Underdiagnosis of comorbid mental illness in repeat DUI offenders mandated to treatment
Journal of Substance Abuse Treatment
Article in Press, Corrected Proof 5 July 2007



Repeat offenders for DUI are routinely mandated to undergo alcohol treatment. These individuals have been shown to have high rates of co-occurring psychiatric disorders, which can be important for the conduct and outcomes of alcohol treatment.

The extent to which treatment providers are aware of these disorders and modify treatment accordingly is unknown.

Adjusted rates of underdiagnosis were commonly high: 97.2% of bipolar disorder cases, 67.5% of major depression cases, 100% of obsessive–compulsive disorder cases, and 37.3% of drug use disorder cases remained undiagnosed during treatment. Rates of overdiagnosis were low for all disorders, with the exception of drug use disorders.

These rates of underdiagnosis represent missed opportunities to improve treatment outcomes among repeat DUI offenders.

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Reprint Request E-Mail: gmcmillan@bhrcs.org
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Economic benefit of chemical dependency treatment to employers
Journal of Substance Abuse Treatment
Article in Press, Corrected Proof 5 July 2007



Using assessment data from the Substance Abuse Treatment Support System, we estimated the economic benefit of chemical dependency treatment to employers.

Compared to intake, subsequent assessments indicated substantial reduction in the number of patients who missed work, were late for work, were less productive than usual at work, and/or had conflict with coworkers or management.

The net economic value of these improvements to their employers depended upon the utilization rate of the benefit and the salary level of the employees receiving treatment. For a utilization rate of 0.9% and a mean annual salary of US$45,000, the net benefit of treatment was US$1,538 for ≥ 61 days of treatment.

Based solely upon these employment-related measures, without factoring in the medical cost offset or indirect benefits of treatment that may help employees to maintain higher levels of productivity, employers break even on an investment of US$30 per member per year for a chemical dependency treatment benefit if the mean annual salary of the employees participating in treatment is US$36,565.

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Reprint Request E-Mail: grant@polarishealth.com
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Brief family treatment intervention to promote continuing care among alcohol-dependent patients in inpatient detoxification: A randomized pilot study
Journal of Substance Abuse Treatment
Article in Press, Corrected Proof 5 July 2007

Alcohol-dependent patients in inpatient detoxification were randomized to treatment-as-usual (TAU) intervention or brief family treatment (BFT) intervention to promote continuing care postdetoxification.

Results showed that BFT patients (n = 24) were significantly more likely than TAU patients (n = 21) to enter a continuing care program after detoxification. This was a medium to large effect size.

In the 3 months after detoxification, days using alcohol or drugs (a) trended lower for treatment-exposed BFT patients who had an in-person family meeting than for TAU counterparts (medium effect), and (b) were significantly lower for patients who entered continuing care regardless of treatment condition (large effect).

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Reprint Request E-Mail: timothy_ofarrell@hms.harvard.edu

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Cost-effectiveness analysis of four interventions for adolescents with a substance use disorder
Journal of Substance Abuse Treatment
Article in Press, Corrected Proof 28 June 2007




The present study attempted a cost-effectiveness analysis of four interventions, including family-based, individual, and group cognitive behavioral approaches, for adolescents with a substance use disorder.

The results indicated that treatment costs varied substantially across the four interventions.

Moreover, family therapy showed significantly better substance use outcome compared to group treatment at the 4-month assessment, but group treatment was similar to the other interventions for substance use outcome at the 7-month assessment and for delinquency outcome at both the 4- and 7-month assessments.

These findings over a relatively short follow-up period suggest that the least expensive intervention (group) was the most cost-effective.

However, this study encountered numerous data and methodological challenges in trying to supplement a completed clinical trial with an economic evaluation. These challenges are explained and recommendations are proposed to guide future economic evaluations in this area.

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Reprint Request E-Mail: mfrench@miami.edu
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Symposium on Improving Educational Outcomes for Students with Intellectual and Behavioral Disabilities due to Prenatal Alcohol Exposure

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Event:	Symposium on Improving Educational Outcomes for Students with Intellectual and Behavioral Disabilities due to Prenatal Alcohol Exposure
Location:	NIAAA, 5635 Fishers Lane, Terrace Level, Rockville, Maryland
Start Date:	7/12/2007 12:30 PM
End Date:	7/13/2007 5:00 PM
Event Details:	Meeting times: Thursday, July 12, 2007, 12:30 p.m. to 8:00 p.m. Friday, July 13, 2007, 8:30 a.m. to 5:00 p.m. Hosted by the Education Work Group of the Interagency Coordinating Committee on Fetal Alcohol Syndrome Sponsored by the Interagency Coordinating Committee on Fetal Alcohol Syndrome, the National Institute on Alcohol Abuse and Alcoholism, the NIH Office of Rare Diseases, and the U.S. Department of Education To register and/or view agenda: www.regonline.com/136647

Commentaries on Cook and Reuter
A CROSS-CUTTING RESEARCH AGENDA ON ALCOHOL, TOBACCO AND OTHER DRUGS: WHERE TO START?
Addiction 102 (8), 1191–1192.



