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, December 1, 2007

The societal cost of alcohol consumption: an estimation of the economic and human cost including health effects in Sweden, 2002
The European Journal of Health Economics, Online First, 28 November 2007

This article estimates the societal cost of alcohol consumption in Sweden in 2002, as well as the effects on health and quality of life. The estimation includes direct costs, indirect costs and intangible costs. Relevant cost-of-illness methods are applied using the human capital method and prevalence-based estimates, as suggested in existing international guidelines, allowing cautious comparison with prior studies.

The results show that the net cost (i.e. including protective effects of alcohol consumption) is 20.3 billion Swedish kronor (SEK) and the gross cost (counting only detrimental effects) is 29.4 billon (0.9 and 1.3% of GDP). Alcohol consumption is estimated to cause a net loss of 121,800 QALYs.

The results are within the range found in prior studies, although at the low end. A large number of sensitivity analyses are performed, indicating a sensitivity range of 50%.

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South-to-North gradient in lipid peroxidation in men with stable coronary artery disease in Europe
European Heart Journal 2007 28(23):2841-2849

A South-to-North gradient across Europe exists for the incidence of coronary artery disease (CAD) rates. Low-density lipoprotein (LDL) oxidation is a hallmark of atherosclerosis and CAD development. The aim of our study was to determine whether differences exist in the degree of LDL oxidation in stable CAD patients from different regions of Europe.

Alcohol intake and lipid profile were significantly associated with oxLDL. The Italian participants had the highest oxLDL levels. A sensitivity analysis showed the models yielded higher adjusted oxLDL values in Northern (63.8 U/L) than in Central (57.6 U/L) and Southern populations (56.5 U/L), P <> Italian subjects. The probability of Southern Europe scoring the lowest oxLDL levels was >71% in all fitted models.

Our findings suggest a gradient in LDL oxidation from Southern to Northern Europe that consistently holds for all levels of LDL, except for Italy; this country displays the highest levels in Europe, for unknown reasons.

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Special Report: ‘Heavy alcohol consumption causes mental illness’

Jane Nafula
December 1, 2007


A SOCIAL event or gathering in Uganda is incomplete without alcohol. Some people claim sipping at least a glass of crude waragi or a cold beer after a hectic day helps them relax and plan for the next day.

In 2005, the World Health Organisation ranked Uganda as the leading consumer of alcohol in the world. Per capita consumption is 19.5 litres, according to the report, closely followed by Luxembourg at 17.54 litres and the Czech Republic at 16.21 litres.

Health experts, however, say excessive consumption of alcohol and abuse of drugs and substances like marijuana have increased the burden of mental illness in Uganda.
One can also develop brain damage in a short period when he /she over drinks.

The Executive Director of Butabika National Psychiatric Referral Hospital, Dr Fred Kigozi, says the majority of patients who go for treatment at various mental health units in the country are alcohol and substance abusers.
. . . . . . .

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Friday, November 30, 2007

One drink may put you over the limit

James Kirkup, Political Correspondent

Drivers could find themselves over the legal alcohol threshold after a single drink under plans being drawn up by the Government to lower the drink drive limit.

Police could also be given powers to stop and breathalyse drivers at random, even if their driving gives no cause for concern.

A Department for Transport consultation to be launched in the New Year is set to propose reducing the legal blood-alcohol limit for driving by almost half.
. . . . . . .

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Determinants of alcohol use and abuse: Impact of quantity and frequency patterns on liver disease
Volume 46, Issue 6 , Pages 2032 - 2039

More than 70% of alcohol is consumed by 10% of the population in the United States. Implicit in this statistic is that tremendous variation in the pattern of drinking (quantity, frequency, and duration) exists among alcohol consumers.

Individuals who are binge or chronic drinkers will have different health outcomes than social drinkers.

Therefore, knowing the pattern of drinking will shed light on how severely individuals are alcohol-dependent and on the extent of liver damage. Thus, these parameters assume particular relevance for the treatment-providing physician.

Genetic factors contribute substantially to differences in alcohol metabolism. Variations in the activities of the alcohol-metabolizing enzymes, cytosolic alcohol dehydrogenase and mitochondrial aldehyde dehydrogenase, in part determine blood alcohol concentration, thereby contributing to the predisposition to becoming alcohol-dependent and to susceptibility to alcohol-induced liver damage.

Chronic alcohol consumption induces cytochrome P450 2E1, a microsomal enzyme that metabolizes alcohol at high concentrations and also metabolizes medications such as acetaminophen and protease inhibitors. Alcohol metabolism changes the redox state of the liver, which leads to alterations in hepatic lipid, carbohydrate, protein, lactate, and uric acid metabolism.

The quantity and frequency of alcohol consumption severely impact the liver in the presence of comorbid conditions such as infection with hepatitis B or C and/or human immunodeficiency virus, type 2 diabetes, hemochromatosis, or obesity and thus have implications with respect to the extent of injury and response to medications.

