Revisiting those risky drinks mixing caffeine and alcohol

Coordinated and well-publicized actions by several federal agencies last month seemed to put the kibosh on caffeinated alcoholic beverages. But nothing is simple.

For one thing, researchers write online in the American Journal of Preventive Medicine, the banned concoctions are simply pre-mixed, branded versions of what lots of college students (24 percent, in a 2006 survey) and bartenders did on their own: mixing energy drinks with alcohol.

For another, while numerous reports of blackouts and trips to the emergency room led the government to act, scientists still don't know exactly how these beverages cause more risk-taking than drinking alcohol or caffeine alone.

For example, caffeine may offset alcohol's effect of decreased alertness but not its cognitive impairment - making people more likely to act impulsively or inappropriately.

There is also the possibility, the authors write, that people drawn to these drinks are already prone to risky behavior, in which case the phenomenon would be "somewhat of a 'red herring' from a risk standpoint."

- Don Sapatkin

More youths use, and may abuse, prescription drugs

Prescriptions for sedatives, stimulants and opioid medications are on the rise among adolescents and young adults, yet many of these drugs are likely being abused.

That's the finding of a study by researchers at the University of Rochester in this month's issue of Pediatrics.

For adolescents aged 15 to 19, these so-called controlled medications were prescribed in 11.2 percent of medical visits in 2007, nearly double the rate of 6.4 percent in 1994. For young adults aged 20 to 29, such prescriptions rose from 8.3 percent to 16.1 percent over the same period.

Some of the increase in opioids was due to an increased focus on treating pain, and thus not necessarily linked to abuse, the authors wrote. But they went on to cite a recent finding by the Drug Abuse Warning Network: Emergency room visits involving nonmedical use of narcotic pain relievers more than doubled between 2004 and 2008. The authors said such medications are either abused by the patient or "diverted" to others, and called for more scrutiny.

- Tom Avril

Surveillance may be best for low-risk prostate cancer

With most men who get therapy for prostate cancer experiencing at least one adverse effect of the care, active surveillance may be a more "reasonable approach" in low-risk cases, says a recent study in the Journal of the American Medical Association.

The researchers compared the quality-of-life benefits and risks of active surveillance to the effects of initial treatment for prostate cancer. "Active surveillance" is close monitoring of selected patients with low-risk prostate cancer, with the intent to avert treatment unless the disease progresses.

Using a simulation model that treated patients at diagnosis with brachytherapy, radiation therapy, prostatectomy or active surveillance, they found that active surveillance was the most effective way to treat low-risk prostate cancer in men 65 years of age.

In this model, active surveillance led to an average 11.07 "quality-adjusted life-years," compared with 10.57 years for brachytherapy, 10.51 years for radiation therapy, and 10.23 years for prostatectomy.

The researchers said that while 16 percent to 40 percent of men diagnosed with the disease are eligible for active surveillance, less than 10 percent choose this approach because they feel treatment will be necessary anyway in the long run.

- Trishula Patel

Labeling of pediatric oral drugs is faulted

A study online in the Journal of the American Medical Association analyzed 200 top-selling pediatric oral liquid medications, and found there was a high level of inconsistency in medical labeling and measuring devices.

The researchers found that 74 percent of these products provided a standardized measuring device. Yet within these 148 products, 98.6 percent had one or more inconsistencies between the labeled directions and accompanying device.

About 24 percent of all the products lacked necessary markings, while in 89 percent of the products, the text used for units of measurement on the product label was inconsistent with the measuring device.

The study comes after the U.S. Food and Drug Administration issued guidelines in November 2009 that recommend greater consistency and clarity in over-the-counter medication dosing directions and their accompanying measuring devices, in response to reports of unintentional drug overdoses among children. - T.P.