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, May 26, 2007

Study: College Breeds Alcoholism

By Jeanna Bryner, LiveScience Staff Writer
posted: 24 May 2007 04:01 pm ET

College can be a blast, but it can also create alcoholics.

Genetics is known to play a role in the risk of alcoholism. A new study, detailed in the June issue of the journal Alcoholism: Clinical and Experimental Research, suggests that college attendance is conducive to and exacerbates the innate predisposition of some young adults to become heavy alcohol users.

"If your genetic makeup predisposes you toward drinking, it may be even more enhanced by attending college," said lead scientist David Timberlake, an epidemiologist at the University of California at Irvine. . . . . . .

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Alcohol & Simulated Driving

This study is currently recruiting patients.
Sponsord by Utrecht Institute for Pharmaceutical Sciences,
Utrecht, Netherlands;

May 2007

Previous studies have shown that alcohol significantly impairs driving performance. Acute alcohol administration also has a detrimental effect on secondary task performance during dual-tasks. The present study will investigate the effects of five different dosages of ethanol (0,0.2, 0,5, 0,8 and 1,0 % BAC) on performance in a driving simulator. Steering performance and brain activity will be recorded in both single- and dual-task conditions.

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2007 NOFAS Leadership Awards Benefit, Hill Day and Affiliates Summit is June 12-13

The annual NOFAS awards benefit, FASD advocate’s Hill Day and gathering of affiliates will take place this year on June 12th and 13th in Washington, D.C.

The sixteen current NOFAS affiliates and several organizations expected to join the network in 2007 will meet on Tuesday, June 12 to feature current programs and set the coalition’s priorities.

Hill Day activities will kick of the 13th with a breakfast orientation leading into a full day of FASD constituent meetings with lawmakers and Congressional staff.

The fifteenth annual awards reception hosted by United States Senator Lisa Murkowski and NOFAS founding members the Honorable Tom Daschle and Linda Hall Daschle will begin at 6:00 p.m. on Capitol Hill.


Drinking and Reproductive Health: A Fetal Alcohol Spectrum Disorders Prevention Tool Kit

The American College of Obstetricians and Gynecologists and the CDC have collaborated to develop the "Drinking and Reproductive Health: A Fetal Alcohol Spectrum Disorders Prevention Tool Kit."

The primary component in the tool kit is a CD-ROM that aims to teach women's health care providers how to screen and advise all of their patients of reproductive age about risky drinking and encourage the use of effective contraception among patients who continue to engage in risky drinking. It also addresses drinking during pregnancy.

This tool kit contains: a brief guide, a laminated screening instrument for providers, resource information, and patient handouts that can be downloaded and printed.

Print copies and a CD version of this gude can be requested through the American College of Obstetricians and Gynecologists of FAXing a request to 202-484-3917 or writing ACOG, Division of Women's Health Issues, PO Box 96920, Washington, DC.

Download Prevention Tool Kit (PDF)
News Release - U.S. Secretary of Transportation Says Traffic Deaths on America’s Highways Down Slightly, but Far Too Many Lives Lost Every Year

DOT 53-07
Contact: Sarah Echols
Tel.: 202-366-4570
Date: Friday, May 25, 2007

PRINCETON, N.J. -- U.S. Secretary of Transportation Mary E. Peters today announced that traffic deaths on U.S. roads were down slightly in 2006 according to preliminary figures, but cautioned that far too many lives continue to be lost.

While the number of road deaths is projected to have declined slightly nationwide from 43,443 in 2005 to 43,300 in 2006, “even one death is too many,” Secretary Peters said. And over half of passenger vehicle occupants killed died unbuckled, the preliminary data shows.

“Bad things happen when people don’t buckle up, and no one is immune from the damage and devastation that comes from not wearing a seat belt,” Secretary Peters said. She also commended New Jersey Governor Jon Corzine for his work to educate drivers and other vehicle occupants about the need to buckle up, saying “perhaps his pictures and his words about his crash will inspire people to buckle up every time they get in the car, no excuses.”

The Secretary noted that, as the summer driving seasons starts this weekend, police officers around the country will be on patrol looking for people who aren't buckling up. She added that the U.S. DOT supports states with millions of dollars in highway safety funds annually, including the nearly $27 million being used to support seat belt enforcement efforts.

The preliminary 2006 fatality numbers released today project a 2006 fatality rate of 1.44 deaths per 100 million vehicle miles traveled (VMT), down from 1.45 in 2005. During the same period, injuries dropped 6 percent from 2.7 million in 2005 to 2.54 million in 2006. Previous estimates show that highway crashes cost society $230.6 billion a year, about $820 per person.

The preliminary figures also show that between 2005 and 2006: overall alcohol-related fatalities increased 2.4 percent from 17,525 to 17,941; pedestrian deaths dropped slightly, from 4,881 to 4,768; and fatalities from large truck crashes dropped from 5,212 to 5,018, a 3.7 percent decline.