Knowledge of the relationships between the quantity, frequency, and patterns of drinking and alcoholic liver disease is limited. A better understanding of these relationships will guide hepatologists in managing alcoholic liver disease.

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Thursday, November 29, 2007

National Alcohol and Drug Addiction. Recovery Month 2007. Join the Voices for Recovery. Saving Lives, Saving Dollars.
Wednesday, November 28, 2007

SAMHSA's Road to Recovery Update

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

It's Not Too Late To Add Details and Photos From Your Event

As we reflect on the year gone by, we are reminded of the tremendous effort put forth by organizations and individuals coast to coast during Recovery Month 2007 to celebrate people in recovery and those who serve them. Congratulations once again to everyone who coordinated and/or participated in a Recovery Month event this September! Recovery Month 2007 would not have been a success without you.

Don't forget to submit your pictures and videos so we can capture all of the Recovery Month events from around the country. Be sure to add any comments from your event and send photos and any samples of materials. You can continue to post your events throughout the year.

Did Your Local Official Sign a Proclamation? Submit It Today!

Thanks to your hard work this year, 130 proclamations declaring September as National Alcohol and Drug Addiction Recovery Month (Recovery Month) were signed by local government officials nationwide. These proclamations are posted to the Recovery Month Web site to draw attention to your Recovery Month events and acknowledge your efforts. If your local official signed a proclamation, we encourage you to submit it. There's still time!

Please mail the signed original or a copy of the signed proclamation to:
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
Office of the Director, Consumer Affairs
1 Choke Cherry Road, Room 2-1062
Rockville, MD 20857

You can also email a copy of the signed proclamation in a high-resolution jpeg file to We will scan and post it for you. Please note that you will not receive the proclamation back. Thank you for your support.

Voices for Recovery

Across the country, people in recovery are celebrating their successes and sharing them with others in an effort to educate the public about treatment, how it works, for whom, and why. Through Voices for Recovery on the Recovery Month Web site, people can read these inspirational stories as well as post their own stories of recovery.

We encourage you to take a moment to visit Voices for Recovery and share your recovery story. Simply click Share Stories to post your story along with your contact information if you choose to provide it. If you prefer to remain anonymous, only provide your State and your story.

After you've entered your information, you will be prompted to download the Hold Harmless Form. This needs to be downloaded, filled out, and faxed back before your story can be posted. If you've already submitted your story to the Recovery Month Web site but have not yet faxed back the Hold Harmless Form, please do so. Your story cannot be posted until the Hold Harmless Form is completed and returned.

Please share your story and help us spread the word to get people nationwide to submit their personal stories. Help others see that recovery is possible.

View the 2007 Recovery Month Webcasts

This year's Road to Recovery multimedia series may have wrapped up, but recovery from drug and alcohol abuse is a yearlong effort. The 2007 Road to Recovery Webcasts are a valuable tool to learn more about all facets of drug and alcohol abuse—from treatment resources to addiction in the workplace to services provided by justice systems.

You can still view all 10 of the 2007 Webcasts on the Recovery Month Web site. Simply select the Webcast you want to view from the main menu, and then select either the "One minute Trailer" or "Complete Webcast." The Webcasts are very user-friendly and widely accessible through a variety of browsers. We stream the multimedia files from our servers using the Microsoft format. In order to view the Webcasts, you must have Microsoft Media Player installed on your computer.

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
Recovery Month 2007 banner: Visit the 2007 Website now

Recovery Updates
as of 11/28/07

Events: 655

Proclamations: 132

Voices for Recovery: 51


If you wish to subscribe to or unsubscribe from the Road to Recovery Update, visit Recovery Month Sign up page.
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Alcoholism, craving, and hormones: the role of leptin, ghrelin, prolactin, and the pro-opiomelanocortin system in modulating ethanol intake.
Volume 31 Issue 12 Page 1963-1967, December 2007

Evidence is growing that appetite regulating peptides such as leptin and ghrelin, but also other hormones including prolactin are altered in alcoholism.

The brain pro-opiomelanocortin (POMC) system which has important mediating roles in alcohol intake also has important functions in prolactin regulation and energy homeostasis.

Furthermore, it has been demonstrated to be functionally integrated with leptin regulation. The satiety factor leptin seems to be counteracted by the gut-derived peptide ghrelin which increases hunger and food intake.

Consequently, the POMC system may have a role in integrating regulation of alcohol effects and these seemingly disparate regulatory systems.

The goal of this mini-review is to discuss the results of some recent investigations of the potential interactions of these systems with acute and chronic alcohol responses.

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Meeting - Cost Function Analysis of the Substance Abuse Treatment Industry: Information Needs, Methods, and Next Steps,
December 13-14
Bethesda Hyatt Regency, Bethesda, MD

Registration for this meeting is now open. Please select the 'Registration' link above or click here.

The draft agenda for this meeting is now available. Please select the 'Agenda' link above or click here.

To view contact information for meeting contacts and logistical contacts please click here.

For meeting logistical information please click here.

