Aims

To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.

___________________________________________

Saturday, February 10, 2007

Progress report from the Action Team Feb 07 - Edinburgh, Scotland



Progress report from the Action Team Feb 07



The following aspects of the work of the Action Team in Edinburgh have been reported:

  • Abstinence funding

  • Scottish Executive stocktaking review of the Action Team
  • Edinburgh alcohol and drugs strategy 2007-10
  • Metro newspaper – Christmas alcohol campaign
  • Alcohol Matters in Edinburgh
  • Edinburgh Fear of Crime Survey
  • Waiting times report

Read the latest quarterly report from the Action Team here>

Sub-diagnostic psychiatric comorbidity in alcoholics

Drug and Alcohol Dependence Volume 87, Issues 2-3 , 16 March 2007, Pages 139-145


Sub-diagnostic psychiatric comorbidity in alcoholics






George Fein a, , mailto:george@nbresearch.com
Victoria Di Sclafani a,
Peter Finn b and
Diane L. Scheiner
a

a Neurobehavioral Research, Inc., 201 Tamal Vista Boulevard, Corte Madera, CA 94925-1110, USA
b Department of Psychological and Brain Sciences, Indiana University, 1101 East Tenth Street, Bloomington, IN 47405-7007, USA

Received 16 May 2006; revised 4 August 2006; accepted 9 August 2006. Available online 11 September 2006.

Abstract
Background
Psychiatric comorbidity in alcohol use disorders is clearly established, however most studies ignore data on psychiatric symptom counts that do not meet criteria for a diagnosis.

We examined psychiatric symptom counts and psychological measures in the domains of anxiety, mood and externalizing pathology in 48 long-term abstinent alcoholics (LTAA) compared to 48 age/gender comparable light/non-drinking controls (NC).

Methods
Continuous measures of pathology (i.e., symptoms counts and psychological assessments) in each domain were compared between groups for: (1) all study participants, (2) excluding individuals with a lifetime psychiatric diagnosis in the domain, and (3) excluding individuals with a current psychiatric diagnosis in the domain.

Results
Psychiatric symptom counts and psychological pathology were greater in LTAA than NC. The differences between groups on these measures were not reduced by removal of individuals with lifetime or current diagnoses.

Conclusions
The bulk of the difference between LTAA and NC in psychiatric illness was carried by sub-diagnostic psychopathology.

In comparison to the limited view provided by using only symptomatology that meets criteria for a diagnosis, the use of continuous measures of psychiatric symptomatology and psychological abnormality yields a much more accurate picture of psychiatric illness co-occurring with alcoholism.

Keywords: Alcoholism; Psychiatric comorbidity; Long-term abstinence; Antisocial personality

Corresponding author. Tel.: +1 415 927 7676; fax: +1 415 924 2903.

Sexual orientation, gender, and alcohol use in a cohort study of U.S. adolescent girls and boys



Drug and Alcohol Dependence Volume 87, Issues 2

Sexual orientation, gender, and alcohol use in a cohort study of U.S. adolescent girls and boys




Najat J. Ziyadeh a,

Lisa A. Prokop a,

Laurie B. Fisher b,

Margaret Rosario
c,

Alison E. Field a, b,

Carlos A. Camargo
, Jr. b and

S. Bryn Austin a, b, , mailto:bryn.austin@childrens.harvard.edu

a Division of Adolescent and Young Adult Medicine, Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA
b Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, 181 Longwood Ave., Boston, MA 02115, USA
c Department of Psychology, City University of New York—City College and Graduate Center, NAC Building 7-120, Convent Avenue and 138th Street, New York, NY 10031, USA

Received 31 March 2006; revised 1 August 2006; accepted 2 August 2006. Available online 12 September 2006.

Abstract

Background

Sexual minority youth may be at elevated risk for alcohol use relative to heterosexual youth, but the reasons underlying higher rates and whether there may be gender differences in risk are not known.

Methods
Cross-sectional survey data from 9731 early and middle adolescent girls and boys in the Growing Up Today Study in 1999 were examined to assess sexual orientation and gender patterns in alcohol use. Multivariable regression models estimated associations between sexual orientation and alcohol-related behaviors, such as binge drinking and drinking before age 12 years. Models controlled for sociodemographic and psychosocial factors, with heterosexuals as the reference.

Results
Girls who described themselves as “mostly heterosexual” and lesbian/bisexual girls were at elevated risk compared to heterosexual girls on almost all alcohol-related behaviors and exposures. “Mostly heterosexual” boys were also at elevated risk. No significant differences in alcohol-related behaviors were observed between gay/bisexual and heterosexual boys.

Gender-by-sexual orientation interactions were statistically significant for LGB but not other orientations, indicating that lesbian/bisexual girls experienced elevated risk above and beyond that of gay/bisexual boys relative to same-gender heterosexual peers.

Conclusions
In early and middle adolescence, sexual minority girls and “mostly heterosexual” boys experienced consistent patterns of elevated risk for alcohol use.

Keywords: Alcohol; Adolescence; Sexual minority; Gay; Lesbian; Epidemiology

Corresponding author at: Division of Adolescent and Young Adult Medicine, Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA. Tel.: +1 617 355 8194; fax: +1 617 730 0185.


SAMHSA Announces Availability of Enhancing Motivation for Change InserviceTraining -TIP 35

SAMHSA Announces Availability of Enhancing Motivation for Change InserviceTraining -TIP 35



Excerpt:

"Participants will learn about change theory and motivational strategies, learn to assess clients’ readiness for change, and develop skills for enhancing client motivation.

Between-session exercises help participantspractice new skills and integrate learning into their practices."and: "The trainer’s manual includes eleven 1½- to 2-hour modules and can be delivered on consecutive days or can be offered over several weeks.

Each module includes presentation instructions, PowerPoint slides (that can be copied onto overhead transparencies), homework assignments, and participant handouts. This manual (Treatment Improvement Protocol 35) includes materials for substance abuse treatment supervisors to provide inservice staff training for clinicians and other treatment professionals.