“The long Memorial Day weekend not only signals the start of summer, it should also serve as a stark reminder that buckling up can be a life-and-death proposition,” Secretary Peters said.

The Department collects the crash statistics from the 50 states and the District of Columbia to produce the annual traffic fatality report. The final 2006 report, pending completion of data collection and analysis, will be available in late summer. The preliminary report is available at:

# # #
Estimates of Motor Vehicle Traffic Crash Fatalities and People Injured

Based on The Fatality Analysis Reporting System (FARS) and The National Automotive Sampling System (NASS)

General Estimates System (GES)
2006 Projections
DOT HS 810 755 May 25, 2007

pg. 20 People Killed in Alcohol-Related Crashes

Ø The estimate of people killed in alcohol-related crashes is projected to increase by about 2 percent

Ø Highest level killed since 1992

Ø Fatalities in crashes involving at least one driver, pedestrian or pedalcyclist with a BAC of .08+ are projected to increase by about 3 percent.

Ø The alcohol-related fatality percentage is projected to increase

Ø From 40 percent to 41 percent

Note: The number of alcohol-related fatalities for the 2005 Annual Report File (ARF) is being revised due to State-reporting problems in Blood Alcohol Concentration (BAC) values that were discovered in the process of building the final file for 2005.

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Obituary - Joseph Zuska, 93; Navy doctor developed treatment for alcoholism

By Jocelyn Y. Stewart, Times Staff Writer
May 24, 2007

Inside a rusted Quonset hut at the Long Beach Naval Station, Dr. Joseph J. Zuska operated a clandestine program, treating sailors for an illness that in the eyes of the Navy did not exist.

It was the mid-1960s, a time when alcoholism and its accompanying behavior were treated as violations of Navy policy, punishable by time in the brig. Yet the atmosphere on base and at sea encouraged heavy drinking. The abiding image of the drunk sailor was a reality for many.

After a conversation with a retired Navy commander who was also a recovering alcoholic, Zuska began treating the illness as a medical problem. His underground program, the first in the history of the armed forces, eventually earned national acclaim, providing a model for other branches of the military and private industry.

Zuska died May 17 at Los Alamitos Medical Center of complications from kidney failure and other illnesses, his son, John Zuska, said. He was 93.
. . . . .

Read Full Obituary

Contributor: Don Phillips

Friday, May 25, 2007

Modulation of GABAA receptors in cerebellar granule neurons by ethanol: a review of genetic and electrophysiological studies
Alcohol Article in Press, On-line 23 May 2007

Cerebellar granule neurons (CGNs) receive inhibitory input from Golgi cells in the form of phasic and tonic currents that are mediated by postsynaptic and extrasynaptic γ-aminobutyric acid type A (GABAA) receptors, respectively. Extrasynaptic receptors are thought to contain α6βxδ subunits.

Here, we review studies on ethanol (EtOH) modulation of these receptors, which have yielded contradictory results.

Although studies with recombinant receptors expressed in Xenopus oocytes indicate that α6β3δ receptors are potently enhanced by acute exposure to low (≥3 mM) EtOH concentrations, this effect was not observed when these receptors were expressed in Chinese hamster ovary cells.

Slice recordings of CGNs have consistently shown that EtOH increases the frequency of phasic spontaneous inhibitory postsynaptic currents (sIPSCs), as well as the tonic current amplitude and noise.

However, there is a lack of consensus as to whether EtOH directly acts on extrasynaptic receptors or modulates them indirectly; that is, via an increase in spillover of synaptically released GABA.

It was recently demonstrated that an R to Q mutation of amino acid 100 of the α6 subunit increases the effect of EtOH on both sIPSCs and tonic current. These electrophysiological findings have not been reproducible in our hands.

Moreover, it was shown the α6-R100Q mutation enhances sensitivity to the motor-impairing effects of EtOH in outbred Sprague-Dawley rats, but this was not observed in a line of rats selectively bred for high sensitivity to EtOH-induced motor alterations (Alcohol Non-Tolerant rats).

We conclude that currently there is insufficient evidence conclusively supporting a direct potentiation of extrasynaptic GABAA receptors following acute EtOH exposure in CGNs.

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GABAA receptors in the thalamus: α4 subunit expression and alcohol sensitivity
Alcohol Article in Press On-line 23 May 2007

The inhibitory neurotransmitter γ-aminobutyric acid (GABA) has long been implicated in the anxiolytic, amnesic, and sedative behavioral effects of alcohol. A large number of studies have investigated the interactions of alcohol with GABA receptors.

Many investigators have reported effects of “high concentrations” (50–100 mM) of alcohol on GABA-mediated synaptic inhibition, but effects of the “low concentrations” (1–30 mM) of alcohol normally associated with mild intoxication have been elusive until recently.

A novel form of “tonic inhibition” has been described in the central nervous system (CNS) that is generated by the persistent activation of extrasynaptic γ-aminobutyric acid type A receptors (GABAA-Rs). These receptors are specific GABAA-R subtypes and distinct from the synaptic subtypes. Tonic inhibition regulates the excitability of individual neurons and the activity and rhythmicity of neural networks. Interestingly, several reports show that tonic inhibition is sensitive to low concentrations of alcohol.

