Alcohol cues increase cognitive impulsivity in individuals with alcoholism.

Psychopharmacology (Berl). 2007 Feb 6; [Epub ahead of print]

Alcohol cues increase cognitive impulsivity in individuals with alcoholism.

Noel X,
Van der Linden M,
d'Acremont M,
Bechara A,
Dan B,
Hanak C,
Verbanck P.

Clinic of Addictions, C.H.U Brugmann, Free University of Brussels (ULB), Salle 72, 4, place Van Gehuchten, 1020, Brussels, Belgium,

email: xnoel@ulb.ac.be.

BACKGROUND: Individuals with alcoholism are characterized by both attentional bias for alcohol cues and prepotent response inhibition deficit. We tested the hypothesis that alcoholics exhibit greater cognitive disinhibition when the response to be suppressed is associated with alcohol-related information.

METHODS: Forty recently detoxified individuals with alcoholism were compared with 40 healthy non-substance abusers on the "Alcohol-Shifting Task", a variant of the go/no-go paradigm requiring a motor response to targets and no response to distracters. The aim was to test the ability of alcoholics to discriminate between alcohol-related and neutral words.

Sometimes, the alcohol-related words were the targets for the "go" response, with neutral words as distracters, sometimes the reverse. Several shifts in target type occurred during the task.

RESULTS: Alcoholics made significantly more commission errors (i.e., press a key when a distracter displayed) and more omission errors (i.e., not press a key when a target displayed) than controls. Moreover, the number of commission errors was greater in alcoholics when alcohol-related stimuli had to be detected.

CONCLUSIONS: These results demonstrate that alcoholics exhibit a basic prepotent response inhibition deficit, which is enhanced when the response to be suppressed is related to alcohol. We discuss clinical and theoretical implications of these findings.

March 15-18, HBO will launch the Addiction Project,

In an unprecedented partnership, Join Together, Community Anti-Drug Coalitions of America (CADCA), and Faces & Voices of Recovery are uniting to help communities make the most of a powerful opportunity to bring the message of addiction treatment and recovery to millions of Americans. We hope you will join with us.

On March 15-18, HBO will launch the Addiction Project, a groundbreaking multi-media campaign to help Americans understand addiction as a treatable brain disease, spotlight new treatment advancements, and provide hope for long-term recovery. The 14-part series will air during a free HBO preview weekend, and it kicks off with a March 15 broadcast of the centerpiece documentary ADDICTION at 9 p.m. ET.

To find out more about HBO's ADDICTION project and exciting ways you can get involved in mobilizing your community around it, visit www.AddictionAction.org.

We urge you to build on these programs and the national attention they will command, mobilizing your community to improve access to treatment and increase support of long-term recovery.

Visit http://members.jointogether.org/ct/dpsNqZS16XlR/ to learn more about the ADDICTION series and find out how you can get involved:

Stand up and be counted. Tell us that you will watch the show and use it to spread the word to your family and friends about addiction and the reality of long-term recovery.

Attend a town hall meeting to view a preview screening of the film. Invite your elected officials to watch it with you, then discuss how it relates to conditions in your community. Events are currently scheduled in over 30 cities.

Host or attend a national house party on March 17 to watch and discuss an airing of ADDICTION with friends, co-workers, or elected leaders -- and develop a plan of action for your community.

Spread the word to friends, family and co-workers.

We'll send you updates - and more information - about ADDICTION and the opportunities for advocacy and public education, but you don't have to wait. Don't pass up the chance to start getting out the word!

Can we count you in to watch ADDICTION March 15-19? Click here to let us know. Then, sign up to host a house party and invite 10 friends to join you in taking action.

With your help, we can play a major role in fundamentally changing the way Americans view – and treat – people with alcohol and drug problems.

Thank you for all that you continue to do.Sincerely,

Join Together, CADCA, and Faces and Voices of Recovery

Working together to reduce underage alcohol problems and to increase access to treatment in New Hampshire

Working together to reduce underage alcohol problems and to increase access to treatment in New Hampshire

E-UPDATE 2/7/2007

Success Story
New Futures News
Legislative Update
Resources
In the News
Upcoming Events

Success Story
Advocacy: A Smart Way to Effect Change
Advocacy: "The act of pleading or arguing in favor of something, such as a cause, idea, or policy."

This month's "success story" comes from a CLI Partner whose 10 year old son's spelling homework included using the word 'community' in a sentence. Having observed his mother's evolving advocacy work over the years, the sentence he wrote says a great deal about her commitment to effecting change: "The community came together to stop drugs and alcohol." Speaking out about the issues that are important to us is a responsibility we all share.

If you would like to advocate to reduce underage alcohol problems and increase access to treatment in our state, consider participating in CLI. On March 8, 2007 New Futures will host a leadership retreat in Londonderry. Contact lking@new-futures.org or visit http://www.new-futures.org/ for information.


New Futures News
a. Good Luck, Jennifer Wierwille Norton
Please join us in wishing good luck to Jennifer Wierwille Norton, who has left her position as Policy Director at New Futures. Jen's contributions to the organization and the issue of alcohol and other drug problems in the state have been substantial, and we wish her well in her future endeavors.

b. "Welcome" to Tricia Lucas
Please join us in welcoming Tricia Lucas to the New Futures team as Policy Director. Before joining New Futures, Tricia served for fourteen years at the Department of Health and Human Services in a number of legal and administrative positions and developed expertise in program areas related to children's services, mental health and health care. Tricia managed the department's legislative work for four years and supervised the state budget process for the Division for Juvenile Justice Services for four years. She is a graduate of the College of Wooster and Harvard Law School and came to public service after a stint in private practice as a corporate attorney. She was an original member of the Belknap County Juvenile Justice Initiative, which ultimately became the Belknap County Citizens' Council. Tricia can be reached at our Concord office 225-9540 or via email at: tlucas@new-futures.org.

Legislative Update
a. New Legislature in Session
The new legislative session convened January 3, 2007. Approximately 1300 bill have been introduced this session. Although the text of many of the bills is not yet available, the titles suggest that there are a number that will be important to those of us interested in alcohol and other drug policy. As the bills come out in print, New Futures will develop positions as appropriate and share that information with you. To see the list of titles for yourself, go to: www.gencourt.state.nh.us/ie/lsrsearch/

b. UPDATE ON THE 2008-2009 Biennium Budget
The first step in the state budget process occurs on February 15, 2007 when the Governor presents his proposed 2008/2009 biennial budget (July 1, 2007 - June 30, 2009) to the Legislature. New Futures will carefully review the Governor's proposed budget for funding for alcohol, tobacco, and other drug prevention, intervention and treatment. Following its introduction, the House of Representatives will begin its deliberations on the Governor's proposed budget and will conduct public hearings work sessions in the House Finance Committee. We will continue to keep you updated as the budget process moves forward.
Resources

a. Searchable On-Line Event Calendar
You are invited to post trainings and events related to alcohol, tobacco, and other drugs on New Futures' event calendar. Go to www.new-futures.org/calendar, scroll down and click on the red button that says "submit an event for our calendar." Go to the same address and pick a category or just click dates on the calendar to see what's going on.