This inservice training is particularly useful for new counselors or for clinicians who are unfamiliarwith the basic concepts of motivational enhancement. Participants will learn about change theory and motivational strategies, learn to assess clients’readiness for change, and develop skills for enhancing client motivation. Between-session exercises help participants practice new skills and integrate learning into their practices.

The trainer’s manual includes eleven 1½- to 2-hour modules and can be delivered on consecutive days or can be offered over several weeks. Each module includes presentation instructions, PowerPoint slides (that can be copied onto overhead transparencies), homework assignments, and participant handouts. The training approach includes presentation, discussion, group or partnered practice exercises, and between-session assignments to enhance participants’ learning.

To order your FREE copy of the Enhancing Motivation for Change Inservice
Drug Information (NCADI). Ask for publication order number PHD1135.

View this publication at:http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid\u003dhstat5.chapter.61302

Phone: 800-729-6686 or 240-221-4017 800-487-4889 (TDD hearing impaired) 877-767-8432 (toll free) Hablamos EspaƱolWeb: www.ncadi.samhsa.gov


TAP 28 (The National Rural Alcohol and Drug Abuse Network Awards for Excellence, 2004—Submitted and Award-Winning Papers) is also available online at www.kap.samhsa.gov."

Contrbutor: Don Phillips

Friday, February 9, 2007

Samuel Guze Symposium on Alcoholism


Samuel Guze Symposium on Alcoholism

Sponsored by the Midwest Alcoholism Research Center & Washington University School of Medicine


The 7th Annual Samuel B. Guze Symposium on Alcoholism
Thursday, February 15, 2007


Alcohol Use Across the Lifespan

Download the Program Brochure

Eric P. Newman Education Center at
Washington University Medical Center, Saint Louis, Missouri


List of Presenters:
Fulton T. Crews, PhD, Professor of Pharmacology; Director, Center for Alcohol Studies, University of North Carolina at Chapel Hill
“Alcohol Use and Consequences: A Developmental Neuroscience Perspective”

Robert A. Zucker, PhD, Professor of Psychiatry and Psychology; Director, Addiction Research Center, and Director, Substance Abuse Section; Department of Psychiatry, University of Michigan, Ann Arbor
“Developmental Models of Drinking in Youth: Where Do They Begin and Where Should They End?”

Brooke S.G. Molina, PhD, Associate Professor of Psychiatry and Psychology; Western Psychiatric Institute & Clinic, University of Pittsburgh, PA
“Alcohol Use, Problems and Disorder in Adolescence”

Kristina M. Jackson, PhD, Research Assistant Professor of Community Health; Center for Alcohol and Addiction Studies, Brown University, Providence, RI
“Understanding the Course of Alcohol Involvement during Emerging Adulthood”

Theodore Jacob, PhD, Senior Research Career Scientist; VAMC Palo Alto Medical System, Menlo Park, CA, and Research Professor; Pacific Graduate School of Psychology, Palo Alto, CA
“The Course of Alcoholism throughout Mid-Life”

Allison A. Moore, MD, MPH, Associate Professor of Medicine and Psychiatry, Division of Geriatrics, University of California at Los Angeles
“Alcohol Use, Misuse and Abuse in Older Adults”


Previous Symposia:

Sixth Annual Guze Symposium, March 2, 2006
"Alcohol and Tobacco Dependence: from Bench to Bedside"
Download the brochure
Symposium Presentations and Posters List (available for viewing and downloading)

Fifth Annual Guze Symposium, February 17, 2005
"Alcoholism and Comorbidity"
Download the brochure
Symposium Presentations and Posters List (available for viewing and downloading)

Fourth Annual Guze Symposium, February 19, 2004
"Alcoholism and the Latest Genetics & Neuroscience Findings"
Download the brochure
Symposium Presentations and Posters List (available for viewing and downloading)

Third Annual Guze Symposium, February 28, 2003
"Drinking and the High School Student"
Download the Brochure
Symposium Presentations and Posters List (available for viewing and downloading)

Second Annual Guze Symposium, March 2, 2002
"The Challenges of College-Age Drinking"
Download the Brochure
Symposium Presentations and Posters List (available for viewing and downloading)

ClinicalTrial - Antabuse in Severe Alcoholism: an Open Controlled Study

Antabuse in Severe Alcoholism: an Open Controlled Study

This study is not yet open for patient recruitment.Verified by Psykiatrisk Center Gentofte

February 2007

Sponsored by:
Psykiatrisk Center Gentofte
Information provided by:
Psykiatrisk Center Gentofte
ClinicalTrials.gov Identifier:
NCT00431262

Purpose
Newly detoxified alcoholics (N=60) are randomised to either disulfiram treatment or the control group for a total of 6 months.All patients will receive cognitive behavioural treatment in groups. The hypothesis to be tested is that more of the patients who receive disulfiram will be alcohol free during the 6 months treatment period compared to the control group. The trial is open.

Condition
Intervention

Phase
Alcoholism

Drug: disulfiram

Phase IV

MedlinePlus related topics: Alcoholism

Study Type: InterventionalStudy Design: Treatment, Randomized, Open Label, Placebo Control, Parallel Assignment, Efficacy Study

Official Title: Antabuse in Severe Alcoholism: an Open Controlled Study

Further study details as provided by Psykiatrisk Center Gentofte:
Primary Outcomes: The number of patients in each group who have not been drinking alcohol after 6 months of treatment.

