Acute alcohol intoxication impairs top–down regulation of stroop incongruity as revealed by blood oxygen level-dependent functional magnetic resonance

Functional neuroanatomy of executive functions has been delineated in a large number of neuroimaging studies using conflict-inducing tasks. The neural basis of alcohol's effects on cognitive control is poorly understood despite the evidence of impaired ability to evaluate competing demands and to inhibit maladaptive responses.

To investigate the effects of moderate intoxication, healthy social drinkers participated in both alcohol (0.60 g/kg ethanol for men, 0.55 g/kg for women) and placebo conditions while being scanned using blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI).

A modified four-color Stroop task combined reading and color naming and used manual responses. Twenty subjects (10 women) were instructed to press a button corresponding to the font color except when a word was written in gray in which case they had to respond to the meaning of the word.

Alcohol increased reaction times and a tendency to make more errors on incongruent trials. Behavioral indices of alcohol-induced premature responding correlated with the current drinking levels and impulsivity traits, suggesting an interaction between alcohol effects and personality predispositions.

A distributed frontoparietal cortical network was activated by incongruity. However, moderate alcohol inebriation selectively attenuated anterior cingulate cortex (ACC) activation during both high-conflict trials and erroneous responses, indicating vulnerability of the regulative function subserved by the ACC.

By disrupting top–down, strategic processing, alcohol may interfere with goal-directed behavior, resulting in poor self control.

The present results support models proposing that alcohol-induced prefrontal impairments diminish inhibitory control and are modulated by dispositional risk factors and levels of alcohol consumption.


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Request Reprint E-Mail: xenia@ucsd.edu

Early-Onset Alcohol Dependence Increases the Acoustic Startle Reflex

Hyperreactivity and impaired sensory gating of the acoustic startle response in alcohol dependence has been suggested to reflect a residual effect of previous detoxifications, increasing the severity of subsequent withdrawal episodes. Previous studies on the acoustic startle only included early-onset alcohol-dependent patients. The observed abnormalities may therefore also be specific for this subtype of alcohol dependence. We investigated the acoustic startle response in alcohol-dependent patients and healthy controls and hypothesized that (i) early-onset alcohol-dependent patients show increased acoustic startle responses compared with late-onset alcohol-dependent patients and healthy controls, and (ii) the duration of alcohol dependence or the number of prior detoxifications would not explain the differences in the acoustic startle between early- and late-onset alcohol dependence.

The acoustic startle reflex was assessed in detoxified, male alcohol-dependent patients (N = 83) and age-matched healthy male controls (N = 86). Reflex eye blink responses to an auditory startle stimulus were measured by means of electromyographic recordings over the right orbicularis oculi muscle. Reflex amplitudes and levels of prepulse inhibition (PPI) were analyzed.

There was no association between number of previous withdrawals and the startle response or PPI. Early-onset alcohol-dependent patients showed higher acoustic startle amplitudes compared with late-onset alcohol-dependent patients and healthy controls [75/105 dB:F(2, 166) = 9.2, p < 0.001; 85/105 dB:F(2, 166) = 12.1, p < 0.001; 95 dB:F(2, 166) = 8.2, p < 0.001; 105 dB:F(2, 166) = 9.7, p < 0.001], and there were no differences in PPI.

Increased acoustic startle response in detoxified early-onset alcohol-dependent patients may reflect a trait marker specifically involved in early-onset alcohol dependence. The findings of the current study do not support the hypothesis that the increased startle response is a residual state marker.

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Request Reprint E-Mail: a.f.a.schellekens@psy.umcn.nl

Anti-obesity effect of a standardised ethanol extract from Curcuma longa L. fermented with Aspergillus oryzae in ob/ob mice and primary mouse adipocyt

We examined the anti-obesity effect of fermented Curcuma longa L. (turmeric) standardised ethanol extract (FTE) in the C57BL/6J ob/ob mouse model. Mice were fed a chow diet containing FTE (0, 200, or 500 mg kg⁻¹ body weight) for 9 weeks.

Supplementation with FTE significantly reduced body weight gain and retroperitoneal and epididymal adipose tissue weights compared to the ob/ob control group. Additionally, total cholesterol and triglyceride levels in serum and liver were significantly decreased in FTE-200 and FTE-500 groups when compared to those of the ob/ob control group, whereas the high-density lipoprotein-cholesterol level was significantly increased. The levels of serum adiponectin as well as mRNA expression of lipases, such as hormone sensitive lipase and adipose triglyceride lipase, were clearly increased. In primary adipocytes of C57BL/6J mice, FTE treatment caused a significant increase glycerol release and hormone sensitive lipase levels and decreased perilipin A levels.

These results suggest that supplementation of FTE has potent anti-obesity effects by controlling body weight, fat mass, serum lipids, and hepatic lipids. Moreover, FTE could be considered a potential resource for the treatment of obesity through its promotion of lipolysis via the protein kinase A pathway.

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Request Reprint E-Mail: jlee2007@khu.ac.kr

Podcast - Binge Drinking – Nationwide Problem, Local Solutions

This podcast is based on the January 2012 CDC Vital Signs report. One in six adults binge drinks about four times a month. It's a problem nationwide but community-based strategies, such as reducing access to alcohol and increasing the price, can prevent binge drinking. Created: 1/3/2012 by Centers for Disease Control and Prevention (CDC). Date Released: 1/3/2012. Series Name: CDC Vital Minute.