b. Substance Abuse Prevention Certification
The deadline for submitting completed Substance Abuse Prevention Certification applications for the March written exam is Feb 2, 2007. Because ethics training has not been offered, applications missing that one piece will be accepted. To learn more about prevention certification send a message to prevcertnh@hotmail.com

c. Podcasts on Youth Exposure to Alcohol Advertising on the Radio
The Morbidity and Mortality Weekly Report (MMWR) is not known for being the most user friendly publication. New "podcasts" allow people to listen to one or five minute reports on a variety of topics. See the list at: www2a.cdc.gov/podcasts/browse.asp?nu=l

d. New Fact Sheet on Costs of Underage Alcohol Use
The PIRE fact sheet on the costs of underage alcohol problems has been updated with 2004 data. Download your own and share them with other interested parties at www.udetc.org/UnderageDrinkingCosts.asp.

e. Supercourse: Alcohol Use, Abuse, and Dependence
Supercourse is a global repository of lectures on public health and prevention targeting educators across the world. A lecture by the director of the National Institute of Alcohol Abuse and Alcoholism is available at: www.pitt.edu/~super1/lecture/lec25521

f. Recovery Community Services Program
Eight grants of up to $350,000 each are expected to be awarded to public and private nonprofit organizations and agencies. The money can be used to support efforts to prevent addiction relapse and promote sustained recovery. Application deadline is Feb. 28, 2007. www.grants.gov/search/search.do?mode=VIEW&oppId=12007

g. Drug Court Discretionary Grant Program
The grants support drug courts that target nonviolent offenders (adults and families). Grants will be awarded in three categories: implementation grants, enhancement grants, and statewide grants. Application deadline is March 6, 2007. www.grants.gov/search/search.do?

In the News
a. Youth Exposure to Televised Alcohol Ads Rising
A proliferation of liquor and other alcohol ads on cable TV has contributed to a 41-percent increase in youth exposure to television alcohol advertising, according to a new report from the Center on Alcohol Marketing and Youth (CAMY). www.camy.org

b. Environmental Strategies Needed to Reduce Binge Drinking
Binge drinking is the most common pattern among high school youth who drink alcohol and is strongly associated with many other risky behaviors. Limiting youth access is critical to reducing underage alcohol problems. http://pediatrics.aappublications.org/cgi/content/abstract/119/1/76

c. AAP: Screen Adolescents for Prescription Drug Abuse
Adolescents should be screened at all annual health maintenance visits for the misuse of alcohol, marijuana, and other drugs-including prescription and over-the-counter medications. http://download.journals.elsevierhealth.com/pdfs/journals/0031-398X/PIIS0031398X06715521.pdf

d. Early Drinkers More Likely to Drink to Relieve Stress as Adults
A new study finds that people who started drinking at 14 or younger are significantly more likely to drink to relieve stress when they are older. Young adolescents would benefit from prevention efforts that include stress-reduction techniques as an alternative to drinking. www.blackwell-synergy.com/doi/abs/10.1111/j.1530-0277.2006.00265.x

e. JOIN TOGETHER: Comprehensive Treatment Helps Homeless Youth Avoid Addiction
Homeless youth who attended drop-in centers that provided a comprehensive intervention program significantly reduced their addiction and mental-health problems and enjoyed increased social stability. www.jointogether.org/news/research/summaries/2007/study-comprehensive.html

f. Australian Teens Drink More Than Americans
A comparison of underage alcohol use by Australian and American high school students finds the Australians' rates of binge drinking are higher than those of the Americans. The legal drinking age is 18 in Australia and many parents introduce alcohol in small quantities. www.ncbi.nlm.nih.gov/entrez/query.fcgi?

g. JOIN TOGETHER: Anatomy of an Advocacy Campaign
In just a few short weeks, an advocacy campaign succeeded in getting three of America's top retailers to stop selling a series of games that critics say promote binge and underage drinking. http://www.jointogether.org/news/features/2007/drinko-anatomy-of-an.html

h. Brain Can Recover from Excessive Alcohol Use
Excessive alcohol use can shrink the brain, impairing memory, learning, and organizational skills. But the brain also can recover most if not all of its capabilities when drinking stops, researchers say. www.sun-sentinel.com/features/health/sfl-122alcoholabstinence,0,4299432.story?coll=sfla-news-health

Upcoming Events
See all this and more at: www.new-futures.org/calendar
a. New Hampshire Initial Training on Substance Abuse
February 9, 2007
May 11, 2007
August 10, 2007
November 9, 2007
This 6-hour workshop is designed to give participants the ability to recognize alcohol and other drug problems of their clients and to understand the holistic nature of the disease of addiction. It also presents information on effects on the family, intervention strategies, and recovery. To register, contact lois.a.davieau@dhhs.state.nh.us, (603) 271-5889, (800) 852-3345, ext. 5889.

b. Working with Retailers: Self Policing Strategies and Collaborative Initiatives Teleconference
March 15, 2007 3:00 - 4:15 p.m.
This presentation will, from the retail perspective, highlight the barriers to gaining participation from the retail community and provide insights into proven ways to increase retail stakeholder involvement and increase self-policing efforts to reduce underage drinking. Participants will also learn strategies for addressing retailers who do not "get on board." Learn more and register at www.udetc.org.

c. HBO's ADDICTION Project - Series of Documentaries
Begins March 15
This 14-part series defines addiction as a chronic relapsing brain disease that is treatable. The series is eye-opening and ultimately hopeful, providing guidance in navigating the often confusing world of addiction treatment and recovery. www.jointogether.org/news/yourturn/announcements/2007/hbo-the-addiction-project.html.
d. Alcohol and Crime Among Youth Teleconference
April 19, 2007 3:00 - 4:15 p.m. Eastern Time
How strong is the relationship between youth alcohol use and criminal behaviors? Presenters for this call will discuss the relationship between alcohol and crime among youth and provide strategies for preventing alcohol-related criminal activity among youth. Learn more and register at www.udetc.org.

e. Recovery as Prevention
April 21, 2007, 1:00 pm EST Via Telephone and Online
RSVP by April 19 by emailing webinar@facesandvoicesofrecovery.org your full name, organization, and preferred email address.

f. Student Athlete Codes of Conduct That Work Teleconference
May 17, 2007 3:00 - 4:15 p.m. Eastern Time
Research shows that High School athletes drink more than other students. Call participants will learn about the purpose of alcohol codes for High School athletes, code components, and the positive results emerging from implementation of such codes. Learn more and register at http://www.udetc.org/.

SAMHSA's Road to Recovery Update

Wednesday, February 7, 2007
www.recoverymonth.gov
SAMHSA's Road to Recovery Update





The Road to Recovery Update keeps you informed about activities leading up to National Alcohol & Drug Addiction Recovery Month (Recovery Month) in September. Feel free to forward this information to friends and colleagues, include it in newsletters or listservs, or link to it from your Web site.