Expected Total Enrollment: 60

Study start: February 2007;

Expected completion: March 2010

Last follow-up: June 2009;

Data entry closure: August 2009

Eligibility
Ages Eligible for Study: 18 Years - 70 Years,

Genders Eligible for Study: Both

Criteria
Inclusion Criteria:
Alcoholism
Living in the departments catchment area

Exclusion Criteria:
Pregnancy
Schizophrenia
Bipolar disorder
Other substance abuse
Dementia
Anorexia

Location and Contact Information
Please refer to this study by ClinicalTrials.gov identifier NCT00431262
Denmark Psykiatrisk Center Gentofte, Hellerup, 2900, Denmark

Jakob Ulrichsen, MD, ph.d., Principal InvestigatorJakob Ulrichsen, MD, ph.d., Principal Investigator

Study chairs or principal investigators
Jakob Ulrichsen, MD, ph.d., Principal Investigator, Psykiatrisk Center Gentofte

More Information
Study ID Numbers: EudraCT no. 2006-004921-27
Last Updated: February 1, 2007
Record first received: February 1, 2007
ClinicalTrials.gov Identifier: NCT00431262
Health Authority: Denmark: The Regional Committee on Biomedical Research

EthicsClinicalTrials.gov processed this record on 2007-02-08

SUMMARIES FOR PATIENTS - A Brief Intervention for Hospitalized Patients with Unhealthy Alcohol Use 6 February 2007 |


SUMMARIES FOR PATIENTS


A Brief Intervention for Hospitalized Patients with Unhealthy Alcohol Use

6 February 2007
Volume 146 Issue 3 Page I-22

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine. Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
The summary below is from the full report titled "Brief Intervention for Medical Inpatients with Unhealthy Alcohol Use. A Randomized, Controlled Trial." It is in the 6 February 2007 issue of Annals of Internal Medicine (volume 146, pages 167-176). The authors are R. Saitz, T.P. Palfai, D.M. Cheng, N.J. Horton, N. Freedner, K. Dukes, K.L. Kraemer, M.S. Roberts, R.T. Guerriero, and J.H. Samet.

What is the problem and what is known about it so far?
Unhealthy alcohol use damages health. It can hurt relationships; increase risks for accidents and violence; and causes problems with the liver, brain, and heart. A form of unhealthy alcohol use known as "risky drinking" does not always signal alcohol dependence, but it does put people at risk for future problems. Several standard questions can help identify people who have such alcohol problems as risky drinking or dependence. Brief counseling by doctors or other health care professionals in outpatient settings can help people cut back or stop drinking if they are drinking too much. It is not known whether brief counseling delivered to patients during a hospital stay can reduce unhealthy alcohol use.

Why did the researchers do this particular study?
To find out if brief counseling delivered during hospitalization decreases alcohol use in patients who reported risky drinking and helps link dependent patients to services to help with alcohol problems.

Who was studied?
341 patients drinking risky amounts who were hospitalized in an urban hospital. The researchers defined risky drinking as more than 14 drinks per week or 5 or more drinks per occasion for men younger than 66 years and as more than 11 drinks per week or 4 or more drinks per occasion for all women and for men 66 years and older.

How was the study done?
The researchers used standard questionnaires to ask patients about alcohol use. They used this information to determine whether people had alcohol dependence in addition to risky drinking behaviors. Next, about half of the patients received either 30 minutes of alcohol-related counseling by trained counselors before they left the hospital. The other half of the patients were simply told that they could discuss their alcohol use with their doctors. Twelve months later, the researchers contacted patients to see whether their alcohol intake decreased. They also asked patients with alcohol dependence whether they had received any specific care to help with their drinking problem since hospital discharge.

What did the researchers find?
Of the 341 patients in the study, 261 had alcohol dependence. The rest drank risky amounts but were not dependent. Patients who received counseling were not more likely to have reduced alcohol intake at 12 months than those who did not receive in-hospital counseling. Alcohol-dependent patients who received brief counseling in the hospital also were not more likely to have received alcohol-related care than those who did not receive the in-hospital counseling.

What were the limitations of the study?
Patients who did not receive counseling were told that they could discuss their alcohol use with their doctors. This is more alcohol-related advice than typically received in hospital settings and could at least partly explain the lack of difference between the groups.

What are the implications of the study?
Brief counseling for hospitalized patients who drink unhealthy amounts of alcohol is not sufficient for reducing alcohol use or for linking dependent patients to assistance. Other strategies for reducing unhealthy alcohol use are required.

Building better cognitive-behavioral therapy



J Stud Alcohol Drugs. 2007 Mar;68(2):238-47.

Building better cognitive-behavioral therapy: is broad-spectrum treatment more effective than motivational-enhancement therapy for alcohol-dependent patients treated with naltrexone?*.




Davidson D, email: ddavids2@iupui.edu
Gulliver SB,
Longabaugh R,
Wirtz PW,
Swift R.

Department of Psychiatry, Veterans Affairs Boston Healthcare System, 150 South Huntington Avenue, Boston, Massachusetts 02130.

ABSTRACT.

Objective: The current study investigated the treatment effectiveness, during treatment, of a second-generation cognitive-behavioral therapy for alcoholism-broad-spectrum treatment (BST)-compared with motivational-enhancement therapy (MET), when both were offered in conjunction with a therapeutic dose of naltrexone (Revia).

Method: One hundred forty-nine alcohol-dependent patients completed a 3-month randomized, controlled trial of BST and naltrexone versus MET and naltrexone.

Results: Patients receiving BST had a significantly higher percentage of days abstinent than patients receiving MET. The superior effect of BST is particularly strong in interaction with support for drinking, suggesting that the advantage of BST is worth the additional cost for patients whose psychosocial networks are supportive of continued drinking. This effect remains significant when controlling for pretreatment percentage of days abstinent.

Conclusions: In aggregate, these findings suggest that it is either the combination of naltrexone and BST or the unique properties of BST that account for BST's superiority to MET and naltrexone. The results of this initial phase of the trial suggest that a second-generation cognitive-behavioral therapy such as BST may have a meaningful clinical advantage over brief interventions such as MET, at least when combined with naltrexone.