Like Cook and Reuter, my impression of the research that informs current understanding of psychoactive substance use and which shapes policy responses is that it largely comprises studies on a single substance type. The last hundred years has seen an explosion in the availability of psychoactive substances; some are developed prescribed medications for the treatment of mental health problems and others are manufactured illegally, often in home-based laboratories. The expansion of international transport, communication and trade has ensured that these new substances as well as more traditional ones are delivered efficiently to drug markets the world over. Contemporary patterns of substance use, especially among younger people, seem to increasingly involve the use of multiple substances both over time and on the same occasion, so that legal, illegal and prescription drug markets are increasingly intertwined. Furthermore, there is strong evidence that patterns of multiple substance use are predictive of increased risk of harms. Cook and Reuter do the substance use field a service, therefore, with their observation that it is time for a cross-cutting research agenda spanning the alcohol, tobacco and other drug fields.While the prevention field has, for some time, recognized the need to address common risk and protection factors regarding the hazardous use of different psychoactive substances and also other problem behaviours, Cook and Reuter make the undeniable point that much research funding and hence research practice to date has occurred within substance-specific silos.

A truly cross-cutting research agenda spanning all psychoactive substances would be an enormous and daunting undertaking. The questions discussed briefly below are but two in a potentially very long list of useful places to start.
. . . . . .

Read Full Text (PDF)
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Commentaries on Cook and Reuter
IS ALCOHOL FOODSTUFF?
Addiction 102 (8), 1190–1191.





When is alcohol just another drug? The answer is simple: always. And if the answer is so simple, then the next question is: why do we need to discuss what is obvious? My guess is that when science is uncomfortable for politicians and policy makers, then the debate never ends. To ‘always’ place alcohol with the rest of drugs would certainly bring to the research and policy arena the coherence we find in the clinical field.

Cook and Reuter have produced an elegant statement to show the benefits of a cross-cutting agenda, and I agree with all the arguments they present. However, their contribution raises an even more important question: why do the agendas for alcohol and the rest of drugs continue to be separate? If we do not reach a clarification of the mechanisms that maintain a situation which we know to be obsolete, it will be difficult for us to be able to reverse it. The problem is that possibly the scientific method is not the best instrument for understanding these mechanisms.
. . . . . .

Read Full Text (PDF)
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Commentaries on Cook and Reuter
ALCOHOL AS A ‘DRUG’: A MORAL REVOLUTION
Addiction 102 (8), 1189–1189.




‘In terms of its effects on the human body and psyche, alcohol is simply another psychoactive substance’. This sentence, which begins the very able essay by Cook andReuter, embodies a statement that will be taken as a truism by most readers of this journal, but would be regarded as a fallacy, an outrage and an insult by many, if not most, ordinary citizens. Why is that claim controversial, and why does the rejection of that claim matter?

It is controversial, I would submit, because the mood in which the public, its elected representatives and their appointed officials consider drugs, drug-taking and drug policy has little to do with the calm, evidence-based, policy-analytical tone taken by Cook and Reuter .
. . . . . .

Read Full Tert (PDF)
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FOR DEBATE
When is alcohol just another drug? Some thoughts on research and policy
Addiction 102 (8), 1183–1188.



To reflect on the divergence and overlap between alcohol and illicit drugs with respect to both current policies and policy research.

For demand reduction, there is considerable overlap in programs and services for prevention and even more clearly for treatment. For supply controls there is mostly divergence, reflecting the difference in legal status. Research generally follows the same pattern. However, a cross-cutting research agenda on the supply side has merit.

Even in a prohibition regime, law-enforcement agencies have considerable discretion. A systematic, pragmatic, ‘evidence-based’ use of that discretion to reduce harm is possible. It can be accomplished only by a continuing program of policy research that measures the harms of drug use and drug enforcement, assesses the effects of current policies on both these sources of social cost and explores alternative strategies. There is a similarly important project for alcohol and tobacco control policy.

The goal for research on alcohol and tobacco is to document the extent to which supply controls can be effective in reducing harm; the additional goal for illicit drugs is to document just how much the current ideologically driven approach is costing the public.