The thalamus is a structure that is critically important in the control of sleep and wakefulness. GABAergic inhibition in the thalamus plays a crucial role in the generation of sleep waves. Among the various GABAA-R subunits, the α1, α4, β2, and δ subunits are heavily expressed in thalamic relay nuclei. Tonic inhibition has been demonstrated in thalamocortical relay neurons, where it is mediated by α4β2δ GABAA-Rs. These extrasynaptic receptors are highly sensitive to gaboxadol, a novel hypnotic, but insensitive to benzodiazepines.

Tonic inhibition is absent in thalamic relay neurons from α4 knockout mice, as are the sedative and analgesic effects of gaboxadol.

The sedative effects of alcohol can promote sleep. However, alcohol also disrupts the normal sleep pattern and reduces sleep quality. As a result, sleep disturbance caused by alcohol can play a role in the progression of alcoholism. As an important regulator of sleep cycles, inhibition in the thalamus may therefore be involved in both the sedative effects of alcohol and the development of alcoholism.

Investigating the effects of alcohol on both synaptic and extrasynaptic GABAA-Rs in the thalamus should help us to understand the mechanisms underlying the interaction between alcohol and sleep.

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Studies of ethanol actions on recombinant δ-containing γ-aminobutyric acid type A receptors yield contradictory results

Alcohol Article in Press On-line 23 May 2007

The γ-aminobutyric acid type A receptors (GABAA-Rs) display a wide variety of subunit combinations. Drugs such as benzodiazepines have shown differential effects based on GABAA-R subunit composition.

Actions of alcohols and volatile anesthetics generally do not vary markedly with subunit composition, with low concentrations of ethanol being poor modulators of these receptors.

Recent studies showed α4/6- and δ-containing GABAA-Rs (located extrasynaptically and responsible for tonic currents in selective brain regions) presenting high sensitivity to low concentrations of ethanol, but these results have not been obtained in other laboratories.

We carried out additional experiments varying the receptor level of expression, and GABA and ethanol concentration, but no sensitivity to low concentrations of ethanol was detected.

We will discuss these results and attempt an analysis of the possible causes for the discrepancies.

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Rates of ethanol metabolism decrease in sons of alcoholics following a priming dose of ethanol

Alcohol Article in Press, On-line 23 May 2007

Rapid changes in rates of ethanol metabolism in response to acute ethanol administration have been observed in animals and humans.

To examine whether this phenomenon might vary by risk for alcoholism, 23 young men with a positive family history of alcoholism (family history positive [FHP]) were compared to 15 young men without a family history of alcoholism (family history negative [FHN]).

FHP subjects demonstrated faster initial rates of ethanol metabolism compared to FHN subjects. However, FHN subjects increased their rate of metabolism compared to a decrease in FHP subjects. Fifty-two percent of the FHP and none of the FHN subjects exhibited a decline in metabolic rate of 20% or more.

Since a significant proportion of FHP subjects exhibited a decrease in the second rate of ethanol metabolism, these preliminary data might help to partly explain why FHP individuals differ in their sensitivity to ethanol and are more likely to develop alcohol dependence.

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Is cigarette smoking related to alcohol use during the 8 years following treatment for adolescent alcohol and other drug abuse?

Alcohol and Alcoholism 2007 42(3):226-233

The present study examined the relationship between cigarette smoking and alcohol use outcomes over an 8-year period following treatment for adolescent alcohol and other drug (AOD) use disorders.

Overall smoking rates decreased significantly over time. Subjects associated with the highest alcohol involvement trajectory reported significantly greater likelihood of persistent smoking as well as higher current smoking and cigarette consumption across time points.

The significant declines observed in smoking from adolescence into young adulthood were contrary to expectations, indicating that this behaviour may be less stable than previously thought among adolescent AOD abusers.

Smoking involvement over time was greater within the highest alcohol use trajectory, consistent with previous evidence for a positive relationship between these behaviours.

However, when compared with the general population smoking rates remained very high regardless of alcohol involvement. Thus, individuals treated for AOD abuse as adolescents remained at elevated risk for tobacco related disease regardless of post-treatment AOD use outcomes.

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Timevarying predictors of smoking cessation among individuals in treatment for alcohol abuse and dependence: findings from project match

Alcohol and Alcoholism 2007 42(3):234-240;

Advanced statistical methodologies that increase study power and clinical relevance have been advocated to examine the timevarying nature of substance use relapse and abstinence, including drinking and smoking.

The purpose of this investigation was to examine timevarying factors that are associated with smoking cessation among smokers in the general population, including alcohol use, self-efficacy, and depression, to determine if they were also related to smoking cessation during and after treatment for alcohol use disorders.

Results showed that greater self-efficacy regarding resisting temptations to drink and lower levels of depression were independently associated with increased likelihood of stopping smoking. In contrast, drinks per drinking day and confidence regarding not drinking did not demonstrate such associations.

