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, July 26, 2008

Introducing The Bridge and an Invitation for Contributions

The Bridge is a quarterly e-pub that links science and service by providing information and tools on technology transfer and implementation science strategies.

Volume 1, Issue 1
In this Issue...

> Introducing The Bridge
> Technology Transfer and American Culture
> From Bench to Bedside: A Useful Formulation?
> Exploring Key Concepts in Technology Transfer
> Technology Transfer in Manufacturing...
> A Heritage in the Field of Agriculture
> Introducing the Editor of The Bridge
> Introducing the Publisher of The Bridge

International rapid evidence review of services for homeless people with substance misuse problems that considers models of service delivery and outcome measurement within a Scottish context.

A Rapid Evidence Assessment of international literature on effective substance misuse services for homeless people was conducted to review best practice in other countries and determine if there were any lessons for Scotland. The review found that:

* The relationship between substance misuse and homelessness appears quite complex. There is strong evidence of a mutually reinforcing relationship between these two social problems. An experience of homelessness increases the risk of substance misuse among previously abstinent people, while entering into substance misuse also increases the risk that someone will become homeless. There is evidence that when someone is homeless and involved in substance misuse each problem compounds the other ( Chapter 2).

* In Scotland, there is evidence that young homeless people, people with experience of sleeping rough and lone homeless people are characterised by higher rates of substance misuse than are found in the general population. There is evidence that parents and children in homeless families are either only a little more likely, or no more likely, to be involved in substance misuse than parents and children in the general population. The same pattern exists in England and in North America ( Chapter 2).

* There is a strong association between the presence of mental health problems or severe mental illness among homeless people with substance misuse problems in Scotland. The same pattern exists in England, the EU, North America and Japan ( Chapter 2).

* Services that are aimed solely at promoting abstinence among homeless people with a substance misuse problem tend to meet with quite limited success. There is evidence that many homeless people with a substance misuse problem either cease contact with these services before treatment or rehabilitation is complete or avoid such services to begin with. Attempts to use short stay detoxification services with homeless people have proven particularly unsuccessful ( Chapter 3).

* When services pursue harm reduction or harm minimisation policies, rather than insisting on total abstinence, there is evidence that they are able to engage with homeless people with a substance misuse problem more effectively. In particular, there is evidence that harm reduction based floating support models used in the United States are able to promote and sustain stable living arrangements and ensure contact with services ( Chapter 3).

* Homeless people with substance misuse problems have a range of needs that can include support with daily living skills, a requirement for mental health services and a requirement for support in managing substance misuse. Their needs are often complex and services that focus on any one element of their need, be it substance misuse, mental health or housing related support, meet with less success than services that are designed to support all their needs ( Chapters 2 and 3).

* There are three main models of resettlement for homeless people with a substance misuse problem. The first, the Continuum of Care or 'Staircase' approach, uses a series of shared supported housing settings that are intended to slowly progress service users towards independent living and abstinence. The evidence is that this model meets with limited success. The second, which is referred to in the US as the 'Pathways' Housing First model, uses intensive floating support to ordinary accommodation, with a strong focus on service user choice and a harm reduction approach to substance misuse. There is evidence that this is more successful and cost effective than the first model. The final model is a package of floating support provided through case management and joint working, which is the standard practice across Scotland. The evidence base on this approach is less developed than for some other models, though it follows the logic of both the flexible packages of support and harm reduction methods used by the more successful services ( Chapter 3).

* There is no strong evidence on the effectiveness of preventative services to counteract potential homelessness among people with a history of substance misuse. Most models of prevention are generic, i.e. they are intended to counteract the risk of homelessness across many groups, including people with a history of substance misuse, rather than being particularly focused on one group ( Chapter 3).

* The evidence base on alcohol misuse by homeless and potentially homeless people was very rich until the early 1980s when street drugs started to become much more widespread among street homeless and other homeless populations. Most research since that date has tended to focus on all forms of substance misuse, rather than dealing solely with alcohol, with the result that there is little recent evidence on services for homeless people that focus only on alcohol misuse. There is some evidence of older street homeless and hostel dwelling populations (people over 50) being more likely to be misusing alcohol and less likely to be using street drugs. However, among younger homeless people, the evidence is of use of alcohol alongside street drugs and other substances ( Chapter 2).

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Thursday, July 24, 2008

The Healthy Moms Study: The Efficacy of Brief Alcohol Intervention in Postpartum Women
Alcoholism: Clinical and Experimental Research Published Online: 9 Jul 2008

The prevention and treatment of alcohol use disorders among women of reproductive age have been well described. However, there is limited information on women specifically during the postpartum period. This period in a woman's life is a time of transition and it provides an ideal opportunity for primary care providers to intervene.