First Webcast
"The Road to Recovery 2007" premieres Wednesday, February 7th. This Webcast is the first in a series of nine programs in anticipation of the 18th annual National Alcohol and Drug Addiction Recovery Month, the theme of which is "Join the Voices of Recovery: Saving Lives, Saving Dollars." The Webcast will look back at Recovery Month events across the country in 2006 and set the stage for another successful celebration in September 2007. In addition, The Road to Recovery 2007 will help individuals, organizations, and communities plan and host successful events to raise awareness about the benefits of addiction treatment and recovery.

Voices for RecoveryYour help needed! Individuals can post their stories of recovery directly on the Recovery Month Web site. We must receive a hold harmless form by the party before their story is posted. Please help us spread the word to get people from across the country to submit their personal stories. Visit http://www.recoverymonth.gov/2007/voices/default.aspx for more information.

Planning Partners Meeting
We held the first 2007 Recovery Month Planning Partners meeting on Friday, January 19th in Washington, DC. Discussion surrounding the 2008 Recovery Month Observance was a focal point on the agenda. Thank you to everyone in attendance.

About Recovery Month
National Alcohol and Drug Addiction Recovery Month, celebrating 18 years of observance in 2007, is an initiative of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration's (SAMHSA's) Center for Substance Abuse Treatment (CSAT). For more information about Recovery Month, visit http://www.recoverymonth.gov/.

Recovery Updates as of 02/07/07
Recovery Month Events: 47
Proclamations: 0
Voices for Recovery: 3

Your Help Needed!Click here to email back ideas for content on the Recovery Month site or for future Road to Recovery Updates.

Subscribe/Unsubscribe
If you wish to subscribe to or unsubscribe from the Road to Recovery Update, visit Recovery Month Sign up page.

Conference - Promoting Responsible Drinking Reducing the Harm Caused by Alcohol

Neil Stewart Associates


Promoting Responsible Drinking Reducing the Harm Caused by Alcohol

Wednesday 31st January 2007 Inmarsat Conference Centre, London EC1


“The Government is committed to tackling alcohol abuse in all its forms whether challenging attitudes to binge drinking or cracking down on the underage sale of alcoholic drinks.”

Vernon Coaker MP, Under-Secretary of State for Policing, Security and Community Safety, Home Office

In the UK , more than 3.8 million people are addicted to alcohol and more than a million 16-24 year olds regularly drink to get drunk. In a bid to change the culture of the way alcohol is consumed the government introduced the 24 hour licensing act at the end of November 2005, with the aim of reducing binge drinking rates, tackling alcohol related disorder and minimising the number of people admitted hospital through alcohol related incidents.

A year on, this timely one day conference will consider the impact of the Licensing Act and Alcohol Harm Reduction Strategy, consider the increasing concerns over binge drinking, preventing alcohol related crime and disorder, and discuss how to promote safe, responsible drinking through strong local partnerships and better management of town centres. The conference will also explore the impact of drinking on the nation's health and discuss how to raise awareness to create a better understanding of the dangers of drinking and alcohol abuse, through campaigns such as the Home Office and Department of Health's “Know Your Limits” initiative.

This conference is a must attend event, for all those who are driving the agenda for safe and responsible drinking.

For further information contact Gemma Suter on 020 7324 4363,e-mail gemma.suter@neilstewartassociates.co.uk

PURPOSE OF THE CONFERENCE

This one day conference will:>
Consider the implications of the Licensing Act and the National Alcohol Harm Reduction Strategy in relation with the government aims to redress the balance between alcohol consumption, crime and public safety

Explore effective methods of countering the binge drinking culture and engaging young people in understanding the harm that alcohol abuse can cause

Explore examples of effective practice in relation to the police and partnership responses to alcohol related crime and disorder

Discuss the role of the individual in ensuring their own well-being, through raising public awareness – including a case study on the joint Home Office / Department of Health “Know Your Limits” campaign

Outline effective strategies of building partnerships for successful town and city management to create safer drinking environment and prevent alcohol related crime, disorder, violence and harm

Share experience and good practice through interactive in-depth conference streams

Provide a networking opportunity aimed at facilitating better inter-agency understanding

'Raise alcohol tax to aid health'By Bonnie Malkin and agencies
January 31, 2007


Tax on alcohol should be increased in order to protect public health, a leading medical expert has said.

Professor Ian Gilmore, president of the Royal College of Physicians, said higher taxes were particularly needed on strong cider, other high strength drinks aimed at young people such as alcopops.

But he warned the alcohol industry operated a powerful lobby which argued against future tax hikes.

Speaking at the Promoting Responsible Drinking conference in London, Prof Gilmore said: "We should try to return the cost of alcoholic beverages in real terms to what they were 20 years ago over a period of time.

"I think there should be a gradual look at returning it in real terms through the annual budgetary process."

He said VAT on cider with an alcohol content of up to 7.5% was currently too low.

"It makes a very significant difference to the cost of cider. It is white cider that is being sold very cheaply - it is the cheapest way of getting drunk.

"It is youngsters and people with alcohol-related problems who go for the cider."

Prof Gilmore said the issue of raising taxes on alcohol was an "uncomfortable" one for the Government.

"The Government is anxious about the nanny state, but I think the harm done by alcohol is such that nannying would be in order," he added.

The jury was still out on the impact of the year-old 24 hour licensing laws on health, he said, and controlling the price, advertising and availability of alcohol were the key methods of tackling alcohol abuse.

New licensing laws came into force in November 2005, permitting round-the-clock alcohol sales in England and Wales.

Around 3,000 premises - of which a quarter are supermarkets - have since gained licences to serve 24 hours a day.

News Release - Holyrood conference launches 'Futures Forum' study into alcohol and drugs in Scotland

Futures Forum news
Holyrood conference launches 'Futures Forum' study into alcohol and drugs in Scotland


002/2007 12 January 2007

A major Holyrood conference on alcohol and drug use in Scotland will mark the launch of a new, year-long study on the subject by Holyrood’s think-tank, Scotland’s Futures Forum.

The one-day conference takes place on Monday 15 January at Holyrood, and sets the stage for a new investigation, which seeks to establish a fresh political perspective on Scotland ’s approach to alcohol and drugs.

The Futures Forum’s latest study is set against a backdrop of current estimates which suggest that there are more than 100,000 children in Scotland affected by parental alcohol use and nearly 60,000 by parental drug use (source: Scottish Executive, May 2006).

Overall themes for the Forum will include education and prevention, regulation and prohibition, improving treatment options, key policy drivers addressing substance use problems and children and young people’s future.

More than 250 experts, including senior police figures, leading academics and health experts will attend Monday’s conference, which is hosted by Scotland’s Futures Forum together with the Scottish Association of Alcohol and Drug Actions Teams.

Entitled ‘Over the horizon: fresh perspectives on alcohol and drugs’, the conference will feature the following three keynote speakers addressing assembled delegates in Holyrood’s debating chamber:

Professor Tony King, Chair of the RSA Commission on Illegal Drugs, Communities and Public Policy, and Professor of Government at Essex University;

Tom Wood, Chair, Scottish Association of Alcohol and Drug Action Teams;

Rev John Miller, Castlemilk East Parish Church.

