Genetic and Environmental Influences on the Development of Alcoholism: Resilience vs. Risk.

Ann N Y Acad Sci. 2006 Dec;1094:193-201.

• Enoch MA. E-mail: maenoch@niaaa.nih.gov
  

NIH/NIAAA/DICBR/LNG, 5625 Fishers Lane, Room 3S32, MSC 9412, Bethesda, MD 20892. maenoch@niaaa.nih.gov.

Abstract

The physiological changes of adolescence may promote risk-taking behaviors, including binge drinking. Approximately 40% of alcoholics were already drinking heavily in late adolescence. Most cases of alcoholism are established by the age of 30 years with the peak prevalence at 18-23 years of age.

Therefore the key time frame for the development, and prevention, of alcoholism lies in adolescence and young adulthood. Severe childhood stressors have been associated with increased vulnerability to addiction, however, not all stress-exposed children go on to develop alcoholism.

Origins of resilience can be both genetic (variation in alcohol-metabolizing genes, increased susceptibility to alcohol's sedative effects) and environmental (lack of alcohol availability, positive peer and parental support).

Genetic vulnerability is likely to be conferred by multiple genes of small to modest effects, possibly only apparent in gene-environment interactions. For example, it has been shown that childhood maltreatment interacts with a monoamine oxidase A (MAOA) gene variant to predict antisocial behavior that is often associated with alcoholism, and an interaction between early life stress and a serotonin transporter promoter variant predicts alcohol abuse in nonhuman primates and depression in humans.

In addition, a common Met158 variant in the catechol-O-methyltransferase (COMT) gene can confer both risk and resilience to alcoholism in different drinking environments.

It is likely that a complex mix of gene(s)-environment(s) interactions underlie addiction vulnerability and development.

Risk-resilience factors can best be determined in longitudinal studies, preferably starting during pregnancy. This kind of research is important for planning future measures to prevent harmful drinking in adolescence.

Thirteenth Annual Maternal and Child Health Epidemiology Conference

Making Methods and Practice Matter for
Women, Children and Families

Conference will be held:
December 12–14, 2007
Crowne Plaza Hotel Atlanta-Ravinia (Perimeter Center)
Atlanta, Georgia

About the Conference

Maternal and Child Health Epidemiology (MCH EPI) conference organizers invite you to join MCH professionals in sharing experiences, enhancing knowledge, and generating new ideas for improved MCH data use and informed policymaking.

Abstracts for the 13th Annual MCH EPI Conference will be accepted until 5:00 p.m. ET, May 11, 2007.

Tentative Conference Schedule
Wednesday, December 12, 8 a.m.–5 p.m.
Thursday, December 13, 8 a.m.–5 p.m.
Friday, December 14, 8 a.m.–12 p.m.

Who Should Attend
Health professionals working with maternal and child health data, programs, or policies, particularly at the national, state, tribal, and local levels, including

• Epidemiologists
• Program specialists
• Evaluators
• Data analysts
• Clinicians
• Community advocates
• Policymakers
• Researchers
• Students

Awards
Awards (Top Abstract and Top Poster - 1^st and 2^nd place) will be presented during the conference for outstanding work.

Travel Scholarships
Limited travel scholarships will be available for those participating this year. Priority will be given to those who are speakers, those who have an accepted abstract, those conducting MCH EPI work, and students.

Please request a travel scholarship application by sending an email to MCHEPI@cdc.gov

Please submit all travel scholarship applications by September 7, 2007. We will not consider requests or applications submitted after the deadline. Submission does not guarantee automatic receipt of a travel scholarship. Final decisions will be made in early to mid fall.

For questions about the conference, please contact the Conference Organizers at mchepi@cdc.gov.

Contributor: Peggy Seo Oba

Using ancestry-informative markers to define populations and detect population stratification

Journal of Psychopharmacology, Vol. 20, No. 4 suppl, 19-26 (2006)









Mary-Anne Enoch E-mail: maenoch@niaaa.nih.gov

Pei-Hong Shen

Ke Xu

Colin Hodgkinson

David Goldman

Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA

Abstract

A serious problem with case-control studies is that population subdivision, recent admixture and sampling variance can lead to spurious associations between a phenotype and a marker locus, or indeed may mask true associations. This is also a concern in therapeutics since drug response may differ by ethnicity. Population stratification can occur if cases and controls have different frequencies of ethnic groups or in admixed populations, different fractions of ancestry, and when phenotypes of interest such as disease, drug response or drug metabolism, also differ between ethnic groups.

Although most genetic variation is inter-individual, there is also significant inter-ethnic variation. The International HapMap Project has provided allele frequencies for approximately three million single nucleotide polymorphisms (SNPs) in Africans, Europeans and East Asians. SNP variation is greatest in Africans. Statistical methods for the detection and correction of population stratification, principally Structured Association and Genomic Control, have recently become freely available. These methods use marker loci spread throughout the genome that are unlinked to the candidate locus to estimate the ancestry of individuals within a sample, and to test for and adjust the ethnic matching of cases and controls.

To date, few case-control association studies have incorporated testing for population stratification. This paper will focus on the debate about the quantity and methods for selection of highly informative marker loci required to characterize populations that vary in substructure or the degree of admixture, and will discuss how these theoretically desirable approaches can be effectively put into practice.

CALIFORNIA ASSOCIATION OF ADDICTION RECOVERY RESOURCES
ANNUAL MEMBERSHIP MEETING


In Sacramento, California!
March 12TH—14TH, 2007

The Annual Membership Meeting has been set for
March 12th through the 14th, 2007 in Sacramento,
California. The meeting will be held at the
Red Lion Inn, 1401 Arden Way in Sacramento.

Registration for the entire event is $150.00.
To make Hotel arrangements with the Red Lion
Inn, call (916) 922-8041. Special room rates of
$84.00/night are available if you mention the
CAARR conference. Register today!