Listen to CDC Podcast

Making the Grade on College Drinking Prevention

In December 2011, the National Institute on Drug Abuse’s Monitoring the Future survey posted some fantastic news: Underage drinking by 8th, 10th, and 12th graders has reached historical lows. Among 12th graders, for example, past-month alcohol use dropped to 63.5 percent in 2010, down from a high of 74.8 percent in 1997. While this decrease is heartening, it also signals a need to step up our prevention game on college campuses. Underage college students drink often and excessively. How can we help maintain our progress in reducing underage drinking as today’s high school students enter college? How can we help current college students who drink make healthier choices?

Please join the Substance Abuse and Mental Health Services Administration (SAMHSA) on February 6, 2012, from 1:45 to 3:00 p.m. (EST), as it hosts Making the Grade on College Drinking Prevention, a live Webcast of a national 2012 Town Hall Meeting on underage drinking prevention. Dr. William DeJong, Boston University School of Public Health, will moderate a panel that will include Dr. Ralph W. Hingson, director of the National Institute on Alcohol Abuse and Alcoholism’s Division of Epidemiology and Prevention Research, and representatives from campus communities. The panel will discuss both challenges and successes in preventing alcohol use by college students, with a focus on proven environmental prevention approaches, and answer questions from a live audience and from people posting via the Web. For more details and login information, visit http://www.stopalcoholabuse.gov/townhallmeetings/resources/trainings/webcasts/making-the-grade/default.aspx. Follow us on Twitter @SAMHSAgov, #THM2012, for meeting highlights before, during, and after the event. > > > > Read More

Alcohol News - 4/2012

MyHealthNewsDaily (Denmark) - 1-2 Drinks a Week Can Raise Miscarriage Risk

Drinking even a small amount of alcohol could increase the risk of miscarriage during the first four months of pregnancy, a new study from Denmark suggests.

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The Local.se (Sweden) - Average Swede likes sweets, booze, and TV

The average Swede is 40+, munches on a weekly bag of sweets, washed down with a glass or three of alcohol, while relaxing in front of the TV, according to the 2012 Statistical Yearbook of Sweden from Statistics Sweden (Statistiska Centralbyrån -SCB).

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TIME - Alcohol in Pregnancy: It’s Never Safe, Especially Not in the First Trimester

A new study finds that the developmental hazards of maternal drinking may be greatest at the end of the first trimester.

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The Age (Australia) - Alcohol incidents skyrocket on Australia Day

HEAVY drinking is the Australian way for many, and more young people are involved in harmful alcohol-related incidents, such as assaults and car accidents, on Australia Day than on any other public holiday, research has found.

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BBC News (Brazil) - Beer 'must be sold' at Brazil World Cup, says Fifa

Beer must be sold at all venues hosting matches in the 2014 World Cup in Brazil, football's world governing body, Fifa, has insisted.

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The Columbian (USA) - Binge drinking can lead to variety of serious consequences

More than 18 percent of Washington residents, and nearly 16 percent of people nationally, binge drink, according to new estimates by the Centers for Disease Control and Prevention. The CDC defines binge drinking as a man drinking five or more alcoholic drinks within a short period of time or a woman drinking four or more alcoholic drinks within a short period of time.

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Irish Examiner (UK) - Almost one in 10 adults in North 'has drink problem'

Nearly one in 10 people surveyed about drinking in the North was found to have a problem with alcohol. The research compiled on behalf of the British Department of Health was based on interviews with more than 2,000 people and revealed trends in alcohol use.

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LiveScience.com - Parental Alcoholism Linked to Brain Changes in Kids

Adolescent brains respond to risky situations differently if the teen's parents are alcoholics, new research finds.

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msnbc.com - 'Sumerian beer' alcohol-free? A controversy is brewing

The fermented cereal beverage enjoyed by Sumerians, so-called Sumerian beer, may have been alcohol-free, suggests a recent review of ancient Sumerian practices.

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Globes (Israel) - New law bans alcohol advertising

The Knesset plenum is due to pass a private member's bill by MK Danny Danon (Likud) which bans alcohol advertising on billboards and buses in its second and third readings today. The bill also restricts alcohol advertisements to media that only targets adults.

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RIA Novosti (Russia) - Beer may return to Russian stadiums: Putin

Russian Prime Minister Vladimir Putin has promised to consider lifting the current ban on sale and advertisement of beer at football stadiums in Russia, which will host the World Cup championship in 2018.

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The Canberra Times (Australia) - Raise alcohol price to 'reduce harm'

A minimum price for alcohol is needed to prevent the industry from selling liquor “below price'', according to a report prepared for the NSW Bureau of Crime Statistics and Research.

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Edinburgh Evening News (Scotland) - Stores accused over alcohol sales

MSPs have accused supermarkets of "undermining the spirit" of alcohol discounting laws by slashing their prices and encouraging online purchasing.

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Irish Times (Ireland) - Supervised teenage alcohol use at home is not a good idea

HOW DO you effectively teach your children about alcohol? Minister of State with responsibility for Primary Care Róisín Shortall has said she felt parents should not be giving their children alcohol at home in an attempt to teach “responsible drinking”, and are sometimes permitting binge drinking at home to try to prevent it going on in unsupervised circumstances elsewhere.