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Reprint Request E-Mail: pcook@duke.edu

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Purkinje cell dysfunction and alteration of long-term synaptic plasticity in fetal alcohol syndrome
PNAS | June 5, 2007 | vol. 104 | no. 23 | 9858-9863





In cerebellum and other brain regions, neuronal cell death because of ethanol consumption by the mother is thought to be the leading cause of neurological deficits in the offspring. However, little is known about how surviving cells function.

We studied cerebellar Purkinje cells in vivo and in vitro to determine whether function of these cells was altered after prenatal ethanol exposure. We observed that Purkinje cells that were prenatally exposed to ethanol presented decreased voltage-gated calcium currents because of a decreased expression of the -isoform of protein kinase C. Long-term depression at the parallel fiber–Purkinje cell synapse in the cerebellum was converted into long-term potentiation.

This likely explains the dramatic increase in Purkinje cell firing and the rapid oscillations of local field potential observed in alert fetal alcohol syndrome mice.

Our data strongly suggest that reversal of long-term synaptic plasticity and increased firing rates of Purkinje cells in vivo are major contributors to the ataxia and motor learning deficits observed in fetal alcohol syndrome.

Our results show that calcium-related neuronal dysfunction is central to the pathogenesis of the neurological manifestations of fetal alcohol syndrome and suggest new methods for treatment of this disorder.

<sup>Read Full Abstract

Reprint Request E-Mail:</sup> laurent.servais@rdb.aphp.fr
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Axis I and II disorders as long-term predictors of mental distress: A six-year prospective follow-up of substance-dependent patients
BMC Psychiatry 2007, 7:29, 26 June 2007

A high prevalence of lifetime psychiatric disorders among help-seeking substance abusers has been clearly established. However, the long-term course of psychiatric disorders and mental distress among help-seeking substance abusers is still unclear.

The aim of this research was to examine the course of mental distress using a six-year follow-up study of treatment-seeking substance-dependent patients, and to explore whether lifetime Axis I and II disorders measured at admission predict the level of mental distress at follow-up, when age, sex, and substance-use variables measured both at baseline and at follow-up are controlled for.

The stability of mental distress is a main finding and the level of mental distress remained high after six years, but was significantly lower among abstainers at T2, especially among female abstainers.

Both the number of and specific lifetime Axis I disorders (social anxiety disorder, generalized anxiety disorder, and somatization disorder), the number of and specific Axis II disorders (anxious and impulsive personality disorders), and the severity of substance-use disorder at the index admission were all independent predictors of a high level of mental distress at follow-up, even when we controlled for age, sex, and substance use at follow-up.

These results underscore the importance of diagnosing and treating both substance-use disorder and non-substance-use disorder Axis I and Axis II disorders in the same programme.

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Risky use of alcohol, drugs and cigarettes in a psychosis unit: a 1 1/2 year follow-up of stability and changes after initial screening
BMC Psychiatry 2007, 7:31 , 6 July 2007

Co-morbidity with substance use disorders negatively influences overall functioning in patients with psychosis. However, frequencies and courses of risky use of alcohol, drugs and cigarettes are rarely investigated in patients at psychosis units.

The purpose of this study is to describe the use of alcohol, drugs and cigarettes in patients at a psychosis unit over a 11/2 year period after them having taken part in a screening investigation including a feed-back of the results to personnel. Relationships with sex and age are also described.

One hundred and eighty-six patients out of 238 at baseline (78 percent) took part in the follow-up. Total AUDIT score decreased in women. Older men more often developed a risky alcohol use. Older women tended to reduce their risky drug habits.

On a group level the habits mostly were stable, but 11 percent changed their alcohol habits and 15 percent changed their smoking habits from risky to no/low risky use, or vice versa. Nine percent changed their drug habits, predominantly from risky to no/low risky use.

A more active approach towards alcohol, drug and smoking habits in psychosis units would probably be beneficial.

Read Full Text (PDF)

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Requests for Applications
Release Date 6 July 2007

• Exploratory/Developmental Alcohol Research Centers (P20)
  (RFA-AA-08-003)
  National Institute on Alcohol Abuse and Alcoholism
  Application Receipt Date(s): December 14, 2007
  

• Resource Core Alcohol Research Centers (P30)
  (RFA-AA-08-004)
  National Institute on Alcohol Abuse and Alcoholism
  Application Receipt Date(s): December 14, 2007
  

• Specialized Alcohol Research Centers (P50)
  (RFA-AA-08-005)
  National Institute on Alcohol Abuse and Alcoholism
  Application Receipt Date(s): December 14, 2007
  

• Comprehensive Alcohol Research Centers (P60)
  (RFA-AA-08-006)
  National Institute on Alcohol Abuse and Alcoholism
  Application Receipt Date(s): December 14, 2007
  

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The red wine hypothesis: from concepts to protective signalling molecules
European Heart Journal 2007 28(14):1683-1693





We review evidence for and against the ‘red wine hypothesis’, whereby red wine is more likely to confer cardiovascular benefits than white.