For further information, please call Ken Jones at
CAARR: 916-338-9460.


CAARR Trainings/Rooms Annual Conference – Red Lion Inn ‘07
1401 Arden Way, Sacramento, CA, 95815
(916) 922-8041

Sunday, March 11, 2007 2:00 PM CAS Examination

Monday, March 12, 2007
10:00-12:00PM State of AOD – Rebecca Lira, 2 CEH
Deputy Director, State AOD Programs
12:00-1:30 PM Keynote speaker and Lunch - Senator Denise Moreno Ducheny
1:30-4:30 PM Training - Eating Disorders – Becky Jackson 3 CEH
1:30-4:30 PM Training –Ethics – Roger Kendrick 3 CEH
4:30-5:30 PM CAARR Institute Coordinator Meeting 1 CEH
6:00 PM CAARR Board of Directors Meeting
Dinner on your own...

Tuesday, March 13, 2007
8:00 AM Continental Breakfast
9:00-12:00 PM CAARR General Membership Meeting 3 CEH
(Vote on Bylaws change)
12:00- 4:00 PM Legislative Information and Capitol visit 4 CEH
4:00-6:00 PM CAS Board of Directors Meeting & Elections 2 CEH

Wednesday, March 14, 2007
8:00 AM Continental Breakfast
9:00 AM Election of CAARR Board of Directors
9:30-12:30 PM Training Confidentiality/HIPAA/Bob Hulsey 3 CEH
9:30-12:30 PM Training Grief & Loss – Janis Martin 3 CEH
12:30-1:30 PM Lunch—Kathy Jett, Director, State AOD Programs
1:30-4:30 PM Training PTSD – Cathy Ciampa 3 CEH
1:30-4:30 PM Management Roundtable

News Release - Cholesterol Could be Key to Treating Fetal Alcohol Syndrome



keywords : Fetal alcohol syndrome
date : 3/8/2007
media contact : Richard Merritt , (919) 684-4148
merri006@mc.duke.edu


DURHAM, N.C. -- Small amounts of alcohol can interfere with the growth of a fetus, but added cholesterol may help prevent a wide array of neurological and physical defects from alcohol exposure, according to a new study in laboratory fish.

Cholesterol is so important to fetal development that pregnant women who do not have high enough cholesterol levels are at increased risk of having babies with developmental problems, even without consuming alcohol. Researchers at Duke University Medical Center, led by Yin-Xiong Li, MD., Ph.D., found that alcohol, even in small amounts, blocks the ability of cholesterol to orchestrate the complex series of events involved in regulating cell fates and organ development in the embryo. Encouragingly, the researchers also found that giving supplemental cholesterol to zebrafish embryos exposed to alcohol restored normal development.

Fetal alcohol syndrome is a term to describe an array of developmental defects affecting the nervous and cardiovascular systems. The syndrome also can lead to growth retardation, facial abnormalities and lowered mental functioning. It is estimated that approximately 100 babies are born in the United States each day with some degree of alcohol induced birth defects, at an annual cost of $10 billion to the health care system.

What alcohol does is interfere with a precisely orchestrated biochemical signaling pathway that guides fetal development. Cholesterol is essential for a single pathway that governs the pattern of tissue development and it is vulnerable to the effects of alcohol.

"This new insight into the molecular basis of fetal alcohol syndrome could have far-reaching implications and suggests new prenatal care that might prevent the developmental defects caused by alcohol consumed during pregnancy," Li said.

The researchers published the findings in the March 2007 issue of the journal Laboratory Investigation. The research was supported by the National Institutes of Health and the American Heart Association.

Li said that the keys to fetal alcohol syndrome's severity are the amount of alcohol consumed, the duration of the consumption and the timing of the pregnancy. For example, alcohol consumed by a mother with a one-month-old fetus could alter the development of the brain; at four to eight weeks, facial structures, heart and eyesight could be affected. Two to three months into fetal development, alcohol consumption could lead to the growth of extra digits.

"The amount of alcohol consumed is important as well," Li said. "Even the equivalent of one 12-ounce beer, consumed at the wrong time, could disrupt the signaling pathway and lead to a defect."

The team also found that increased amounts of alcohol exposure by the fetus led to increased severity of the syndrome.

Li pointed out that the findings could have other theoretical implications as well. He said giving alcoholics supplemental cholesterol could help slow down or prevent the occurrence of alcoholic liver disease, even chronic alcoholic induced cirrhosis, characterized by replacement of liver tissue by scar tissue, leading to progressive loss of liver function.

Also, he said the findings provide further credence to current practice of ensuring that pregnant women should not lower their cholesterol too low. A recent study found that women who took cholesterol-lowering drugs known as statins were at greater risk of giving birth to babies with developmental problems.

Other Duke members of the team were Anna Mae Diehl, Hai-Tao Yang, Marzena Zdanowicz, Yi Qi and Terese Camp. Jason Sicklick of the Johns Hopkins University School of Medicine also participated in the study.

Source: EurekAlerts 8 March 2007

Plan to label every alcoholic drink

DAMIEN HENDERSON

March 06 2007

Warning labels which say how much alcohol drinks contain, along with daily recommended amounts, have been prepared by health officials.