The goal of this report was to present the results of a brief alcohol intervention conducted in 34 obstetrical practices with women seeking routine postpartum care.

A total of 8,706 women were screened for high-risk alcohol use during routine postpartum care with 997 (12%) of these women testing positive for at-risk drinking. A total of 235 women met inclusion criteria and were randomized to either "usual care" or "brief intervention." The 4-session intervention was delivered by outpatient obstetrical nurses and research staff. The mean age of the women in the sample was 28, 19.3% were from minority groups, 60.8% were married, 53.2% reported current tobacco use, and 17.9% had used marijuana in the previous 30 days.

At the 6 month follow-up appointment, there were significant reductions in mean number of total drinks in the previous 28 days (p < class="i">p < class="i">p <>

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Sound Level of Environmental Music and Drinking Behavior: A Field Experiment With Beer Drinkers
Alcoholism: Clinical and Experimental Research Published Online: 21 Jul 2008

It had been found that environmental music was associated with an increase in alcohol consumption. The presence versus absence of music, high versus slow tempo and the different styles of environmental music is associated with different level of alcohol consumption. However, the effect of the level of the environmental music played in a bar still remained in question.

The results show that high level volume led to increase alcohol consumption and reduced the average amount of time spent by the patrons to drink their glass.

The impact of environmental music on consumption was discussed and the "arousal" hypothesis and the negative effect of loud music on social interaction were used to explain our results.

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Coffee and Cigarette Consumption and Perceived Effects in Recovering Alcoholics Participating in Alcoholics Anonymous in Nashville, Tennessee
Alcoholism: Clinical and Experimental ResearchPublished Online: 24 Jul 2008

Alcoholics Anonymous (AA) members represent an important and relatively understudied population for improving our understanding of alcohol dependence recovery as over 1 million Americans participate in the program. Further insight into coffee and cigarette use by these individuals is necessary given AA members' apparent widespread consumption and the recognized health consequences and psychopharmacological actions of these substances.

Mean (±SD) age of onset of alcohol consumption was 15.4 ± 4.2 years and mean lifetime alcohol consumption was 1026.0 ± 772.8 kg ethanol. Median declared alcohol abstinence was 2.1 years (range: 0 days to 41.1 years) and median lifetime AA attendance was 1000.0 meetings (range: 4 to 44,209 meetings); average AA affiliation score was 7.6 ± 1.5. Most (88.5%) individuals consumed coffee and approximately 33% of coffee consumers drank more than 4 cups per day (M = 3.9 ± 3.9).

The most common self-reported reasons for coffee consumption and coffee-associated behavioral changes were related to stimulatory effects. More than half (56.9%) of individuals in AA smoked cigarettes. Of those who smoked, 78.7% consumed at least half a pack of cigarettes per day (M = 21.8 ± 12.3). Smokers' FTND scores were 5.8 ± 2.4; over 60% of smokers were highly or very highly dependent. Reduced negative affect was the most important subjective effect of smoking.

A greater proportion of AA participants drink coffee and smoke cigarettes in larger per capita amounts than observed in general U.S. populations. The effects of these products as described by AA participants suggest significant stimulation and negative affect reduction.

Fundamental knowledge of the quantitative and qualitative aspects of coffee and cigarette consumption among AA members will enable future research to discern their impact on alcohol abstinence and recovery.

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European ECAT conference: 'Empower the Community in response to Alcohol Threats'

VAD and the ECAT network have the pleasure of inviting you to the European ECAT conference: 'Empower the Community in response to Alcohol Threats'

Friday 24 October 2008
Flemish Parliament | Leuvenseweg 86 | 1000 Brussels | Belgium

ECAT is an EC-co-funded project that aims to enhance the effectiveness of local alcohol prevention campaigns, based on:

· guidelines for local campaigning, built on evidence based practice;

· local quick scan analysis to describe the local situation on alcohol use, as a starting point to develop local actions and more specifically local alcohol prevention campaigns;

· evaluation of the reach and visibility of the local alcohol prevention campaigns.

We present the conceptual frame of the ECAT methodology and the field experiences in the local communities of the participating countries: Great Britain, Germany, Austria, Slovenia, Italy and Belgium.
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Epidemiology for Researchers Performing Genetic/Genomic Studies

This is a short course targeted at investigators and trainees doing research in human genetics, particularly studies employing genomic analyses of samples from human population. It aims to familiarize researchers studying the human genome with basic principles and potential pitfalls of epidemiology as applied to human genome research. It will draw from traditional genetic epidemiology and statistical genetics, but will emphasize the application of genomic technologies to unrelated subjects in human populations. Focus will be on the design, conduct, analysis, and interpretation of the epidemiologic studies most feasible and appropriate to address the genomic questions of interest.