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Olive Press (Spain) - Spain rejects breathalysers for cars

SPAIN has rejected breathalysers for cars on the basis that “the only safe way to drive is with zero alcohol in your system”.

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Small rise in alcohol-related deaths in 2010

A slight rise in alcohol-related deaths has been reported for 2010, according to the ONS (bulletin here). Figures show a rise of 126 to 8,790 from 8,664 in 2009. Last year a slight fall was reported, though Alcohol Concern Chief Executive Don Shenker attributed the drop to a fall in consumption triggered by the recession. See BBC and Press Association reports.

Key points from the bulletin include:

• In 2010 there were 8,790 alcohol-related deaths in the UK, 126 more than in 2009 (8,664)
• There are more alcohol-related deaths in males than in females, with 67 per cent of all alcohol-related deaths in the UK in 2010 being male
• Alcohol-related death rates were highest for those aged 55-74 and lowest for those aged under 35 over the last ten years
• UK males aged 55-74 years showed a sharp and statistically signficant increase in alcohol-related death rate from 41.8 per 100,000 in 2009 to 45.2 per 100,000 in 2010
• Alcohol-related death rates varied between the regions of England and tended to be highest in the North and lowest in the East of England over the last ten years

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Medical Treatment of Alcohol Dependence: A Systematic Review

To summarize published data on pharmacologic treatments for alcohol dependence alone and in combination with brief psychosocial therapies that may be feasible for primary care and specialty medical settings.

We conducted electronic searches of published original research articles and reviews in MEDLINE, SCOPUS, CINAHL, Embase, and PsychINFO. In addition, hand searches of reference lists of review articles, supplemental searches of internet references and contacts with experts in the field were conducted. Randomized controlled studies published between January 1960 and August 2010 that met our inclusion/exclusion criteria were included.

A total of 85 studies, representing 18,937 subjects, met our criteria for inclusion. The evidence base for oral naltrexone (6% more days abstinent than placebo in the largest study) and topiramate (prescribed off-label) (e.g., 26.2% more days abstinent than placebo in a recent study) is positive but modest. Acamprosate shows modest efficacy with recently abstinent patients, with European studies showing better results than U.S. ones. The evidence-base for disulfiram is equivocal. Depot naltrexone shows efficacy (25% greater reduction in rate of heavy drinking vs. placebo, in one of the largest studies) in a limited number of studies. Some studies suggest that patients do better with extensive psychosocial treatments added to medications while others show that brief support can be equally effective.

Although treatment effects are modest, medications for alcohol dependence, in conjunction with either brief support or more extensive psychosocial therapy, can be effective in primary and specialty care medical settings.


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Request Reprint E-Mail: millerpm@musc.edu

Why should I comply? Sellers' accounts for (non-)compliance with legal age limits for alcohol sales.

Availability is an important predictor of early and excessive alcohol consumption by adolescents. Many countries have implemented age limits to prevent underage purchases of alcohol. However, shop-floor compliance with these age limits appears to be problematic. This study addresses the issue of non-compliance with age limits. Which measures do vendors take to avoid underage alcohol sales, and what do they report as important reasons to comply or not with age limits for alcohol sales?

Open-ended telephone interviews were conducted with store managers selling alcohol (N=106). Prior to the interviews, all outlets were visited by an underage mystery shopper in order to measure compliance with the legal age limits on alcohol sales. The interview results are compared against actual compliance rates.

Several measures have been taken to prevent underage sales, but the compliance level is low. Furthermore, open coding resulted in 19 themes, representing both valid and invalid arguments, that vendors mentioned as relevant to their decisions of whether to comply with the law. Compliance with age limits is dependent on the knowledge of the rules and the ability and motivation to follow the rules. The ability aspect in particular seems to be problematic, but in many cases, the motivation to actively comply with the age limits is lacking.

To enhance compliance, it is important to raise the awareness of the importance of age limits and to connect possible violations of the regulations to negative consequences.

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Wine and Health: A Review

As indicated by epidemiological studies, regular and moderate wine consumption, particularly red wine, has been associated with health benefits. Clinical studies and work performed with animal models indicate that wine may protect against cardiovascular disease, atherosclerosis, hypertension, certain types of cancer, type 2 diabetes, neurological disorders, and metabolic syndrome.

The mechanism of action has been attributed to antioxidant, lipid regulating, and anti-inflammatory effects. A variety of wine constituents have been studied in various disease models. Both the alcoholic and polyphenolic components of wine are believed to contribute to these beneficial effects.

As wine is a complex mixture, it is likely that a multitude of chemical constituents, as well as their metabolites, work synergistically to impact human health. In sum, although wine drinking may be contraindicated in certain individuals, in healthy people, regular consumption of moderate amounts of wine may protect against certain chronic health conditions


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APHA 140th Annual Meeting and Exposition San Francisco, CA • October 27-31, 2012

2012 Annual Meeting Call for Abstracts Now Open

The American Public Health Association is announcing the Call for Abstracts for the 2012 Annual Meeting to be held October 27-31 in San Francisco, CA. The theme is Prevention and Wellness Across the Lifespan.

We encourage abstracts in all areas of public health and are also interested in abstracts that focus on the Annual Meeting theme. All abstracts must be submitted online. An easy to use online form will walk you through the process step-by-step. The deadlines for submission of abstracts range from Feburary 6-10, 2012 depending on the Section, SPIG, Caucus or Forum to which you wish to submit your abstract. All submissions will end at 11:59 pm Pacific Standard Time on the due date listed on the Call for Abstracts. No late submissions will be accepted.

