According to recent studies from the Norwegian Institute of Public Health, long-term methadone treatment can cause changes in the brain. The results show that treatment may affect the nerve cells in the brain and the studies follow on from previous investigations where methadone was seen to affect cognitive functioning, such as learning and memory.
Since it is difficult to perform controlled studies of methadone patients, and unethical to attempt in healthy volunteers, rats were utilised in the studies. Previous research has shown that methadone can affect cognitive functioning in both humans and experimental animals.
Sharp Decrease in Key Signalling Molecule
Rats were administered with a daily dose of methadone for the duration of three weeks. Once treatment was completed, areas of the brain which are central for learning and memory were removed and examined for possible neurobiological changes or damage.
On the day after the last exposure to methadone in one study, there was a significant reduction (around 70 per cent) in the level of a signal molecule, which is important in learning and memory, in both the hippocampus and frontal area of the brain. This reduction supports findings from a previous study (Andersen et al., 2011), where impaired attention in rats was observed at the same time. At this time, methadone is no longer present in the brain, which indicates that methadone can lead to cellular changes that affect cognitive functioning after the drug has left the body. This may be cause for concern.
No Effect on Cell Generation
The second study, a joint project with South-western University in Texas, investigated whether methadone affects the formation of nerve cells in the hippocampus. Previous research has shown that new nerve cells are generated in the hippocampus in both adult humans and rats, and it is possible that this formation may be important for learning and memory. Furthermore, it has been shown that other opiates, such as morphine and heroin, can inhibit this formation. Therefore, it was reasonable to assume that methadone, which is also an opiate, would have the same effect.
However, the researchers did not find any change in the generation of new nerve cells after long-term methadone treatment. If the same is true in humans, this is probably more positive for methadone patients than continuing with heroin. However, the researchers do not know what effect methadone has on nerve cells that have previously been exposed to heroin.
Large Gaps in Knowledge
Since the mid-1960s, methadone has been used to treat heroin addiction. This is considered to be a successful treatment, however, despite extensive and prolonged use, little is known about possible side effects. There are large knowledge gaps in this field.
The studies show that prolonged methadone treatment can affect the nerve cells, and thus behaviour, but the results are not always as expected. Many more pre-clinical and clinical studies are required in order to understand methadone’s effect on the brain, how this can result in altered cognitive function and, if so, how long these changes last. Knowledge of this is crucial – both for the methadone patient and the outcome of treatment.
Adapted from original press release at http://www.fhi.no
Andersen JM, Klykken C, Mørland J. (2012) Long-term methadone treatment reduces phosphorylation of CaMKII in rat brain. J Pharm Pharmacol. 64(6):843-7.
Sankararaman A, Masiulis I, Richardson DR, Andersen JM, Mørland J, Eisch AJ. (2012) Methadone does not alter key parameters of adult hippocampal neurogenesis in the heroin-naïve rat. Neurosci Lett. 516(1):99-104.
A study by Barret et al, published in the Journal of Applied Toxicology, found one or more of the paraben esters studied in 99 per cent of the 160 tissue samples collected from the 40 mastectomy samples. Researchers found that all five paraben esters were present in as much as 60 per cent of the samples.
The researchers found higher concentrations of the parabens in the upper outer quadrants of the breast and axillary area, which is where antiperspirants are usually applied. Researchers did, however, comment on a significant issue;
“The source of the paraben cannot be identified, but paraben was measured in seven of 40 patients who reported never having used underarm cosmetics in their lifetime.”
There was no correlation found between paraben concentrations and age, tumour location, tumour oestrogen receptor content or length of breastfeeding. The editorial review of study noted that;
“The data from this latest study, the most extensive examination of parabens in human breast so far published, confirm previous work and raise a number of questions on the entire parabens, personal-care product and human health debate, particularly relating to the source and toxicological significance of the paraben esters.”
There does, however, need to be more research completed before antiperspirants can be deemed a carcinogen. In 2009, researchers at the United States National Cancer Institute (NCI), part of the National Institutes of Health, studied underarm antiperspirants and deodorants and claimed that they are “not aware of any conclusive evidence linking the use of underarm antiperspirants or deodorants and the subsequent development of breast cancer.” The NCI also commented, saying that “the US Food and Drug Administration, which regulates food, cosmetics, medicines and medical devices, also does not have any evidence or research data that ingredients in underarm antiperspirants or deodorants cause cancer.”
