MAUREEN CAVANAUGH: This is KPBS Midday Edition. I'm Maureen Cavanaugh. Teenagers experimenting with alcohol is not approved of. It's not even legal but it does happen a lot. Most adults can't remember their first trekking experiences and although not a proud member is usually accepted as part of growing up. But there are those kids in each generation who develop a problem with alcohol. Sometimes a lifelong problem. A new study attempts to find the reason why some teenagers are more susceptible to alcohol abuse. And universities like San Diego State are trying to help students assess how drinking is affecting the lives. I'd like to welcome my guests Dr. Susan Tapert is professor of psychiatry at UC San Diego and Prof. Tapert, welcome to the show. SUSAN TAPERT: Hi. MAUREEN CAVANAUGH: And Dr. Jennifer Rikard is here she's coordinator of the aspire program at UCSD. She was part of the team that help the alcoholic he check up to go, alcohol each epoch to go it's an online tool and Dr. Rikard welcome to the show JENNIFER RIKARD: Thank you, Maureen. MAUREEN CAVANAUGH: Now Prof. Susan Tapert, how big a problem with alcohol abuse among teenagers? SUSAN TAPERT: Well that one in start and for teenagers and reports of the truck to the point of intoxication in the past month so it is a pretty common problem in high school and even more prevalent in college. MAUREEN CAVANAUGH: The difference between kids experiment occasionally with drinking and those whogo on to frequent drinking binges is often explained by teenagers about paying out with or their own life, but your research has actually uncover differences in the brain. Tell us about that. SUSAN TAPERT: There are several specific brain features that we are kind of able to detect now that appear to be linked to an increased chance of subsequent drinking. So, for example this recent study we looked at 12 to 14-year-olds that had been drinking yet and those who showed kind of a reduced level of activation during a memory task were much more likely to engage in heavy levels of drinking in the next three years. MAUREEN CAVANAUGH: That is fascinating so let me break this down. You started studying teen brains in the early teen years before they started drinking is that right SUSAN TAPERT: That's right MAUREEN CAVANAUGH: So what does this difference in activity in these areas of the brain indicate? SUSAN TAPERT: Well they are brain areas that are developing quite a bit during adolescence and the task that we are having them do well we are conducting magnetic red resonance imaging of the brain is one that is usually going to activate kind of the front part of your brain and some areas kind of in the back garden as well for you to be able to do a good job on the task. The kids did okay on the task, but their brain was suggestive of not fully engaging the task like kind of not trying their hardest. This is very similar to another study we conducted a few years ago and to some studies that we've done with adults who are in treatment for alcohol and drug programs those who show less activation during a cognitive test are much more likely to relapse after they left treatment. MAUREEN CAVANAUGH: So what do we know why these lower activation patterns are linked with binge drinking? Is there any kind of a hypothesis that you have about why this particular thing might lead to someone abusing alcohol? SUSAN TAPERT: Yeah, we have a couple of hypotheses kind of putting it together with some other studies that we have. One is kind of a general sense of kind of not trying as hard and in difficult situations, but situations where kind of nobody is watching. It didn't really matter how well they did on the task while they are in the MRI scanner having to remember things and those who were not trying super hard see more likely to get into trouble later with alcohol and other drugs so it could be kind of an issue of how hard you try on things when no one is watching. We've also seen that kids who have poor developed white matter, that is kind of the wiring deep inside of our brain, which is also important for being able to activate brain areas that kids at the poor quality white matter also more likely to develop substance problems later. So it could be reflective of a little bit immature neural maturation. MAUREEN CAVANAUGH: So you have two different hypotheses there one that seems to have a biological origin and the other that seems to have to do with the way the early teens are actually using their brains is that right? SUSAN TAPERT: That's exactly right and of course what we are thinking about the brain it is all kind of intertwined. MAUREEN CAVANAUGH: I see okay so how much of a correlation have you found between this lower activation pattern and a subsequent drinking behavior? SUSAN TAPERT: It is certainly statistically significant it's fairly substantial but it is not a perfect correlation. So there were kids who have high activation patterns who started to drink and some of the activation patterns who didn't start to drink sodas not a 141 correspondence. But if we put it together with other bits of information it seems to put together a bit of a picture of a certain kind of brain tendency that seems a little bit more predisposed to developing heavy levels of substance use string teenagers. MAUREEN CAVANAUGH: Is it defined to even say percentage? SUSAN TAPERT: Probably about 8%, something on that order of magnitude. MAUREEN CAVANAUGH: 80? SUSAN TAPERT: 8%. So it is not definitive. But what we are doing now is we are just starting a new research study this month they will go on for five years at UCSD we are going to be able to look at a larger number of kids using several different brain imaging techniques to see if we are able to predict with a greater degree of certainty the kids who are more likely to need programming and interventions to help make sure they don't get into problems with alcohol and drugs early in life. MAUREEN CAVANAUGH: I want to invite our listeners to join the conversation if you've questions about teenage drinking if you had a problem with drinking when you were younger or perhaps you know a young person who is struggling with alcohol or substance abuse give us a call and tell us your story. It is 1-888-895-5727. That is 188895K PBS. Let me go to Dr. Jennifer Rikard. Now, schools like SDSU are now using an online tool to help students assess their own alcohol consumption. And Dr. Jennifer Rikard was part of the team that developed the assessment tool. Jen, tell us about alcohol E check up to go. JENNIFER RIKARD: Yes we were able to develop this at the counseling center and it is an online tool in which students can put in there personalized information and get immediate feedback about their own use. And these are on a lot of different data points such as how much money they are spending on alcohol or caloric information. We actually calculate the amount of drinks into cheeseburgers. And create a graphic for that