You do not need to be an APHA member to submit an abstract. However, if your abstract is accepted for presentation, the presenting author MUST become an APHA Individual member and MUST register for the Annual Meeting by the September advance registration deadline. Submission of an abstract implies a commitment to make the presentation at the annual meeting, therefore please make sure you understand what is required of you before submitting.

START YOUR ABSTRACT SUBMISSION

A prospective study of mortality up to eight years after starting treatment for alcohol and drug problems in Stockholm County: 2000–2008 Read More:

Research indicates an association between substance use and premature death and that misuse of illicit drugs is more closely linked to mortality than alcohol misuse. Given that these studies often are based on homogeneous treatment populations, we sought to analyse long-term mortality among both alcohol and drug misusers in a representative treatment system sample by examining: (1) excess death ratios (SMR, standardised mortality ratio) in comparison with the general population and (2) risk factors for mortality within the sample.

Prospective study (N = 1659; 28% women) interviewed when starting treatment in Stockholm County, 2000–2002, and followed-up with regard to mortality up to 8 years after baseline. Analyses were based on death certificates and intake interview data (demographics, social situation/support, ICD-10 alcohol/drug dependence, treatment experiences). The strength of the study is the prospective design, that we have been able to link mortality to interview data, and to reach a heterogeneous treatment population.

(1) SMR was 5.7 (no sex difference). (2) Logistic regression showed that being older, male, retired and having reported living with a substance misuser were identified as risk factors for mortality within the sample. Housing organised by authorities and no dependence on alcohol/drugs were protective factors. The mortality risk did not differ between alcohol and drug-dependent cases. Neither was homelessness, living situation (3 years) nor education predictive of mortality.

No difference regarding mortality risk between treated alcohol and drug-dependent patients in Sweden is found when controlling for age.

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Request Reprint E-Mail: jessica.storbjork@sorad.su.se

FASD News - 3/2012

Medical News Today - No Safe Level Of Alcohol During Pregnancy

The authors of a study published online on Tuesday that was designed to overcome the difficulties of obtaining accurate and reliable data in Fetal Alcohol Syndrome research, say their findings reinforce the warning that there is no safe level of alcohol consumption during pregnancy.

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Edmonton Journal (Canada) - Justice system struggles to deal with fetal alcohol disorder

Since the Alberta government launched its 10-year plan on FASD five years ago — a strategy with heavy emphasis on screening and education — more offenders are coming to court already diagnosed with FASD, and the justice system is struggling to find the most effective ways to deal with them.

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Daily Mail - Mothers warned drinking during seventh to 12th week of pregnancy puts unborn babies at highest risk of foetal alcohol syndrome

Drinking regularly during pregnancy is known to increase the odds of having children with foetal alcohol syndrome. However, scientists have now found that the risk to a woman's baby is highest if they consume alcohol in the seventh to 12th week.

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AngolaPress (Angola) - Sociologist warns about alcohol consumption during pregnancy

The sociologist Maria Fernanda Nguenda, on Tuesday here criticised pregnant women that consume alcoholic drinks, putting at risk their own health and their babies, ANGOP has learnt.

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MyHealthNewsDaily (Denmark) - 1-2 Drinks a Week Can Raise Miscarriage Risk

Drinking even a small amount of alcohol could increase the risk of miscarriage during the first four months of pregnancy, a new study from Denmark suggests.

Read more

MedicalXpress (USA) - SDSU researchers develop an assessment tool to identify birth defects

Researchers with the National Children’s Study at South Dakota State University, in collaboration with Dr. H. Eugene Hoyme, chief academic officer at Sanford Health and president and senior scientist for Sanford Research/University of South Dakota, are working to develop a standardized assessment tool that would be used to identify birth defects in infants.

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MATERIALS and BLOGS

Empowering Front-Line Staff and Families Through a Collection of Lived Experiences

NAT member Anne Guarasci and colleagues at the College of New Caledonia have developed a resource for front-line workers who work with women who have FASD or FASD behaviours and characteristics.

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POPFASD - 2 New eLearning Videos featuring Kim Barthel

There are two new eLearning videos available on the POPFASD website. In the first video, Kim Barthel speaks about the "Brain and FASD" and in the second video, she discusses the "Theory of Attachment". The videos are excerpts from the 2009 POPFASD District Partner Meeting in Richmond, B.C.

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Daysofwanderandgrace - O’Malley on ADHD in FASD

Chapter 4 of Kieran O’Malley’s ADHD and Fetal Alcohol Spectrum Disorders is the most comprehensive research-based discussion I’ve found about the unique challenges ADHD poses in FASD. It was published in 2007, so there is more recent research than O’Malley reviews here.

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Urban Servant - FASD: Not Diagnosed and Identified to The Legal System......

Yesterday at the Legal Aspects of FASD seminar Hon. Anthony P. Wartnick quoted these two sources... There is a fundamental principle of juvenile and adult criminal law which is this. "The treatment of criminal offenders as rational, autonomous and choosing agents is a fundamental organizing principle of our criminal law."