Clinical implications of these findings suggest that interventions to help alcoholics in recovery avoid temptations to drink, as well as decrease depression, may be warranted. By using advanced statistical techniques, these results can help clinicians and organizations working with smokers in treatment for alcohol use disorders to make informed decision regarding how best to use limited resources.

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Concurrent alcohol and tobacco use during early adolescence characterizes a group at risk
Alcohol and Alcoholism 2007 42(3):219-225

To investigate whether concurrent alcohol and tobacco use during early adolescence characterizes a subgroup that differs from users of one substance only regarding several risk factors for later substance use problems.

Concurrent alcohol and tobacco use during early adolescence is associated with characteristics that are well known as risk factors for later alcohol use problems and dependence and that should be targeted by prevention programs.

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The neurobiological and neurocognitive consequences of chronic cigarette smoking in alcohol use disorders
Alcohol and Alcoholism 2007 42(3):174-185

Despite the high prevalence of comorbid chronic smoking in alcohol use disorders, very few studies have addressed the potential neurobiological or neurocognitive effects of chronic smoking in alcohol use disorders.

Here, we briefly review the existing literature on the neurobiological and neurocognitive consequences of chronic cigarette smoking and summarize our neuroimaging and neurocognitive studies on the effects of comorbid chronic excessive alcohol consumption and cigarette smoking in treatment-seeking and treatment-naiddotv populations.

Our research suggests comorbid chronic cigarette smoking modulates magnetic resonance-detectable brain injury and neurocognition in alcohol use disorders and that neurobiological recovery in our abstinent alcoholics is adversely affected by chronic smoking.

The material presented also contributes to ongoing discussions about treatment strategies for comorbid alcoholism and cigarette smoking and will hopefully stimulate further research into the neurobiological and neurocognitive consequences of chronic smoking in alcoholism and other substance use disorders.

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D2 dopamine receptor gene haplotypes and their influence on alcohol and tobacco consumption magnitude in alcohol-dependent individuals
Alcohol and Alcoholism 2007 42(3):258-266

Alcohol dependence and habitual smoking frequently co-occur and possibly mutually influence each other. Both have been related to alterations of dopaminergic neurotransmission.

The aim of this analysis of the Munich Gene Data Bank for Alcoholism(MGBA) was to re-evaluate the potential relation between D2 receptor and dopamine transporter gene haplotypes and quantity-related phenotypes of alcohol consumption (average daily alcohol intake before admission for treatment) and smoking (average units smoked per day).

Strong drinkers reported significantly higher amounts of smoking and vice versa. While no association was detected for dopamine transporter genetic variants, a number of D2 receptor gene single nucleotide polymorphisms were related to both smoking- and drinking-related behaviours.

Subsequent analysis of D2 receptor gene haplotypes revealed that two common haplotypes had a significant association with quantitative phenotypes of regular drinking (Ins-C-G-C-A1) and smoking (Ins-T-G-A-A2).

The finding of an association between common D2 dopamine receptor gene haplotypes with the quantity of drinking and smoking corroborates with results from previous studies suggesting a relationship between the dopamine system and alcohol and substance use disorders.

Furthermore, it makes D2 dopamine receptor a candidate gene significantly influencing both alcohol and nicotine dependence.

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A Randomized Trial of a DWI Intervention Program for First Offenders: Intervention Outcomes and Interactions With Antisocial Personality Disorder Among a Primarily American-Indian Sample
Alcoholism: Clinical and Experimental Research 31 (6), 974–987.

Randomized trial evidence on the effectiveness of incarceration and treatment of first-time driving while intoxicated (DWI) offenders who are primarily American Indian has yet to be reported in the literature on DWI prevention.

Further, research has confirmed the association of antisocial personality disorder (ASPD) with problems with alcohol including DWI.

Nonconfrontational treatment may significantly enhance outcomes for DWI offenders with ASPD when delivered in an incarcerated setting, and in the present study, such effects were found in a primarily American-Indian sample.

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Alcohol Effects on Behavioral Control: The Impact of Likelihood and Magnitude of Negative Consequences
Alcoholism: Clinical and Experimental Research 31 (6), 955–964.

This study utilized Signal Detection Theory to examine the relative influence of likelihood and magnitude of consequences when assessing alcohol effects on behavioral control.

Results suggest that likelihood of punishment is a more powerful determinant of alcohol-induced disinhibition than is magnitude.

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Increased Drinking During Withdrawal From Intermittent Ethanol Exposure Is Blocked by the CRF Receptor Antagonist d-Phe-CRF(12-41)
Alcoholism: Clinical and Experimental Research 31 (6), 939–949.

Studies in rodents have determined that intermittent exposure to alcohol vapor can increase subsequent ethanol self-administration, measured with operant and 2-bottle choice procedures.

Two key procedural factors in demonstrating increased alcohol intake are the establishment of stable alcohol self-administration before alcohol vapor exposure and the number of bouts of intermittent vapor exposure.

