The effect of tolerance: how drinking can have really killed Amy Winehouse

Amy Winehouse died of alcohol poisoning, according to the British coroner released Wednesday. The singer had a blood alcohol level five times the legal limit for driving at the time of his "death by misadventure", said the report. But the ultimate cause of his death have ignorance: Amy Winehouse was probably not aware of the change potentially deaths of tolerance of alcohol following a period of sobriety.

Obviously, soulful singer had been sober for about a month, before recurring in the days preceding his death. Police recovered three empty vodka bottles in the apartment in London where his body was found. Amy Winehouse had been prescribed a sedative to reduce withdrawal symptoms, but no other drugs were found in his body when she died, and the coroner found that drugs do contribute to his death.

In view of the well-known story of Amy Winehouse to excess, it is probably safe to assume that in the past that she had consumed the same amount of alcohol that killed, probably without experiencing many more pass and wake up with a hangover. Then why was it different this time?

It was perhaps because of recent abstinence from Amy Winehouse. Amy Winehouse had built almost certainly tolerance to alcohol while she was drinking, he loses then in a few weeks of sobriety. Tolerance develops in part because the brain is a very conservative body. When drugs grow some brain systems in one direction, other systems try to balance the effect by pulling back the opposite way.

This means that the same dose of a drug will be, over time, producing a smaller effect. And this increasingly unsatisfactory experience invites to take more and more addicts. Finally, users need to extreme doses to get the same high.

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This is precisely why doctors cannot always determine if any given dose of a "lethal" drug, and coroners may not be able to establish whether it was the cause of death. Heroin addicts often take doses that would kill 10 people re-engineering, and they can do without even feeling high or impaired. (Indeed, methadone treatment is based on the fact that a regular, scheduled product substance dose this predictable tolerance that it does not affect cognitive functioning or skills such as driving.)

However, important periods of abstinence, can eliminate or significantly reduce the tolerance. If you need 10 drink to get drunk before leaving alcohol, then you can slug their bottom before go you account how much stronger the effects are now. It is possible that in the case of Amy Winehouse, such an error was fatal.

Research shows that a higher overdose risk periods is in the early days of relapse, immediately after a period of abstinence. This is true if the substance is alcohol, opioids such as heroin or - as is often the case — a mixture of several drugs. This aspect of the gap of tolerance is an important cause of death by overdose.

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Obviously, it is more secure avoid becoming a drug addict or alcoholic in the first place - and if you become addicted, it is certainly preferable to avoid relapse. But the relapse is not to be fatal. Awareness of the problem of tolerance can at least give people a chance to reduce the risk of overdose, so that they can hopefully return to recovery. If you relapse, be aware that the dose that you have taken the day before leave you can now be fatal.

R.I.P., Amy Winehouse.

Maia Szalavitz, is a writer of health at TIME.com. Find him on Twitter at @ maiasz. You can also continue the discussion on the time Facebook page Healthland and on Twitter at @ TIMEHealthland.

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Teen dating may spread teen drinking

AppId is over the quota
AppId is over the quota
Parents should talk with their children about peer pressure and alcohol abuse even before they begin dating.Study says teens will be influenced more by new partner's friends' habitsFamily and friends can "spread" obesity, drinking, smoking, and even happinessResults emphasize need to learn more about people your teen hangs out with

(Health.com) -- Parents who are concerned about drinking and other risky behavior often try to steer their teenage children away from friends and dating partners whom they consider "bad influences."

Those parents may want to look one step further: A new study suggests that teenagers with a new boyfriend or girlfriend tend to be more influenced by the drinking habits of their romantic partner's friends than they are by the partners themselves.

Why? Dating introduces adolescents to new and different social networks and also creates a kind of indirect peer pressure, says lead researcher Derek Kreager, Ph.D., an associate professor of crime, law, and justice at Pennsylvania State University, in University Park.