NEWS RELEASE - New Native American Center for Excellence to Strengthen Substance Abuse Prevention Efforts Throughout Native American Communities

November 29, 2007

The Substance Abuse and Mental Health Services Administration (SAMHSA) today announced its financial and technical sponsorship of the Native American Center for Excellence, Prevention Technical Assistance Resource Center – a first-of-its-kind national Native American-run project to promote effective substance abuse prevention programs in Native American communities throughout the United States. Once it is established, the center’s data base will be accessible through SAMHSA’s Web site.

. . . . . .

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Alcohol Ingestion by Donors Amplifies Experimental Airway Disease after Heterotopic Transplantation
American Journal of Respiratory and Critical Care Medicine
Vol 176. pp. 1161-1168, (2007)

Obliterative bronchiolitis (OB) after lung transplantation is triggered by alloimmunity, but is ultimately mediated by transforming growth factor (TGF)-beta1–dependent airway fibrosis.

Chronic alcohol use increases TGF-beta1 expression and renders the lung susceptible to injury. Therefore, we hypothesized that donor alcohol abuse could prime the lung allograft for OB, as many organ donors have a history of alcohol abuse.

Although donor alcohol ingestion did not increase the number of antigen-presenting cells or infiltrating lymphocytes, it nevertheless increased allograft lumenal collagen content fourfold compared with allografts from control donors. In parallel, alcohol increased TGF-beta1 and {alpha}-smooth muscle actin expression in allografts. Alcohol amplified airway disease even in isografts with minor alloimmune mismatches. In contrast, it did not cause any airway disease in isografts in a pure isogenic background, suggesting that a minimal alloimmune response is necessary to trigger alcohol-induced airway fibrosis.

Although alloimmune inflammation is required to initiate airway disease, alcohol primes the allograft for greater TGF-beta1 expression, myofibroblast transdifferentiation, and fibrosis than by alloimmune inflammation alone. T

This has serious clinical implications, as many lung donors have underlying alcohol abuse that may prime the allograft recipient for subsequent OB.

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Effects of chronic alcohol drinking on receptor-binding, internalization, and degradation of human immunodeficiency virus 1 envelope protein gp120 in hepatocytes
Alcohol Volume 41, Issue 8, December 2007, Pages 591-606

Although alcohol drinking increases susceptibility to human immunodeficiency virus (HIV) infection, possible mechanisms underlying the effects of alcohol are not yet known.

Since the HIV envelope protein gp120 plays a key role in progression of HIV infection, the aim of the present study was to evaluate the toxicity and degradation of gp120 in hepatocytes isolated from liver of alcohol-preferring rats drinking either 15% ethanol in water or pure water for 70 days. The hypothesis was that alcohol drinking augmented the toxicity, but suppressed degradation of gp120.

Hepatocytes from water-drinking rats (C-cells) or ethanol-drinking rats (Et-cells) were treated with laptacystin, anti-CD4 antibodies, CCR5 antagonist, or mannose, followed by [125I]gp120 or native gp120. At predetermined intervals, control (C) and ethanol exposed (Et) cells were analyzed for toxicity and degradation of gp120.

In C-cells, [125I]gp120 binding and internalization peaked within 5–45 min and remained elevated for up to 10 h and then decreased gradually. In Et-cells, [125I]gp120 binding peaked comparably to C-cells, but the binding remained to the peak level throughout the experimental period. C-cells exhibited the lysosomal/ubiquitin-mediated degradation of intracellular gp120, resulting in released gp120 fragments into the incubation medium that suppressed gp120–CD4 binding, improved cell viability, and inhibited gp120-induced apoptosis.

Ethanol drinking suppressed gp120 degradation in and release of gp120 fragments from hepatocytes. The incubation medium of Et-cells did not suppress gp120–CD4 binding or the gp120-mediated apoptosis in hepatocytes.

Thus, chronic alcohol drinking augmented the adverse effects of gp120 possibly by suppressing its degradation in hepatocytes.

The present observation also suggests that a number of CCR5 or ubiquitin-based therapeutic drugs may not be effective in suppressing HIV infection in alcohol-drinking subjects.

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Effects of maternal administration of vitamins C and E on ethanol neurobehavioral teratogenicity in the guinea pig
Alcohol Volume 41, Issue 8, December 2007, Pages 577-586

Consumption of ethanol during human pregnancy can produce a wide spectrum of teratogenic effects, including neurobehavioral dysfunction.

This study, in the guinea pig, tested the hypothesis that chronic maternal administration of antioxidant vitamins C plus E, together with ethanol, mitigates ethanol neurobehavioral teratogenicity.

Pregnant guinea pigs received one of the following four chronic oral regimens: ethanol and vitamins C plus E; ethanol and vitamin vehicle; isocaloric-sucrose/pair-feeding and vitamins C plus E; or isocaloric-sucrose/pair-feeding and vehicle. Vitamins C (250 mg) plus E (100 mg) or vehicle were given daily, and ethanol (4 g/kg maternal body weight/day) (E) or isocaloric-sucrose/pair-feeding was given for 5 consecutive days followed by 2 days of no treatment each week throughout gestation.