As background, there is a strong epidemiological and mechanistic evidence for J-shaped relation between alcohol intake and total mortality. However, epidemiological data favouring a specific benefit of red over white wine are not strong and the ‘French paradox’ could at least in part be explained by confounding factors.

More convincing evidence is that human studies with de-alcoholized red but not white wine show short-term cardiovascular benefits. The specific components of the de-alcoholized wine that are active on cardiovascular endpoints, are the polyphenols found in red wine, especially resveratrol.

The effects of resveratrol on isolated tissues or organs are well-described including molecular mechanisms leading to decreased arterial damage, decreased activity of angiotensin-II, increased nitric oxide, and decreased platelet aggregation. Anti-ischaemic effects include stimulation of prosurvival paths, decreased LDL-oxidation, atheroma, and on the ischaemic-beneficial metabolic changes.

Most recently, the agonist effect of resveratrol on the anti-senescence factor sirtuin has lessened cell death in myocytes from failing hearts.

Mechanistic feasibility strengthens the case for prospective therapeutic trials of alcohol vs. red wine vs. resveratrol, for example in those with heart failure.

<sup>Read Full Abstract


Reprint Request E-Mail:</sup> lionel.opie@uct.ac.za

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How We Get Addicted

July 16, 2007

By MICHAEL D. LEMONICK



Humans have an odd habit of getting hooked on harmful things. New research is revealing why, and opening the door to the long-dreamed-of cure

Read Full Article
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Toolkit Supports Efforts in Native Communities to Prevent Fetal Alcohol Spectrum Disorders


A toolkit to help Native communities protect their children from the harm caused by drinking alcohol during pregnancy is now available from the Substance Abuse and Mental Health Services Administration.

The American Indian/Alaska Native/Native Hawaiian Resource Kit is designed to help mothers-to-be and their friends, relatives, health professionals, and leaders understand and prevent fetal alcohol spectrum disorders. FASD describes the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications.

Each year, at least 40,000 babies are born with an FASD in the United States, and Native communities have some of the highest rates. This new resource will support prevention and treatment efforts in American Indian, Alaska Native and Native Hawaiian communities.

The kit, which was developed and reviewed by representatives from Native communities and FASD experts, includes the following:

• Current data and statistics on FASD
• Fact sheets and brochures for women, men, youth and communities on how to prevent FASD and how to find help
• Strategies for FASD education and prevention
• Posters that can be copied and shared
• FASD--The Basics, a slide presentation for people with no prior knowledge of or experience with FASD
• A CD with an electronic version of the entire resource kit

The American Indian/Alaska Native/Native Hawaiian Resource Kit is available on the Web at http://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=17702
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SAMHSA's Road to Recovery Update

Wednesday, July 5, 2007

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

Next Webcast

Thursday, July 5: "Treatment and Recovery: Reducing the Burden on the Justice System and Society".

In a 2002 report, nearly 1.7 million of the 2 million adult Americans in prison or jail were seriously involved with drugs or alcohol. Luckily, approximately 73 percent of local jails provide drug treatment or recovery programs. Various justice systems provide a variety of services and programs such as individual, family, and juvenile drug courts; jail diversion programs; and counseling services.

Join Ivette Torres, Associate Director for Consumer Affairs, Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS) and a panel of experts to examine the relationship between addiction treatment and recovery and the criminal justice system. This program will focus on both the practical and economic benefits to society from treating substance abuse and dependence issues surrounding the criminal justice system.

Ask the Expert

Get answers to your questions about the topics covered in the latest Road to Recovery Webcast, "Treatment and Recovery: Reducing the Burden on the Justice System and Society" Submit your questions using our anonymous online form, and answers from our expert will be posted in early August.

Visit Ask the Expert before July 20 to submit questions for this month's expert: Roger H. Peters, Ph.D., Chair and Professor, Department of Mental Health Law and Policy University of South Florida, Louis de la Parte Florida Mental Health Institute

ROGER H. PETERS, Ph.D.
Dr. Peters serves as Chair and Professor in the Department of Mental Health Law and Policy at the Louis de la Parte Florida Mental Health Institute (FMHI), University of South Florida, where he has been a faculty member since 1986. He received his Ph.D. in clinical psychology from the Florida State University, following completion of a pre-doctoral internship at the University of North Carolina, School of Medicine. Dr. Peters has served as Principal Investigator and Director for several grant projects, including the SAMHSA-funded Suncoast Practice and Research Collaborative (SPARC) project. From 1995-2004 Dr. Peters served as the lead consultant to the National GAINS Center for People with Co-occurring Disorders in the Justice System. Dr. Peters has pursued research, consultation, and training initiatives involving substance abuse treatment within the criminal justice system. He has published frequently in major journals, served on federal expert panels, grant and document reviews, national advisory boards and committees, and has served as a consultant to federal and state agencies. Dr. Peters served for four years on the Board of Directors of the National Association of Drug Court Professionals, and for the past seven years has served on the Treatment-Based Drug Court Steering Committee for the Supreme Court of Florida. He recently served as Chair and Co-Editor of the SAMHSA/CSAT Treatment Improvement Protocol (TIP) #44 on "Substance Abuse Treatment for Adults in the Criminal Justice System".