so that they can see how much calories they are consuming. MAUREEN CAVANAUGH: Is that because for students going to university at the amount that they are drinking unless they actually sit down and think about it and get away from them, they are not really cognizant of how much alcohol they are consuming? JENNIFER RIKARD: I think they see it as normative many times. So you are right, they would see it as something that would be of concern or out of the ordinary. If they see their use as normative. So one of the things we are able to do it until is correct that misperception on this idea that if people he has that everybody drinks college and actually tell them where they stand related to their peers. MAUREEN CAVANAUGH: That's interesting are other schools also using the tool? JENNIFER RIKARD: About 600 colleges and universities in the world a few other countries and the US. MAUREEN CAVANAUGH: What are, Dr. Rikard some of the common pitfalls that students face with their drinking patterns? JENNIFER RIKARD: While there can be a lot of consequences with substance use and abuse such as lower academic standing, lower GPA, there could be blacking out and certain incidents that happened when students having blackouts and are forgetting things. And you know the worst-case scenario is they could, there could be a death. MAUREEN CAVANAUGH: Right, let me take a call. Lisa is calling from Rancho Bernardo. Lisa welcome to the program. CALLER: Hi, thank you, thanks for taking my call. MAUREEN CAVANAUGH: You are welcome. Yes anytime with your question. CALLER: Sorry. I was wondering I was what I would consider to be pretty ADHD I was never diagnosed I also started drinking pretty early in life as a way to kind of stimulate my brain and help with my social activities so I thought but now that I have a 14-year-old daughter who I feel is also very much ADHD we are getting her tested in a few weeks, but she, we were talking earlier about taking those tests with the MRI scans and not doing so well or not paying attention or when no one was looking I know that I have that problem today and I did back then and my daughter does now and I'm wondering if ADHD factors into all of this? MAUREEN CAVANAUGH: Great question thank you, Lisa. Dr. Tapert? SUSAN TAPERT: Sure that is at hat test question Lisa there is a bit of a link between ADHD and risk for substance abuse problems later but it's strongest if you are not just having attention problems, but also don't really care about getting in trouble you know like you get sent to the principal's office, get in fights and things like that. That combination is a very high risk for alcohol and other drug use problems. The good news is if you get the appropriate kinds of treatments for ADHD that could really diminish the risk associated with substance use problems later so it's gray you are getting your daughter testing. There are some effective treatments available MAUREEN CAVANAUGH: One of our other listeners called up and asked a similar question about bipolar disorder. Is that also indicator for early alcohol abuse? SUSAN TAPERT: In some cases I think with bipolar disorder the profile can be very different for different folks. But sometimes when people are in a kind of manic stage of bipolar disorder they can be very likely to engage in a wide range of unsafe behaviors including substance use. So again, getting treatment from an improperly trained mental health professional is certainly recommended. MAUREEN CAVANAUGH: Now Dr. Rikard, when a student takes alcoholE check up to go does the school get those results? Are they able to link with the student is putting in with the actual student? JENNIFER RIKARD: One of the things that's very important is that it is confidential and anonymous so the student doesn't have to worry about the information getting back to the school officials. If they elect to, they can send their verification for the schools because now all new students have to take this, so they would need verification. MAUREEN CAVANAUGH: What is the protocol for intervention if someone, SDSU if the student is exhibiting signs of alcohol and substance abuse. Is it all on a voluntary basis, or are there times when the school steps in? JENNIFER RIKARD: A lot of times it is a voluntary basis but the aspire program there we see a lot of students are mandated for alcohol policy violations on-campus and this would be to the center students rights and responsibilities hundreds of students per year would be referred through this program. MAUREEN CAVANAUGH: So what are some of the criteria to be mandated to the program JENNIFER RIKARD: Any policy violation of alcohol, possession of alcohol in a residence hall room, anything like that or if they need transport to the hospital for alcohol intoxication they would also be referred. MAUREEN CAVANAUGH: I would say that would also be an indicator, yes. Professor Tapert, usually research does study brains before kids start drinking I think of all the research that looks into what drinking does to the brains of young adults what do we know about the effects of alcohol on growing brains? SUSAN TAPERT: These kind of long-term studies are so important because we had many studies comparing drinkers to nondrinkers and there are differences but we don't know why so now we have studies where we looked at kids before they started drinking and we can kind of make comparisons to what was happening before. So now we can see if you started to drink heavily it looks like there could be some attenuation said the development of the white matter, the wiring deep inside the brain and also the gray matter which is kind of where all of your synaptic activity is occurring both of these processes appear to be affected adversely by repeated high-dose drinking. MAUREEN CAVANAUGH: I see, and do you envision, as you say you are just embarking on another long-term study when it comes to trying to find the linkage between brain activity and the kids who go on to have problems with heavy drinking, do you envision someday there being some sort of a test that can set a rather early age can take to know whether or not they have this risk starting to drink? SUSAN TAPERT: That is something that this larger study will seek to do to see kind of with what probability we can predict who will go on to have problems versus those who will not. Then we can tailor some of the kinds of programming early on for the kids who would be in greatest need. MAUREEN CAVANAUGH: Okay I have to wrap it up there but I want to thank you both very much. I've been speaking with Dr. Susan Tapert, professor of psychiatry at UC San Diego and Dr. Jennifer Rikard, co-coordinator of the aspire program at SDSU. Thank you both very much. BOTH: Thank you. MAUREEN CAVANAUGH: you can listen for a feature report on this brain research and into binge drinking by KPBS health reporter Kenny Goldberg. It airs tomorrow morning during morning edition right here on KPBS.