The morning session closes with a Q&A session then moves into smaller discussion groups to focus on issues including the role of communities, improving treatment options and children and young people.

Speaking ahead of the conference, Scottish Parliament Presiding Officer George Reid, who chairs Scotland’s Future Forum, said:

"One week after Scotland ’s Futures Forum published its groundbreaking report on ageing, we now move on to the next year-long investigation into alcohol and drugs use.

"Through the Futures Forum, we are developing long-term strategic thinking on the issues which Scotland will face in the future. We are engaging with those we represent and those who know the challenges and opportunities that will arise.”

Tom Wood, Chair, Scottish Association of Alcohol and Drug Action Teams added:
"The Forum is a unique opportunity to address some major challenges facing Scotland, for example, creating a future for our children safer from the devastating effects of alcohol and drugs misuse."

The participation on Monday of members of the Royal Society of Arts Commission on Illegal Drugs comes ahead of the publication of its two-year study due on 8 March 2007. It is expected that knowledge and experience gained from its study will help inform Monday’s proceedings.
Susan Deacon MSP, a member of the UK-wide RSA Commission on Illegal Drugs, Communities and Public Policy, said:

"There is a pressing need for a more open and informed debate on drug and alcohol use in our society. I am delighted the Scottish Parliament Futures Forum is taking forward this major project. I hope that work such as this, and the forthcoming RSA Commission report, will help to stimulate fresh thinking on this important and challenging issue."

The conference begins in Holyrood’s debating chamber at 10.30am on Monday 15 January. Media are welcome to attend. Media who require parliamentary accreditation for the day should contact the Parliament’s Media Relations Office in advance on 0131 348 6852.

Full programme details are available on the Parliament’s website.

View programme details.

Background notes
Scotland’s Futures Forum was created by the Scottish Parliamentary Corporate Body in August 2005. The forum aims to identify key challenges facing the nation and stimulate debate between MSPs, academics, civic society, wealth creators and international organisations on the ways of meeting them.

For more information on Scotland’s Futures Forum go to: www.scotlandfutureforum.org
www.scottish.parliament.uk/nmCentre/news/futuresforum_news.htm

For more information on the RSA Commission on Illegal Drugs, Communities and Public Policy visit: www.rsadrugscommission.org

Programme
9.30 - 10.30 am: Coffee and registration
10.30 - 10.35 am: Plenary session in the Chamber, Scottish Parliament. Welcome and introduction from Facilitator
10.35 - 11.00 am: Prof Tony King, Chair, RSA Commission and Professor of Government at Essex University
11.00 - 11.15 am: Q & A
11.15 - 11.30 am: Rev John Miller, Castlemilk East Parish Church
11.30 - 11.45 am: Tom Wood, Chair, The Scottish Association of Alcohol and Drug Action Teams
11.45 - 12.00 pm: Q & A
12.00 - 1.00 pm: Lunch ( Sandwich buffet lunches will be served)
1.00 - 2.45 pm: Conversation cafes within Committee rooms
2.45 - 3.00 pm: Return to Chamber for Plenary session
3.00 - 3.45 pm: Final Plenary session
3.45 pm: Close

For further information, the Scottish Parliament media contact is:
Eric MacLeod: 0131 348 5389 RNID TypeTalk calls welcome email: sp.info@scottish.parliament.uk

Interview - Professor Ian Gilmore - Royal College of Physicians

ePolitix.com
Published: Wed, 26 Jan 2005 00:02:00 GMT+00

Professor Ian Gilmore - Royal College of Physicians
Royal College of Physicians

Question: You are holding a conference on alcohol this week - what is it going to focus on and why is there a need for the conference?

Prof Ian Gilmore: It is now a year since the government produced its long-awaited alcohol harm reduction strategy, and more recently its public health white paper "Choosing health".

However, the recommendations and policy measures promoted in these two documents concentrate too heavily on the aspects of drinking most closely related to law and order issues at the expense of health, and fall short of meeting the concerns of the medical profession. We are using this conference to put the health consequences of alcohol misuse back on the agenda.

Question: In your opinion is the government taking alcohol related harm seriously?

Prof Ian Gilmore: I think the government is taking alcohol related harm seriously, however I believe they are working under considerable constraints due to the massive force of the drinks industry lobby.

I think the government finds it easier to tackle the law and order aspects of alcohol misuse, as they are politically attractive. It may be true that it is only a small minority who are creating havoc in our inner cities and making them no go areas at night.

However, 25 per cent of the population are drinking at potentially harmful levels and five million people in the population are alcohol dependent. So we are not talking about small numbers.

We are talking about immediate health risks which are linked to binge drinking; like getting a glass in the face, unwanted pregnancies, but we are also talking about the long term consequences like cirrhosis of the liver.

Cirrhosis of the liver has gone up 900 per cent since the 1970s during which time our alcohol consumption as a country has gone up 50 per cent. We are drinking more and more as alcohol is getting cheaper year on year and we fear that a change to the licensing laws is about to make alcohol more available than it has ever been.

Question: Should the government be doing more considering the effects on health, work, anti-social behaviour?

Prof Ian Gilmore: The alcohol harm reduction strategy as produced by the Cabinet Office was cross cutting but since then I think the focus on alcohol related harm has been lost to some extent. The Home Office was given the responsibility of pulling the strategy together but the Home Office inevitably has a much more law and order focus.

Question: Is the drinks industry taking alcohol related harm seriously?

Prof Ian Gilmore: I believe that this drinks industry is being vocal on the issues of binge drinking and I believe that they want to see law and order problems sorted out as currently it gives them a bad name; I do not believe that they wish to see the nation drinking less.

The industry has a £30 billion annual turnover, they have some social responsibility programmes, however at the end of the day they have a responsibility to the shareholders.

I am not blaming the drinks industry for the problems that we have now, but I am concerned the government wants to work alongside the industry and I am doubtful that this will be effective.

For example, in the public health white paper one of the government’s recommendations is that there should be a public information campaign in partnership with the Portman Group. We do not think that is the right partnership for a public information campaign when there are other independent bodies like Royal College of Physicians or Alcohol Concern who could and would be much better placed to work to publicise this information

(more)

Impact of Race and Ethnicity on Counseling for Alcohol Consumption: A Population-Based, Cross-Sectional Survey

Alcoholism: Clinical and Experimental Research (OnlineEarly Articles)

Impact of Race and Ethnicity on Counseling for Alcohol Consumption: A Population-Based, Cross-Sectional Survey

Kenneth J. Mukamal1

1Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts
1Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts

Reprint requests: Kenneth J. Mukamal, MD, MPH, MA, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, RO-114, Boston, MA 02215; Fax: 617-667-2854; E-mail: kmukamal@bidmc.harvard.edu

Abstract
Background: Counseling for alcohol use is of proven utility, but whether disparities in provision of counseling exist is uncertain.