Thursday, February 8, 2007


Volume 102 Issue 3 Page 362 - March 2007

RESEARCH REPORT
Alcohol tax cuts and increase in alcohol-positive sudden deaths—a time-series intervention analysis

Anna Koski1 1Department of Forensic Medicine, University of Helsinki, Finland,
Reino SirƩn
22National Research Institute of Legal Policy, Helsinki, Finland and ,
Erkki Vuori
1 1Department of Forensic Medicine, University of Helsinki, Finland, &
Kari Poikolainen
33The Finnish Foundation for Alcohol Studies, Helsinki, FinlandKari Poikolainen, The Finnish Foundation for Alcohol Studies, PO Box 220, FI-00531 Helsinki, Finland. E-mail: kari.poikolainen@stakes.fi

1Department of Forensic Medicine, University of Helsinki, Finland,
2National Research Institute of Legal Policy, Helsinki, Finland and
The Finnish Foundation for Alcohol Studies, Helsinki, Finland

Kari Poikolainen, The Finnish Foundation for Alcohol Studies, PO Box 220, FI-00531 Helsinki, Finland. E-mail:
kari.poikolainen@stakes.fi

ABSTRACT
Aims The impact of alcohol regulation changes in Finland during 2004 on alcohol-positive sudden deaths was analysed, focusing on: (1) removal of traveller's allowance quotas on alcohol imports from other European Union (EU) countries, (2) lowering of Finnish alcohol excise duty rates and (3) Estonia joining the EU.

Design The impact of these changes was estimated using an autoregressive integrated moving average (ARIMA) analytical technique. Post-mortem forensic toxicology data were analysed over a 15-year period to account for seasonal and long-term variation. In all, the data comprised a weekly series of 33 782 alcohol-positive cases (at least 0.20 mg/g alcohol in blood) and a control series of 37 617 alcohol-negative cases.

Setting Finland in 1990–2004.

Findings The liberation of traveller's allowances had no material impact on alcohol-positive sudden deaths, but the impact of alcohol tax cuts in March 2004 was significant, resulting in an estimated eight additional alcohol-positive deaths per week, which is a 17% increase compared with the weekly average of 2003. The impact associated with Estonia joining the EU was not statistically significant. In the models applied to the control series of alcohol-negative deaths, none of the impact coefficients was statistically significant.

Conclusions Alcohol tax cuts were associated with an increase in the number of sudden deaths involving alcohol. This parallels the reported increases in alcohol consumption and alcohol-related causes of death in 2004 in Finland.

Alcohol and violence: use of possible confounders in a time-series analysis

Volume 102 Issue 3 Page 369 - March 2007


RESEARCH REPORT
Alcohol and violence: use of possible confounders in a time-series analysis




Elin K. Bye
Norwegian Institute for Alcohol and Drug Research, Oslo, Norway
Elin K. Bye, Norwegian Institute for Alcohol and Drug Research, POB 565 Sentrum, N-0105 Oslo, Norway. E-mail:
ekb@sirus.no

ABSTRACT
Aims To assess the aggregate association between alcohol consumption and violence, while controlling for potential confounders.

Design and measurements The data comprise aggregate time-series for Norway in the period 1880–2003 and 1911–2003 on criminal violence rates and per capita alcohol consumption. Possible confounders comprise annual rates of unemployment, divorce, marriage, total fertility rate, gross national product, public assistance/social care and the proportion of the population aged between 15 and 25. Autoregressive integrated moving average (ARIMA) analyses were performed on differenced data. Both semilogarithmic and linear models were estimated.

Findings Alcohol consumption was associated significantly with violence, and an increase in alcohol consumption of 1 litre per year per inhabitant predicted a change of approximately 8% in the violence rate. The parameter estimate for the alcohol variable remained unaltered after including the covariates both in the semilogarithmic and the linear models. Of the seven covariates included in the models, only divorce was associated significantly with violence rate.

Conclusions The results suggest that alcohol consumption has an independent effect on violence rates when other factors are controlled for. The results support the assumption of a causal effect of alcohol consumption on violence, and it appears that alcohol consumption is an important factor when we wish to explain changes in violence rates over time.

A randomized controlled trial of Minnesota day clinic treatment of alcoholics

Volume 102 Issue 3 Page 381 - March 2007


RESEARCH REPORT
A randomized controlled trial of Minnesota day clinic treatment of alcoholics




Morten GrĆønbƦk1
1Centre for Alcohol Research, National Institute of Public Health, Copenhagen, Denmark andMorten GrĆønbƦk, Centre for Alcohol Research, National Institute of Public Health, Ƙster Farimagsgade 5, 2nd floor, DK-1399 Copenhagen K, Denmark. E-mail: mg@niph.dk &
Bent Nielsen
2 2Department of Psychiatry Odense, University Hospital, Odense, Denmark

1Centre for Alcohol Research, National Institute of Public Health, Copenhagen, Denmark and 2Department of Psychiatry Odense, University Hospital, Odense, Denmark

Morten GrĆønbƦk, Centre for Alcohol Research, National Institute of Public Health, Ƙster Farimagsgade 5, 2nd floor, DK-1399 Copenhagen K, Denmark. E-mail:

mg@niph.dk

ABSTRACT

Aim To compare the Minnesota day clinic treatment with the traditional public psychosocial treatment.

Design Randomized controlled trial.

Setting Public out-patient alcohol clinic and privately funded Minnesota day clinic in Denmark.

Participants A total of 148 individuals with alcohol dependence were included in a 1-year clinical trial.

Measurements Self-reported drinking pattern and the seven composite scores from the addiction severity index (ASI).

Findings A total of 42 (57%) and 45 (61%) patients (P > 0.05) completed the Minnesota treatment and public treatment, respectively.

Throughout the whole 12-month follow-up period, 35% of the patients treated at the Minnesota day clinic were abstainers, while this was the case for 20% of the patients treated in the public out-patient alcohol clinic (P = 0.043).

During the last month before the end of the 1-year follow-up, 53% of the patients treated according to the Minnesota model were abstainers, while this was the case for 43% of the patients treated in the public out-patient alcohol clinic (P = 0.249).