Heavy drinking isn’t confined to alcoholics. A recent survey found nearly 20 percent of students in San Diego high schools have had at least five drinks at any one time.
A new study from UC San Diego suggests there could be a biological origin to binge drinking. The research is based on a series of brain scans.
Researchers at UC San Diego have been scanning the brains of a group of young people for more than 10 years.
Tim Little, 24, has been involved since the beginning. Little says a friend told him about it.
"He came upon a flyer at the corner by Del Taco in Claremont, and said, 'hey listen, they’re doing brain scans, brain imaging, and you know, they’ll pay us a couple of hundred bucks,'" Little recalled. "'Do you want to check it out?' And when we were kids, 13 or something. So I was like, 'yeah, hop down in it,' and became part of the study that way."
Once a year since he was 13, Little has gotten his brain scanned at the Keck building on the UC San Diego campus.
Inside, the MRI scanner sits behind locked doors. It looks like the kind you’d find in a hospital. But this one allows more detailed, refined images.
While their brains are being scanned, study participants are asked to solve puzzles, complete simple tasks and answer questions.
This study focused on 40 young people. Their brains were first scanned when they were 12 to 14 years old, prior to the onset of drinking. Researchers scanned them again three years later.
Susan Tapert, a professor of psychiatry at UC San Diego and the study's principal investigator, said she found some surprising results when she looked back at the original scans.
"There’s actually some differences in the brains of the kids who later went on to drink or use substances, as compared to those who didn’t," Tapert said. "The kids who later were going to start drinking showed less brain activation in some frontal and parietal areas as they were doing the tasks. They did okay on the tasks, but this maybe showed that they weren’t as fully engaged in the tasks as the kids who were gonna get through adolescence without starting to drink heavily."
Tapert explained that as kids go through adolescence, their brains generally become more efficient. In other words, their brains don’t require as much neural energy to accomplish a given cognitive task. But she says for the kids who later started to drink heavily, their brains worked harder to accomplish the same task.
"Well, there is something that we need to take note of, about these activation patterns prior to the onset of substance use, that might be linked to some kind of feature related to maybe self-control, propensity for intoxication, kind of other kind of risk-taking propensities," Tapert explained.
UC San Diego’s Marc Schuckit has been studying alcoholism for more than 30 years. The psychiatrist’s research focuses on how genetics and environmental factors influence heavy drinking and other substance abuse.
Schuckit said Tapert’s study suggests there may be patterns in adolescent brains that indicate the likelihood of future alcohol abuse. But he pointed out that doesn’t mean doctors could tell someone they’re going to be an alcoholic by the time they’re 25.
"But I can do, I think, and what people in our field can look forward to, is I can say to you, 'you are carrying an increased risk for diabetes or for alcoholism, and regarding that risk, it appears that it operates through this particular characteristic,'" Schuckit explained. "Perhaps impulsivity related to some of the risk, perhaps a low sensitivity to alcohol for others. And then I can say, 'considering the fact that you carry a risk related to that particular factor, I think I can work with you if you’re willing to, to help you try to diminish your risk.'"
Researchers haven’t told Tim Little whether his early brain scans showed any unusual patterns.
But he says he did drink when he was in high school. Heavily at times.
These days, Little says he’ll have a beer every now and then.
And if it turns out Little has a biological propensity for alcoholism?
"Shoot, you know, I’d have to make a whole lifestyle change," Little said. "If that was the case, I’d have to give it up, you know, I’d have to focus on being healthy. Try to, you know, try to make the best of what cards I got dealt. You know, if that’s the case, obviously, changes have to be made."
A much larger study is underway to determine how reliably certain brain patterns predict future substance abuse.