One neonate from selected litters was studied on postnatal day (PD) 0. Neurobehavioral function was determined by measuring task acquisition and task retention using an 8-day moving-platform version of the Morris water-maze task, starting on PD 45. Thereafter, in vivo electrophysiologic assessment of changes in hippocampal synaptic plasticity was conducted.

There was an ethanol-induced decrease in neonatal brain weight compared with sucrose. The vitamins C plus E regimen protected hippocampal weight relative to brain weight in ethanol offspring, and mitigated the ethanol-induced deficit in the task-retention component of the water-maze task. However, in the sucrose group, this Vit regimen produced deficits in both task acquisition and task retention.

The vitamins C plus E regimen did not mitigate the ethanol-induced impairment of hippocampal long-term potentiation.

These results indicate that maternal administration of this high-dose vitamins C plus E regimen throughout gestation has limited efficacy and potential adverse effects as a therapeutic intervention for E neurobehavioral teratogenicity.

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Short-term selection for acute ethanol tolerance and sensitization from an F2 population derived from the high and low alcohol-sensitive selectively bred rat lines
Alcohol Volume 41, Issue 8, December 2007, Pages 557-566

Previous studies have identified quantitative trait loci (QTL) in the inbred high and low alcohol-sensitive rat (IHAS1 and ILAS1) strains. The original development of the strains involved selection for ethanol sensitivity based on duration of the loss of the righting reflex (LORR) after a standard dose of ethanol.

This paper confirms some of these QTL using a short-term selection procedure based on the difference between the blood ethanol level at LORR and regain of the righting response.

An F2 population of rats was developed by a reciprocal cross of IHAS1 and ILAS1 rats. Selection for five generations was carried out using delta-blood ethanol concentration (dBEC) as the selection trait, where dBEC = BECLR (BEC at loss of righting reflex) − BECRR (BEC at regain of righting reflex). The lines were labeled tolerant (TOL) or sensitive (SENS).

Approximately one-third of the offspring for each generation in each line were genotyped using DNA markers that had been previously found to be linked to QTL on chromosomes 1, 2, 5, 12, and 13. By the fifth generation of selection, the lines showed a very large difference in dBEC, BECRR, and duration of LORR; BECLR showed little segregation during the selection, and latency to lose the righting reflex showed none. IHAS allele frequency increased in the SENS line for markers on chromosomes 1, 5, 12, and 13 while ILAS allele frequency increased in the TOL line.

These results were in good agreement with the two previous QTL studies. On chromosome 2, the selection resulted in an accumulation of ILAS alleles in both lines.

This study provides independent confirmation of the location of QTL on chromosomes 1, 5, 12, and 13 for ethanol sensitivity. It also suggests that genetic differences in duration of LORR are mediated primarily by the dBEC phenotype.

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Effects of alcohol consumption and other lifestyle behaviors on blood pressure for the middle-aged and elderly in the Guangxi Hei Yi Zhuang and Han populations
Alcohol Volume 41, Issue 8, December 2007, Pages 541-550

Han is the largest group and Zhuang is the largest minority among the 56 ethnic groups in China. Geographically and linguistically, Zhuang can be classified into 43 ethnic subgroups, in which Hei Yi Zhuang is proved to be the most conservative subgroup. Little is known about the relationship between alcohol consumption and blood pressure levels in this population.

Therefore, the present study was undertaken to compare the effects of alcohol consumption and other lifestyle behaviors on blood pressure levels for the middle-aged and elderly in the Guangxi Hei Yi Zhuang and Han populations.

The levels of systolic blood pressure and pulse pressure in Hei Yi Zhuang were higher than those in Han. Hypertension was positively correlated with sex (male), age, physical activity, alcohol consumption, serum triglyceride levels, and total energy, total fat, and salt intakes, and negatively associated with educational level in Hei Yi Zhuang, whereas positively correlated with sex (male), age, physical activity, alcohol consumption, body mass index, waist circumference, serum total cholesterol levels, and total energy, total fat, and salt intakes, and negatively associated with educational level in Han.

The difference in blood pressure levels between the two ethnic groups might result from different dietary habit, lifestyle, sodium intake, educational level, physical activity, and even genetic factors.

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Growth hormone response to the GABA-B agonist baclofen in 3-week abstinent alcoholics
Alcohol Volume 41, Issue 8, December 2007, Pages 551-556

Gamma-aminobutyric acid (GABA) dysfunction is a known feature of alcoholism. We investigated GABA-B receptor activity in 3-week abstinent alcoholics using the growth hormone (GH) response to baclofen, a GABA-B receptor agonist.