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A teen's longtime friends tend to be like-minded when it comes to values and lifestyle, but romantic partners are more likely to come from a different circle.

"Think of your son or daughter's new significant other as a bridge to a whole other group that he or she is now going to be exposed to," Kreager says.

When teenagers begin dating, they tend to meet in the middle when it comes to habits like drinking. If a teen girl who has yet to experiment with alcohol starts dating a boy who drinks often, for instance, the boy is likely to cut back while the girl is likely to give drinking a try.

"He has an incentive to change, to be more like her," Kreager explains. "On the other hand, his friends don't really have any reason to change, so they continue drinking. Meanwhile, she has incentive to be like those friends, because that's what appeals to her partner."

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It's no surprise that social networks have a strong influence on personal health. Several studies from a research team based at Harvard University and the University of California, San Diego. have documented how family and friends can "spread" obesity, drinking, smoking, and even happiness.

These social patterns may be even more important among teenagers, says Angela Diaz, M.D., program and research director of the adolescent health center at the Mount Sinai Medical Center, in New York.

"It's during adolescence that kids start exploring adult behavior and adult roles, and looking for acceptance and respect," she says. "And throughout high school, a child's peer groups will change dramatically based on the new behaviors they pick up and the new people they encounter."

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In the study, which was published in the American Sociological Review, Kreager and his colleagues analyzed questionnaires from 898 students that were collected as part of a larger national survey on adolescent health.

When the students were in seventh through twelfth grade, researchers interviewed the kids about drinking and binge drinking (among other health-related behaviors), and also asked them to name several of their close friends at school, many of whom were also study participants.

In a follow-up interview two years later, the same students answered similar questions and were also asked to name special romantic partners from the past 18 months. By identifying pairs of students who became a couple and comparing their survey responses, the researchers were able to see how the teens' social networks and drinking habits changed over time.

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They found that younger teenagers tend to socialize with friends of the same gender, and that being involved in romantic relationships often introduces them to mixed-gender peer groups. And while friends and significant others both influenced the future drinking habits of the study participants, it was the second-degree friends of partners that had the strongest influence on drinking frequency and binge drinking.

The findings may not be news to parents, Kreager says. But they do emphasize the need to learn more about the group of people their children's romantic partners -- and therefore their children -- may be spending time with.

Parents should talk with their children about peer pressure and alcohol abuse even before they begin dating, says Diaz, so that as teenagers they can recognize potential hazards in new social situations. They should also make an effort to get to know a new romantic partner in their teen's life, as well as that partner's friends.

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"Invite them to your home, just as you would with your own son's or daughter's friends" she says. "Create an environment where they are comfortable and where you can learn their values."

It's also important to remember that dating is not necessarily a bad thing, Kreager says. Adolescents can also be swayed in a positive direction by peer groups who drink less than they do -- especially boys, who, according to the study, were more likely to binge drink, and who may be more susceptible to a significant other's influences.

Copyright Health Magazine 2010

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HEALTH MANAGEMENT. Pattern of drinking linked to alcohol's effect on heart health