For more information about Roger H. Peters Ph.D., visit http://www.recoverymonth.gov/2007/
multimedia/bio.aspx?ExpertID=5.

Official Proclamations

Encourage your local government officials to sign an official proclamation that designates September as National Alcohol and Drug Addiction Recovery Month (Recovery Month). To acknowledge your efforts, we will post your proclamation to our Web site! Click here for more information.

About Recovery Month

National Alcohol and Drug Addiction Recovery Month, celebrating 18 years of observance in 2007, is an initiative of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration's (SAMHSA's) Center for Substance Abuse Treatment (CSAT). For more information about Recovery Month, visit www.recoverymonth.gov.
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Summer 2007, Number 13

Table of Contents

• Coding Changes for Screening and Brief Intervention Services
• Alcohol Research Center Directors Meet
• Personnel News
• Fordham Prevention Workshop
• New Publications
• Calendar of Events

This document can be downloaded in its original graphic format (PDF)

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Six- and Twelve-Month Outcomes among Homeless Youth Accessing Therapy and Case Management Services through an Urban Drop-in Center
Health Services Research (OnlineEarly Articles) 05 July 2007

To evaluate the impact of case management and individual therapy offered through a drop-in center for homeless youth on substance use, mental health, housing, education, employment, and medical care utilization.

Statistically significant improvements were found in substance abuse, mental health, and percent days housed up to 12 months postbaseline. Decreased alcohol and drug use was associated with an increase in housing.

However, most youth did not acquire permanent housing, and education, employment, and medical service utilization did not significantly change over time.

While treatment offered through drop-in centers for homeless youth can positively impact homeless youth, policy, funding, and service provision need greater focus, collaboration, and support if youth homelessness is to be successfully addressed.

Read Full Abstract

Reprint Request E-Mail: nslesnick@ehe.osu.edu

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Variation in the gene coding for the M5 Muscarinic receptor (CHRM5) influences cigarette dose but is not associated with dependence to drugs of addiction: evidence from a prospective population based cohort study of young adults
BMC Genetics 2007, 8:46 doi:10.1186/1471-2156-8-46, 3 July 2007

The mesolimbic structures of the brain are important in the anticipation and perception of reward. Moreover, many drugs of addiction elicit their response in these structures. The M5 muscarinic receptor (M5R) is expressed in dopamine-containing neurones of the substantia nigra pars compacta and ventral tegmental area, and regulates the release of mesolimbic dopamine. Mice lacking M5R show a substantial reduction in both reward and withdrawal responses to morphine and cocaine. The CHRM5, the gene that codes for the M5R, is a strong biological candidate for a role in human addiction. Our data suggest that variation within the CHRM5 locus may play an important role in tobacco and cannabis but not alcohol addiction in European ancestry populations. This is the first study to show an association between CHRM5 and substance use in humans. These data support the further investigation of this gene as a risk factor in substance use and dependence. Read Full Text (PDF) _________________________________________________________________

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Smoking, alcohol and dietary choices: evidence from the Portuguese National Health Survey
BMC Public Health 2007, 7:138 doi:10.1186/1471-2458-7-138, 3 July 2007

Unhealthy lifestyle choices tend to cluster, but controversy remains regarding relationships between smoking and dietary habits.

The aim of this study was to compare dietary intake and alcohol consumption, according to smoking status, in the Portuguese population.

This study showed that smokers have a higher intake of alcoholic beverages and a lower consumption of food items rich in fibre, antioxidants, or phytochemicals, which are suspected to have beneficial roles in the prevention of multiple chronic diseases.

Read Full Text (PDF)

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Policing the drunk driver: Measuring law enforcement involvement in reducing alcohol-impaired driving
Journal of Safety Research
Volume 38, Issue 3, 2007, Pages 267-272




With many thousands of deaths still annually attributable to driving under the influence (DUI), it remains imperative that we continually address the problem of producing and sustaining effective countermeasures, and that we subject these efforts to empirical scrutiny. This article presents relevant findings from state-wide datasets.

A formula generating a potentially useful metric for assessing aspects of the DUI prosecutorial chain is presented, focusing on the rate of proactive DUI arrests.