Methods: Using the 1999 Behavioral Risk Factor Surveillance System, a population-based telephone survey, we examined participant-reported physician counseling for alcohol use among 15,498 adults in 5 U.S. states. Participants reported their usual alcohol intake, risky drinking (intake of 5 or more drinks on occasion, greater than 60 drinks per month, or driving after drinking), and whether a doctor had spoken with them about alcohol use.

Results: Race and ethnicity were strongly associated with reported receipt of alcohol counseling. Compared with whites, black and Hispanic adults had 2-fold higher odds of reporting receiving counseling among all participants, among problem drinkers, and among abstainers. There were modest differences according to sex, income, self-reported health, and education, but not body mass index. Multivariable adjustment and restriction to participants who reported a recent checkup did not alter these findings. No such disparity was noted for general diet counseling.

Conclusions: Clear racial and ethnic differences exist in physician counseling for alcohol use, with higher prevalence estimates among racial and ethnic minority populations. Although the cause of these differences is uncertain, systematic application of preventive medical services such as alcohol screening and counseling is needed for all patients.

Research Article - The economic cost of teen drinking: late graduation and lowered earnings

Early View (Articles online in advance of print)
Published Online: 9 Oct 2006

Research Article
The economic cost of teen drinking: late graduation and lowered earnings Francesco Renna *
Department of Economics, The University of Akron, USA

email: Francesco Renna (Frenna@uakron.edu)
*Correspondence to Francesco Renna, Department of Economics, The University of Akron, USA

Abstract
This paper analyzes the effect that binge drinking has on the probability of graduating on time from high school and on future earnings. The analysis is conducted on students in their senior year of high school using data from the National Longitudinal Survey of Youth 1979.

Importantly, the usual instruments used to correct for the endogeneity of the drinking variable are found to be robust only for women.

This paper finds that heavy drinking decreases the probability of graduating on time. Binge drinking does not have a direct impact on adults' labor earnings, but graduating late results in lower labor income. Because of a late graduation, young men who binge in high school will face an earnings penalty of 1.5-1.84 percentage points.

Women also face a penalty, but this seems mostly due to the fact that women who graduate late work in industries and occupations that pay less.

Research Article - The association of alcohol dependency with employment probability: evidence from the population survey Health 2000 in Finland

Health Economics Early View (Articles online in advance of print)
Published Online: 22 Dec 2006


Research Article
The association of alcohol dependency with employment probability: evidence from the population survey Health 2000 in Finland



Edvard Johansson 1 *, Hannu Alho 2 3, Urpo Kiiskinen 4, Kari Poikolainen 2 5

1Swedish School of Economics and Business Administration, Helsinki, Finland
2Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
3Research Unit of Substance Abuse Medicine, University of Helsinki, Helsinki, Finland
4Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
5The Finnish Foundation for Alcohol Studies, Helsinki, Finland

email: Edvard Johansson (edvard.johansson@hanken.fi)
*Correspondence to Edvard Johansson, Swedish School of Economics and Business Administration, Perhonkatu 6B, 00100 Helsinki, Finland



Abstract
In this paper, we investigate to what extent alcohol-dependent individuals fare worse in the Finnish labour market, using data from a large Finnish health survey.

We used the DSM-IV criteria for alcohol dependence assessed by a composite international diagnostic interview (CIDI).

We find that there are substantial disadvantages for alcohol-dependent men and women in the labour market, in the sense that they have lower employment probabilities.

Treating alcohol dependence as an exogenous variable, we find that alcohol dependence is associated with decrease in the probability of full-time or part-time work of around 14 percentage points for men and 11 percentage points for women.

However, accounting for endogeneity increases the negative effect to some 50 percentage points for men and to some 40 percentage points for women.

SNP- and Haplotype Analysis of the Tryptophan Hydroxylase 2 Gene in Alcohol-Dependent Patients and Alcohol-Related Suicide

Neuropsychopharmacology advance online publication 24 January 2007;
SNP- and Haplotype Analysis of the Tryptophan Hydroxylase 2 Gene in Alcohol-Dependent Patients and Alcohol-Related Suicide








Peter Zill1, Ulrich W Preuss1,2, Gabrielle Koller1, Brigitta Bondy1 and Michael Soyka1
1Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
2Department of Psychiatry, Martin-Luther-University, Halle, Halle/Saale, Germany

Correspondence: Dr P Zill, Department of Psychiatry, Psychiatric Hospital of the Ludwig-Maximilians-University, Nussbaumstr. 7, D-80336 Munich, Germany. Tel: +49 89 51602741, Fax: +49 89 51604741, E-mail: Peter.Zill@med.uni-muenchen.de

Abstract
Several lines of evidence indicate that disturbances of the central serotonergic system are involved in the pathophysiology of alcohol dependence and suicidal behavior.

Recent studies have indicated that a newly identified second isoform of the tryptophan hydroxylase gene (TPH2) is preferentially involved in the rate limiting synthesis of neuronal serotonin. Genetic variations in the TPH2 gene have been associated with an increased risk for major depression and suicidal behavior.

We performed single SNP (single nucleotide polymorphism), linkage disequilibrium and haplotype studies on 353 alcohol-dependent patients of whom 102 individuals had a history of at least one suicide attempt and 305 healthy controls with 20 SNPs covering the entire gene region of TPH2.

Neither single SNP-, nor haplotype analysis could detect significant associations with alcohol dependence and/or suicidal behavior among alcohol-dependent patients.

One major haplotype block of strong linkage disequilibrium between introns 5 and 8 of the TPH2 gene has been found in alcoholics and controls, which is in concordance with recent reports.

In conclusion, our results suggest that single SNPs, respectively, haplotypes of the TPH2 gene are unlikely to play a major role in the pathophysiology of alcohol dependence or the alcoholism-related phenotype suicidal behavior. Further analysis are needed to confirm these results.

Brain Morphometry and Cognitive Performance in Detoxified Alcohol-Dependents with Preserved Psychosocial Functioning

Neuropsychopharmacology (2007) 32, 429–438.

Brain Morphometry and Cognitive Performance in Detoxified Alcohol-Dependents with Preserved Psychosocial Functioning

Sandra Chanraud1, Catherine Martelli2, Francoise Delain2, Nikoletta Kostogianni3, Gwenaelle Douaud4, Henri-Jean Aubin3, Michel Reynaud2 and Jean-Luc Martinot1

1Inserm U.797, CEA–INSERM Research Unit 'Neuroimaging & Psychiatry', Institute for Health and Medical Research (INSERM) and Atomic Energy Commission (CEA) Hospital Department Frédéric Joliot, IFR49, Univ Paris-sud, Univ Paris 5, Orsay, France
2APHP, Department of Psychiatry and Addictology, Paul Brousse Hospital, Villejuif, France
3APHP, Addiction Treatment Center, Emile Roux Hospital, Limeil-Brevannes, France
4URA CNRS-CEA 2210, Frédéric Joliot Department (SHFJ), Orsay, France

Correspondence: Jean-Luc Martinot, U797 INSERM-CEA, Service Hospitalier Frédéric Joliot, CEA, 4, place du Général Leclerc, 91401 Orsay, France. Tel: +33 1 6986 7742; Fax: +33 1 6986 7810; E-mail: jean-luc.martinot@cea.fr

Abstract
The extent of structural brain damage and related cognitive deficits has been little described in alcohol-dependent individuals with preserved social functioning.