The labels, which could be applied to every bottle, can and carton of alcohol sold in the UK, would say how many units it contained and give alcohol consumption guides for men and women.
.... (more)

Source: Alcoholics Anonymous Reviews 10 March 2007

New Research by the Alcohol Policy Network, Ontario Public Health Association

Friday, 23 February 2007

Contents I Introduction: Alcohol and Chronic Disease II An Overview of the Harms of Alcohol III Consequences of Alcohol Consumption in Canada and Ontario IV Proximal and Distal Factors in Alcohol Consumption and Harms V Data Quality and Emerging Challenges VI Recommendations VII Conclusion --by Ben Rempel, Manager, Alcohol Projects, Ontario Public Health Association ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *~ ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *~ I Introduction: Alcohol and Chronic Disease The literature documenting the role of alcohol in multiple chronic diseases continues to grow, but the identification of risk factors and the prevention of alcohol-related chronic disease has not received the full attention it deserves. There is a disjunction between the damage from alcohol and initiatives to control or more effectively manage this damage. Professionals and the population at large are quite aware of the more acute consequences of alcohol intoxication, such as drinking and driving; however, alcohol-related chronic disease has, so far, been second to these. In research, intervention, and policy concentrated on chronic disease, the main attention to date has been on risk factors of tobacco use, physical activity, diet, and unhealthy weight. The overarching purpose of a new research paper by the Alcohol Policy Network is to bring the relationships between alcohol and chronic disease to the forefront, with the goal of informing professional awareness, policy and intervention. This document is a resource for those involved in prevention planning, policy development, and public health advocacy. The paper examines the following topic areas: 1. An overview of the harms of alcohol consumption (chronic and acute) and factors that contribute to these harms 2. Alcohol-related chronic disease in different populations, specifically by age and gender, focusing on data from Canada and Ontario 3. The role of alcohol in specific chronic diseases, including cancers, diabetes, neuropsychiatric conditions, cardiovascular diseases, cerebrovascular diseases, and digestive diseases 4. Implications for policy. While we recognize the role of alcohol in a number of acute health and social consequences, and we do consider these briefly, the primary goal of the document is to examine the role of alcohol in chronic disease and make recommendations for increasing the profile of these relationships and incorporating them further into policy and practice. For the purposes of the paper, we define chronic disease as a malady that generally takes a long time to develop, is recurring or ongoing, and requires multiple management strategies, often without cure. Many injuries also have a chronic aspect to them, in that they can either result in long-term care and rehabilitation demands and/or prolonged trauma associated with an injury can result in chronic adverse effects, either mental or physical. The following summarizes key section of the longer paper. ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *~ II An Overview of the Harms of Alcohol The research paper describes the literature on the harms of alcohol consumption, including the acute and chronic health and social consequences and related proximal and distal factors that can shape the relationship between alcohol consumption and consequences. The paper includes a discussion of data quality and emerging challenges in documenting the links between alcohol and potential consequences. The paper provides an overview of the rationale for examining the role of alcohol consumption on certain chronic diseases such as cardiovascular diseases, cancers, and mental disorders. ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *~ III Consequences of Alcohol Consumption in Canada and Ontario Alcohol use in Canada accounted for over $14 million in direct and indirect costs (37% of the total substance use related costs), representing $463 per capita. The paper details specific data from Canada and Ontario regarding the economic costs and harms of alcohol consumption and includes data on mortality and morbidity rates. ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *~ IV Proximal and Distal Factors in Alcohol Consumption and Harms The consumption of alcohol is not only a matter of personal choice; it is influenced by a range of social, cultural, economic, and environmental factors. Population-level phenomena and individual-level factors are important considerations in understanding the role of alcohol in chronic disease and in developing interventions, explained in detail within the paper. ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *~ V Data Quality and Emerging Challenges The paper identifies and analyzes multiple challenges emerging in understanding the development and impact of alcohol-related chronic disease. These challenges include alcohol consumption patterns, the types of evidence that form the knowledge base of alcohol-related chronic disease, and the current state of integration of alcohol research into chronic disease initiatives. Alcohol-related problems do not result solely from excessive drinking and intoxication. In fact, even low or moderate levels of alcohol consumption can have deleterious effects, including workplace performance, traffic safety, and cancer risk. ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *~ VI Recommendations We see a number of recommendations emerging from the existing knowledge of alcohol-related chronic disease that would be useful for policymakers, practitioners, and others interested in addressing this important health issue. There is a dire need of expansion of efforts, particularly in the following areas: Goal setting: Are there clear goals and are the resources accessible to achieve them? Policy development: Are most effective policies in place, implemented and enforced, and at all relevant levels? Programs: Are most effective best practices the most common? Are there mechanisms in place to facilitate coordination and avoid a duplication of effort? Research: Is there a good mix of multidisciplinary initiatives to assess causation of chronic diseases, and inform and evaluate interventions? Monitoring and surveillance: Is the available surveillance adequate to capture inter-regional differences and sensitive to special populations? Coordination: Are there adequate resources for infrastructure development, training, dissemination of best practices? Is there a clear understanding of who is responsible for what and how? ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *~ VII Conclusion In Canada, alcohol is consumed by the majority of the population. Even for those individuals not drinking in a "risky" fashion, the possibility of developing alcohol-related chronic disease still exists. Alcohol consumption and high-risk drinking are increasing in Canada. Both developments are expected to contribute to chronic disease as well as trauma associated with alcohol consumption. In turn, the social, health and other costs are expected to increase. To explore this topic further, the Alcohol Policy Network is co-hosting the Alcohol and Chronic Disease Prevention Forum, on March 22, 2007 in Toronto. For more information on the forum or this research paper, please visit http://www.apolnet.ca.

Do soap shows encourage teenage drinking?

Press release: Embargo 00.01am Saturday 10th March 2007

Popular soap shows are awash with alcohol, according to a survey published in The Food Magazine. Alcohol featured in 18% of scenes shown during Hollyoaks, in over 17% of scenes shown during Coronation Street and in over 16% of scenes shown during EastEnders and Emmerdale. Home and Away did better, with alcohol limited to just 6.7% of screen time.*

With a large proportion of teenage viewers there is concern that soap shows may be conditioning British teenagers to accept high alcohol consumption as the norm. Hollyoaks, which boasts that it is the UK’s most watched teenage drama serial, goes out Monday to Friday at 6.30pm, right after the Simpsons.