Some bodybuilding and weight loss supplements have been found to be linked to a risk of liver damage. Researchers used data from a national registry and found that herbal and dietary supplements were implicated in 18 per cent of liver injury cases from 2003 to 2011.
Bodybuilding and weight loss supplements were the biggest offenders, linked to 34 per cent and 26 per cent of 93 cases studied, respectively, says researcher Victor J. Navarro, MD, a professor of medicine, pharmacology and experimental therapeutics at Thomas Jefferson University, Philadelphia.
The study shows an insight into the potential dangers of these supplements, it is not meant to scare people into not using them, however. The risk of a person developing supplement-associated liver injury may be very small. The findings were presented at the Digestive Disease Week conference in San Diego.
“There is little regulation of the many products on the market. We couldn’t possibly begin to figure out which products to target first without doing this research.” (Navarro)
Liver damage from medication is a common reason that drugs are taken off the market. There is a lack of information about side effects and liver-related toxicities in the supplements used by approximately 40 per cent of Americans which do not require prescriptions and are not tightly regulated by the FDA. Researchers turned to the National Institutes of Health-funded Drug-induced Liver Injury Network (DILIN), a nationwide registry of people who experience liver injury within six months of using certain drugs or alternative-medicine herbal products and supplements. Different supplements were associated with different types of liver injury.
“We’re not saying they all caused liver injury. They did appear to have the potential to cause harm and people need to recognise that.” (Navarro)
Bodybuilding supplements were linked to jaundice that can last for approximately a month.
“Bodybuilding products left some men bright yellow and itching like crazy with a jaundice so severely debilitating they couldn’t work. Their quality of life deteriorated.” (Navarro)
More than half of the 29 men taking part in the study and taking these supplements had to be hospitalised.
Weight loss supplements were linked to inflammation of the liver that, in some cases, could have been fatal without a liver transplant. In the study, 12 per cent of the 17 people taking weight loss products needed a transplant.
Donald M. Jensen, MD, professor of medicine and director of the Centre for Liver Diseases at the University of Chicago Medical Centre said that it is important to inform your doctor if you are considering taking supplements, as they can offer guidance as to which may be beneficial. Jensen was not involved with the work.
“Patients need to be label readers. You can’t just assume that everything out there is safe; there are [products] out there that can be potentially damaging.” (Jensen)
CRN, the trade group that represents the supplement industry, has been working with the FDA since 2010 to address the health problems posed by the illegal addition of approved drugs or unproven drugs to these products.
Researchers from the University of Almeria in Spain have developed a system to analyse residues of drugs given to livestock found in meat-based baby foods and milk powders. Antibiotics, such as tilmicosine, and antiparasitic drugs, such as levamisole, are given to livestock to avoid illnesses, but research has shown that these can remain in food. Scientists at the University of Almeria (UAL) have confirmed this while checking a new methodology to identify the minute quantities of these substances that remain in baby foods.
“The concentrations detected have been generally very low. On one hand, this suggests they are not worrying amounts, on the other hand, it shows the need to control these products to guarantee food safety.” (Antonia Garrido, Professor of Analytical Chemistry at UAL)
The research team at UAL developed a “multi-residue” method. This method allows several drugs to be detected at a time in baby foods. To separate compounds, chromatographic techniques are used and to identify them, mass spectrometry is used.
Sulfonamides, macrolides and other antibiotic traces have been found, as well as anthelmintics and fungicides. Five veterinary drugs were detected in milk powders and ten in meat products, especially in chicken or other poultry based products.
The study is published in the Food Chemistry journal and suggests this is due to no thorough control over the administration of drugs to animals in some farms.
The European Commission has regulated the levels of pesticides and other substances in children’s cereal based foods but not in animal based foods. A lack of regulation results in a zero tolerance policy usually applied to veterinary drugs in food, as they can cause allergic reactions, resistance to antibiotics and other health problems.
Have a go at this short quiz to test your knowledge of drug and alcohol addiction (U.K.). The answers are at the bottom (no cheating!!)
True or false?
Here are the multiple choice answers: 1 (b). 2 (c). 3 (b). 4 (c). 5 (c). 6 (b). 7 (c ). 8 (c). 9 (b). 10 (b)
Here are the true or false answers: 1 – True, 2 – True, 3 – True, 4 – False, 5 – True
Researchers at the Environmental Working Group (EWG), a non-profit public health advocacy in Washington, D.C., released its “Cleaners Hall of Shame” last month– a list of popular cleaning products that may pose a hazard to health.