Thus, we investigated the relationship between regional alterations, executive performance, and drinking history. Volumes of gray and white matter were assessed using magnetic resonance imaging voxel-based morphometry in healthy men and in detoxified alcohol-dependent men with good psychosocial functioning.

Their executive performance was assessed using neuropsychological tests. Regression analyses were carried out in the regions in which volume differences were detected.

Decreases in gray matter were detected bilaterally in alcohol-dependents in the dorsolateral frontal cortex (up to 20% lower), and to a lesser extent in the temporal cortex, insula, thalamus, and cerebellum. Decreases in white matter volume were widespread, being up to 10% in corpus callosum. The degradation of neuropsychological performance correlated with gray matter volume decreases in the frontal lobe, insula, hippocampus, thalami and cerebellum, and with white matter decrease in the brainstem.

An early age at first drinking was associated with decreased gray matter volumes in the cerebellum, brainstem (pons), and frontal regions.

Regional alteration in gray and white matter volume was associated with impairment of executive function despite preserved social and somatic functioning in detoxified patients.

Besides involving frontal regions, these findings are consistent with a cerebello-thalamo-cortical model of impaired executive functions in alcohol-dependent individuals.

Endogenous Opioid Blockade and Impulsive Responding in Alcoholics and Healthy Controls

Neuropsychopharmacology (2007) 32, 439–449.

Endogenous Opioid Blockade and Impulsive Responding in Alcoholics and Healthy Controls

Jennifer M Mitchell1, Venessa C Tavares1, Howard L Fields1,2,3, Mark D'Esposito4 and Charlotte A Boettiger1,2

1Ernest Gallo Clinic and Research Center, University of California at San Francisco, Emeryville, CA, USA
2Department of Neurology, University of California at San Francisco, San Francisco, CA, USA
3Wheeler Center for the Neurobiology of Addiction, University of California at San Francisco, San Francisco, CA, USA
4Helen Wills Neuroscience Institute, University of California at Berkeley, Berkeley, CA, USA

Correspondence: Dr CA Boettiger, Ernest Gallo Clinic and Research Center, University of California at San Francisco, 5858 Horton St, Suite 200, Emeryville, CA 94608, USA. Tel: +1 510 985 3973, Fax: +1 510 985 3101; E-mail: cab@phy.ucsf.edu

Abstract
The opioid receptor antagonist naltrexone (NTX) is one of few approved treatments for alcoholism, yet the mechanism by which it reduces drinking remains unclear.

In rats, NTX reduces morphine-induced impulsive choice bias; however, nothing is known about the drug's effect on discrete aspects of impulsive behavior in humans, such as decision-making and inhibitory control.

Here, we used a modified delay discounting procedure to investigate whether NTX improves decision-making or inhibitory control in humans. We measured the effect of acute NTX (50 mg) on choice between smaller sooner (SS) and larger later monetary rewards and on response errors (motor mismatch) in a high conflict condition in a group of abstinent alcoholics (AA) and healthy control subjects (CS).

We previously reported that AA selected the SS option significantly more often than did CS in this paradigm. If the choice bias of AA is due to enhanced endogenous opioid signaling in response to potential reward, NTX should reduce such bias in the AA group.

We found that NTX did not reliably reduce impulsive choice in the AA group; however, NTX's effect on choice bias across individuals was robustly predictable. NTX's effect on choice bias was significantly correlated with scores on Rotter's Locus of Control (LOC) scale; increasingly internal LOC scores predicted increasing likelihood of impulsive choices on NTX.

In addition, we found that NTX significantly enhanced control of motor responses, particularly within the CS group. These results suggest that endogenous opioids may impair response selection during decision-making under conflict, and that NTX's effects on explicit decision-making are personality-dependent.

Determining the biological basis of this dependence could have important implications for effective alcoholism treatment.

Association of the neuronal nicotinic receptor 2 subunit gene (CHRNB2) with subjective responses to alcohol and nicotine

Research Article
Association of the neuronal nicotinic receptor 2 subunit gene (CHRNB2) with subjective responses to alcohol and nicotine

Marissa A. Ehringer 1 2 *, Hilary V. Clegg 1, Allan C. Collins 1 3, Robin P. Corley 1, Thomas Crowley 4, John K. Hewitt 1 3, Christian J. Hopfer 4, Kenneth Krauter 5, Jeffrey Lessem 1, Soo Hyun Rhee 1 3, Isabel Schlaepfer 1 2, Andrew Smolen 1, Michael C. Stallings 1 3, Susan E. Young 1, Joanna S. Zeiger 1

1Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado2Department of Integrative Physiology, University of Colorado, Boulder, Colorado3Department of Psychology, University of Colorado, Boulder, Colorado4Department of Psychiatry, Division of Substance Dependence, University of Colorado School of Medicine, Denver, Colorado5Department of Molecular, Cellular, and Developmental Biology, University of Colorado, Boulder, Colorado

email: Marissa A. Ehringer (Marissa.Ehringer@colorado.edu)

*Correspondence to Marissa A. Ehringer, University of Colorado, Institute for Behavioral Genetics 447 UCB, Boulder, CO 80309.

Abstract
Nicotine addiction and alcohol dependence are highly comorbid disorders that are likely to share overlapping genetic components.

We have examined two neuronal nicotinic receptor subunit genes (CHRNA4 and CHRNB2) for possible associations with nicotine and alcohol phenotypes, including measures of frequency of use and measures of initial subjective response in the period shortly after first using the drugs.

The subjects were 1,068 ethnically diverse young adults participating in ongoing longitudinal studies of adolescent drug behaviors at the University of Colorado, representing both clinical and community samples.

Analysis of six SNPs in the CHRNA4 gene provided modest support for an association with past 6 month use of alcohol in Caucasians (three SNPs with P < 0.08), but no evidence for an association with tobacco and CHRNA4 was detected.

However, a SNP (rs2072658) located immediately upstream of CHRNB2 was associated with the initial subjective response to both alcohol and tobacco.