During the survey period alcohol appeared as the most dominant food group in Hollyoaks, appearing in almost 40% of background scenes. In contrast, dairy foods appeared as the dominant food group in less than 1% of shots.

Cally Matthews, author of the study said, “Soap shows are awash with scenes showing alcohol being consumed as part of a seemingly healthy lifestyle and appearing as a normal part of everyday life. There is a real danger that this naturalisation of alcohol consumption may desensitise teenagers to the dangers of excessive alcohol consumption.”

The survey data is backed up by other studies, including one for Alcohol Concern, the national agency on alcohol misuse. Their report, The Portrayal of Alcohol and Alcohol Consumption in Television News and Drama Programmes (Hansen 2003), surveyed soap opera content over several weeks and found, on average, seven drinking scenes per hour, with alcohol used primarily for celebrations and as an aid to romance. The study found no explicit portrayal of alcoholism and a tendency to portray potential problem drinkers in a humourous, or light-hearted way.

* Analysis took place over a two week period in July 2006

More information
For full article see: www.foodcomm.org.uk/latest_alcohol_Mar07.htm

Alcohol Concern: www.alcoholconcern.org.uk

Contact: Cally Matthews on 020 7565 2810 or Jessica Mitchell on 020 7837 2250; email:press@foodcomm.org.uk

Embargo 00.01am Saturday 10th March 2007

Stuck with the booze bill

Doc says parents have to take more responsibility

EVERY weekend Richard McCallum deals with the aftermath of someone else's night out.
From teeny tipplers brought to hospital in an unconscious heap to young men with injuries sustained in a drunken brawl, he has treated them all.

Doctor McCallum is a consultant within the accident and emergency department at Stirling Royal Infirmary, working on the front line of the NHS.

Every weekend Dr McCallum and his colleagues deal with the after-effects of Scotland's hard-drinking culture. And every weekend they fulfil a duty of care that often goes beyond reasonable expectations.

Verbal and physical abuse is now an all too common reality for hospital staff, and alcohol often plays a significant part.

Having worked as an A&E consultant for over a decade, Dr McCallum is now well-used to dealing with the deluge of patients who clog up his department on a Friday and Saturday night.
He said: "Every weekend there is a constant stream of kids who are under the influence and we tend to get a lot of attitude and hassle from them.

"But most of the aggro comes from the ones who have been fighting, and that gets to the staff because they shouldn't have to put up with that sort of abuse at work. Alcohol is definitely a catalyst for violent behaviour in some people."

While calls have been made for security to be beefed up in hospitals to discourage such behaviour, Dr McCallum believes the answer lies elsewhere.

He said: "It would be good to see alcohol-related violence become as unacceptable as drink-driving, but there needs to be a zero tolerance approach. I heard of a man who assaulted a nurse in Glasgow who only got 20 hours community service, and that sends out the wrong message."

He continued: "I shouldn't have to deal with people who try to use the fact that they were drinking as an excuse for their violent behaviour, because they are responsible for drinking, and responsible for the consequences.

"I'm not trying to come across as dictatorial, because I like a drink myself. I had several drinks after Scotland played Italy in the rugby, but then I didn't get into a fight, get injured, or get arrested. The point is that people have to be made to take responsibility for their actions, drink or no drink."

Alcohol-related violence aside, another worry for Dr McCallum is the tender age of some of the patients he has to care for.

He said: "We are increasingly dealing with patients in their early teens, and it's a real concern. On one occasion I got a young girl of about 12 or 13 who was brought in drunk and unconscious, but we had no idea what had happened to her.

"We had to assume she had been either sexually or physically assaulted, and run all the appropriate checks. We are a tough bunch in A&E, but I have to admit that that scared the living daylights out of me. This wee girl could have been through anything."

While he knows there is no quick fix available to solve these problems, Dr McCallum believes that again, responsibility is the key.

"There is a responsibility that comes with selling alcohol, and shopkeepers can't completely absolve themselves from the blame. It angers me when I hear about shopkeepers who have knowingly sold to under-age drinkers, but get to keep their licence.

"At the same time, there are parents out there who need to take more responsibility for their children."

Despite these concerns, Dr McCallum's duty of care as a consultant remains his primary focus, even if it means cleaning up the mess left by someone else's drunken night out.

"Whoever comes in will be looked after, but we ask that people put themselves in our shoes and appreciate the fact that we are here to help, not to get abuse."

r.turbyne@falkirkherald.co.uk

08 March 2007

The Effects of Education on Health

March 2007

David M. Cutler E-mail: dcutler@harvard.edu

and Adriana Lleras-Muney E-mail: alleras@princeton.edu

"An additional four years of education lowers five-year mortality by 1.8 percentage points; it also reduces the risk of heart disease by 2.16 percentage points, and the risk of diabetes by 1.3 percentage points."

