Thursday, March 5, 1998
The University Daily Kansan
Section A · Page 9
Genes may spark nicotine habit
Addiction part of gene pattern study reports
The Associated Press
HOUSTON — Genes may be the reason why some cigarette smokers can kick the habit after years while others hopelessly are hooked after just a short time, a new study suggests.
The smoker who insists "I can't quit" may be battling a genetic predisposition to a smoking addiction, said Margaret Spitz, head of the epidemiology department at the University of Texas M.D. Anderson Cancer Center.
"Even after years of smoking, some individuals are able to quit the habit while others are unsuccessful," Spitz said. "This study sheds light on why that may occur."
The preliminary findings, published today in the Journal of the National Cancer Institute, center on an unusual genetic brain pattern that impairs the ability to perceive pleasure. That apparently makes it likely that a person will compensate for that lack by using drugs, alcohol or nicotine.
Spiitz said the findings eventually could aid in developing chemical treatments to help even the most addicted person stop smoking, but she cautioned her study was small and needed to be duplicated by other
researchers.
The key is the gene for a protein called DRD2, one of five known receptors for dopamine, which carries messages between brain cells and is crucial circuitry for producing the psychological "reward" people feel when using drugs.
Spitz and two colleagues studied 157 patients who recently had been diagnosed with lung cancer and compared them to 126 healthy individuals matched for age, sex, race and smoking status.
There were no major differences in the DRD2 gene among all the patients, but Spitz and associates found smokers were more likely to carry one variant of DRD2.
People carrying the variant gene started smoking earlier than people who did not, Spitz said, giving
weight to the common excuse of smokers that "cannot quit."
The same genetic pattern previously has been associated with an increased susceptibility to alcoholism, drug abuse, compulsive overeating and pathological gambling.
A researcher who was not involved in the study, George Uhl of the National Institute on Drug Abuse, noted that although the gene Spitz studied was not the only one that controlled susceptibility to nicotine addiction, if provided a way to target smokers with the unusual gene pattern for intervention.
"If we gave a handle on even a small fraction of that, even 10 percent to 15 percent, it would have a big public health impact," Uhl said in yesterday's Los Angeles Times.
Doctors may have skeletons in closets
The Associated Press
WASHINGTON — A doctor was convicted of sexually assaulting child patients in the 1980s, but he still can practice medicine. In Indiana, his license requires a chaperone in the examining room, but Virginia lifted all restrictions on him in 1994.
A California doctor was suspended for six months, then practiced during three years' probation after improperly treating a heart attack and misdiamaging cancer.
Illustrating how difficult it is for patients to know if their physicians have questionable or even criminal pasts, a consumer advocacy group released 16,638 names yesterday of U.S. doctors disciplined by states or federal agencies. It is the nation's only comprehensive public list.
"Most of the doctors on this list are still practicing. Most of their patients have not volde," said Public Citizen's Sidnev Wolfe.
Problems include sexually abusing patients, providing incompetent care, misprescribing medicine, abusing alcohol and drugs and technicalities such as improperly renewing licenses.
Experts agree that the majority of the nation's 600,000 doctors are competent and law-abiding. But how to choose a good physician is under increasing scrutiny.
Most hospitals have doctors who patients know are not up to standard but have not done anything egregious enough for formal sanctions, said Lucian Leape of Harvard University. "How do we identify doctors who have problems before they hurt patients?" Leape asked.
The federal government keeps a larger list of sanctioned doctors that includes malpractice payouts and hospitals' discipline of staff doctors, similar to the early detection Leape advocates.
By law, this National Practitioner Data Bank is kept secret, with only hospital administrators and licensing boards given access.
Patients can call state medical licensing boards to check physicians' licenses, but how much patients learn varies. Some states reveal only a doctor's current status, not past problems. Others post physicians' license status on the Internet. California provides step-by-step information about how to choose a doctor and ensure a specialist is board-certified — and promises to reveal felony convictions or malpractice judgments against sanctioned physicians.
"Most of the doctors on this list are still practicing. Most of their patients have no idea."
Sidney Wolfe
Public Citizen consumer advocacy
The American Medical Association has lobbied fiercely to prevent Congress from opening the National Practitioner Data Bank. It agrees that consumers need to know when a state disciplines a doctor but says broader information is unfair.
"Some of the best physicians get sued," said Thomas Reardon, chairman of the AMA's Board of Trustees.
Sen. Ron Wyden, D-Ore., said yesterday he again would attempt to legislate somewhat of a compromise — making public all records except malpractice payouts.
AMA's Reardon also questioned how much of a doctor's past the patient needed to know, citing physicians who overcome alcoholism or drug abuse.