The present studies provide additional behavioral validation and initial pharmacological validation of this withdrawal-associated drinking procedure.

Intermittent alcohol vapor exposure significantly increased alcohol intake and produced signs of physical dependence. Initial pharmacological studies suggest that manipulation of the CRF system in the CeA can block this increased alcohol intake.

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Role of Appetite-Regulating Peptides in Alcohol Craving: An Analysis in Respect to Subtypes and Different Consumption Patterns in Alcoholism
Alcoholism: Clinical and Experimental Research 31 (6), 950–954.

A role of appetite-regulating peptides like leptin and ghrelin in the neurobiology of alcohol craving has been proposed by several studies.

Aim of this analysis was to search for differences regarding an association between these peptides and alcohol craving with respect to different subtypes and beverage consumption patterns in patients with alcohol dependence.

Our findings show that appetite-regulating peptides may be of special importance regarding alcohol craving in subtypes of patients. This may explicate at least in part previous contradictory findings.

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Extreme Prematurity: An Alcohol-Related Birth Effect
Alcoholism: Clinical and Experimental Research 31 (6), 1031–1037.

Rates of preterm delivery, a major proximate cause of perinatal morbidity and mortality, have been increasing. Prenatal alcohol exposure has been implicated in preterm delivery, although results have been inconsistent due to inadequate control for confounding factors, insufficient power, unreliable and inaccurate assessment of both exposure and gestational age, and lack of stratification of prematurity into severity levels.

The purpose of this study was to examine the relation between maternal alcohol, cocaine and cigarette use during pregnancy, and extreme and mild preterm birth.

Alcohol and cocaine, but not cigarette use, were associated with increased risk of extreme preterm delivery after control for potential confounders. Abstention from alcohol while continuing to use cocaine and tobacco was related to a decrease in extreme prematurity of 41%.

The risk of extreme preterm delivery associated with alcohol use is substantial and similar in magnitude to other well-recognized risks. Increased accuracy in identifying exposure and the use of ultrasound to confirm gestational age dating likely contributed to the findings of the current study.

These findings suggest that eliminating pregnancy alcohol use might substantially reduce the risk of preterm delivery.

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News Release - Alcohol and pregnancy
25 May 2007

Pregnant women or those trying to conceive are being advised to avoid drinking alcohol, and not to get drunk.

Women who do choose to drink, before and during pregnancy, should drink no more than one to two units of alcohol once or twice a week.

The new guidelines have been introduced by the Department of Health to provide stronger, consistent advice for the whole of the UK.

Deputy Chief Medical Officer Dr Fiona Adshead said: ‘We have strengthened our advice to women to help ensure that no one underestimates the risk to the developing foetus of drinking above the recommended safe levels. Our advice is simple: avoid alcohol if pregnant or trying to conceive.’

The National Organisation on Foetal Alcohol Syndrome estimates that there are more than 6,000 children born each year with Foetal Alcohol Spectrum Disorder, as a result of their mother’s alcohol consumption.

The Pregnancy Book 2007 - Alcohol - (UK)
24 May 2007

pg. 14

"Research shows that heavy or frequent drinking can seriously harm your baby’s development. When you drink, alcohol reaches your baby through the placenta. But your baby cannot process it as fast as you can, and is exposed to greater amounts of alcohol for longer than you are. And too much exposure to alcohol can seriously affect your baby’s development and can cause Fetal Alcohol Syndrome. Children with The UK’s Chief Medical Officers advise that, as a general rule, pregnant women or women trying to conceive should avoid drinking alcohol. If you do choose to drink, to protect your baby you should not drink more than one or two ‘units’ of alcohol once or twice a week and should not get drunk."

Web Page for Publication and PDFs
Latest alcohol-related deaths published (UK)
Health Statistics Quarterly Autumn 2006 No. 31

In 2005 ONS began to review its existing definition of alcohol-related deaths which is based on those causes regarded as most directly due to alcohol consumption. A discussion paper on potential options for revising the causes included was circulated to individuals and organisations with relevant topic expertise. Following this discussion process, the definition of alcohol-related deaths used by ONS has been revised. ONS also discussed its proposals for amending the definition of alcohol-related deaths with the General Register Office for Scotland and Northern Ireland Statistics and Research Agency. It has been agreed that the new harmonised definition will be used when reporting alcohol-related deaths for the UK.
. . . . . .

The harmonised definition of alcohol-related deaths was used to report alcohol-related death rates in the UK on 18 July 2006.

These figures showed that rates in the UK almost doubled between 1991 and 2004, increasing from 6.9 to 13.0 per 100,000 population. The number of alcohol-related deaths more than doubled from 4,144 in 1991 to 8,380 in 2004.

Read Health Statistics Quarterly Autumn 2006 No. 31 (PDF)

Thursday, May 24, 2007

Preventing Underage Drinking:

Using Getting To Outcomes with the SAMHSA Strategic Prevention Framework to Achieve Results

Underage drinking is a significant problem in the United States: Alcohol is the primary contributor to the leading causes of death among adolescents. As a result, communitywide strategies to prevent underage drinking are more important than ever. Such strategies depend on the involvement and education of adolescents, parents, law enforcement officials, merchants, and other stakeholders.