here is a well known, large, and persistent association between education and health. This has been observed in many countries and time periods, and for a wide variety of health measures. The differences between the more and the less educated are significant: in 1999, the age-adjusted mortality rate of high school dropouts ages 25 to 64 was more than twice as large as the mortality rate of those with some college. In Education and Health: Evaluating Theories and Evidence (NBER Working Paper No. 12352), authors David Cutler and Adriana Lleras-Muney review what we know about the relationship between education and health, in particular about the possible causal relationships between education and health and the mechanisms behind them. At the outset they note that this is a controversial topic, with previous studies offering contradictory conclusions. People value health highly. As a result, the health returns to education can outweigh even the financial returns. Many estimates suggest that a year of education raises earnings by about 10 percent, or perhaps $80,000 in present value over the course of a lifetime. Using data from the National Longitudinal Mortality Study (NLMS), the authors find that one more year of education increases life expectancy by 0.18 years, using a 3 percent discount rate, or by 0.6 years without any discounting. Assuming that a year of health is worth $75,000 - a relatively conservative value - this translates into about $13,500 to $44,000 in present value. These rough calculations suggest that the health returns to education increase the total returns to education by at least 15 percent, and perhaps by as much as 55 percent. The causal effects of education on health would call for education subsidies only to the extent that there is a market failure and that individuals are investing at sub-optimal levels; otherwise, individuals would be basing their education decisions on health benefits along with financial benefits. The possible rationales for education subsidies include the idea that individuals may be unaware of the health benefits of education when they make their education decisions, that they may be credit constrained, that some groups do not know about or are excluded from higher education, or that there are externalities to education and health beyond the individual affected. Understanding the mechanism by which education affects health is therefore important for policy. It may be more cost effective to tap that mechanism than to increase educational attainment. For example, if all of the education effect operated through income, and income improved health, then it might be cheaper to transfer income directly rather than to subsidize schooling. But, increasing educational attainment might be the correct policy response if, for example, there were no alternative (or cheaper) method for acquiring the skills that ultimately affect health. In spite of these caveats, the authors point out that education policies have the potential to have a substantial effect on health. Assuming that the observed correlations between education and health are long-term causal effects from education to health, and that the relationship is linear and identical across gender, race, and other groups, the authors can do a rough calculation of the health returns of education policies. Prior research has found that offering $1,000 (in 1998 dollars) in grant aid results in an increase in education of 0.16 years, which translates into 0.03-0.10 years of additional life (depending on discounting). This is roughly $2,250-$7,200 in present value. This is a very large rate of return. The data that the authors present show that the more educated report having lower morbidity from the most common acute and chronic diseases (heart condition, stroke hypertension, cholesterol, emphysema, diabetes, asthma attacks, ulcer). More educated people are less likely to be hypertensive, or to suffer from emphysema or diabetes. Physical and mental functioning is also better for the better educated. The better educated are substantially less likely to report that they are in poor health, and less likely to report anxiety or depression. Finally, better educated people report spending fewer days in bed or not at work because of disease, and they have fewer functional limitations. The magnitude of the relationship between education and health varies across conditions, but is generally large. An additional four years of education lowers five-year mortality by 1.8 percentage points; it also reduces the risk of heart disease by 2.16 percentage points, and the risk of diabetes by 1.3 percentage points. Four more years of schooling lowers the probability of reporting oneself in fair or poor health by 6 percentage points and reduces lost days of work to sickness by 2.3 each year. Although the effects of gender and race are not shown, the magnitude of four years of schooling is roughly comparable in size to being female or being African American. These are not trivial effects. There are multiple reasons for these associations, although it is likely that these health differences are in part the result of differences in behavior across education groups. In terms of the relation between education and various health risk factors - smoking, drinking, diet/exercise, use of illegal drugs, household safety, use of preventive medical care, and care for hypertension and diabetes - overall the results suggest very strong gradients where the better educated have healthier behaviors along virtually every margin, although some of these behaviors may also reflect differential access to care. Those with more years of schooling are less likely to smoke, to drink heavily, to be overweight or obese, or to use illegal drugs. Interestingly, the better educated report having tried illegal drugs more frequently, but they gave them up more readily -- Les Picker

http://papers.nber.org/papers/W12352

Behavioural Economics and Drinking Behaviour: Preliminary Results from an Irish College Study






Publisher:'Behavioural Economics and Drinking Behaviour: Preliminary Results from an Irish College Study': University College Dublin Geary Institute 08 Mar 2007

A new discussion paper published by the Geary Institute in UCD examines the results of single-equation regression models of the determinants of alcohol consumption patterns among college students modelling a rich variety of covariates including gender, family and peer drinking, tenure, personality, risk perception, time preferences and age of drinking onset. The results demonstrate very weak income effects and very strong effects of personality, peer drinking (in particular closest friend), time preferences and other substance use.

The task of future research is to verify these results and assess causality using more detailed methods.

Download the discussion paper

Source: Daily Dose March 9, 2007

Scottish Alcohol Research Framework (Summary) PDF


Publication of the Scottish Alcohol Research Framework, and related documents. The Framework sets out planned work, together with priority areas for new research to directly support policy developments. Comments welcomed.

Contents of Summary

Scottish Alcohol Research Framework
Summary of Current Alcohol Research and Research Gaps
1. Background
2. Alcohol consumption in Scotland
3. Patterns of alcohol-related harm
4. Drinking Cultures
5. Prevention and education
6. Treatment and support services
7. Protection and controls

SCOTTISH ALCOHOL RESEARCH FRAMEWORK
(Full Report)



Introduction

Ministers are placing increasing priority on the alcohol harm reduction agenda, and on developing interventions which are informed by a strong evidence base. There is a considerable body of UK and international research on the extent and nature of alcohol problems and the effectiveness of harm reduction interventions. At present, new alcohol-related research in Scotland might be commissioned by a wide range of bodies including the Executive, Information Services Division (ISD), Health Scotland and Alcohol Focus Scotland. This has the potential for overlap or omission. To date there has been no systematic process for feeding the developing evidence base into policy and for identifying gaps. The Alcohol Evidence Group was established in 2006 to oversee the development of a co-ordinated alcohol evidence base in which existing research (from Scotland, the rest of the UK and internationally) is consolidated and gaps identified, and the development and implementation of Executive policy on alcohol-related health, criminal justice and wider social issues is supported by research by agreed parties.

Membership of the Group is given below.

The following framework, which has been compiled by NHS Health Scotland with advice from the Alcohol Evidence Group, meets a commitment in the Executive’s Updated Plan for Action on alcohol problems, published in February. It builds upon previous work to review gaps in research knowledge undertaken by NHS Health Scotland in 2002/03.

The framework sets out existing and planned work, together with priority areas for new research should budgets allow. It identifies research to directly support policy development. The Executive recognises that individuals and organisations will have other priorities and will wish to undertake research in other areas.

