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The Future HOPE FOR How alcohol affects epigenetics

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It’s in the Genes Researchers Probe Alcohol’s Effect on Epigenetics

As scientists gain a better understanding of the human genome, one rapidly emerging area of research is the effect of alcohol on epigenetics – external modifications to DNA that turn genes “on” or “off.” Epigenetic changes alter the physical structure of DNA. One example of an epigenetic change is DNA methylation — the addition of a methyl group, or a “chemical cap,” to part of the DNA molecule, which prevents certain genes from being expressed. A recent article in the National Institute on Alcohol Abuse and Alcoholism’s Alcohol Alert reports on a growing body of research showing how alcohol’s influence on epigenetics may be associated with an array of illnesses and disorders. These include fetal alcohol spectrum disorders (FASD), cancer, liver disease and other gastrointestinal disorders, brain development, the body’s internal clock, and immune function. Researchers and clinicians are beginning to explore therapies that might be developed to target the changes occurring through epigenetics. How alcohol affects epigenetics Alcohol consumption leads to

oxygen species (ROS), which are chemically reactive molecules that at high levels can damage cells. Fetal alcohol spectrum disorders Women who drink during pregnancy put their developing fetuses at serious risk for a range of conditions collectively known as FASD. In exploring how epigenetics contributes to FASD, researchers have also begun to investigate two complex enzymes that play a crucial role in cell differentiation during fetal development. One, called polycomb protein, remodels chromatin to turn genes off; the other, called trithorax protein, remodels chromatin to turn genes on. Research suggests that exposure to alcohol may

chemical changes within the body that can affect all the epigenetic mechanisms. For one, excessive alcohol consumption interferes with the body’s ability to process and access a chemical called folate. Folate is critical for methylation, a biochemical process that attaches a methyl group to a specific spot on DNA. DNA methylation acts to lock genes in the “off ” position. Chronic alcohol consumption leads to lower-than-normal methylation, or “hypomethylation.” Research also finds that alcohol metabolism leads to an increase in a substance called NADH, which is a byproduct of alcohol metabolism, and through production of reactive

Researchers and clinicians are beginning to explore therapies that might be developed to target the changes occurring through epigenetics due to alcohol use.

disrupt these two enzyme complexes, altering how cells differentiate during fetal development.

alcohol abuse and alcohol dependence, and may contribute to alcohol relapse and craving. Hope for the future As researchers begin to untangle the exact nature of alcohol’s interactions with epigenetics, they will be able to design better medications to treat or alleviate a wide range of alcohol-related disorders, including FASD, alcohol addiction, cancer and organ damage. In addition, researchers can now analyze DNA methylation patterns for the entire human genome. This work could yield comprehensive maps of DNA methylation changes in alcohol-associated cancers. Those maps then could potentially be used to develop pharmacological treatments that target epigenetic markers and develop new markers for cancer detection and prognosis. 

Liver disease and the gastrointestinal tract

Alcohol affects epigenetics on many levels within the GI tract and liver, where the majority of consumed alcohol is metabolized and cleared from the body. As alcohol enters the liver, it sets off what could be described as a cascade of epigenetic changes that increase the risk of liver disease, liver cancer and immunological problems. In addition, alcohol-associated epigenetic changes may play a role in what researchers call organ “cross- talk” between the GI tract, the liver and other organs. For one, epigenetic changes to genes involved in joining the cells lining the intestines may be partially responsible for “leaky gut,” which allows endotoxins to enter circulation and initiate liver damage. Alcohol-associated cancers As suggested above, alcohol-related changes involved in epigenetics can be linked to the development of liver cancer. In particular, research suggests that some epigenetic changes can transform normal liver cells back into stem cells, which then can develop into liver cancer. In addition, alcohol acts indirectly on a receptor that, when disrupted, is involved in the development of liver cancer. Alcohol’s role in changing DNA methylation patterns, leading to hypomethylation, may be one of the main routes between alcohol consumption and liver cancer as well as other types of alcohol-associated cancers. Changes in brain functioning Alcohol’s epigenetic effects within the brain are complex and intertwined. But increasing evidence suggests that they result in adaptations within the brain that ultimately influence addictive behaviors, including tolerance and alcohol dependence. As seen in other disorders, changes in DNA methylation are one of the epigenetic changes in the brain caused by chronic alcohol consumption. Although researchers still are piecing together the details, findings to date suggest that epigenetic changes in gene expression induced by alcohol consumption may underlie the brain pathology and adaptations in brain functioning associated with

As researchers begin to untangle the exact nature of alcohol’s interactions with epigenetics, they will be able to design better medications to treat or alleviate a wide range of alcohol-related disorders.

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Youth Precvention Program The goal of youth indicated prevention is to prevent or interrupt the use of alcohol, tobacco and other drugs by youth who are showing early warning signs of substance use or abuse and/or exhibiting other at-risk problem behaviors, in order to halt the progression and escalation of use, abuse, and related problems. Youth Prevention-Indicated (YPI) Program targets a subset of the general population who may already be experimenting with drugs or who exhibit other problem-related behaviors that could put them at risk for using drugs.The target youth age is 12-17.The secondary target population includes the parents and or guardians of the youth population.