While in need of cautious interpretation due to issues of inherent inaccuracies in large databases, small numbers of crashes and/or arrests in multiple jurisdictions, and the lack of replication in other states, the analyses show no relationship between the level of DUI arrest activity and DUI-related crashes.

This finding brings into question the efficacy of the many millions of dollars devoted each year to targeted DUI enforcement, as it is currently being implemented.

Results are discussed in terms of developing adequate disincentives to DUI so as to raise general deterrence via dramatic increases in proactive DUI enforcement and then engaging in pervasive and persistent social marketing of such efforts to maximize the perception that arrest and punishment for DUI is always imminent, that penalties will be swift, certain, and severe.

Read Full Abstract

Reprint Request E-Mail: dulac@etsu.edu

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Effects of acute alcohol intoxication on visuospatial attention
Human & Experimental Toxicology, Vol. 26, No. 4, 311-319 (2007)









The aim of the present study was to examine the effects of acute alcohol intoxication on the spatial distribution of visual attention measured with simple reaction times (RTs) to targets presented over an extended region of the visual field.

Results showed that controls were able to direct their attention tightly towards the centre (Expt I) and also to divide attention (Expt II) to the right and left.

Participants in the alcohol group fixed their attention more diffusely in the centre (Expt I) and were unable to disengage attention from the centre in Experiment II.

We conclude that acute alcohol intoxication impairs the ability to dissociate attention from gaze

Read Full Abstract


Reprint Request E-Mail: lviz.canto@tuebingen.mpg.de
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Marin Institute News for July 4, 2007




1. Responsibility Messages Overshadowed by Ads
2. Outdoor Ads Encourage Youth to Drink
3. CBS Outdoor Running Alcohol Ads on Public Transit...Again!
4.Viral Energy Drinks
5. Our Founding Brewers?

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Kick back and destroy the ride: Alcohol-related violence and associations with drinking patterns and delinquency in adolescence
Substance Abuse Treatment, Prevention, and Policy 2007, 2:18 , 2 July 2007

To assess how drinking patterns and delinquency are associated with self-reported experiences of alcohol-related violence in an adolescent population.

All drinking pattern indicators were statistically significantly associated with alcohol-related violence, high usual volume of distilled spirits consumed being the strongest. Delinquency had, when included in the analysis, a significant effect; however, the drinking pattern indicators also remained statistically significant. An analysis of the effect moderation between usual volume of distilled spirits consumed and delinquency showed that there was a synergetic effect between them.

A separate analysis for non-delinquent students, those with little experience of delinquency, and those who engaged regularly in delinquent activities, showed that the effects of different drinking patterns, especially use of distilled spirits, were significant in both groups, however, differently distributed.

The results show that alcohol consumption pattern, with usual volume of distilled spirits being the most prominent one, had an effect on alcohol-related violence, and that this effect was amplified by delinquent behavior.

The analyses also showed that there are similarities, regarding risk factors for alcohol-related violence, between delinquent and non-delinquent youth. This, indicating that consumption pattern cannot be discarded as a key factor in alcohol-related violence in adolescence.

The study shows that alcohol-related violence in adolescence is related to both alcohol consumption patterns, e.g. usual volume of distilled spirits consumed, and delinquency. In order to prevent the harm outcome, both phenomenons have to be targeted, either by alcohol or broader social policy initiatives.

Read Full Text (PDF)
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Gender, Early Alcohol Use, and Suicide Ideation and Attempts: Findings from the 2005 Youth Risk Behavior Survey
Journal of Adolescent Health
Article in Press, Corrected Proof 25 May 2007

To examine the cross-sectional associations between preteen alcohol use initiation and subsequent suicide ideation and attempts for boys and girls in a nationally representative sample of high school students.

Among study participants, 25.4% reported drinking before age 13 years. Preteen alcohol use initiation was statistically significantly associated with suicidal ideation and suicide attempts relative to those in nondrinkers. Preteen alcohol use initiation was statistically significantly associated with suicidal ideation and attempts relative to nondrinkers for both boys and girls.

Alcohol use among adolescents, particularly preteen alcohol use initiation, is an important risk factor for both suicide ideation and suicide attempts among boys and girls. Increased efforts to delay and reduce early alcohol use are needed, and may reduce suicide attempts.

Read Full Abstract

Reprint Request E-Mail: MSwahn@cdc.gov

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Adolescents’ Attention to Responsibility Messages in Magazine Alcohol Advertisements: An Eye-Tracking Approach
Journal of Adolescent Health
Volume 41, Issue 1, July 2007, Pages 27-34

To investigate whether adolescent readers attend to responsibility or moderation messages (e.g., “drink responsibly”) included in magazine advertisements for alcoholic beverages and to assess the association between attention and the ability to accurately recall the content of these messages.