NHS Health Scotland undertook a scoping of the research literature in Scotland identifying current research and research gaps which informed the development of the framework. The literature review and a summary of current research and research gaps are also being circulated for information, and are available online at http://www.alcoholinformation.isdscotland.org

The Executive is seeking your comments on the framework, in particular whether you aware of any current or planned work in the areas identified for new research? In addition, organisations are invited to express an interest in the collaborative funding of projects identified in this
framework.

Comments should be emailed to alcoholenquiries@scotland.gsi.gov.uk by 12 April 2007.

If you would like to discuss the framework in more detail please call Lindsay Liddle (0131 244 2107) or Iain MacAllister (0131 244 3473).

Alcohol Evidence Group membership:

Deborah Smith Head of Alcohol and Drugs Misuse, Scottish Executive Health Department (Chair)

Sally Haw Principal Public Health Advisor, NHS Health Scotland

Laurence Gruer Director of Public Health Science, NHS Health Scotland

Steve Pavis Assistant Head of Group, Epidemiology and Statistics, ISD, NHS National Services Scotland

Lesley Graham Associate Specialist (Public Health), ISD, NHS National Services Scotland

Jack Law Chief Executive, Alcohol Focus Scotland

Kerry McKenzie Public Health Adviser, NHS Health Scotland

Maggie Watts Vice Chair, Scottish Association of Drug and Alcohol Action Teams

Peter Rice Consultant Psychiatrist, Tayside Alcohol Problems Service

Karen MacNee Senior Principal Researcher, Analytical Services, Scottish Executive Health Department

Iain MacAllister Principal Researcher, Alcohol and Drugs Misuse, Scottish Executive Health Department

Donna MacKinnon Senior Researcher, Analytical Services, Scottish Executive Justice Department

Lindsay Liddle Alcohol and Drugs Misuse, Scottish Executive Health Department

Denise Coia Psychiatric Adviser, Scottish Executive Health Department

Peter Craig Research Manager, Scottish Executive Chief Scientist Office

Beatrice Cant Scottish Executive Chief Scientist Office

David Pattison Health Promotion Adviser, Scottish Executive Health Department

SAMHSA Launches Searchable Database of Evidence-Based Practices in Prevention and Treatment of Mental Health and Substance Use Disorders

Date: 3/1/2007
Media Contact: SAMHSA Press Office
Telephone: 240-276-2130

The new National Registry of Evidence-based Programs and Practices (NREPP) debuts online today, greatly expanding the Substance Abuse and Mental Health Services Administration’s efforts to help local organizations make informed decisions about evidence-based interventions for the prevention and treatment of mental health and substance use disorders.

NREPP (http://www.nrepp.samhsa.gov/) is a searchable database with up-to-date, reliable information on the scientific basis and practicality of interventions. Users, such as community organizations and state and local officials, can perform custom searches to identify specific interventions based upon desired outcomes, target populations and service settings.

“The new NREPP is a major advancement in SAMHSA’s efforts to translate substance abuse and mental health research into practice,” said Terry Cline PhD, SAMHSA Administrator. “As more interventions become available, NREPP will accelerate the adoption of effective, evidence-based services to prevent and treat mental health and substance use disorders in community-based settings, achieving the goal of SAMHSA’s Science to Service Initiative.”

Originally created in the 1990s, NREPP has been redesigned based on extensive input from scientific communities, service providers, expert panels and the public.

Key features of the new NREPP system include:

• Custom searches based upon desired outcomes, target populations and service settings;
• Details on each intervention including: a brief descriptive summary, the types of outcomes achieved, the costs of implementing the intervention, and the complete contact information for the intervention developer;
• Two independent expert ratings for each intervention – the first assessing the quality of research supporting specific intervention outcomes, and the second assessing the availability of implementation and training materials to support adoption of the intervention in routine service settings.

To have an intervention listed in NREPP, the intervention’s developer submits required information about the intervention for expert review. Experts then rate the intervention on the quality of research supporting specific intervention outcomes, and on the availability of implementation resources to translate the scientific findings into routine practice. All NREPP reviewers are recruited, selected, and approved by SAMHSA based on their experience and areas of expertise.

NREPP initially will offer information on 25 interventions that have been examined and rated by experts. With more than 200 additional interventions under review, NREPP is expected to add five to 10 new interventions each month.

As NREPP grows, it will address service needs and gaps in the substance abuse and mental health fields. New interventions may be submitted for review each year in response to an annual Federal Register notice.

NREPP supports SAMHSA’s Science to Service Initiative, which promotes greater adoption in routine clinical and community-based settings of those services that science has demonstrated to be effective in preventing and treating mental and substance use disorders. SAMHSA collaborates with the National Institutes on Drug Abuse, Alcohol Abuse and Alcoholism, and Mental Health on this agency-wide effort.

For more information about NREPP ratings, how to use NREPP to identify specific interventions, or how to submit an intervention for review, visit the Web site at http://www.nrepp.samhsa.gov/; contact NREPP at 1-866-43NREPP (1-866-436-7377); or send an e-mail to NREPP@samhsa.hhs.gov.

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SAMHSA is a public health agency within the Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation's substance abuse prevention, addictions treatment, and mental health services delivery system.

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This is a monthly discussion of "issues to watch" in the field of alcohol policy.

February/March 2007

"You drink like a girl"

New booze rules

Alcohol and Chronic Disease Prevention

"You drink like a girl"

Information collected in a study appearing in Addictive Behaviours journal, indicates that historically males are known for excessive drinking but that now female college students seem to be participating in drinking games regularly and that participation in those games leads to increased consumption of alcohol.

High school students are following suit. The National Survey on Drug Use and Health from the United States indicates 1.5 million girls ages 12 to 17 started drinking alcohol in 2004 compared to about 1.3 million boys.