"Yes, they've made a mistake," Reardon said. "Does that warrant them being put in Sid Wolfe's book
as a bad physician? People can be rehabilitated."
Wolfe began compiling the list of questionable doctors — he is careful to say they are not necessarily all bad — several years ago in protest of the national database secrecy. For the first time this year, he has lists from all 50 states, Medicare and, after suing to open Drug Enforcement Administration records, federal narcotics license data with 10 years of doctor records.
The report shows huge variations in how states deal with problem doctors. Mississippi in 1996 issued 10.8 serious disciplinary actions per 1,000 doctors; North Dakota, 9.2 serious sanctions per 1,000; and Kansas 8.6.
By contrast, New Hampshire's disciplinary rate is 1.7 serious actions per 1,000 doctors, and Virginia's is 2.2.
Nor do states always curb physicians disciplined by federal agencies. The DEA revoked or restricted 1,883 doctors' federal licenses to prescribe controlled substances, typically for drug abuse or misprescribing these powerful drugs. But a doctor can still prescribe other medicines without a narcotics license—and 25 percent of DEA-sanctioned physicians never faced further state discipline.
Castration doesn't make judge easy on child molester
The Associated Press
GENEVA, Ill. — An admitted child molester whose attorney called him the safest sex offender in the United States because he had himself surgically castrated was sentenced to 26 years in prison.
Jeffrey Morse, 30, who could have been sentenced to nearly 100 years for molesting two young girls, had himself castrated in hopes of getting a lighter sentence. But Judge Donald Hudson on Tuesday sentenced him to a much harsher penalty than the six years his attorney had asked for.
Hudson noted that Morse waited until the gates of the penitentiary were closing in on him before he had the procedure performed. The judge also said he wanted to keep the threat of a long sentence as a deterrent.
"I choose not to lose the threat
of a longer sentence and its deterence because the defendant wants to use his body parts as a bargaining chip." Hudson said.
Prosecutor Kathy Diamond Karayannis asked for a sentence of 25 to 60 years and called Morse's castration a ploy to evoke sympathy.
"He had control over these victims," she said. "Do not let him get control over this court, too."
Morse pleaded guilty to aggravated criminal sexual assault and three other charges for molesting the girls, ages 8 and 11.
Defense attorney Paul Wharton urged the judge to impose a lighter sentence, possibly even the minimum six-year term.
"Jeff Morse has made himself as nondangerous a pedophile as a pedophile can be," he said.
Morse spoke briefly before the sentencing. In a trembling voice, he said he was sorry but he could not undo what he had done.
Philip Morris memos link teen-age desires
The Associated Press
ST. PAUL, Minn. — Confronted by documents yesterday that showed his company comparing a teenager's desire to drive with the desire for a smoke, the head of the nation's largest cigarette company again said he was embarrassed by attempts to capture the youth market.
Geoffrey Bible, chairman and chief executive of Philip Morris, was shown a 1981 Philip Morris memo about the effect of a cigarette-tax increase on the teen-age market.
"I think it is more than coincidental that the sharpest declines in smoking prevalence among teen-age males occurred in 1979 and 1980, the years in which the price of gasoline rose most sharply," researcher
Myron Johnston wrote in the memo, "When it comes to a choice between smoking cigarettes or cruising around in his car, the average teenage male will probably choose the latter."
"I don't think we should have been commenting on matters like that," Bible said. "I'm embarrassed by it."
Minnesota is suing the tobacco industry to recover the $1.77 billion it says it has spent smoking illnesses.
Michael Ciresi, lead attorney for the plaintiffs, also asked Bible about a 1977 memo describing how the company hid its connection with a German research laboratory by routing lab samples through a dummy mailing address at a Swiss center.
It bears repeating!
LAWRENCE
AUTOMOTIVE
DIAGNOSTICS
842-8665
2858 Four Wheel Dr.
DKNY FYES
The Etc. Shop
928 Mass.
Downtown
Parking in
the rear
JOIN A WINNING TEAM
IMMEDIATE OPENINGS FOR PART-TIME PACKAGE HANDLERS IN OUR LENEXA FACILITY
$8.50 - $9.50 HOUR
Part-time/Monday-Friday
3:30a.m.-8:00a.m. (preload)
10:30a.m.-3:00p.m. (day)
Full Benefits/Paid Vacations
20-25 Hours/Week
4:30p.m.-9:00p.m. (twilight)
10:30p.m.-3:00a.m. (night) (hours approximate)
10:30p.m.-3:00a.m. (night)
No Weekends
Promotions From Within
To Schedule an Appointment Call 1-888-WORK-UPS (Toll Free)