This guide is designed to take communities through the process of planning, implementing, and evaluating strategies to prevent underage drinking and youth access to alcohol.

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A score test for linkage analysis of ordinal traits based on IBD sharing
Biostatistics Advance Access published online on May 22, 2007

Statistical methods for linkage analysis are well established for both binary and quantitative traits. However, numerous diseases including cancer and psychiatric disorders are rated on discrete ordinal scales.

To analyze pedigree data with ordinal traits, we recently proposed a latent variable model which has higher power to detect linkage using ordinal traits than methods using the dichotomized traits.

We then applied our method for the Collaborative Study on the Genetics of Alcoholism and performed a genome scan to map susceptibility genes for alcohol dependence. We found a strong linkage signal on chromosome 4.

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WHO Expert Committee on Problems Related to Alcohol Consumption

A resolution adopted at the Fifty-eighth World Health Assembly requested the Director-General "to report to the Sixtieth World Health Assembly on evidence-based strategies and interventions to reduce alcohol-related harm, including a comprehensive assessment of public-health problems caused by harmful use of alcohol", and to "draw up recommendations for effective policies and interventions to reduce alcohol-related harm" (resolution WHA58.26).

To this end, a WHO Expert Committee on Problems Related to Alcohol Consumption met in Geneva from 10-13 October 2006. The main objectives of the Expert Committee meeting were to review a range of public health problems attributable to alcohol consumption as well as scientific and empirical evidence of effectiveness of different policy options, and to provide technical recommendations on effective policies and interventions to reduce alcohol-related harm.

Download Agenda (PDF)

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Download Report (PDF)

Source: Robin G W Room


WHO Expert Committee on Problems Related to Alcohol Consumption

A resolution adopted at the Fifty-eighth World Health Assembly requested the Director-General "to report to the Sixtieth World Health Assembly on evidence-based strategies and interventions to reduce alcohol-related harm, including a comprehensive assessment of public-health problems caused by harmful use of alcohol", and to "draw up recommendations for effective policies and interventions to reduce alcohol-related harm" (resolution WHA58.26).

To this end, a WHO Expert Committee on Problems Related to Alcohol Consumption met in Geneva from 10-13 October 2006. The main objectives of the Expert Committee meeting were to review a range of public health problems attributable to alcohol consumption as well as scientific and empirical evidence of effectiveness of different policy options, and to provide technical recommendations on effective policies and interventions to reduce alcohol-related harm.

Download Agenda (PDF)

Download Recommendations (PDF)

Download Report (PDF)

Source: Robin GW Room


Established Risk Factors Account for Most of the Racial Differences in Cardiovascular Disease Mortality PLoS ONE 2(4): e377 (2007)

Cardiovascular disease (CVD) mortality varies across racial and ethnic groups in the U.S., and the extent that known risk factors can explain the differences has not been extensively explored.

We examined the risk of dying from acute myocardial infarction (AMI) and other heart disease (OHD) among 139,406 African-American (AA), Native Hawaiian (NH), Japanese-American (JA), Latino and White men and women initially free from cardiovascular disease followed prospectively between 1993–1996 and 2003 in the Multiethnic Cohort Study (MEC).

Relative risks of AMI and OHD mortality were calculated accounting for established CVD risk factors: body mass index (BMI), hypertension, diabetes, smoking, alcohol consumption, amount of vigorous physical activity, educational level, diet and, for women, type and age at menopause and hormone replacement therapy (HRT) use.

In men and women in this cohort, the protective effect of alcohol consumption was seen in all racial groups (data not shown), findings consistent with those reported by others. In the MEC, the protective effect of alcohol was not dependent on the type of alcohol (red wine, beer, grain alcohol) consumed. While our results demonstrate an essentially linear decrease in AMI and OHD mortality with increasing alcohol consumption, there have been other reports indicating that this decreasing trend eventually begins to reverse. It is possible that alcohol consumption was too infrequent in the MEC to study this phenomenon. Alcohol was also associated with a significant and consistent decrease in mortality from more chronic forms of heart disease (OHD) in all the racialities studied.

Known risk factors explain the majority of racial and ethnic differences in mortality due to AMI and OHD. The unexplained excess in NH and AA and the deficits in JA suggest the presence of unmeasured determinants for cardiovascular mortality that are distributed unequally across these populations.

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Adolescent Treatment Admissions by Gender, 2005


  • Based on SAMHSA's Treatment Episode Data Set (TEDS), of the 142,600 adolescent admissions aged 12 to 17 in 2005, about 31% (44,600) were female.