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RESEARCH

Alcoholism - Prenatal Alcohol Exposure Patterns and Alcohol-Related Birth Defects and Growth Deficiencies: A Prospective Study

The physical features of fetal alcohol syndrome include smooth philtrum, thin vermillion border, short palpebral fissures, microcephaly, and growth deficiencies on weight and height. However, little is known about the specific quantities of alcohol exposure, pattern of drinking, timing of exposure, and magnitude of risk for each of these features.

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Alcohol and Alcoholism - Placental Hypoxia and Foetal Development Versus Alcohol Exposure in Pregnancy

To examine the causes of variability in the effect of maternal drinking on the foetus, with particular reference to the pattern, frequency and duration of the period of drinking, differences in maternal, foetal and placental metabolism of ethanol/acetaldehyde, and genetic factors.

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International Journal of Epidemiology - Moderate alcohol intake during pregnancy and risk of fetal death

Even low amounts of alcohol consumption during early pregnancy increased the risk of spontaneous abortion substantially. The results indicate that the fetus is particularly susceptible to alcohol exposure early in pregnancy.

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The American Journal of Occupational Therapy - Neurocognitive Habilitation Therapy for Children With Fetal Alcohol Spectrum Disorders: An Adaptation of the Alert Program

The authors carried out a neurocognitive habilitation group therapy with the goal of increasing self-regulation in kids with FASD. The therapy consisted of a 12 week program using techniques adapted from the Alert Program, in which children learn to identify their state of regulation by recognizing when they are over-aroused (their engine is running “too high”), under-aroused (their engine is running “too low”), or at an optimal state of alertness (their engine is running “just right”).

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IN OTHER LANGUAGES

AGI - Agenzia Giornalistica Italia (Italy) - Alcol: dopo 7 settimane di gravidanza a rischio feto

Bere regolarmente durante la gravidanza aumenta le probabilita' di avere figli con sindrome feto-alcolica. Tuttavia, un gruppo di scienziati statunitensi ha ora dimostrato che il rischio per il bambino aumenta se la mamma consuma alcool dalla settima alla dodicesima settimana.

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Healthylives (Netherlands) - Ook een beetje alcohol slecht tijdens de zwangerschap

Dat het drinken van alcohol tijdens de zwangerschap ernstige gevolgen kan hebben voor je ongeboren baby is bekend. Toch denken sommige zwangere vrouwen dat het drinken van af en toe een glaasje alcohol geen kwaad kan.

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A Retrospective Analysis of the Nature, Extent and Cost of Alcohol-Related Emergency Calls to the Ambulance Service in an English Region

To measure the prevalence, pattern and associated financial cost of alcohol-related ambulance call outs in the North East of England using routinely collected data from the North East Ambulance Service (NEAS).

A retrospective cohort study over a 1-year time period (1 April 2009 to 31 March 2010) using NEAS patient record forms.

In the North East, 10% of ambulance call outs were alcohol-related. Males were 2.5 times more likely than females to be attended by an ambulance on the street rather than at home. People aged 10–19 had the highest relative risk ratio (3.4) of an ambulance pick up being on the street compare with those aged over 60. These call outs and subsequent accident and emergency (A&E) attendances cost over £9 million in a 1-year period. When extrapolated to the whole country the cost could be as much as £152 million per year.

In a 1-year period, we estimated that over 31,000 ambulance call outs were alcohol-related. A large discrepancy was found between manual and electronic recording of alcohol-related ambulance attendances to A&E. The workload and cost of alcohol-related call outs is high and mostly preventable. Ambulance visits may present a teachable moment for brief intervention to reduce alcohol-related risk and harm.

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Mapping the Maintenance Stage of Recovery: A Qualitative Study among Treated and Non-treated Former Alcohol Dependents in Poland

The study provides an in-depth qualitative understanding of the maintenance stage when recovering from alcohol dependence with a focus on the broader social context of change of addictive behaviour. It explores the recovery as a subjective process within the abstinence-oriented Polish treatment system organized on the basis of the Minnesota model and is probes for group differences between treated and non-treated populations.

The study is based on qualitative data from a media-recruited sample of 29 treated and non-treated former alcohol dependents (ICD-10) in Warsaw/Poland 2006/2007. They reported a recovery time of at least 2 years (M_recovery = 11, SD = 9). In-depth, semi-structured interviews were analysed according to the problem-centred interview method using ATLAS.ti software.

A wide range of maintenance strategies potentially contributing to the stabilization of recovery from alcohol dependence was identified. However, from the respondents' point of view, the change process is contingent upon the subjective weighing of specific maintenance factors and the importance attributed to their interplay. This includes time management as well as one's ability to invest available resources and strengths in shaping and pursuing personal goals.

More commonalities than differences can be observed between groups during the maintenance stage, regardless of respondents' type of the pathway out of addiction. However, when confronting professional concepts of recovery with subjective accounts, only a subgroup conforms to the invasive, potentially normative definitions of recovery, while others do not link their recovery with identity transformation.



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Request Reprint E-Mail: zulewska@ipin.edu.pl

Interactive Influences of Neighborhood and Individual Socioeconomic Status on Alcohol Consumption and Problems

To assess cross-level interactions between neighborhood and individual socioeconomic status (SES) on alcohol consumption and problems, and investigate three possible explanations for such interactions, including the double jeopardy, status inconsistency and relative deprivation hypotheses.