For the first time, new research shows that patterns of alcohol consumption - a drink or two every night, or several cocktails on Friday and Saturday nights only - may be more important in determining alcohol's influence on heart health than the total amount consumed.
In the journal Atherosclerosis, scientists found that daily moderate drinking - the equivalent of two drinks per day, seven days a week - decreased atherosclerosis in mice, while binge drinking - the equivalent of seven drinks a day, two days a week - increased development of the disease. Atherosclerosis, or the hardening and narrowing of arteries, is a serious condition that can lead to a heart attack or stroke.
While population studies support an association between alcohol and cardiovascular disease, they've relied on self-reported data, which is not always accurate or reliable. According to study authors, this is the first study to provide concrete evidence linking drinking patterns to the development of vascular disease, and the nearly 15 percent of Americans who binge drink - as estimated by the Centers for Disease Control and Prevention - should take note.
"People need to consider not only how much alcohol they drink, but the way in which they are drinking it," said lead study author John Cullen, Ph.D., research associate professor in the Department of Surgery at the University of Rochester Medical Center. "Research shows that people have yet to be convinced of the dangers of binge drinking to their health; we're hoping our work changes that."
Scientists don't yet understand how moderate alcohol consumption benefits cardiovascular health or how heavy drinking episodes hurt it.
The National Institute on Alcohol Abuse and Alcoholism defines binge or "at-risk" drinking as consuming more than four drinks on any day for men, and more than three drinks on any day for women. Understanding how much alcohol is in a "standard" drink is also critical, something the institute is promoting through its new "Rethinking Drinking" campaign.
Health care professionals also need to be aware that drinking style matters and should address the issue when discussing alcohol consumption with patients, especially those who are at higher risk of atherosclerosis or who have suffered a heart attack in the past, added Cullen.
"This evidence is very interesting because it supports a pattern of drinking that is emerging in clinical studies as both safe and seemingly most protective against heart disease - frequent consumption of limited amounts of alcohol. This certainly backs up widespread clinical guidelines that limit drinking to one drink daily for non-pregnant women and two drinks daily for men," said Kenneth Mukamal, M.D., M.P.H., Associate Professor of Medicine at Harvard Medical School who studies the role of dietary and lifestyle factors, particularly alcohol consumption, on the incidence of cardiovascular and neurovascular disease.
In the study, mice in the "daily-moderate" group were fed ethanol equivalent to two drinks every day of the week, mice in the "weekend-binge" group were fed approximately seven drinks on two days of the week and mice in the control group were fed a non-alcoholic cornstarch mix. All mice were put on an atherogenic diet, which Cullen equates to a high-fat Western diet - think fried food every day - to encourage the development of atherosclerosis, which forms when fatty deposits or plaque collect on the inner walls of the arteries, causing them to narrow.
Levels of LDL or "bad" cholesterol plummeted 40 percent in the daily-moderate drinking mice, but rose 20 percent in the weekend-binge drinking mice, compared to the no-alcohol controls. High levels of bad cholesterol increase the risk of heart disease, and past studies show that every 10 percent increase in LDL results in a 20 percent increase in atherosclerosis risk.
Surprisingly, levels of HDL or "good" cholesterol went up in both the moderate and binge drinking groups, which Cullen speculates is an acute or short-term effect.
The volume of plaque, as well as the accumulation of immune cells that promote inflammation and consequently contribute to the narrowing of arteries, decreased in the moderate mice compared to no-alcohol mice. The opposite occured in the binge-drinking mice: Plaque volume and the number of inflammatory immune cells grew.
Another unexpected yet noteworthy finding was that the binge drinking mice gained significantly more weight than the moderate and control mice. Though all mice started at approximately the same weight and consumed similar amounts of food over the course of the study, the binge mice gained more than three times as much weight as the moderate mice and about twice as much weight as the control mice.
Building on this study, Cullen is investigating genes that are turned on or off following moderate and binge drinking episodes to determine if they influence outcomes.
The research was supported in part by the Founders Affiliate of the American Heart Association, which supports research exploring new ideas to combat cardiovascular disease. Founders Affiliate research committee chair Lucy Liaw, Ph.D. said these first-time findings could have far-reaching public health implications. "The discoveries of Dr. Cullen's group show that binge drinkers may have increased risk of developing atherosclerosis and experiencing weight gain. Because obesity is also a risk factor for disease, binge drinking may have a strong negative impact on cardiovascular health," said Liaw, who is also a member of the AHA national research committee.
The study was also funded by the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health. In addition to Cullen, Weimin Liu, M.D., Ph.D., Eileen Redmond, Ph.D. and David Morrow, Ph.D. from the Medical Center contributed to the research.
Article adapted by Medical News Today from original press release.

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