Overall, the responsibility or moderation messages were the least frequently viewed textual or visual areas of the advertisements. Participants spent an average of only .35 seconds, or 7% of the total viewing time, fixating on each responsibility message. Beverage bottles, product logos, and cartoon illustrations were the most frequently viewed elements of the advertisements.

Among those participants who fixated at least once on an advertisement’s warning message, only a relatively small percentage were able to recall its general concept or restate it verbatim in the masked recall test.

Voluntary responsibility or moderation messages failed to capture the attention of teenagers who participated in this study and need to be typographically modified to be more effective.

Read Full Abstract

Reprint Request E-Mail: steven_thomsen@byu.edu
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Reactions to a Concept for Physician Intervention in Adolescent Alcohol Use
Journal of Adolescent Health
Volume 41, Issue 1, July 2007, Pages 35-41

This study was designed to understand adolescent and parental perceptions, receptivity, and reactions to the concept of screening and brief intervention that primary care physicians can use to reduce alcohol consumption by their non-alcohol-dependent adolescent patients.

Parents and adolescents held similar views on the prevalence and harms of adolescent alcohol consumption, but different levels of concern about them. After initial surprise and needed dispelling of misconceptions, all groups expressed interest, support, and suggestions for the concept of a physician-initiated, office-based intervention to address younger adolescent alcohol use.

Because both adolescents and parents of adolescents expressed interest in this type of intervention, physicians should be aware of this receptivity and consider focus group findings in how to structure development of a potential counseling-based intervention.

Prior education about the target and nature of the intervention is necessary, lest adolescents and parents assume—incorrectly—that it is about doctors preaching to high-risk adolescents to stop drinking.

Read Full Abstract


Reprint Request E-Mail: richard.yoast@ama-assn.org
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TRIADD: THE RISK FOR ALCOHOL ABUSE, DEPRESSION, AND DIABETES MULTIMORBIDITY IN THE AMERICAN INDIAN AND ALASKA NATIVE POPULATION
American Indian and Alaska Native Mental Health Research: The Journal of the National Center Volume 14, Number 1, 2007 pp. 1-23

This study examined the risk for alcoholism, diabetes, and depression (triADD) in American Indian/ Alaska Native (AI/AN) populations in the U.S.

Using the Behavioral Risk Factor Surveillance System, a series of descriptive statistics and regression models were used to examine the interrelationships among these disorders in AI/AN populations.

Despite a small sample size, results indicate that AI/ANs are at elevated risk for the individual and combined presence of triADD (OR=12.5) when compared to the White population.

These findings indicate the need for further investigation and prevention focused on effective, culturally appropriate interventions with these populations.

Read Full Issue (PDF)
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Prevalence and patterns of alcohol use in the Australian workforce: findings from the 2001 National Drug Strategy Household Survey
Addiction (OnlineEarly Articles) 04 July 2007

To describe Australian workers' prevalence and patterns of alcohol use.

Approximately 8% of the workforce drank at least weekly at short-term risky or high risk levels, 17% drank at least monthly, 18% drank at least yearly and 11% drank at long-term risky or high risk levels. The prevalence of risky or high risk drinking was higher for younger than for older workers.

Controlling for socio-demographic factors, the risk of workers frequently drinking at levels associated with short-term harm was lowest in the education industry and significantly higher in the hospitality, agriculture, manufacturing and construction industries.

Drinking patterns associated with long-term harm were more prevalent in the agriculture, retail and manufacturing industries, compared to the education industry. Drinking patterns associated with both short- and long-term harm were more prevalent for blue-collar workers than professionals.

Risky and high risk drinking occurred at least occasionally in 44% of Australian workers. Workers in the hospitality, agriculture, manufacturing, construction and retail industries, workers in blue-collar occupations and young workers were identified as at-risk subgroups.

These data provide evidence that patterns of consumption differ between occupational and industry groups, and highlight the pressing need to develop policies, prevention and intervention strategies to reduce harmful alcohol use in Australia, particularly among young adults.

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Reprint Request E-Mail: jesia.berry@flinders.edu.au
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Advancing the analysis of treatment process
Addiction (OnlineEarly Articles) 04 July 2007

To review the role of process research in clinical research, to summarize progress in statistical methods for process analyses, and to describe a dynamic analytical approach that can provide new insights into the processes responsible for the effects of treatments and other variables.

Process research helps us to understand what happens during our interventions, and can yield valuable knowledge regardless of whether an intervention is found to have significant effects. This is a review of recent statistical advances for dealing with missing data, tests for mediation and hierarchical modeling and demonstrate how these advances can help process researchers overcome obstacles that had limited past studies. However, the standard paradigm for process analysis, although conceptually sound, is based upon a static model that does little justice to the dynamics of treatment.