This study provides the first evidence for association between the CHRNB2 gene and nicotine- and alcohol-related phenotypes, and suggests that polymorphisms in CHRNB2 may be important in mediating early responses to nicotine and alcohol

Association of the ADHIB*3 Allele With Alcohol-Related Phenotypes in Trinidad

Alcoholism: Clinical and Experimental Research
Volume 31 Issue 2 Page 216 - February 2007

Association of the ADHIB*3 Allele With Alcohol-Related Phenotypes in Trinidad

Cindy L. Ehlers1
1Department of Molecular and Integrative Neurosciences, The Scripps Research Institute, La Jolla, California; ,
Karelia Montane-Jaime1
1Department of Molecular and Integrative Neurosciences, The Scripps Research Institute, La Jolla, California; ,
Shelly Moore2
2Department of Pharmacology University of the West Indies, St. Augustine, Trinidad and Tobago; and ,
Samuel Shafe2
2Department of Pharmacology University of the West Indies, St. Augustine, Trinidad and Tobago; and ,
Roma Joseph2
2Department of Pharmacology University of the West Indies, St. Augustine, Trinidad and Tobago; and , and
Lucinda G. Carr1
1Department of Molecular and Integrative Neurosciences, The Scripps Research Institute, La Jolla, California;

1Department of Molecular and Integrative Neurosciences, The Scripps Research Institute, La Jolla, California;
2Department of Pharmacology University of the West Indies, St. Augustine, Trinidad and Tobago; and
3Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

Reprint requests: Cindy L Ehlers, PhD, SP30-1501 TSRI, 10550 North Torrey Pines Road, La Jolla, CA 92037; Fax: 858-784-7409; E-mail: cindye@scripps.edu

Abstract
Background: Two of the class I alcohol dehydrogenase (ADH) genes located on chromosome 4 (ADH1B and ADH1C) encode for multiple isozymes that differ in their kinetic properties. At the ADH1B locus, 3 polymorphisms are present (ADH1B*1, ADH1B*2, ADH1B*3). ADH1B*2 (found mostly in individuals of East Asian and Jewish descent) and ADH1B*3 (found mostly in individuals of African decent) alleles encode for a more active enzyme variants than ADH1B*1 and the presence of these alleles has been associated with protection from alcohol dependence. The relationship between these alleles and alcohol-associated phenotypes has not been previously investigated in individuals living in the Caribbean.

Methods: One hundred thirty-three alcohol-dependent individuals of either East Indian or African ancestry and 98 controls matched by age, sex, education, and ethnicity participated in the study. A structured interview [the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA)] was used to gather information on demographics, psychiatric diagnoses, personal drinking, and drug use history. Leukocyte DNA extracted from a blood sample obtained from each participant was genotyped at the ADH1B locus. Serum levels of the liver enzymes alanine and aspartate aminotransferase (ALT, AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), and γ-glutamyl transferase (GGT) as well as the presence of HIV, hepatitis B surface antigen, and antihepatitis C virus antibody were also assayed. The specific aim of the study was to investigate the associations between ADH1B alleles and alcohol dependence, drinking history, and liver function in individuals from the 2 major ethnic groups of Trinidad (individuals of African and East Indian ancestry).

Results: Twenty-eight of the Afro-Trinidadian (Afro-TT) participants (41%) and 1 Indo-Trinidadian (Indo-TT) (>1%) had at least 1 ADH1B*3 allele and 3 Afro-TT were homozygous for the allele. African participants with at least 1 ADH1B*3 allele were found to be significantly less likely to be alcohol dependent (p<0.018), and to have lower alcohol consumption levels (p<0.05). Among those participants who were alcohol dependent, ADH1B*3 was associated with significantly higher levels of ALT (p<0.05).

Conclusions: This study suggests, in this sample of Trinidadians, that the ADH1B*3 allele is associated with protection from the development of alcoholism but is also associated with enhanced risk for elevated serum ALT levels in those individuals who do become alcohol dependent.

[see news releases Bulletin Board-Alcohol Reports Feb 5,2007 & Jan 30,2007]

Accumbens neurochemical adaptations produced by binge-like alcohol

Psychopharmacology (Berl). 2007 Mar;190(4):415-31. Epub 2007 Jan 16.

Accumbens neurochemical adaptations produced by binge-like alcohol
consumption.



Szumlinski KK, Email: szumlinski@psych.ucsb.edu
Diab ME,
Friedman R,
Henze LM,
Lominac KD,
Bowers MS.

Department of Psychology and the Neuroscience Research Institute, University of California at Santa Barbara, Santa Barbara, CA, 93106-9660, USA,

RATIONALE: The Scheduled High Alcohol Consumption (SHAC) binge drinking model is a simple, partial murine model with which to investigate some of the neurobiological underpinnings of alcoholism.

OBJECTIVES: The SHAC model was used to characterize monoamine and amino acid adaptations produced in the nucleus accumbens (NAC) by repeated bouts of high alcohol consumption.

METHODS: In vivo microdialysis was conducted in the NAC of C57BL/6J (B6) mice during consumption of water, a 5% alcohol (v/v) solution for the first time (SHAC1) or a 5% alcohol solution for the sixth time (SHAC6). A second set of microdialysis experiments assessed the neurotransmitter response to an alcohol challenge injection (1.5 or 2 g/kg, IP).

RESULTS: In both drinking experiments, SHAC1 and SHAC6 mice consumed comparable amounts of alcohol during the 40-min period of alcohol availability (~1.5 g/kg) and total fluid intake was similar between water and SHAC1/6 mice.

Despite the similarity in alcohol consumption, alcohol-mediated increases in the extracellular concentration of GABA and serotonin were reduced, but glutamate was increased in the NAC of SHAC6 mice, relative to SHAC1 animals.

No differences were observed in extracellular dopamine between SHAC1 and SHAC6 mice during alcohol consumption. After alcohol injection, SHAC6 mice also exhibited sensitized glutamate release, but did not differ from water or SHAC1 animals for any of the other neurotransmitters examined.

Brain alcohol concentrations did not differ between groups after injection.

CONCLUSIONS: Repeated bouts of high alcohol consumption induce an imbalance between inhibitory and excitatory neurotransmission within the NAC that may drive excessive drinking behavior.

Evidence of Positive Selection on a Class I ADH Locus.

Am J Hum Genet. 2007 Mar; 80(3):441-56. Epub 2007 Jan 30.


Evidence of Positive Selection on a Class I ADH Locus.

Han Y,
Gu S,
Oota H,
Osier MV,
Pakstis AJ,
Speed WC,
Kidd JR, mailto:kidd@biomed.med.yale.edu
Kidd KK.

Department of Genetics, School of Medicine, Yale University, New Haven, CT, 06510, USA.


The alcohol dehydrogenase (ADH) family of enzymes catalyzes the reversible oxidation of alcohol to acetaldehyde. Seven ADH genes exist in a segment of ~370 kb on 4q21. Products of the three class I ADH genes that share 95% sequence identity are believed to play the major role in the first step of ethanol metabolism.

Because the common belief that selection has operated at the ADH1B*47His allele in East Asian populations lacks direct biological or statistical evidence, we used genomic data to test the hypothesis.

Data consisted of 54 single-nucleotide polymorphisms (SNPs) across the ADH clusters in a global sampling of 42 populations. Both the F(st) statistic and the long-range haplotype (LRH) test provided positive evidence of selection in several East Asian populations. The ADH1B Arg47His functional polymorphism has the highest F(st) of the 54 SNPs in the ADH cluster, and it is significantly above the mean F(st) of 382 presumably neutral sites tested on the same 42 population samples.