The study aimed to investigate the relationship between GABA-B receptor activity and alcohol withdrawal. GH response to baclofen was measured in alcohol-dependent males without depression (n = 22) who were on day 21 of alcohol abstinence and in healthy control male subjects (n = 23). After 20 mg baclofen was given orally to the subjects, blood samples for GH assay were obtained every 30 min for the subsequent 150 min. The patients were divided into two subgroups (continuing withdrawal and recovered withdrawal subgroups) according to their withdrawal symptom severity scores on day 21 of alcohol cessation.

Baclofen administration significantly altered GH secretion in the controls, but not in the patients. When GH response to baclofen was assessed as ΔGH, it was lower in the patients with continuing withdrawal symptoms than in the controls and in the recovered withdrawal group.

Impaired GH response to baclofen in all patients mainly pertained to the patients whose withdrawal symptoms partly continued.

Our results suggest that reduced GABA-B receptor activity might be associated with longer-term alcohol withdrawal symptoms in alcoholic patients.

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Identifying the determinants of premature mortality in Russia: overcoming a methodological challenge
BMC Public Health 2007, 7:343, 28 November 2007

It is thought that excessive alcohol consumption is related to the high mortality among working age men in Russia. Moreover it has been suggested that alcohol is a key proximate driver of the very sharp fluctuations in mortality seen in this group since the mid-1980s. Designing an individual-level study suitable to address the potential acute effects of alcohol consumption on mortality in Russia has posed a challenge to epidemiologists, especially because of the need to identify factors that could underlie the rapid changes up and down in mortality rates that have been such a distinctive feature of the Russian mortality crisis. In order to address this study question which focuses on exposures acting shortly before sudden death, a cohort would be unfeasibly large and would suffer from recruitment bias.

Although the situation in Russia is unusual, with a very high death rate characterised by many sudden and apparently unexpected deaths in young men, the methodological problem is common to research on any cause of death where many deaths are sudden.

We describe the development of an innovative approach that has overcome some of these challenges: a case-control study employing proxy informants and external data sources to collect information about proximate determinants of mortality.

This offers a set of principles that can be adopted by epidemiologists studying sudden and unexpected deaths in other settings.

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Wednesday, November 28, 2007

Long-term behavior in treated alcoholism: Evidence for beneficial carry-over effects of abstinence from smoking on alcohol use and vice versa
Addictive Behaviors Volume 32, Issue 12, December 2007, Pages 3093-3100

Co-dependence of alcohol and nicotine is quite frequent. Research results on the mutual influence one drug has on the other – i.e., on the further course of the dependence – has been inconclusive.

Our primary aim is to investigate the natural course of smoking behavior in a long term follow-up study with alcohol-dependent patients who completed an inpatient treatment program.

Our results show that being a non-smoker at treatment entry is a predictor for alcohol abstinence 7 years later. The rate of non-smokers among the abstinent patients increased by 32%. Potential explanations for our findings lie in carry-over effects. Skills and insights gained in treatment of alcohol dependence could be instrumental in coping with smoking behavior as well. Non-smokers may have more functional coping abilities from the beginning.

We conclude that it is warranted and recommendable to explore the willingness of alcohol-dependent patients to quit smoking and to offer them treatment options addressing this point.

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School based interventions on alcohol

Interventions in schools to prevent and reduce alcohol use among children and young people.


This NICE guidance on school based interventions to prevent and reduce alcohol use is aimed at anyone who works with children and young people in schools and other education settings. It gives advice on incorporating alcohol education into the national science and personal, social and health education (PSHE) curricula, and helping children and young people access the right support. It also looks at how to link these interventions with community initiatives, including those run by children's services.

There are no national guidelines on what constitutes safe and sensible alcohol consumption for children and young people, so the recommendations focus on:

  • encouraging children not to drink,
  • delaying the age at which young people start drinking and
  • reducing the harm it can cause among those who do drink.


For healthcare professionals

For patients, carers and the public

Background information

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

Press Release - 2007/059 New NICE guidance for schools published to prevent and reduce alcohol use in children and young people

The National Institute for Health and Clinical Excellence (NICE) has today issued national guidance on effective ways to encourage children not to drink, delaying the age at which young people start drinking and reducing the harm it can cause among those who do drink. The guidance is aimed at anyone who works with children and young people in schools and other education settings. It gives advice on incorporating alcohol education into the national science and personal, social and health education (PSHE) curricula, and helping children and young people access the right support. In 2006, 21 per cent of pupils in England aged 11-15 reported drinking alcohol in the previous week.

