Diagnosis and treatment of teen drug use.

Small but significant decreases in adolescent abuse of tobacco, alcohol, and marijuana in recent national surveys allow clinicians to feel some optimism about defeating the specter of substance abuse. It appears that changing the perception of risk and increasing adolescent disapproval of substance abuse are key goals. For every adolescent, reducing risk factors while identifying and enhancing protective factors optimizes an individual's opportunity to avoid potentially harmful behaviors. While focusing energy and commitment on each adolescent, however, clinicians cannot ignore the need for wider social change because the proximal adolescent domains of individual, family, and school factors are interrelated and embedded in the community and societal contexts. Every sector in society plays a crucial role in preventing adolescents from experimenting with and continuing to abuse tobacco, alcohol, or illicit drugs, from parents, physicians, educators, and policy makers to every adult invested in the health and well-being of adolescents.

Preconditioning with cortical spreading depression decreases intraischemic cerebral glutamate levels and down-regulates excitatory amino acid transporters EAAT1 and EAAT2 from rat cerebal cortex plasma membranes.

We previously reported a 50% reduction in cortical infarct volume following transient focal cerebral ischemia in rats preconditioned 3 days earlier with cortical spreading depression (CSD). The mechanism of the protective effect of prior CSD remains unknown. Recent studies demonstrate reversal of excitatory amino acid transporters (EAATs) to be a principal cause for elevated extracellular glutamate levels during cerebral ischemia. The present study measured the effect of CSD preconditioning on (a) intraischemic glutamate levels and (b) regulation of glutamate transporters within the ischemic cortex of the rat. Three days following either CSD or sham preconditioning, rats were subjected to 200 min of focal cerebral ischemia, and extracellular glutamate concentration was measured by in vivo microdialysis. Cortical glutamate exposure decreased 70% from 1,772.4 +/- 1,469.2 microM-min in sham-treated (n = 8) to 569.0 +/- 707.8 microM-min in CSD-treated (n = 13) rats (p <0.05). The effect of CSD preconditioning on glutamate transporter levels in plasma membranes (PMs) prepared from rat cerebral cortex was assessed by western blot analysis. Down-regulation of the glial glutamate transporter isoforms EAAT2 and EAAT1 from the PM fraction was observed at 1, 3, and 7 days but not at 0 or 21 days after CSD. Semiquantitative lane analysis showed a maximal decrease of 90% for EAAT2 and 50% for EAAT1 at 3 days post-CSD. The neuronal isoform EAAT3 was unaffected by CSD. This period of down-regulation coincides with the time frame reported for induced ischemic tolerance. These data are consistent with reversal of glutamate transporter function contributing to glutamate release during ischemia and suggest that down-regulation of these transporters may contribute to ischemic tolerance induced by CSD.