There were insignificant differences in the seven ASI scores.

Conclusions Twelve months after onset of treatment, the Minnesota day clinic treatment does not differ in effect from the much cheaper 'standard' public treatment. However, patients in Minnesota treatment were total abstainers throughout a longer period.


The monoamine oxidase A (MAO-A) gene, family function and maltreatment as predictors of destructive behaviour during male adolescent alcohol consumpti

Volume 102 Issue 3 Page 389 - March 2007

RESEARCH REPORT

The monoamine oxidase A (MAO-A) gene, family function and maltreatment as predictors of destructive behaviour during male adolescent alcohol consumption

Kent W. Nilsson1 1Centre for Clinical Research, Uppsala University, Central Hospital VƤsterƄs, VƤsterƄs, Sweden and Kent Nilsson, Centre for Clinical Research, Central Hospital VƤsterƄs (1), S-721 89 VƤsterƄs, Sweden. E-mail: kent.nilsson@ltv.se ,
Rickard L. Sjƶberg
1 1Centre for Clinical Research, Uppsala University, Central Hospital VƤsterƄs, VƤsterƄs, Sweden and ,
Hanna-Linn Wargelius
2 2Department of Neuroscience, Unit of Pharmacology, Uppsala University, Uppsala, Sweden ,
Jerzy Leppert
1 1Centre for Clinical Research, Uppsala University, Central Hospital VƤsterƄs, VƤsterƄs, Sweden and, Leif Lindstrƶm1 1 Centre for Clinical Research, Uppsala University, Central Hospital VƤsterƄs, VƤsterƄs, Sweden and & Lars Oreland2 2 Department of Neuroscience, Unit of Pharmacology, Uppsala University, Uppsala, Sweden

1Centre for Clinical Research, Uppsala University, Central Hospital VƤsterƄs, VƤsterƄs, Sweden and

2Department of Neuroscience, Unit of Pharmacology, Uppsala University, Uppsala, Sweden


Kent Nilsson, Centre for Clinical Research, Central Hospital VƤsterƄs (1), S-721 89 VƤsterƄs, Sweden. E-mail: kent.nilsson@ltv.se


ABSTRACT


Aim To investigate possible interactions between a polymorphism in the monoamine oxidase A (MAO-A) gene promoter, family relations and maltreatment/sexual abuse on adolescent alcohol-related problem behaviour among male adolescents.


Design, setting and participants A cross-sectional study of a randomized sample of 66 male individuals from a total population of 16- and 19-year adolescents from a Swedish county. Boys, who volunteered to participate answering an alcohol-related problem/behaviour questionnaire, were investigated with regard to interactions between such problems, family function, maltreatment and MAO-A genotype.


Measurements MAO-A genotype, family relations history, history of being maltreated or abused and alcohol-related problem behaviour.


Findings Boys with the short (three-repeat) variant of the MAO-A gene, who had been maltreated/abused or came from families with poor relations, showed significantly higher scores of alcohol-related problems. We also found that maltreatment/abuse independently showed the strongest relation to alcohol-related problems among boys in our model.


Conclusions The results suggest that both maltreatment and MAO-A genotype may be useful for the understanding of male adolescent alcohol-related problem behaviour.

Exploring the relationship between genetic and environmental influences on initiation and progression of substance use

Volume 102 Issue 3 Page 413 - March 2007
RESEARCH REPORT

Exploring the relationship between genetic and environmental influences on initiation and progression of substance use


Tom Fowler

1 1Department of Psychological Medicine, Cardiff University, Cardiff, UK, Tom Fowler, Department of Psychological Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. E-mail: fowlerta@cardiff.ac.uk , Kate Lifford1 1Department of Psychological Medicine, Cardiff University, Cardiff, UK, , Katherine Shelton1 1Department of Psychological Medicine, Cardiff University, Cardiff, UK, , Frances Rice1 1Department of Psychological Medicine, Cardiff University, Cardiff, UK, , Anita Thapar 1 1Department of Psychological Medicine, Cardiff University, Cardiff, UK, , Michael C. Neale 2 2Department of Psychiatry and Human Genetics, Virginia Commonwealth University, Richmond, VA, USA and ,
Andrew McBride
3 3 Oxfordshire Community Mental Healthcare Trust, Oxford, UK and Marianne B. M. van den Bree 1 1Department of Psychological Medicine, Cardiff University, Cardiff, UK,


1Department of Psychological Medicine, Cardiff University, Cardiff, UK, 2Department of Psychiatry and Human Genetics, Virginia Commonwealth University, Richmond, VA, USA and 3Oxfordshire Community Mental Healthcare Trust, Oxford, UK


Tom Fowler, Department of Psychological Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. E-mail:

fowlerta@cardiff.ac.uk


ABSTRACT


Aims To examine the genetic and environmental contributions to the initiation of use and progression to more serious use of alcohol, cigarettes and marijuana during adolescence, and to examine the relationship between initiation and progression of substance use.


Design The study used a twin-based design and a new theoretical model, the causal–common–contingent (CCC) model. This allows modelling of the relationship between initiation of use and progression to heavier use as a two-stage model and the examination of genetic and environmental influences on both stages, while taking into account their relationship.


Participants The participants consisted of 1214 twin pairs (69% response rate) aged 11–19 years sampled from the UK population-based Cardiff Study of All Wales and North-west of England Twins (CaStANET).


Measurements Data on adolescent initiation and progression to more serious use of alcohol, cigarettes and marijuana were obtained using self-report questionnaires.


Findings Initiation of alcohol and progression to heavier alcohol use had separate but related underlying aetiologies. For cigarette and marijuana use the relation between initiation and progression to heavier use was stronger, suggesting greater overlap in aetiologies. For all three substances, environmental influences that make twins more similar (common environment) tended to be greater for initiation, while genetic influences were stronger for heavier use.