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National Survey of Substance Abuse Treatment Services: 2006


  • SAMHSA's Office of Applied Studies (OAS) conducts the National Survey of Substance Abuse Treatment Services (N-SSATS), an annual census of facilities providing substance abuse treatment. This survey is designed to collect data on the location, characteristics, and use of alcoholism and drug abuse treatment facilities and services throughout the 50 States, the District of Columbia, and other U.S. jurisdictions. The reference date for the 2006 one-day census was March 31, 2006.
  • The number of reporting facilities has increased since 2000 and remained relatively constant between 2002 and 2006. There were 13,428 reporting facilities in 2000. There were 13,720 reporting facilities in 2002 and 13,771 facilities in 2006. The number of clients in substance abuse treatment on the survey reference date decreased by less than 1% from 1,136,287 clients in 2002 to 1,130,881 in 2006.
  • Facility characteristics: Most of the substance abuse treatment facilities continue to be operated by private non-profit organizations. In 2006, 59% were private nonprofit organizations, 28% were private for-profit organizations, 7% were operated by local governments, 3% by State governments, 2% by the Federal government, and 1% by tribal governments.
  • Client distribution: Between 2002 and 2006 on the survey reference date, the proportion of substance abuse treatment clients in private for-profit facilities increased from 26% to 29%; the proportion of substance abuse treatment clients in local State, and Federal government operated facilities fell from 17% to 15% and in tribal government facilities remained unchanged at 1%.
  • Facility focus: On March 31, 2006, 62% of the facilities reported substance abuse treatment services was their primary focus of activity, 27% of the facilities reported that their primary focus was a mix of mental health and substance abuse treatment services, 8% reported mental health services and 2% reported general health care as their primary focus.
  • Facility utilization: On March 31, 2006, 91% of non-hospital residential beds and 90% of all hospital inpatient beds designated for substance abuse treatment were in use.
  • Payment options and facility funding: A sliding fee scale for substance abuse treatment charges was used by 63% of all facilities, 53% of all facilities offered substance abuse treatment at no charge to eligible clients who could not pay, and 4% provided substance abuse treatment at no charge to all clients. Federal, State, or local government funds for the provision of substance abuse treatment services was received by 59% of all facilities.
  • Special services Offered: Most facilities (83%) offered specially designed programs: 37% offered programs or groups for persons with co-occurring mental health and substance abuse disorders, 32% for adult women, 32% for adolescents, 31% for driving under the influence of alcohol or drugs (DUI/DWI), 28% for criminal justice clients, 25% for adult men, 14% for pregnant/postpartum women, 10% for persons with HIV or AIDS, 7% for seniors or older adults, and 6% for gays or lesbians. Substance abuse treatment services in sign language for the hearing impaired were offered in 29% of all facilities and in languages other than English in 45%.
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Risk, resilience, and natural recovery: a model of recovery from alcohol abuse for Alaska Natives
Addiction (OnlineEarly Articles) 28 November 2007

The People Awakening (PA) study explored an Alaska Native (AN) understanding of the recovery process from alcohol abuse and consequent sobriety.

PA utilized a cross-sectional, qualitative research design and community-based participatory research methods.

The study included a state-wide convenience sample of 57 participants representing all five major AN groups: Aleut/Alutiiq, Athabascan, Inupiaq, Yup'ik/Cup'ik and Tlingit/Haida/Tsimshian. Participants were nominated and self-identified as being alcohol-abstinent at least five years following a period of problem drinking.

Open-ended and semistructured interviews gathered extensive personal life histories. A team of university and community co-researchers analyzed narratives using grounded theory and consensual data analysis techniques.

A heuristic model of AN recovery derived from our participants' experiences describes recovery as a development process understood through five interrelated sequences: (i) the person entered into a reflective process of continually thinking over the consequences of his/her alcohol abuse; (ii) that led to periods of experimenting with sobriety, typically, but not always, followed by repeated cycling through return to drinking, thinking it over, and experimenting with sobriety; culminating in (iii) a turning point, marked by the final decision to become sober.

Subsequently, participants engaged in (iv) Stage 1 sobriety, active coping with craving and urges to drink followed for some participants, but not all, by (v) Stage 2 sobriety, moving beyond coping to what one participant characterized as ‘living life as it was meant to be lived.

The PA heuristic model points to important cultural elements in AN conceptualizations of recovery.

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Addiction science and its genetics
Addiction (OnlineEarly Articles) 28 November 2007

To assess the progress and impact of genetic studies in the addictions arena and to present this information in a form accessible to the general readership of Addiction.

Review of the evidence that genes are involved in addiction, approaches to their identification, current findings and the potential implications.

Family, twin and adoption studies provide strong evidence that addiction runs in families and that this is determined in part by genetic factors.

Two main molecular genetic approaches, namely linkage and association, have been adopted to identify the specific genes involved. Both methods are fraught with problems. Linkage is limited by issues of sensitivity, and association by false positives.

Perhaps the strongest finding in psychiatric genetics to date is the impressive effect that a single genetic variant, in the aldehyde dehydrogenase 2 gene, has on drinking behaviour and reducing the risk of developing alcohol dependence.

Other findings are currently less robust; however, the implications of elucidating the genetic underpinning of addiction will be profound.

Addiction genetics is a developing science that has yet to prove its worth in the clinical setting

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The concentration-dependent effects of ethanol on Caenorhabditis elegans behaviour
The Pharmacogenomics Journal
(2007) 7, 411–417

The effects of ethanol on the brain are concentration dependent. Low concentrations (mM) intoxicate, while greater than 100 mM anaesthetize. Of most relevance to human alcohol addiction are mechanisms of intoxication.

