett writes that it is imperative to locate a trained Post-Traumatic Stress Disorder specialist while the trauma is still fresh, “before this horrific experience can burrow and establish psychological roots.”

She advises that trauma not be allowed to ferment, “or the injured party could take their recovery into their own hands with self-medication, which could lead to addiction.” If addiction becomes a reality, the person now has two issues to deal with: the unresolved traumatic event and addiction to alcohol or drugs.

“Trauma should never be taken lightly,” she writes, especially when it involves a child. Bennett explains that for a child, trauma can include anything from bathroom accidents to being picked on by classmates. Many events in a child’s formative years become “larger than life and therefore more traumatic.”

Bennett explains that many parents deny that their child has experienced any trauma or downplay the significance of some events. But parents must take appropriate action to place their child in the care of a professional to talk about their experiences in a safe environment.

Regardless of whether you are dealing with a child or an adult, Bennett warns that if these traumas are not dealt with as soon as possible, it can result in “unfinished business and could rear its ugly head later in life in the form of addictive behavior.”