Conclusions These findings have implications for policy decisions aimed at an adolescent and early adult age group. Specifically, these findings suggest that it may be more efficacious to focus alcohol interventions on risk factors for the development of heavier use rather than initiation of use. In contrast, interventions aimed at reducing the initiation of cigarettes and marijuana use may be more appropriate.

Treatment setting and baseline substance use severity interact to predict patients' outcomes

Volume 102 Issue 3 Page 432 - March 2007
RESEARCH REPORT
Treatment setting and baseline substance use severity interact to predict patients' outcomes

Quyen Q. Tiet1,2
1Center for Health Care Evaluation, Department of Veterans Affairs, Palo Alto Health Care System, Menlo Park, CA, 2Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA and Quyen Tiet, Center for Health Care Evaluation, VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA 94025, USA. E-mail: quyen.tiet@va.gov; tietq2@yahoo.com ,

Mark A. Ilgen
1
1Center for Health Care Evaluation, Department of Veterans Affairs, Palo Alto Health Care System, Menlo Park, CA, ,

Hilary F. Byrnes
3
3University of California, Berkeley, School of Public Health, and Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA ,
Alex H. S. Harris1
1Center for Health Care Evaluation, Department of Veterans Affairs, Palo Alto Health Care System, Menlo Park, CA, &

John W. Finney
1,2
1Center for Health Care Evaluation, Department of Veterans Affairs, Palo Alto Health Care System, Menlo Park, CA, 2Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA and
1Center for Health Care Evaluation, Department of Veterans Affairs, Palo Alto Health Care System, Menlo Park, CA, 2Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA and 3University of California, Berkeley, School of Public Health, and Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA

Quyen Tiet, Center for Health Care Evaluation, VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA 94025, USA. E-mail:
quyen.tiet@va.gov; tietq2@yahoo.com

ABSTRACT

Aims This study tested the hypothesis that patients with more severe substance use disorders (SUDs) at intake respond better when treated in more structured and intensive settings (i.e. in-patient/residential versus out-patient), whereas patients with less severe SUD problems have similar outcomes regardless of treatment setting.

Design, setting and participants Up to 50 new patients were selected randomly from each of a random and representative sample of 50 Department of Veterans Affairs (VA) SUD treatment programs (total n = 1917 patients), and were followed-up an average of 6.7 months later (n = 1277).

Measures Patients completed a brief self-report version of the Addiction Severity Index (ASI) at baseline and at follow-up.
Findings In mixed-model regression analyses, baseline substance use severity predicted follow-up substance use severity and there were no main effects of treatment setting. However, interaction effects were found, such that more severe patients experienced better alcohol and drug outcomes following in-patient/residential treatment versus out-patient treatment; on the other hand, patients with lower baseline ASI drug severity had better drug outcomes following out-patient treatment than in-patient treatment. Treatment setting was unrelated to alcohol outcomes in patients with less severe ASI alcohol scores.

Conclusions Results provide some support to the matching hypothesis that for patients who have higher levels of substance use severity at intake, treatment in in-patient/residential treatment settings is associated with better outcomes than out-patient treatment. More research needs to be conducted before in-patient/residential settings are further reduced as a part of the SUD continuum of care in the United States.

Attentional re-training decreases attentional bias in heavy drinkers without generalization

Volume 102 Issue 3 Page 399 - March 2007

RESEARCH REPORT
Attentional re-training decreases attentional bias in heavy drinkers without generalization




Tim Schoenmakers1
1Experimental Psychology, Maastricht University, Maastricht, the Netherlands, Tim Schoenmakers, PO Box 616, 6200 MD, Maastricht, the Netherlands. E-mail: t.schoenmakers@psychology.unimaas.nl ,

Reinout W. Wiers
1,2,3
1Experimental Psychology, Maastricht University, Maastricht, the Netherlands, 2Behaviour Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands, 3Rotterdam Addiction Research Institute, Rotterdam, the Netherlands and ,

Barry T. Jones
4
4Department of Psychology, Glasgow University, Glasgow, UK ,
Gillian Bruce
4
4Department of Psychology, Glasgow University, Glasgow, UK &

Anita T. M. Jansen
1
1Experimental Psychology, Maastricht University, Maastricht, the Netherlands,


1Experimental Psychology, Maastricht University, Maastricht, the Netherlands, 2Behaviour Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands, 3Rotterdam Addiction Research Institute, Rotterdam, the Netherlands and 4Department of Psychology, Glasgow University, Glasgow, UK
Tim Schoenmakers, PO Box 616, 6200 MD, Maastricht, the Netherlands.

E-mail: t.schoenmakers@psychology.unimaas.nl


ABSTRACT


Aims To examine whether alcohol-related attentional bias (AB) can be reduced by training heavy drinkers to attend to soft drinks as an alternative to alcohol. Diminishing AB is important because AB has been suggested to be a significant factor in the development, maintenance and relapse of addictive behaviours. AB was trained in a clinically relevant design, and we studied the generalization of this training.


Design, participants and intervention We assigned randomly 106 heavy drinking male college and university students to the attentional re-training (AR; modified visual-probe task) or control condition (standard visual-probe task).
Setting Laboratory at Maastricht University.


Measurements We measured the effects of AR on the visual-probe task with stimuli that were presented in the AR and with new stimuli, and on an alternative measure of AB, the flicker paradigm. We further measured effects on craving and preference for either an alcohol beverage or a soft drink.


Findings After AR, participants had learned to avoid alcohol stimuli and had developed an AB for soft drinks. This effect was restricted to stimuli used in the AR. The flicker task, where AB for alcohol was found in both the AR and control groups, was not affected by the AR. No effect was found on craving and the preference task.


Conclusions Although heavy drinkers can learn to attend selectively to an alternative category for alcohol, a single AR is not sufficient to decrease symptoms of problem drinking.