  • Adolescent female substance abuse treatment admissions were less likely than adolescent male admissions to report marijuana as their primary substance of abuse (51% vs. 72%) and more likely to report alcohol (23% vs. 16%) or stimulants (12% vs. 4%) as their primary substance of abuse.
  • Adolescent female substance abuse treatment admissions were more likely than adolescent male substance abuse treatment admissions to have a co-occurring psychiatric and substance abuse disorder (23% vs. 18%).
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Cognitive impairment in Aboriginal people with heavy episodic patterns of alcohol use
Addiction 102 (6), 909–915.

With chronic alcohol abuse, cognitive studies suggest that progressive cognitive decline may precede more serious and irreversible neurological syndromes. The early detection of cognitive impairment may therefore aid in the prevention of permanent brain damage.

Despite the devastating consequences of alcohol abuse among Aboriginal Australians, the effects on brain function have never been studied in this population and a lack of appropriate assessment tools has prevented the development of such research.

To determine the impact of long-term and heavy episodic alcohol use on cognitive function in Aboriginal people.

Specific cognitive abnormalities that suggest frontostriatal abnormalities and have been observed in association with chronic alcoholism in other populations were observed among Aboriginal Australians who were heavy episodic alcoholic users.

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Genetic and environmental influences on the relationship between peer alcohol use and own alcohol use in adolescents
Addiction 102 (6), 894–903.

Genetically influenced aspects of adolescent behaviour can play a role in alcohol use and peer affiliation. We explored the correlations between friends' alcohol use and adolescent own use with a genetically sensitive design.

Genetic and environmental factors were estimated on adolescent reports of their friends' alcohol use and their own use and problem use of alcohol. The correlations between the genetic and environmental factors that influence friends' alcohol use and adolescent own alcohol use and problem use were also estimated.

There is considerable overlap in the common environmental and genetic factors that contribute to the relationship between adolescents' own alcohol use and that of their friends. These findings contribute to understanding of the mechanisms by which friends' alcohol use influences adolescent drinking behaviour.

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LECTURE - A vision of the next generation of behavioral therapies research in the addictions
Addiction 102 (6), 850–862.

Increasingly rigorous research in behavioral therapies has yielded a large number of effective therapies, but comparatively little work, demonstrating that integrating empirically supported therapies (ESTs) into standard practice results in meaningful improvements in patient outcomes.

Methodology and strategies for evaluating ESTs and their effectiveness in clinical practice is a fairly recent innovation, and a host of unanswered questions remain regarding issues such as selection among different ESTs and what type of ESTs should be emphasized in dissemination efforts, what type of clinicians should be trained in what type of ESTs, the most effective training strategies for various types of clinicians, the need for ongoing supervision to maintain minimum levels of treatment fidelity and skill.

In this review, we call for broader use of new research strategies and methods relevant to dissemination of ESTs; these may include adaptive designs, identification of mechanisms of action to foster greater emphasis on effective change principles, training and adoption trials, as well as novel implementation strategies including computer-assisted therapy and computer-assisted training.

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Wednesday, May 23, 2007

JANUARY 6, 2007


The NAS is a comprehensive, collaborative strategy that provides direction and recommendations to reduce alcohol-related harms. The notion of sensible alcohol use, or developing a culture where moderation is the goal, underpins the Strategy.

The NAS is an initiative of the Federal Government under Health Canada. It was developed in a consultative manner involving representatives from health care organizations, researchers, alcohol treatment agencies, MADD, the alcohol/hospitality industry (spirits, wine and beer industry associations, restaurant association) and CALJ/ALAC.

It lays out for discussion on a national basis, beginning with provincials Ministers of Health, policy recommendations (not directives) which are intended to move Canadians towards a culture of moderation, thereby reducing the harms associated with the inappropriate use of alcohol.

It is also important that the document is non-directive, the Federal Government is not going to pass laws enforcing these recommendations; instead they encourage review, consideration, research and evaluation by the provinces.

In summary, the Strategy provides a long-term vision of how to reduce alcohol-related issues in Canada. Its recommendations can be used by the provinces (and Liquor Boards) to support positions that may be sensitive provincially, but given the weight of a national long-term policy can be implemented more easily (e.g. mandatory server training for licensee staff).

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Endogenous Nociceptin (Orphanin FQ) Suppresses Basal Hedonic State and Acute Reward Responses to Methamphetamine and Ethanol, but Facilitates Chronic Responses
advance online publication 23 May 2007

The opioid peptide nociceptin (orphanin FQ) suppresses drug reward, drug self-administration, and impedes some of the processes believed to underlie the transition to addiction.

As virtually all previous studies have used administration of nociceptin receptor agonists to evaluate the role of nociceptin on addiction-like behavior, the current study used a pharmacological (nociceptin receptor antagonist) and genetic (nociceptin receptor knockout mice) approach to elucidate the role of endogenous nociceptin.

These results suggest that endogenous N/OFQ suppresses basal and drug-stimulated increases in hedonic state, and plays either a permissive or facilitatory role in the development of addiction.

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Beware the wowsers who are trying to stop us enjoying a drink

James Campbell
May 15, 2007

FROM time to time, Australians worry about how much they drink. This should surprise no one in a country whose first currency was rum. The worriers about liquor have always been with us, but it is observable that each age produces temperance fanatics in its own image.