This program provides the following services: • Prevention Education and Skills Training • Prevention Activities to Alcohol Other Drugs; Tobacco • Problem Identification and Referral services to the identified target population • Include activities that are tobacco-specific alternative activities • Include specific family strategies Unlimited Visions uses the “Project Towards No Drug Abuse” curriculum for this population. “Project Towards No Drug Abuse” is a drug use prevention program for middle and high school youth.The current version of the curriculum is designed to help students develop self control and communication skills, acquire resources that help them resist drug use, improve decision making strategies, and develop the motivation to not use drugs. This curriculum is a set of 12 in-class interactive sessions provide motivation-skills- decision-making material targeting the use of cigarettes, alcohol, marijuana, hard drug use, and violence related behavior. The instruction to students provides cognitive motivation enhancement activities to not use drugs, detailed information about the social and health consequences of drug use, and correction of cognitive misperceptions. The current version of the curriculum is designed to help students develop self control and communication skills, acquire resources that help them resist drug use, improve decision making strategies, and develop the motivation to not use drugs.

It addresses topics such as active listening skills, effective communication skills, stress management, coping skills, tobacco cessation techniques, and self-control, all to counteract risk factors for drug abuse relevant to older teens. In addition, participants receive indicated counseling and case management services as needed.

APPROXIMATELY 1 IN 4 CHILDREN IN THE US IS EXPOSED TO FAMILY ALCOHOL ABUSE OR ALCOHOL DEPENDENCE NOT MY CHILD ANYMORE...

HOUSTON FACILITY 5527/5528 LAWNDALE HOUSTON, TX 77023 OFFICE: (713) 921-2276 BAYTOWN FACILITY 313 HIGHWAY 146 S. BAYTOWN, TX 77520 OFFICE: (281) 427-8786 WWW.UNLIMITEDVISIONS.ORG PASADENA FACILITY 907 PRESTON PASADENA, TX 77503 OFFICE: (713) 534-8191

SOURCE: HELPING CHILDREN & ADOLESCENTS IN FAMILIES AFFECTED BY SUBSTANCE USE BY H. ADGER, EL AL.

NOT MY CHILD ANYMORE...

IT IS ESTIMATED THAT MORE THAN 4.6 MILLION PEOPLE ARE “IN DENIAL” OF THEIR DRUG ABUSE.

HOUSTON FACILITY 5527/5528 LAWNDALE HOUSTON, TX 77023 OFFICE: (713) 921-2276 BAYTOWN FACILITY 313 HIGHWAY 146 S. BAYTOWN, TX 77520 OFFICE: (281) 427-8786 WWW.UNLIMITEDVISIONS.ORG PASADENA FACILITY 907 PRESTON PASADENA, TX 77503 OFFICE: (713) 534-8191

Adolescent Residential Treatment Our intensive residential program is structured to provide 10 hours of education toward substance

Unlimited Visions Adolescent Residential Treatment provides face-to-face programming utilizing individual and group therapy with an Individual Treatment Plan and a family component.

free from the negative effects of chemical dependency. The client must develop the skills needed to live a healthy indepen- dent life as a productive member of society.The mission is to en- able these individuals to obtain and maintain a lifestyle free from The residential program is struc- tured to provide an orientation period and three levels of care.The orientation begins with a 14-day orientation and assessment period wherein the staff determines the immediate basic needs of its clients and formulates individualized treat- ment plans. Once the orientation and assessment period is complet- ed, the client is then transitioned to Level I which is structured to teach clients basic knowledge regarding the physiological and psychological damage of alcohol and drugs. Treatment Level I is founded in the principles of client-centered coun- seling, motivational enhancement therapy, the concepts and ideas that define the pre-contemplative and contemplative stages of change, the CBT principles of client-counselor collaborative partnership, relapse prevention, and that change is me- diated by cognitive processes. chemical dependency. Levels of Care

use, relapse prevention, and anger management (relapse prevention group), 10 hours of group counsel- ing with one hour devoted toward the individual plan plus 10 hours of school each week. In addition, clients participate in family sessions and recreational activities. Our supportive residential program is structured to provide 10 hours of chemical dependency services per week, with two individual sessions per month and one family session per month. ProgramDesign Unlimited Visions’ program de- sign and therapeutic interventions are based on cognitive behavioral theory and motivational enhance- ment techniques.The approach is based on the belief that cognition’s, emotions, and behaviors interact significantly and have a reciprocal cause-and-effect relationship. Unlimited Visions goals are break- ing through feelings of isolation and denial, identifying and address- ing those attitudes and behaviors which are not conducive to ongoing recovery, and replacing them with new attitudes and behaviors needed to obtain and maintain a lifestyle

The underlying premise of Level I is that the first step in change is self-awareness and that self-awareness is enhanced through self-disclo- sure. Self-disclosure is enhanced through the use of client-centered and motivational enhancement skills. Once clients successfully complete Level I, they are transitioned to Level II.