The LRH test that uses cores including that site and extending on both sides also gives significant evidence of positive selection in some East Asian populations for a specific haplotype carrying the ADH1B*47His allele.

Interestingly, this haplotype is present at a high frequency in only some East Asian populations, whereas the specific allele also exists in other East Asian populations and in the Near East and Europe but does not show evidence of selection with use of the LRH test.

Although the ADH1B*47His allele conveys a well-confirmed protection against alcoholism, that modern phenotypic manifestation does not easily translate into a positive selective force, and the nature of that selective force, in the past and/or currently, remains speculative.

Scripps Research Institute - Genetic Variation Found to Protect Some Afro-Trinidadians from Alcoholism

Genetic Variation Found to Protect Some Afro-Trinidadians from Alcoholism

Sherry Wasilow-Mueller and Mika Ono Benedyk

A group of scientists at The Scripps Research Institute, the University of the West Indies, and the Indiana University School of Medicine has found that a specific genetic variation appears to protect some Afro-Trinidadians from developing alcoholism. However, the same variation may also increase the risk of liver disease if these individuals choose to drink.

The results are published in the February 2007 issue of Alcoholism: Clinical & Experimental Research, the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism.

Alcohol dehydrogenase (ADH) is one of the major enzymes involved in alcohol metabolism. Yet this enzyme is not identical in all people. Some individuals have genetic variations that lead to differences in the enzyme, and thus in the ability to metabolize alcohol.

In the recent study, the researchers investigated the effects of one of the known variations of the ADH gene, ADH1B*3, which has been found in people of African descent.Although ADH1B*3 was identified in Indianapolis 10 years ago, since that time few studies have been conducted on its role in drinking or the development of alcoholism.

To study the effect of ADH1B*3 on alcohol dependence, the research team turned to the Republic of Trinidad and Tobago, an island nation in the Caribbean comprised mainly of individuals of two separate ethnic groups of African and East Indian ancestry, respectively.
"Island populations often provide a unique opportunity to evaluate genetic factors as populations on these islands are often genetically 'isolated' for a number of generations," said Cindy Ehlers, associate professor at Scripps Research, who led the study. "These can provide a more homogenous environment when compared to large heterogeneous cultures such as the United States."

Study participants were recruited from the two major ethnic groups of Trinidad: 138 alcohol-dependent individuals, as well as 98 "controls" or non-alcohol-dependent individuals matched on age, gender, education, and ethnicity. Researchers assessed all participants using the Semi-Structured Assessment for the Genetics of Alcoholism in order to gather information on demographics, psychiatric diagnoses, personal drinking, and drug-use history. Each participant was genotyped at the ADH1B locus through a blood sample, and also provided a number of other health measures.

As predicted, the researchers discovered a relatively high prevalence—a full 41 percent—of the ADH1B*3 allele in Afro-Trinidadians. An allele is a member of a pair of genes, one inherited from each parent.

Significantly, the study found that, on average, individuals with at least one ADH1B*3 allele had lower alcohol consumption levels and were less likely to be alcohol dependent. However, individuals with the ADH1B*3 allele who were alcohol dependent tended to have elevated serum alanine aminotransferease levels, a measure of liver dysfunction.

"Having the ADH1B*3 allele provides some genetic protection from developing alcoholism, but it is not complete," noted Ehlers. "Individuals can choose to drink at high levels in spite of having some protection against alcoholism, just like individuals at high genetic risk for alcoholism can choose not to drink. There are no genes for alcohol dependence like there are genes for Huntington's chorea or other single-gene disorders. There are only genes that influence risk and protection for the disorder."

In addition to Ehlers, authors of the Alcoholism: Clinical & Experimental Research paper, "Association of the ADH1B*3 Allele with Alcohol Related Phenotypes in Trinidad," were: Karelia Montane-Jaime, Shelly Moore, and Samuel Shafe of the University of the West Indies; Roma Joseph of the San Fernando Hospital in Trinidad; and Lucinda G. Carr of Indiana University.
The study was funded by the National Institute on Alcohol Abuse and Alcoholism, the Stein Endowment Fund, and the University of the West Indies.

Send comments to: mbenedyk@scripps.edu

(see Bulletin Board-Alcohol Reports Jan 30 20o7 news release)

US Dept of Veterans Affairs Clinical Study- Alcohol Care Management

Alcohol Care Management

This study is not yet open for patient recruitment.

Verified by Department of Veterans Affairs January 2007
Sponsored by:
Department of Veterans Affairs
Information provided by:
Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00419315

Purpose
A randomized study of Alcohol Care Management for the treatment of alcohol dependence in primary care settings.

Condition
Intervention
Phase
Alcohol Dependence
Behavior: Alcohol Care Management
Phase IV

MedlinePlus related topics: Alcoholism

Study Type: Interventional Study Design: Treatment, Randomized, Single Blind, Active Control, Parallel Assignment, Efficacy Study

Official Title: Primary Care Based Disease Management for Alcohol Dependence

Further study details as provided by Department of Veterans Affairs:

Primary Outcomes:

-Treatment Engagement

-Secondary Outcomes: Alcohol Use

Expected Total Enrollment: 250

Study start: March 2007;

Expected completion: July 2010

Last follow-up: January 2010;

Data entry closure: July 2010

Background: Alcohol dependence is one of the leading causes of disability worldwide. Despite the availability of efficacious treatments less than 20% of individuals with alcohol dependence are actively engaged in treatment. Within the VA system systematic screening was implemented to increase the identification of patients with both abuse and dependence.

However, there continues to be a marked discrepancy in the care offered or accessed among those identified with alcohol dependence. Existing treatment guidelines suggest that all persons with dependence receive care in specialty addiction treatment.

Data from our center indicate that among those individuals screened in primary care who have AUDIT - C scores of greater than 7, only 30% are formally evaluated with 50% receiving only brief advice and 20% having no evidence of assessment or referral. Of those assessed and referred to specialty care only 60% attend an initial visit and only 33% meet the EPRP performance measure of 2 visits per month for 90 days.

This disparity in treatment access exists even though Veterans self report a desire to cut down and readiness to change drinking behaviors. (VA ACQUIP) and a willingness to consider pharmacotherapy.

Aims: Available evidence suggests that primary care may be a key component in the identification of alcohol dependent patients, delivery of initial interventions, and to the success of addiction treatment. Indeed, the vast majority of screening and new case identification occurs within primary care.

The primary aims of this proposal are to test the effectiveness of a primary care based Alcohol Care Management (ACM) program and to evaluate the barriers and facilitators to accessing and engaging individuals into treatment. The ACM program uses a Behavioral Health Specialist to deliver care focused on the use of pharmacotherapy in combination with psychosocial support (Medication Management).

This model may overcome barriers to care such as frequent intensive visit schedules often required in specialty settings, stigma associated with specialty care or group therapy approaches, access to specialty care in remote areas, and the current focus on a 12 step model of treatment.

Secondary aims are to establish the acceptability of primary care based treatments and defining treatment modifiers such as age, barriers, co-occurring depression, and pharmacogenetic response.
(Full text of clinical trial announcement)