Health impact of young people's drinking


Health impact of young people's drinking



  • Doctors have warned of a "sinister" rise in alcohol-related brain damage in young people as new evidence shows Scotland is set to suffer the consequences of the explosion in teenage binge drinking. Clinics across the country are dealing with numerous drinkers aged only in their twenties and thirties but suffering from brain damage - a scenario one charity described as "the tip of a substantial and growing iceberg". Dr Jonathan Chick, a consultant psychiatrist with Lothian Health Board's alcohol problem service, said: "For the first time, we are seeing people in their thirties and early forties with conditions such as Korsakoff's syndrome. "This is at least ten years younger than the patients with alcohol-related brain damage we used to deal with. This definitely reflects the growing trend for heavy alcohol consumption at an ever earlier age." Symptoms of the condition include difficulty in acquiring new information or learning new skills, and lack of insight into the condition - even a person with great gaps in their memory may believe their memory is functioning normally. Others involve inventing events to fill the gaps in memory and apathy in some cases, or talkative and repetitive behaviour in others. The Scotsman

  • Teenagers as young as 13 are being admitted to hospital requiring treatment for alcohol intoxication. New figures from Northumbria Healthcare NHS Foundation Trust show that alcohol abuse has seen, on average, two youngsters a month admitted to Wansbeck Hospital in the space of a year.
    The figures, obtained under the Freedom of Information Act, relate to the number of patients aged 17 and under admitted to the hospital with a diagnosis of alcohol abuse between April 1, 2005, and March 31, 2006. During this period 24 young people were taken to Wansbeck General requiring medical attention for alcohol intoxication.
    The age with the highest number of admissions for alcohol abuse were 16-year-olds, with 11 needing hospital treatment. Figures from Northumbria Healthcare Trust for a three-month period last year revealed that six youngsters aged 17 or under were taken to Wansbeck with alcohol intoxication. Between April 1, 2006, and June 30, 2006, an average of two youngsters a month were taken to the hospital. Blyth and Wansbeck Today

    Contributor: Libby Ranzetta Alcohol Policy UK February 08, 2007

Alcohol in the news 8.2.07


Alcohol in the news 8.2.07



  • Britain's leading abortion provider carried out the highest number of abortions in a single month in January. Marie Stopes International (MSI) said Christmas drinking, leading to unprotected sex, could be to blame for the highest figure recorded in its 32-year history. A total of 5,992 abortions were carried out at the charity's nine UK clinics in January - a rise of 13 per cent on the 5,304 figure for January 2005. In total, 61,983 abortions were performed at Marie Stopes clinics in the UK in 2006. Liz Davies, MSI director of UK operations, said: "It's too soon to say whether the figures we have recorded will be reflected across the country in official national statistics to be published later this year. It does seem, however, that we may be seeing the consequences of the festive season, when partying excess and alcohol consumption combine to increase libido and lower inhibition, with the inevitable consequences of unprotected sex resulting in unplanned pregnancies." This is London

  • Reducing harm from binge-drinking should be done for the UK’s health and not for economic reasons, it has been argued. Speaking at the Promoting Responsible Drinking conference in London, Ben Baumberg of the
    Institute of Alcohol Studies claimed that the economic burden of alcohol harm has been over-stated. He pointed to figures which suggested that £2bn would be saved if alcohol harm is reduced. But Baumberg argued that this cost would stay with the health service and go towards treating people for other diseases. “The difference reducing alcohol harm could make to the economy is really very small,” he told delegates. “This is not the reason to reduce alcohol harm, the harm itself is the reason to reduce it.” The Publican Hear more from Ben Baumberg in the Alcohol Policy UK podcast episode 8; see Ben's report Alcohol in Europe

  • Professor Ian Gilmore, the president of the Royal College of Physicians, has called for an increase in tax on alcohol to protect public health. Higher taxes were particularly needed on strong cider, other high strength drinks and booze aimed at young people such as alcopops, he said, adding that VAT on cider with an alcohol content of up to 7.5 per cent was too low. He also warned that the Government's failure to take public health into account when introducing 24-hour drinking would lead to an increase in alcohol-related illness. Telegraph

  • Police officers in Suffolk will face random drug and alcohol testing within the next few weeks it has emerged.The force has been working to introduce a substance misuse testing programme for the past year and is now in the final stages of agreeing who will administer the scheme. Home Office guidelines indicated that forces nationwide had to have a strategy for substance testing in place by January 1 and testing should begin soon after.
    Superintendent John Everett, head of professional standards for Suffolk police, said: “We will be testing probationers (new officers), and those in what are designated as safety critical posts, things like response drivers, firearms officers and search officers. They can be tested for controlled drugs and those in safety critical posts can also be tested for alcohol on a random basis.”
    Evening Star 24

  • A major North Sea operator has sparked a storm of protest by introducing the first "zero tolerance" policy on alcohol for offshore workers in British waters. Until now, an industry-wide alcohol curb was imposed - which barred workers from travelling offshore while over the legal limit for drink driving. But employees at Canadian-based Nexen Petroleum UK have been warned they face a ban if they are found to have any trace of non-naturally occurring alcohol in their system during routine checks at the heliport. Scotsman


Contributor: Libby Ranzetta AlcoholPolicy UK February 08, 2007

Tackling young people's drinking pt83


Tackling young people's drinking pt83



  • Wales: Police claim to have successfully targeted alcohol related violence and disorder during a month long campaign. Over the Christmas and New Year period officers in the Blaenau Gwent and Caerphilly County Borough areas confiscated alcohol from under 18s on 95 separate occasions, preventing any further potential disorder. During the campaign extra patrols were on duty targeting such behaviour. 21 arrests were also made for various offences such as drunk and disorderly behaviour and other public order offences. News Wales


  • Police have published a picture showing just some of the booze that they took from teenagers last Friday night, in a blitz on anti-social behaviour in Dunstable and Houghton Regis. A police team led by Insp Dave Boyle found youngsters, aged from 13 to 16, was out until 11.30pm. Alcohol seized from the under-age drinkers including cases of strong lager and vodka-based alcopops. Police immediately took many children home, and the youngsters were asked to explain themselves in front of their parents. This was the second police operation of its kind in recent weeks. Bedford Today