Data from the 2000 and 2005 US National Alcohol Surveys were linked to the 2000 US Census to define respondent census tracts as disadvantaged, middle-class and advantaged. Risk drinking (consumption exceeding national guidelines), monthly drunkenness and alcohol problems were examined among low-, middle- and high-SES past-year drinkers (n = 8728). Gender-stratified, multiple logistic regression models were employed, and for outcomes with a significant omnibus F-test, linear contrasts were used to interpret interactions.

Cross-level SES interactions observed for men indicated that residence in advantaged neighborhoods was associated with markedly elevated odds of risk drinking and drunkenness for low-SES men. Linear contrasts further revealed a nearly 5-fold increased risk for alcohol problems among these men, relative to middle-SES and high-SES men also living in advantaged neighborhoods. Among women, neighborhood disadvantage was related to increased risk for alcohol problems, but there were no significant SES interactions. These findings did not support theories of double jeopardy and status inconsistency.

Consistent with the relative deprivation hypothesis, findings highlight alcohol-related health risks among low-SES men living in affluent neighborhoods. Future research should assess whether this pattern extends to other health risk behaviors, investigate causal mechanisms and consider how gender may influence these.


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Request Reprint E-Mail: nmulia@arg.org

The relationship between naloxone-induced cortisol and delta opioid receptor availability in mesolimbic structures is disrupted in alcohol-dependent s

Hypothalamic-pituitary-adrenal (HPA) axis responses following naloxone administration have been assumed to provide a measure of opioid receptor activity. Employing positron emission tomography (PET) using the mu opioid receptor (MOR) selective ligand [¹¹C] carfentanil (CFN), we demonstrated that cortisol responses to naloxone administration were negatively correlated with MOR availability.

In this study, we examined whether naloxone-induced cortisol and adrenocorticotropin (ACTH) responses in 15 healthy control and 20 recently detoxified alcohol-dependent subjects correlated with delta opioid receptor (DOR) availability in 15 brain regions using the DOR-selective ligand [¹¹C] methyl-naltrindole (MeNTL) and PET imaging.

The day after the scan, cortisol responses to cumulative doses of naloxone were determined.

Peak cortisol and ACTH levels and area under the cortisol and ACTH curve did not differ by group. There were negative relationships between cortisol area under curve to naloxone and [¹¹C] MeNTL-binding potential (BP_ND) in the ventral striatum, anterior cingulate, fusiform cortices, temporal cortex, putamen and a trend in the hypothalamus of healthy control subjects.

However, in alcohol-dependent subjects, cortisol responses did not correlate with [¹¹C]MeNTL BP_ND in any brain region. Plasma ACTH levels did not correlate with [¹¹C]MeNTL BP_ND in either group.

The study demonstrates that naloxone provides information about individual differences in DOR availability in several mesolimbic structures.

The data also show that the HPA axis is intimately connected with mesolimbic stress pathways through opioidergic neurotransmission in healthy subjects but this relationship is disrupted during early abstinence in alcohol-dependent subjects.

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Request Reprint E-Mail:

gwand@jhmi.edu

Widespread and sustained cognitive deficits in alcoholism: a meta-analysis

The cognitive repercussions of alcohol dependence are well documented. However, the literature remains somewhat ambiguous with respect to which distinct cognitive functions are more susceptible to impairment in alcoholism and to how duration of abstinence affects cognitive recovery.

Some theories claim alcohol negatively affects specific cognitive functions, while others assert that deficits are more diffuse in nature.

This is the first meta-analysis to examine cognition in alcohol abuse/dependence and the duration of abstinence necessary to achieve cognitive recovery. A literature search yielded 62 studies that assessed cognitive dysfunction among alcoholics. Effect size estimates were calculated using the Comprehensive Meta-Analysis V2, for the following 12 cognitive domains: intelligence quotient, verbal fluency/language, speed of processing, working memory, attention, problem solving/executive functions, inhibition/impulsivity, verbal learning, verbal memory, visual learning, visual memory and visuospatial abilities.

Within these 12 domains, three effect size estimates were calculated based on abstinence duration. The three groups were partitioned into short- (<1 month), intermediate- (2 to 12 months) and long- (>1 year) term abstinence.

Findings revealed moderate impairment across 11 cognitive domains during short-term abstinence, with moderate impairment across 10 domains during intermediate term abstinence. Small effect size estimates were found for long-term abstinence.

These results suggest significant impairment across multiple cognitive functions remains stable during the first year of abstinence from alcohol. Generally, dysfunction abates by 1 year of sobriety.

These findings support the diffuse brain hypothesis and suggest that cognitive dysfunction may linger for up to an average of 1 year post-detoxification from alcohol.

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Request Reprint E-Mail: stephane.potvin@umontreal.ca

Alcohol administration attenuates hypothalamic–pituitary–adrenal (HPA) activity in healthy men at low genetic risk for alcoholism, but not in high-ris

Acute alcohol challenge studies in rodents and naturalistic observations in drinking alcoholics suggest that alcohol stimulates the hypothalamic–pituitary–adrenal (HPA) system.

The literature on respective studies in healthy volunteers is more inconsistent, suggesting differential alcohol effects depending on dosage, recent drinking history, family history of alcoholism and alcohol-induced side effects.