In Ontario, girls are keeping pace with their male counterparts as well, as the prevalence of drinking does not significantly differ between males (62%) and females (62%) according to the OSDUS survey [PDF] published in 2006. Perhaps of even more concern is that 20% of females in grades 7-12 admit binge drinking (5 or more drinks on an occasion) in the past 4 weeks, only slightly behind males at 25%.

Reasons why girls are starting to drink so much differ. However, studies suggest that women may be copying the heavy drinking behavior of males often in an effort to gain the esteem of male peers. In addition, according to Dr. Ralph Lopez, associate professor at Cornell University, there is the enhanced expectations of girls to succeed academically and also to look perfect … "They have to be skinny and gorgeous".

Increased alcohol consumption among females is an alarming trend for public health officials due to the fact that girls are more vulnerable to the effects of alcohol than boys. Warren Seigel, past president of the New York State chapter of the American Academy of Pediatrics, points out that even moderate drinking among females can disrupt their growth and the development of their reproductive systems. Further, almost 15% of girls reported sexual assault [PDF] or making a poor sexual decision when alcohol was involved.

Other consequences experienced when alcohol is involved are missing class, driving under the influence, engaging in unplanned or unprotected sexual activity, and of course, hangovers. As well, bad behaviours generally travel together, so it is not surprising that those that drink are also more prone to trying nicotine, marijuana, and to misuse prescription drugs.

Going forward, prevention programming for drinking games and high-risk activities involving alcohol and other substances can no longer focus solely on the male population. "If drinking games are a factor in increased alcohol-related consequences in women …, then targeted interventions addressing drinking games may be necessary," concludes Dr. Joseph LaBrie, professor of psychology at Loyola Marymount University.

New booze rules

On February 1, 2007, the Alcohol and Gaming Commission of Ontario implemented legislation allowing patrons in bars to carry their drinks into the washrooms. The idea around this initiative is to discourage the spiking of drinks with rape drugs.

Presently, it is quite difficult to assess whether this new legislation will have an effect on sexual assaults stemming from spiking drinks due to the facts that it was just implemented in February AND that not all bars are allowing it. This is because the law doesn't take effect automatically – establishments must apply for the privilege.

"We want to be comfortable with what they're going to ask us for before we approve anything," said Ab Campion, of the Alcohol and Gaming Commission of Ontario. "We want to have a look at (the bars) design and of the hallways and washrooms first."

The new legislation can be found on the AGCO website, with specific mention of the washrooms, stairwells, hallways and other similar areas (WHS Policy).

Alcohol and Chronic Disease Prevention

Alcohol consumption has been causally linked with over 60 chronic diseases and acute conditions. With regard to chronic disease, these include, for example, several types of cancer, liver disease, cardiovascular diseases, high blood pressure, depression and other mental disorders, and Type 2 diabetes. There are also associations between high risk drinking and other risk factors for chronic disease, such as smoking, unhealthy eating, obesity, and illicit drug use.

Join us for the 4th annual forum focusing on current and emerging issues related to alcohol consumption and implications for health and safety policies. The aim of this forum is to bring substance abuse prevention and chronic disease professionals together in an opportunity for networking and knowledge exchange. This year we will be discussing the link between alcohol and chronic disease and the practical programming that is currently available in relation to this relevant and timely topic.

The fourth annual Alcohol: No Ordinary Commodity forum will take place on Thursday, March 22, 2007 at the Harbourfront Community Centre in Toronto. For further information and registration, visit the Forum Registration page.

Alcohol in the News
February 16 - February 28, 2007

The Alcohol Policy Network (APN) is a network of over 1000 individuals and organizations across Ontario concerned about the impact of alcohol on our friends, families and communities.

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1. Alcohol Advertising / Promotion / Sponsorship

Anheuser-Busch Urged to Abandon "Idiotarod" Beer Promotion

Media Release, Center for Science in the Public Interest, February 28, 2007

Anheuser-Busch should drop its sponsorship of a charity event called the "Idiotarod," a Pub Crawl in Shopping Carts, organized by a local group that goes by the acronym "SMASHED."

http://www.cspinet.org/new/200702281.html

Expert says ban all alcohol ads

Media Story, BBC News, February 23, 2007

A leading doctor says all advertising of alcohol must be banned in a bid to curb Britain's growing drink problem.

http://news.bbc.co.uk/2/hi/health/6390663.stm

Big tobacco asks Supreme Court to clarify ad restrictions, make it more like beer

CHRISTOPHER MAUGHAN, Canada.com, February 19, 2007

Canada’s three major tobacco companies are at the Supreme Court arguing for looser restrictions on tobacco advertising, saying the current law is so vague it amounts to a total ban and violates the companies’ constitutional right to advertise.

http://www.canada.com/topics/bodyandhealth/story.html?id=2419a0a7-c9af-4b7d-9ffd-0731d39c5a9b&k=81790

2. Impaired Driving / Road Safety

Mount Forest Man wins car for smart answers to prevent drinking and driving

News Release, Canadian News Wire, February 23, 2007

Bruce Fulcher of Mount Forest, Ontario is the proud owner of a new smart fortwo coupé - just because he took a few minutes to think about ways to prevent someone from drinking and driving.

http://www.newswire.ca/en/releases/archive/February2007/23/c3778.html

On-Trail or Off-Trail…Zero Tolerance is the Message…Don't Drink and Ride

Media Release, MADD Canada, February 20, 2007

In a united effort towards eliminating alcohol as a contributing factor in snowmobiling fatalities and injuries, the Canadian Council of Snowmobile Organizations and MADD Canada announced today that they are joining forces for a National “Zero Tolerance” Awareness Day.