  • Isle of Man: In line with the Chief Minister's Drug and Alcohol Strategy, year seven students are being informed about the dangers of volatile substance abuse, year nines about cannabis and year 10s about binge drinking. Students from each year group are being invited to take part in a competition to design a poster linked to the theme they are learning about. Judged with the help of the Department of Health and Social Security's health promotion office, a winning entry in each category from each of the five secondary schools will be picked to be made into an official poster that will be displayed in schools and youth centres. Meanwhile a drug and alcohol education website for students is being developed by a year 11 student from St Ninian's High School, Douglas. The site will target under-18s and will include information, a monthly newsletter, details of where to get help and interactive elements. Isle of Man Today


  • Off-licences in an area of Teesside have brought in a permanent ban on selling alcohol to people under 21. Five shops in Marske introduced the trial ban in August last year to try to reduce drink-related crime. Since the voluntary ban Cleveland Police said incidents of youngsters being drunk and disorderly had plummeted in the town. Traders also said their staff and customers were happy with the ban and had decided to make it permanent. BBC News

Contributor: Libby Ranzetta AlcoholPolicy UK February 08, 2007

DASIS Report - Primary Alcohol Admissions Aged 21 or Older: Alcohol Only vs. Alcohol plus a Secondary Drug: 2005

February 2, 2007
Primary Alcohol Admissions Aged 21 or Older: Alcohol Only vs. Alcohol plus a Secondary Drug: 2005


In Brief


Admissions aged 21 or older in 2005 that were for alcohol only were more likely than admissions for alcohol plus a secondary drug to be White (68 vs. 58 percent) -->

  • Admissions aged 21 or older for alcohol only were more likely than admissions for alcohol plus a secondary drug to have been referred to treatment by the criminal justice system (41 vs. 33 percent) -->


  • Among admissions aged 21 or older, admissions for alcohol only were more likely than admissions for alcohol plus a secondary drug to be first-time admissions (50 vs. 39 percent)

  • The National Survey on Drug Use and Health found that about 18.7 million Americans were dependent on or abused alcohol in 2005. Of these, 3.3 million were dependent on or abused an illicit drug. Some of these people enter treatment, and their admissions can be monitored with the Treatment Episode Data Set (TEDS), an annual compilation of data on the 1.8 million annual admissions to substance abuse treatment facilities, primarily those that receive some public funding. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once during a single year.

    In 2005, over one third of all TEDS admissions (36 percent) were both aged 21 or older and reported alcohol as the primary substance of abuse. This report examines these admissions, comparing about 374,000 admissions (56 percent) where alcohol was the only substance of abuse (alcohol only) with about 289,000 admissions (44 percent) that reported alcohol plus a secondary drug.
    (full report)

    Drinkaware Trust Board appointed

    Drinkaware Trust Board appointed




    The Drinkaware Trust (Drinkaware) has announced the Charity’s ten Trustees.

    The new appointments are :

    Carolyn Bradley - Commercial Director, TESCO Stores Limited (corporate responsibility page)

    Tim Clarke - Chief Executive, Mitchells & Butlers PLC (social responsibility page)

    John Dunsmore - Chairman and Managing Director, Scottish &Newcastle UK (responsible drinking page)

    Prof. David Foxcroft - School of Health and Social Care, Oxford Brookes University

    Nick Grant - Head of Legal Services, Sainsbury’s Supermarkets Ltd (responsibility page)

    Stephen Hogg - Senior Communications Officer, Centrepoint

    Srabani Sen - Chief Executive, Alcohol Concern

    Dr Nick Sheron - Head of Clinical Hepatology, Southampton General Hospital

    Benet Slay - Managing Director, DIAGEO Great Britain (corporate citizenship page)

    Dr Michael Wilks - Chairman, Representative Body, British Medical Association

    The Drinkaware Trust is an independent, UK wide, public facing body with the objective of positively changing public behaviour and the national drinking culture to help reduce alcohol misuse and minimise alcohol-related harm. Launching in early 2007, it has a projected budget of £12m over its first three years. The Trust is a charity, registered number 1094586.
    The appointment of Trustees follows an open competition as set out in the memorandum of understanding signed by Ministers and industry last summer. Tenure or each position is staggered to 2, 3 or 4 years (to be decided) and the positions are unpaid. The Appointments panel decided not to appoint the two lay (that is no professional interest in alcohol) posts at a later date. Drinkaware’s Independent and unpaid Chair - Debra Shipley was appointed from 1st January.
    ontributor: Libby Ranzetta Alcohol Policy UK Feberuary 8, 2007

    Alcohol misuse in the South East region - new report from SEPHO

    Alcohol misuse in the South East region - new reportfrom SEPHO

    South East Public Health Observatory (SEPHO) has published a report presenting data on alcohol in the South East region, as part of its Choosing Health series.
    The main purpose of the report is to describe the pattern and impact of alcohol consumption in the region. It also highlights the relationship between alcohol and health and its association with crime, and sets out ways of tackling alcohol-related issues.
    Contributor: Libby Ranzetta Alcohol Policy UK February 8,2007

    Alcohol Statistics for Scotland - new compendium published




    A compendium of previously released statistics was published on 30th January by ISD Scotland, together with new data on hospital alcohol-related discharges and alcohol-related deaths.

    Latest statistics demonstrate the massive health and social cost of alcohol misuse in Scotland and illustrate why doing nothing is not an option, Deputy Health Minister Lewis Macdonald said:

    • Between 2001/02 and 2005/06, the number of people discharged from hospital with alcohol-related injuries or illnesses rose from 35,445 to 39,061, an increase of 10%

    • There were 2,372 deaths in Scotland in 2005 where alcohol was either the cause or a contributing factor, an increase of 15% since 2001
    Contributor: Libby Ranzetta Alcohol Policy UK February 8, 2007