Therefore, it is proposed that the paradigm is extended to study the time–course of dynamic processes, using existing statistical methods. Hierarchical linear modeling, structural regression modeling and event history methods are among the most promising tools for more advanced process analyses because of their ability to incorporate time-varying predictors.

The function of process analysis is to probe into the mechanisms of action of treatment to locate both weaknesses and strengths, but methods for process research are still rudimentary. By conceptualizing process analysis as a problem of relating multiple time-series, many new analytical opportunities, and challenges, present themselves.

Modern statistical methods can help to lead to broad advances in our understanding of the processes that affect treatment success.

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Reprint Request E-Mail: stout@pire.org

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Addiction sciences and its psychometrics: the measurement of alcohol-related problems
Addiction (OnlineEarly Articles) 04 July 2007

The focus of this paper is on psychometric issues related to the measurement of alcohol problems.

Taking a broad perspective, this paper first examines several issues around the use of instruments to provide diagnostic categories in surveys, including dimensionality, severity and alcohol consumption.

Secondly, a discussion of some of the political issues surrounding measurement of alcohol problems is presented, including some of the conflicts that arise when the psychometric properties of commonly used instruments are questioned.

Finally, newer statistical techniques that can be applied to scale development in the alcohol field are examined, including non-linear multivariate analyses and confirmatory/hypothesis-based methods.

Continued scholarly discussion needs to be encouraged around these psychometric issues so that instrument development and maintenance in the addiction sciences becomes an ongoing academic pursuit as we strive to measure alcohol problems in the best way possible.

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Reprint Requst E-Mail: lmidanik@berkeley.edu
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Rethinking the paradigms that inform behavioral treatment research for substance use disorders
Addiction (OnlineEarly Articles). 04 July 2007

Over the last three decades, the randomized controlled trial or ‘psychotherapy technology’ approach has been the dominant model of inquiry in research on addiction treatment. This period has yielded impressive discoveries, but recent failures to confirm core research hypotheses such as occurred in Project MATCH and the Cocaine Collaborative Treatment Study have raised questions about future research directions.

The paper identifies several testable assumptions of the psychotherapy technology model.

A review is conducted on four substance use disorder behavioral interventions—motivational interviewing, cognitive–behavioral treatment, behavioral couples treatment and 12-Step-oriented treatment—to determine whether these assumptions are supported by research findings.

Overall, the review suggests weak support for the technology model of psychotherapy research. Lack of support is interpreted as indicating flaws in several model assumptions about how to conceptualize and measure patient responsivity and the interaction of non-specific and specific therapeutic factors.

The paper offers alternative strategies for addressing these issues drawn from the general psychotherapy process literature and provides illustrative examples of how these could be used to spur innovation in addiction treatment research.

The addiction treatment research field is coming up against the limitations of the psychotherapy technology model as the dominant paradigm guiding treatment research. It is important for addiction treatment researchers to explore alternative conceptualizations and methodologies in order to understand more clearly how treatment works.

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Reprint Request E-Mail: jm977@columbia.edu

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Alcohol accounts for a high proportion of premature mortality in central and eastern Europe
International Journal of Epidemiology 2007 36(2):458-467

There is a west–east mortality gradient in Europe, more pronounced in men.

The objective of this article was to quantify the contribution of alcohol use to the gap in premature adult mortality between three old (France, Sweden and United Kingdom) and four new (Czech Republic, Hungary, Lithuania and Poland) European Union (EU) member states for the year 2002. Russia was added as an external comparator.

Alcohol consumption was responsible for 14.6% of all premature adult mortality in the eight countries, 17.3% in men and 8.0% in women. This proportion was clearly higher in the new EU member states and Russia compared with the comparison countries from the old EU.

For men, Russia with 29.0 alcohol-attributable premature deaths per 10 000 population had a more than 10-fold higher rate compared with Sweden (2.7 deaths/10 000). For women, the ratio between Hungary (5.0 alcohol-attributable deaths/10 000) and Russia (4.7 deaths/10 000) compared with Sweden (0.5 deaths/10 000) was almost as high, but the rates were much lower.

The Czech Republic and Poland showed proportionally less alcohol-attributable premature mortality than the other new EU member states or Russia for both genders, which, however, was still higher than in any of the old EU member states.

Alcohol is a strong contributor to the health gap between western and central and eastern Europe, with both average volume of consumption and patterns of drinking contributing to burden of disease and injury. Alcohol also contributes substantially to male–female differences in mortality and life expectancy.

However, there are feasible and cost-effective measures to reduce alcohol-related burden that should be implemented in central and eastern Europe.

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