According to the EWG’s research team, which consists of toxicologists, chemists, public health officials and lawyers, many common household cleaners that claim to be safe or non-toxic could be harmful, especially to children who could ingest them or inhale their fumes. There are many products which contain ingredients that have been banned in other countries due to links to ailments including cancer and blindness, according to the EWG, and others have been “greenwashed” (not environmentally friendly, in contrast to their marketing claims). The EWG also said that other products do not offer enough information about their ingredients to make an informed judgement about their safety.
“Cleaning you house may come at a high price. Almost any ingredient is legal and almost none of them are labelled, leaving families at risk. Our Hall of Shame products don’t belong in the home.” (Jane Houlihan, EWG’s senior vice president for research and co-author of the Cleaners Hall of Shame report)
The Hall of Shame is a forerunning publication of the products that will be included in the EWG’s larger, more comprehensive Cleaner’s Database project, which is due to be completed in fall 2012.
“We saw the next hole in information was cleaning products, so we decided to put our research expertise into this. As we’ve been working on this database for the last few months, we realised Americans really need to be aware of some of the ingredients in these products. We feel we have to release some of this information early.” (Nneka Leiba, a senior analyst for EWG)
The research team collected packaging for thousands of cleaning products and looked carefully at all the ingredients, warnings, restrictions and technical documents pertaining to each product’s make-up. They took this data and ran it against two large sources of information on toxins and carcinogens – the International Agency for Research on Cancer (IARC) database and the Association of Occupational and Environmental Health’s List of Asthmagens. Through this, the team could show which ingredients were linked to which hazards.
“After we looked at all the information for the products, it became so obvious how little was known about our cleaning products.” (Leiba)
The Federal Hazardous Substances Act requires all household products to list any toxic ingredients on the container and to provide customers with guidelines for immediate first aid in case of an accident. The EWG claims that not all products adhere to the full-disclosure rule.
Some of the EWG’s “worst offenders”:
- Mop & Glo Multi-Surface Floor Cleaner: This cleaner contains methoxydiglycol (DEGME), which is “suspected of damaging the unborn child” (United Nations Economic Commission for Europe). Levels of DEGME are an astonishing 15 times higher than permitted in the European Union.
- Tarn-X: This tarnish remover contains up to 7 per cent thiourea, which is categorised as a carcinogen by the state of California. Thiourea is “reasonably anticipated to be a human carcinogen”. (The National Toxicology Program – an interagency federal group)
- Simple Green Concentrated All-Purpose Cleaner: This product claims to be “non-toxic” but contains 2-butoxyethanol, a solvent which if absorbed through the skin may cause eye irritation and damage red blood cells. The cleaner is sold in a ready-to-use spray bottle despite diluting instructions, even for heavy cleaning.
- Target’s Up & Up and Walmart’s Great Value brands: Both of these products offer little or no ingredient information
More Cleaners Hall of Shame offenders can be found on their website. The full database is still a work in progress and will be the first comprehensive independent safety analysis of toxic chemicals in more than 2,000 household cleaning products and brands.
In response to the Hall of Shame list and the EWG’s suggestion that these products ingredients should be better regulated, the United States Environmental Protection Agency (EPA) had this to say;
“The EPA encourages consumers to buy DfE-labeled products, which are available for a wide range of consumer cleaning and other applications. Our stringent human and environmental health criteria help ensure that DfE-labeled products are safer, perform well and contain the safest possible ingredients.”
However, not all responses to the research have been positive. The American Cleaning Institute (formerly known as the Soap and Detergent Association) called the EWG’s Hall of Shame an, “outrageous new publicity campaign designed to promote false fears about cleaning products that are used safely and efficiently every day.”
The group said in a statement;
“The Environmental Working Group’s new publicity attack on practically every cleaning product category is really an assault on common sense. The group distorts the science and research about product and ingredient safety. It ignores the fact that an enormous amount of resources are dedicated to assuring the safety of products, including many millions of dollars in research, development and testing before products ever hit the shelves. And they seem to forget the three words on product labels that prevent potential real-life problems from occurring: Use as directed.”
The Consumer Product Safety Commission (CPSC) also recommends the following to reduce potential risks to consumers;
- Follow product label instructions carefully
- Throw away partially full containers of old or unneeded products properly
- Buy cleaning supplies in limited quantities
- Report safety incidents to the government
- Educate themselves about other incidents involving household products
Guidelines and other advice about products can be found here.