http://www.madd.ca/english/news/pr/p20070220.htm

Habitual DUI abuser is biggest concern

RICHARD RUSSELL , Globeandmail.com, February 15, 2007

Extensive research, design, development and engineering have gone into roadways, vehicles, signage and every other aspect of the transportation system. That has yielded heartening results. But the problem of people consuming alcohol or drugs before getting behind the wheel lingers on.

http://www.theglobeandmail.com/servlet/story/LAC.20070215.WHDRIVER15/TPStory/?query=alcohol

3. Demographic Groups

a. Youth & Young Adults

Alcohol Interventions That Teach Practical Skills Work Best With High-Risk University Students

Media Report, Medical News Today, February 27, 2007

Heavy drinking among university students appears to be a universal problem. Although most universities have alcohol policies, it is unclear which interventions can effectively reduce alcohol consumption.

http://www.medicalnewstoday.com/medicalnews.php?newsid=63723&nfid=al

More Young Brits Die from Excessive Drinking

Boston University, Join Together Direct, February 23, 2007

Drinking-related deaths among 15- to 34-year-olds in the U.K. have doubled between 1991 and 2004. The Independent reported Feb. 23 that 8,221 alcohol-related deaths were reported in 2004, not counting alcohol-related traffic crashes or injuries.

http://www.jointogether.org/news/headlines/inthenews/2007/more-young-brits-die-from.html

Britney's partying a turn-off for teens

LEE-ANNE GOODMAN, Toronto, Star, Feb 20, 2007

An allegedly drug-addled Britney Spears's decision to shave her head in full view of a horde of paparazzi on the weekend is just the latest example of disturbing behaviour from young Hollywood women seemingly bent on destroying themselves with drugs and alcohol.

http://www.thestar.com/article/183426

b. Older Adults

Trends in Alcohol Consumption and Related Harms for Australians Aged 65 to 74 Years, 1990-2003

TANYA CHIKRITZHS & RICHARD PASCAL, National Alcohol Indicators, Feb, 2007

The eighth bulletin documents trends in alcohol-attributable harms due to risky and high risk drinking among those aged 65-74 years in Australia.

http://www.ndri.curtin.edu.au/pdfs/naip/naip008.pdf

4. Alcohol Controls / Liability / Licensing

An Honest Conversation About Alcohol

News Release, Inside Higher Education, February 16, 2007

The current drinking age is “bad social policy and terrible law,” and that it was having a bad impact on both students and colleges.

http://www.insidehighered.com/news/2007/02/16/drinking

5. Health and Safety

a. Fetal Alcohol Spectrum Disorder (FAS/FASD) / Pregnancy

Sorry - no articles found

b. Low / High Risk Drinking / Harm Reduction

Study Says Women Who Think Drinks Were Spiked Were Just Drunk

Press Release, Join Together Direct, February 20, 2007

In a study by U.K. researchers, not one of 75 women who thought their drinks were spiked with date-rape drugs like GHB, ketamine or Rohypnol tested positive for the drugs.

http://www.jointogether.org/news/research/summaries/2007/study-finds-women-who-think.html

c. Crime / Violence / Injury Prevention

Alcohol Plays Role in 62 Percent of All Arrests in Wyoming

Boston University, Join Together Direct, February 20, 2007

Alcohol use is involved in a remarkable 62 percent of all arrests in the state of Wyoming, from drunk driving to domestic assaults, according to a study by the Wyoming Sheriffs and Chiefs Association.

http://www.jointogether.org/news/headlines/inthenews/2007/alcohol-plays-role-in-62.html

d. Addictions Treatment

Current issues in older adults with substance misuse issues

Webinar, Robert Eves, To take place March 27, 2007.

Addictions to alcohol, drugs, and other substances are shared by 1 in 10 older adults. Using harm reduction methods, case workers help clients return to a higher quality life.

Registration details at: www.copacommunity.ca/seminar.html

6. Workplace

Sorry - no articles found

7. Industry News

Markets feel a glow as booze makers post big day

JOHN HEINZL, Globeandmail.com, February, 2007

Drinking heavily may not be good for your liver. But for investors, booze is beautiful.

http://www.theglobeandmail.com/servlet/Page/document/v5/content/subscribe?user_URL=http://www.theglobeandmail.com%2Fservlet%2Fstory%2FLAC.20070216.RHEINZL16%2FTPStory%2F%3Fquery%3Dalcohol&ord=1172768274172&brand=theglobeandmail&force_login=true

8. International Alcohol Related News

Inaction on Consumption

Media Release, Alcohol Health Watch, February 23, 2007 (New Zealand)

Figures released by Statistics New Zealand show alcohol consumption is the highest in 20 years.

http://www.ahw.co.nz/pdf/InactionConsumption23.02.07.pdf

Sale and Supply of Liquor to Minors

Media Release, Alcohol Health Watch, February 19, 2007 (New Zealand)

A mixed bag! That’s the verdict of Alcohol Healthwatch on the release of the Terms of Reference for the Review of the Sale and Supply of Liquor to Minors.

http://www.ahw.co.nz/pdf/SupplyReview19.02.07.pdf

9. Odds and Ends

Roll out the barrels for beer

Josh Rubin, The Toronto Star, February 28, 2007

Shortly after he left Scotland's Caledonian Brewery in 2002, the Edinburgh native was commissioned by William Grant & Sons scotch distillery to create a beer simply to add flavour to oak barrels, which would then be used to age the family-owned, Scottish company's whisky.

http://www.thestar.com/article/186272

Minorities More Likely to Be Screened for Alcohol Use, Study Says

Newswise, Join Together Direct, February 22, 2007

Hispanics and African-Americans rarely get superior healthcare compared to white Americans, but a new report finds one exception: primary-care physicians may be more willing to query minorities about their alcohol use than to counsel white patients.

http://www.jointogether.org/news/research/summaries/2007/minorities-more-likely-to-be.html