These papers and the putative pharmacologic mechanisms underlying alcohol effects on the HPA system are reviewed here and compared with a new study, in which we investigated how secretion of adrenocorticotrophin (ACTH) and cortisol is affected by ingestion of 0.6 g/kg ethanol in 33 young healthy socially drinking males with a paternal history of alcoholism (PHP) versus 30 family history negative (FHN) males.

Alcohol and placebo were administered in a 2-day, double-blind, placebo controlled crossover design with randomized administration sequence

After administration of placebo, ACTH and cortisol decreased steadily over 130 minutes. In FHN subjects, secretion of both hormones was even more attenuated after alcohol, resulting in significantly lower levels compared with placebo. In PHP subjects, no alcohol effect on hormone secretion could be detected. The ratio of cortisol to ACTH secretion, each expressed as area under the secretion curve, was significantly increased by alcohol in FHN and PHP participants.

These results argue against HPA stimulation being a mechanism that promotes the transition from moderate to dependent drinking. The fact that alcohol-induced HPA suppression was not detected in PHP males is consistent with the general concept that subjects at high risk for alcoholism exhibit less-pronounced alcohol effects.

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ulrich.zimmermann@uniklinikum-dresden.de

Conference - "Can Brief Interventions change Scotland's relationship with alcohol? Developing the model for community settings."

Tuesday 27th March 2012, Murrayfield Stadium, Edinburgh

A one day conference organised by Edinburgh Cyrenians, in association with Create Consultancy, Comic Relief, INEBRIA and Alcohol Research UK.

Since the Scottish government published Changing Scotland's Relationship with Alcohol in 2008, Scotland has been setting an example worldwide in terms of political commitment and funding for the delivery of alcohol screening and brief interventions in primary care. As strategic, multi-agency Alcohol and Drug Partnerships become responsible for continued investment in this approach, interest in whether the model can be successfully replicated across community settings is growing.

The conference will feature international speakers from INEBRIA as well as local academics and practitioners. It will discuss the evidence base for brief interventions in non-healthcare settings and debate whether more evidence is required before introducing the model to diverse settings and client groups. It will ask: should the traditional model of ABI be adapted for community settings? What are the challenges of implementation with vulnerable groups and young people? And how can projects measure the impact of alcohol brief interventions and contribute to the evidence base? > > > > Read More

News Release - Adult Drinking Patterns Survey in Northern Ireland 2011

The survey, conducted on behalf of the Department of Health, Social Services and Public Safety, examines the amount people drink, when, where and what they drink and who they drink with.

It also examines how drinking behaviours vary across different sections of the public, the proportion of people who binge drink, problem drinking, and perceptions of drinking.

Key Findings

Alcohol Consumption:]

• More than seven out of ten (74%) adults drink alcohol.
• A larger proportion of males (78%) than females (72%) drink alcohol.
• Younger adults (18-29 years) are more likely to drink than older adults (60-75 years).

Frequency of Drinking:

• Around half (52%) of drinkers reported drinking alcohol at least once a week or more frequently (6% of respondents reported drinking on an almost daily basis).
• A greater proportion of male respondents (8%) compared to females (5%) reported drinking alcohol daily or on most days.

Drinking Behaviour

The following results are based on those respondents who drank alcohol in the week prior to the survey.

Days on which drinking occurs:

• Most drinking occurs over the weekend and peaks on Saturdays.

Type of drinks consumed:

• The most common drinks consumed were wine (48%) and beer (47%).

Where and with whom people drink:

• Most of those who drank in the week prior to the survey had either consumed alcohol at home (64%), in the pub (20%) or at someone else’s home (20%).

Drinking Levels

Recommended daily drinking limits:

• Around eight in ten respondents (78%) reported having reached or exceeded the recommended daily limit for drinking on at least one occasion in the week prior to the survey.
• 18% of male drinkers reached or exceeded the recommended daily limits on three or more days that week, compared to 16% of female drinkers.
• The recommended daily limits are exceeded most often on a Saturday (53% of drinkers) and on a Friday (31% of drinkers).

Weekly guidelines for sensible drinking:

• More females (80%) compared to males (74%) stayed within the weekly guidelines for sensible drinking limits.

Binge Drinking:

• Three in ten (30%) of those who drank in the week before the survey had engaged in at least one binge drinking session.
• Males (35%) are more likely than females (25%) to binge drink.
• Half (50%) of respondents in the youngest age group (18-29) who drank in the week prior to the survey had engaged in at least one binge drinking session compared to 13% of respondents in the oldest age group (60-75).

Problem Drinking:

• CAGE question analysis (clinical interview questions) indicated that one in ten (9%) of those who drank in the week prior to the survey are likely to have a problem with alcohol.
• Six in ten (61%) of those who consumed alcohol in the week prior to the survey consider themselves to be light drinkers.
• Just over one third (36%) consider themselves to be moderate drinkers and 3% consider themselves to be heavy drinkers.

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System Identification to Characterize Human Use of Ethanol Based on Generative Point-Process Models of Video Games with Ethanol Rewards

EMBC'11 Paper Abstract

The influence of family history and genetics on the risk for the development of abuse or dependence is a major theme in alcoholism research. Recent research have used endophenotypes and behavioral paradigms to help detect further genetic contributions to this disease.

Electronic tasks, essentially video games, which provide alcohol as a reward in controlled environments and with specified exposures have been developed to explore some of the behavioral and subjective characteristics of individuals with or at risk for alcohol substance use disorders.