“Poisoning is one of the top causes of unintended injury among children each year. About 2 million calls are made each year to poison control. We want to reduce children’s exposure to these chemicals as much as possible. Not only do we reduce their exposure through safety caps and packaging, but we encourage parents to be alert when using these products. Parents do not want to step away from cleaning and have their child exposed.” (Scott Wolfson, CSPC’s director of communications)
An editorial published in the Environmental Health Perspectives journal calls for more research to identify possible causes of autism and other neurodevelopmental disorders in America’s children. The editorial gives a list of ten toxic chemicals including those which are considered highly likely to contribute to the aforementioned conditions.
The editorial, which is entitled, “A Research Strategy to Discover the Environmental causes of Autism and Neurodevelopmental Disabilities,” was co-authored by Philip Landrigan, MD, MSc, a world-renowned leader in children’s environmental health and Director of the Children’s Environmental Health Centre (CEHC) at Mount Sinai School of Medicine, along with Luca Lambertini, PhD, MPH. MSc, Assistant Professor of Preventive Medicine at Mount Sinai and Linda Birnbaum, Director of the National Institute of Environmental Health Sciences.
Three per cent of all neurobehavioral disorders in children (such as Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are caused by toxic exposures in the environment according to the National Academy of Sciences. They also reported that another 25 per cent are caused by interactions between environmental factors and genetics even though the precise environmental causes are not yet known. Mount Sinai is leading an effort to understand the role of these toxins in a condition that now affects between 400,000 and 600,000 of the 4 million children born in the United States each year.
“A large number of the chemicals in widest use have not undergone even minimal assessment of potential toxicity and this is of great concern. Knowledge of environmental causes of neurodevelopmental disorders is critically important because they are potentially preventable.” (Dr. Landrigan)
A list of ten chemicals found in consumer products that are suspected to contribute to autism and learning disabilities. The CEHC developed this list to guide a research strategy to discover potentially preventable environmental causes. The top ten chemicals are:
- Organophosphate pesticides
- Organochlorine pesticides
- Endocrine disruptors
- Automotive exhaust
- Polycyclic aromatic hydrocarbons
- Brominated flame retardants
- Perfluorinated compounds
The California Environmental Protection Agency’s Department of Toxic Substances Control released a report earlier this month which found the chemicals toluene, formaldehyde and dibutyl phthalate (DBP) in most of the twenty-five nail products that the agency tested at random. Many of the products tested by the Department of Toxic Substances Control (DTSC) claimed to be free of at least one, if not all three, of the chemicals on their labels, and several also contained chemicals “whose purpose, property, human toxicity and environmental fate are unknown to DTSC.”
Formaldehyde is a known carcinogen and DBP and toluene are known developmental toxins. Toluene should not be inhaled due to its health effects. Low to moderate levels can cause weakness, tiredness, confusion, memory loss, nausea, loss of appetite and hearing and colour vision loss. Inhaling high levels in a short period of time may cause light-headedness, sleepiness, unconsciousness and even death. Alternate names of the chemical include methylbenzene and phenylmethane. Toluene is metabolised into benzoic acid in the body and is cardiotoxic (intoxication associated with arrhythmias). Biological samples which can be taken from the body for testing by a forensic toxicologist or clinical toxicologist can include the following;
- Cardiac muscle
- Adipose tissue
The therapeutic/non-toxic, toxic and lethal levels which can be detected within these samples by toxicologists are outlined in the table below;
(Adapted from Molina 2010:299)
Although these toxins can be extremely dangerous, the US FDA and the Cosmetic Ingredient Review Panel (CIR – founded by the Personal Care Products Council) have both advised the toxic levels in nail products are within safe levels.
The Professional Beauty Association’s – Nail Manufacturer’s Council (PBA-NMC) agreed that the mislabelling of the products should not be allowed. They did, however, criticise the report saying that the DTSC did not reach out to industry experts and manufacturers;
“NMC condemns any manufacturer misleading customers about the ingredients in their products. The public should, however, be aware that nearly the entire nail polish industry voluntarily took steps years ago to remove toluene and DBP from their products.” (Myra Irizarry, PBA’s Director of Government Affairs.)
San Francisco is already working to address the health concerns surrounding nail salons. The city launched its “Healthy Nail Salons Recognition” program in late 2010.
Doug Schoon, a scientist at the Nail Manufacturers Council had this to say; “The most relevant health-related concerns in nail salons are not ingredients, but ventilation, sanitation, education and work practices.”