For the Victorians, the Demon Drink was a moral danger to society leading good men into sin, vice and depravity. In our age, wowsers clothe their arguments in pious talk about the threat to our health and the cost to the public purse. To observe the modern wowser in its native habitat, turn your eye to Grog Watch, "a weekly update of alcohol-related news" produced by the Community Alcohol Action Network. It's the War Cry for our times, and lately the news from the front is good. . . . .

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The Guardian Public Service Awards 2007

Judge's biography
Lord Victor Adebowale
Chief executive, Turning Point

Wednesday May 23, 2007

Victor joined Turning Point as chief executive in September 2001. Turning Point is the UK's leading social care organisation. We provide services for people with complex needs, including those affected by drug and alcohol misuse, mental health problems and those with a learning disability. Turning Point runs projects in 244 locations across England and Wales and last year had contact with 130,000 people. In addition to providing direct services, Turning Point also campaigns nationally on behalf of those with social care needs.

Victor began his career in Local Authority Estate Management before joining the housing association movement. He spent time with Patchwork Community Housing Association and was regional director of the Ujima Housing Association, Britain's largest black-led housing association. He was director of the Alcohol Recovery Project and then chief executive of youth homelessness charity Centrepoint before taking up his current post. . . . . .

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Health - Ad Limits Seen as Way to Curb Youth Smoking and Drinking

Published: May 22, 2007

Price-cutting and other marketing strategies widely used by the tobacco and alcoholic beverage industries are highly effective in encouraging children and teenagers to smoke and drink, according to two new studies.

In one study, researchers showed that point-of-sale advertising and other marketing significantly increase the likelihood that junior and senior high school students will try smoking
or become habitual smokers. Another has found that exposure to alcohol advertising among sixth graders strongly predicts alcohol use a year later.

That advertising liquor and tobacco increases their sales may not be a revelation. But both studies suggested that fairly simple public policy changes might significantly reduce underage smoking and drinking. . . . . . .

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Tuesday, May 22, 2007

Stability of subtypes of natural recovery from alcohol dependence after two years
Addiction 102 (6), 904–908.

The lack of consistent findings in studies on natural recovery from alcohol dependence may reflect heterogeneous subgroups according to social support and problem severity.

In a previous report, we identified the following groups: high severity of dependence, low alcohol-related problems and low social support (low problems–low support: LPLS), high severity of dependence, high alcohol-related problems and medium social support (high problems–medium support: HPMS) and high social support, late age of onset, low severity of dependence and low alcohol-related problems (low problems–high support: LPHS).

However, little is known about the trajectories of these groups. The aim of the present study is to analyse the stability of these three groups report on longer-term outcomes.

Differences between the cluster groups in social support diminished over time; however, even at follow-up, LPLS revealed less social support by friends when compared to LPHS and showed significant higher rates of relapse and utilization of formal help than did HPHS and LPHS.

Data show that the interplay between psychosocial resources and substance-related problems may still account for differences in trajectories of naturally remitted individuals in a 2-year follow-up.

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Alcoholics Anonymous in Ireland: AA's first European experience
Addiction 102 (6), 879–886.

To trace the evolution of Alcoholics Anonymous in Ireland from its establishment there in 1946, focusing on the efforts of early members to publicize the fellowship and negotiate a role for themselves in relation to existing religious and healthcare institutions.

Anticipated tensions between this fellowship, which had its roots in Evangelical Protestantism, and the politically powerful Roman Catholic Church in Ireland were skillfully avoided; initial hostility from the medical profession quickly dissipated; and AA distanced itself from policy debate on the wider topic of alcoholism as disease.

The relatively smooth introduction of AA to Ireland, the first European country in which it was established, may be attributed to the essentially pragmatic nature of the fellowship and the strategic abilities of its early members

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The spatial ecology of alcohol problems: niche theory and assortative drinking
Addiction 102 (6), 870–878.

This paper summarizes several theoretical perspectives that serve to explain observed associations between concentrations of alcohol outlets and alcohol-related problems. A critique of each perspective discusses how each addresses the social etiology of these problems; that is, how, where and why these problems arise in association with alcohol outlets?

Associations between outlets and problems are thought to arise from the concentration of individuals in drinking places (‘flow models’), the attraction of some places for people at risk for problems (‘gravity models’), or because outlets are located in high-risk neighborhoods and have negative social normative effects (‘social contextual models’). None of these approaches explain how some outlets come to have more problems than others (e.g. violent outlets).

An alternative social ecological model is introduced which asserts that the complementary processes of niche marketing and assortative drinking form the social dynamic that explains these relationships. Alcohol sellers ‘niche market’ to select social strata, drinkers return to establishments at which they find people like themselves, and consequent social stratification of the market-place increases the levels of related problems in some outlets.

The proposed mechanism is very general, and suggests that over-concentrations of outlets will lead to stratification of drinking groups and intensification of problems related to those outlets.

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