A generative model (containing parameters with unknown values) of a simple game involving a progressive work paradigm is described along with the associated point process signal processing that allows system identification of the model.

The system is demonstrated on human subject data. The same human subject completing the task under different circumstances, e.g., with larger and smaller alcohol reward values, is assigned different parameter values.

Potential meanings of the different parameter values are described.


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Contact E-Mail: io35@cornell.edu

Hospitalized Patients’ Acceptability of Nurse-Delivered Screening, Brief Intervention, and Referral to Treatment

Inpatient healthcare providers in the United States may soon be required to offer alcohol screening, brief intervention, and referral to treatment (SBIRT) for hospital accreditation, but little is known about inpatient acceptability for SBIRT, particularly when performed by nonphysician providers such as nurses. The purpose of this study was to assess patient acceptability for and comfort with nurse-delivered SBIRT care among hospitalized patients and to identify factors associated with SBIRT acceptability.

We conducted a cross-sectional survey of 370 hospitalized medical–surgical patients at a large university-affiliated medical center, which is part of the U.S. Department of Veterans Affairs.
  Patient acceptability for 8 of 10 individual nurse-delivered SBIRT tasks was >84%. Patients were more accepting of SBIRT tasks if they felt able to determine their alcohol risk, able to reduce alcohol-related health risks, and expressed some degree of concern about their own use of alcohol. Approximately 20% of patients reported some degree of personal discomfort with alcohol-related discussions. Patients who were less comfortable with these discussions had lower perceived ability to reduce alcohol-related health risk, were >60 years old, had a positive AUDIT-C screening, and were of nonblack race.

Among hospitalized patients, patient acceptability for nurse-delivered SBIRT is high, and alcohol-related risk perceptions appear to be important factors associated with acceptability for SBIRT tasks. Providers can proceed with greater confidence in SBIRT-related discussions with most hospitalized patients but may need particular sensitivity and skill addressing alcohol with patient subgroups such as older patients and those with positive alcohol screenings.

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Lauren.Broyls@va.gov

Risky Decision-Making: An fMRI Study of Youth at High Risk for Alcoholism

Adolescents with a family history of alcoholism (FHP) are at risk for developing an alcohol use disorder (AUD), and some studies indicate that FHP individuals show deficits in executive functioning. The ability to make adaptive decisions is one aspect of successful executive functioning that is often measured during risk-taking tasks; however, this behavior has not been examined in FHP youth. As impaired decision-making could predispose FHP youth to make poor choices related to alcohol use, the current study examined the neural substrates of risk-taking in FHP adolescents and their family history negative (FHN) peers.

Thirty-one (18 FHP, 13 FHN) youth between 13 and 15 years old were included in this study. All youth had used little to no alcohol prior to study involvement. Functional magnetic resonance imaging was used to examine the neural substrates of risk-taking during the Wheel of Fortune (WOF) decision-making task (Ernst et al., 2004) in FHP and FHN youth.

FHP youth did not differ from FHN youth in risk-taking behavior, but showed less brain response during risky decision-making in right dorsolateral prefrontal cortex and right cerebellar regions compared with FHN peers.

Despite no behavioral differences on the WOF decision-making task, FHP youth exhibited atypical neural response during risk-taking compared with FHN peers. Atypical brain activity, in regions implicated in executive functioning could lead to reduced cognitive control, which may result in risky choices regarding alcohol use. This could help explain the higher rates of AUDs seen in FHP adolescents. Further examination of risky behavior and associated brain response over the course of adolescence is necessary to characterize the vulnerabilities of FHP youth in the absence of alcohol abuse.

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Prenatal Alcohol Exposure Patterns and Alcohol-Related Birth Defects and Growth Deficiencies: A Prospective Study

The physical features of fetal alcohol syndrome include smooth philtrum, thin vermillion border, short palpebral fissures, microcephaly, and growth deficiencies on weight and height. However, little is known about the specific quantities of alcohol exposure, pattern of drinking, timing of exposure, and magnitude of risk for each of these features.

Using data on 992 subjects collected prospectively in California between 1978 and 2005, we examined the patterns and timing of alcohol exposure in relation to these features. Structural features were assessed by a dysmorphologist who performed a blinded physical examination of all infants. Patterns of drinking were evaluated by drinks per day, number of binge episodes, and maximum number of drinks. Timing of exposure was evaluated 0 to 6 weeks postconception, 6 to 12 weeks postconception, first trimester, second trimester, and third trimester.

Higher prenatal alcohol exposure in every pattern was significantly associated with the incidence of smooth philtrum but not with short palpebral fissures. The strongest associations were with timing of exposure in the second half of the first trimester (RR 1.25, 95% CI 1.14 to 1.36 for average number of drinks per day; RR 1.17, 95% CI 1.09 to 1.26 for maximum number of drinks in 1 episode). Similarly, thin vermillion border was most strongly associated with exposure in the second half of the first trimester. Findings with respect to timing of exposure were similar for microcephaly and reduced birth weight. However, reduced birth length was increased with exposure in any trimester. These associations were linear, and there was no evidence of a threshold.

Reduced birth length and weight, microcephaly, smooth philtrum, and thin vermillion border are associated with specific gestational timing of prenatal alcohol exposure and are dose-related without evidence of a threshold. Women should continue to be advised to abstain from alcohol consumption from conception throughout pregnancy.

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