Previously, Caenorhabditis elegans has been employed in genetic screens to define effectors of intoxication. Here, we inform interpretation of these studies by providing evidence that ethanol rapidly equilibriates across C. elegans cuticle. Importantly, the effect of ethanol on muscle activity rapidly reaches steady-state, and the concentration-dependence of the effect is very similar in intact animals and exposed muscle.

Thus the cuticle does not present an absorption barrier for ethanol, and furthermore the internal concentration is likely to approach that applied externally. Thus, modelling intoxication in C. elegans requires exposure to external ethanol less than 100 mM.

Furthermore, the permeability of the cuticle to ethanol enables analysis of precisely controlled concentration-dependent effects of acute, chronic, and episodic ethanol exposure on behaviour.

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Tuesday, November 27, 2007

Press Release - Abstinence Offers Alcoholics Best Chance for Lasting Recovery
By Taunya English, Associate Editor
Health Behavior News Service

Release Date:November 27, 2007

Recovering alcoholics whose chosen strategy is to abstain from drinking are least likely to relapse, according to a new study of a nationally representative sample of adults.

However, although abstinence is the most reliable form of recovery to help middle-age and older adults avoid alcohol abuse and dependence problems, the study found that sustained recovery might be more elusive for young people, regardless of whether they avoid all alcohol or simply restrict their consumption.

“The biggest surprise was how little abstinence did to improve the prospects for younger alcoholics remaining in remission. To my knowledge, no one has looked at this age differential before,” said lead study author Deborah Dawson, Ph.D. She is a substance abuse researcher with the National Institute on Alcohol Abuse and Alcoholism.
. . . . . . . .

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The Positive Drinking Consequences Questionnaire (PDCQ): Validation of a new assessment tool
Addictive Behaviors Volume 33, Issue 1, January 2008, Pages 54-68

Expected and experienced negative consequences and expected positive consequences of alcohol use have been widely studied, while little attention has been given to experienced positive drinking consequences.

Although existing studies suggest that positive consequences may be important, it is not clear if they are distinct from expected positive outcomes or uniquely associated with drinking behavior.

The primary goal of the current study was to develop a measure that directly assessed specific, real life drinking consequences rather than relying on general past tense derivations (“I forgot my worries”) of expectancy items. Such a measure is necessary to determine whether or not positive consequences are distinct from positive expectancies and to assess the unique contribution of positive drinking consequences to drinking behavior.

Principal components analysis of the Positive Drinking Consequences Questionnaire (PDCQ) identified a single-factor structure with good internal and split-half reliability. The PDCQ also demonstrated discriminant validity relative to a positive expectancy measure and incremental validity in relation to drinking behavior.

Although additional studies with heavier drinking populations are needed, the PDCQ may ultimately serve as a valuable research and clinical assessment tool.

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Is depressed mood in childhood associated with an increased risk for initiation of alcohol use during early adolescence?
Addictive Behaviors Volume 33, Issue 1, January 2008, Pages 24-40

Using prospective data, we tested the hypothesis that early depressed mood was associated with an increased risk for initiation of alcohol use. In addition, we examined whether these associations varied according to the youths' report that alcohol consumption occurred with or without parental permission.

Higher level of early depressed mood was associated with an earlier and increased estimated risk of initiating alcohol use without parental permission for boys but not for girls. Depressed mood was not associated with alcohol use initiation that occurred with parental sanctions.

Findings from the current study support the hypothesis that among urban youth, early depressed mood influences the initiation of alcohol consumption without parental permission for boys.

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Relative risks of adolescent and young adult alcohol use: The role of drinking fathers, mothers, siblings, and friends
Addictive Behaviors Volume 33, Issue 1, January 2008, Pages 1-14

The present study examined to what extent regular drinking of fathers, mothers, co-twins, siblings, and friends was related to adolescent regular drinking in three age groups: 12–15, 16–20 and 21–15-year olds.

The sample consisted of 3760 twins (1687 boys, 2073 girls) with a mean age of 17.8 years. Data were based on twins' self-reported alcohol uses and reports about siblings' and friends' alcohol use, and on parents' self-reports.

Results showed that generally in each of the three age groups, regular drinking of same-sex co-twins and friends posed the highest risk for regular drinking. Age differences indicated that these risks decreased with age. Irrespective of age, regular drinking of fathers and mothers posed the lowest risk. Findings were generally the same for males and females.

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Neurocognitive effects of alcohol hangover
Addictive Behaviors Volume 33, Issue 1, January 2008, Pages 15-23

Alcohol hangover is characterized by adverse physical and mental effects that occur the next morning after the intake of toxic doses of alcohol.

One of the more relevant functional consequences of hangover is the cognitive and subjective impairment, which could be related to the high socioeconomic costs of alcohol consumption. Nevertheless, few studies have addressed the study of neurocognitive and subjective effects of hangover.