Important concepts that contribute to the development of Level II are in-depth assessment, coping and social skills training, the feedback principles of client-centered coun- seling, motivational enhancement therapy, the concepts and ideas which define the determinative and action stages of change, the cli- ent-counselor collaborative part- nership, enhanced self-awareness, and that change is mediated by cognitive processes.The client then transitions to Level III.

The average length of stay for our Intensive Residential Program is 30 days and our Supportive

(Transitional) Residential is 45 days.

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Treating addiction with vaccines is a relatively new idea with many unanswered questions

ARE VACCINES THE ANSWER

that arise out of a lack of research. But a new study suggests vaccinating against illicit drugs is not only possible, it could be extremely effective. At the Scripps Research Institute in California, researchers were looking for a way to guard against the lethal and addictive effects of synthetic opioid “designer drugs.” A potentially deadly opioid, fentanyl, is often used as a heroin substitute or mix-in by drug dealers, so researchers developed a vaccine to try to mitigate its effects. Researchers injected mice with three rounds of the vaccine and then exposed them to doses of fentanyl. They found the vaccinated mice did not display any “high” behaviors even months after the last series of vaccine injections. Researchers say the immune systems of the mice developed antibodies that successfully blocked the drug from reaching the brain. “The results were the best we’ve ever seen for any drug vaccine,” says Paul Bremer, a graduate student at Scripps Research Institute who worked on the study.

A new

HAS BEEN SHOWN TO PREVENT OVERDOSES AND STOP OPIOID “DESIGNER DRUGS” FROM AFFECTING THE BRAIN vaccine

The results were the best we’ve ever seen for any drug vaccine. - Paul Bremer, Scripps Research Institute

“ WE WERE ABLE TO BLOCK EXTREMELY LARGE - Paul Bremer DOSES OF FENTANYL TO PROTECT AGAINST OVERDOSES

SAFE AND POWERFUL Not only was the vaccine able to stop intoxication (something researchers suggest could aid in opioid addiction treatment), the vaccine also proved extremely effective in blocking the potentially lethal effects of fentanyl as well. While the chemical is not necessarily toxic in itself, it does produce psychoactive effects that can shut down breathing and stop a person’s heart. Researchers say mice injected with the vaccine could withstand doses of fentanyl up to 30 times the normal rate. “It was just a rst generation vaccine, but it did prove to be very potent,” Bremer says. “We were able to block extremely large doses of fentanyl to protect against overdoses.” A SINGLE PURPOSE Researchers say the vaccine would not protect against heroin or oxycodone, and a mixture of vaccines would be needed to protect against all opioids. But that was somewhat by design. To make sure the vaccine would not interfere with any medications a person may take responsibly later in life, researchers targeted specic molecules so the vaccine would only block fentanyl and its derivatives.

“For unrelated drugs that you would be taking, there would be no effect from the vaccine,” Bremer says. LOOKING TOWARD THE FUTURE Although still in the early stages of development, researchers say the vaccine represents an exciting step forward in drug vaccine research. The lab is beginning more advanced trials on a similar heroin vaccine which should give them a better idea of how successful the fentanyl vaccine could become. But until more testing can be completed, researchers say they were pleased with the progress and excited for the future of vaccines in the treatment of addiction. “This concept of using a vaccine for addiction isn’t just an academic pursuit, it could really be used in practice,” Bremer says. “I think it’s really promising.”

NOT MY CHILD ANYMORE... NEARLY 1 IN 10 HIGH SCHOOL SENIORS REPORTED NONMEDICAL USE OF PERSCRIPTION DRUGS SUCH AS VICODIN

HOUSTON FACILITY 5527/5528 LAWNDALE HOUSTON, TX 77023 OFFICE: (713) 921-2276 BAYTOWN FACILITY 313 HIGHWAY 146 S. BAYTOWN, TX 77520 OFFICE: (281) 427-8786 WWW.UNLIMITEDVISIONS.ORG PASADENA FACILITY 907 PRESTON PASADENA, TX 77503 OFFICE: (713) 534-8191

STOP

HOUSTON FACILITY 5527/5528 LAWNDALE HOUSTON, TX 77023 OFFICE: (713) 921-2276 PASADENA FACILITY 907 PRESTON PASADENA, TX 77503 OFFICE: (713) 534-8191 BAYTOWN FACILITY 313 HIGHWAY 146 S. BAYTOWN, TX 77520 OFFICE: (281) 427-8786

IN

TODAY

WWW.UNLIMITEDVISIONS.ORG

NOT MY CHILD ANYMORE... THERE ARE ANYWHERE BETWEEN 40-60,000 PEOPLE IN A TREATMENT CENTER A MONTH IN TEXAS ALONE.

HOUSTON FACILITY 5527/5528 LAWNDALE HOUSTON, TX 77023 OFFICE: (713) 921-2276 BAYTOWN FACILITY 313 HIGHWAY 146 S. BAYTOWN, TX 77520 OFFICE: (281) 427-8786 WWW.UNLIMITEDVISIONS.ORG PASADENA FACILITY 907 PRESTON PASADENA, TX 77503 OFFICE: (713) 534-8191

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