The systematic and exhaustive study of neurocognitive and subjective effects has not been done. In the present work we briefly review the hangover impact, not only in the objective execution of attention, psychomotricity and memory tasks, but in the subjective state of the subjects as well.

Moreover, we also highlight the methodology difficulties to study neurocognitive effects of hangover and suggest several aspects to take into account in future investigations.

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Alcohol in emerging adulthood: 7-year study of problem and dependent drinkers
Addictive Behaviors Volume 33, Issue 1, January 2008, Pages 134-142

This study examined the level, changes and predictors of alcohol consumption and binge drinking over a 7-year period among young adults (18–25 years) who met the criteria for problem drinking.

Interviews with 270 18 to 25 years old problem and dependent drinkers from representative public and private substance use treatment programs and the general population were conducted after 1, 3, 5, and 7 years. Measures included demographic characteristics, severity measures, and both formal and informal influences on drinking.

Overall alcohol consumption declined over time but leveled off around 24 years of age. Being male, not attending AA over time, as well as more baseline dependence symptoms and greater ASI alcohol and legal severity were associated with greater consumption and binge drinking. In addition, greater levels of binge drinking were associated with less education, earlier age of first use, and a larger social network of heavy drinkers.

In conclusion, more attention should be paid to heavy drinking among young adults and to the factors that influence their drinking patterns.

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Nucleotide sequence variation within the human tyrosine kinase B neurotrophin receptor gene: association with antisocial alcohol dependence
The Pharmacogenomics Journal (2007) 7, 368–379

To identify sequence variants in genes that may have roles in neuronal responses to alcohol, we resequenced the 5' region of tyrosine kinase B neurotrophin receptor gene (NTRK2) and determined linkage disequilibrium (LD) values, haplotype structure, and performed association analyses using 43 single nucleotide polymorphisms (SNPs) covering the entire NTRK2 region in a Finnish Caucasian sample of 229 alcohol-dependent subjects with antisocial personality disorder (ASPD) and 287 healthy controls.

Individually, three SNPs were associated with alcohol dependence and alcohol abuse (AD) (P-value from 0.0019 to 0.0059, significance level was set at Pless than or equal to0.01 corrected for multiple testing), whereas a common 18 locus haplotype within the largest LD block of NTRK2, a 119-kb region containing the 5' flanking region and exons 1–15, was marginally overrepresented in control subjects compared to AD individuals (global P=0.057).

Taken together, these results support a role for the NTRK2 gene in addiction in a Caucasian population with AD and a subtype of ASPD.

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Involvement of cannabinoid CB2 receptor in alcohol preference in mice and alcoholism in humans
The Pharmacogenomics Journal (2007) 7, 380–385

We tested if cannabinoid type 2 receptor (CB2) in the central nervous system plays a role in alcohol abuse/dependence in animal model and then examined an association between the CB2 gene polymorphism and alcoholism in human.

Mice experiencing more alcohol preference by drinking showed reduced Cb2 gene expression, whereas mice with little preference showed no changes of it in ventral midbrain. Alcohol preference in conjunction with chronic mild stress were enhanced in mice treated with CB2 agonist JWH015 when subjected to chronic stress, whereas antagonist AM630 prevented development of alcohol preference.

There is an association between the Q63R polymorphism of the CB2 gene and alcoholism in a Japanese population. CB2 under such environment is associated with the physiologic effects of alcohol and CB2 antagonists may have potential as therapies for alcoholism.

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Monday, November 26, 2007

Alcohol Consumption, %CDT, GGT and Blood Pressure Change During Alcohol Treatment
Alcohol and Alcoholism Advance Access published online on November 25, 2007

Blood pressure (BP) changes in alcohol-dependent individuals during a 12-week alcohol relapse prevention study were examined in light of drinking status and biomarkers of alcohol consumption [carbohydrate-deficient transferrin (%CDT) and gamma-glutamyl transpeptidase (GGT)].

A significant effect of complete abstinence on both SBP (–10 mmHg; P = 0.003) and DBP (–7 mmHg; P = 0.001) when compared to any drinking (SBP and DBP = –1 mmHg) was observed. At week 12, participants with a positive %CDT (≥2.6) had 7 mmHg greater SBP (P = 0.01) and DBP (P <> than those with negative %CDT. Participants with positive GGT (≥50 IU) had 10 mmHg greater SBP (P = 0.12) and 9 mmHg greater DBP (P = 0.03) than those with negative GGT. The percent change in SBP was correlated with percent change in %CDT (P = 0.003) but not GGT (P = ns). The percent change in DBP was correlated with both percent change in %CDT (P <>P = 0.03).

Abstinence from alcohol significantly decreased the BP and a positive relationship between BP and both alcohol-use biomarkers was illustrated. Since %CDT is more specific than GGT for heavy alcohol consumption, clinicians may monitor the role of alcohol in hypertension using %CDT as a supplemental aid, providing an objective assessment of drinking to influence BP treatment decisions.

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