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Expert view: Alcohol consumption

Many in the medical industry are worried that drinkers aren’t aware of increasing strengths of wine - not to mention bigger glasses

n the north-west of England one person is admitted to hospital with an alcohol-related illness every seven seconds so we are very clear that alcohol consumption is a significant concern. The interventions proposed today are welcome in helping to get a cultural shift in the way people consume alcohol. Part of that is to provide information but obviously it’s more than that and today’s proposals cover a whole range of things that will help people consider their personal alcohol consumption.
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Drinks industry regulation: 'The government are nervous about taking a tough stance'

Health editor Sarah Boseley on plans to better regulate the alcoholic drinks industr
  • Wednesday July 23 2008


Wednesday, July 23, 2008

Psychometric properties of the alcohol use disorders identification test: a Korean version.
Archives of Psychiatric Nursing Volume 22, Issue 4, August 2008, Pages 190-199

The Alcohol Use Disorders Identification Test (AUDIT) is an important screening tool but has never been administered to Korean Americans. This study was conducted to examine the psychometric properties of a Korean version of the AUDIT referred to as AUDIT-K and to determine which cutoff score of the scale would perform better in Korean Americans.

Approximately 47.5% of Korean American men who participated in the study were identified as having drinking problems when using the World Health Organization's recommended cutoff score of 8, whereas approximately 20.3% were found to have problems with alcohol when using the cutoff score of 12, the one recommended for Koreans. Cronbach's alpha was .82 at Time 1 and was .80 at Time 2. Test–Retest reliability assessed via the intraclass correlation coefficient for the total AUDIT scale was .85. Principal components factor analysis with varimax orthogonal rotation revealed a two-factor solution, alcohol consumption and drinking problems, resulting in 57% of the explained variance.

The AUDIT-K was found to be internally consistent and stable over time and should be used in primary health care settings to screen Korean American men for alcohol use disorders to facilitate early interventions.

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Family Meals and Substance Use: Is There a Long-Term Protective Association?
Journal of Adolescent Health Volume 43, Issue 2, August 2008, Pages 151-156

To examine 5-year longitudinal associations between family meal patterns and subsequent substance use in adolescents.

Family meal frequency at baseline was associated with significantly lower odds of cigarette smoking, alcohol use, and marijuana use at follow-up among female adolescents, even after adjusting for baseline substance use and additional covariates. Family meals were not associated with use of any substance at follow-up for male adolescents after adjusting for baseline use.

Results from this study suggest that regular family meals in adolescence may have a long-term protective association with the development of substance use over 5 years among females. Parents should be encouraged to establish a pattern of regular family meals, as this activity may have long lasting benefits

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New Strategies to Detect Alcohol Use Disorders in the Preoperative Assessment Clinic of a German University Hospital.
Anesthesiology. 109(2):171-179, August 2008.

Although alcohol use disorders (AUDs) have enormous public health consequences, the rate of diagnosis of AUDs remains unsatisfactorily low. The primary aim of this study was to compare the detection of AUDs by anesthesiologists in a large preoperative assessment clinic to that by computerized self-assessment of the Alcohol Use Disorder Identification Test. Secondary outcome measures were to compare the actions taken by anesthesiologists upon a finding of an AUD.

The prevalence rate of AUDs determined by the anesthesiologists was 6.9% (107 of 1,556), whereas the proportion of patients positive for an AUD using the computerised Alcohol Use Disorder Identification Test was 18.1% (282 of 1,556) (P <>

The computer-based self-assessment increases detection rates of AUDs in busy settings such as a preoperative assessment clinic. Prevalence rates of AUDs are underestimated. Best-practice guidelines for detection of AUDs are not implemented in the daily clinical routine. Barrier analysis is urgently required.

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'A culture of intoxication'

High-risking drinking still a big problem in N.S.

Nova Scotia still has a drinking problem.

People in the province still drive drunk, still go on benders at bars, still drink underage and some drink while pregnant.

To combat this, last August the provincial Department of Health Promotion and Protection launched a strategy called Changing the Culture of Alcohol Use in Nova Scotia.

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Los Angeles, CA (July 23, 2008) --- Marin Institute, the alcohol industry watchdog, held a news conference and town hall meeting in Los Angeles today to release the disturbing findings of its landmark report, The Annual Catastrophe of Alcohol in California. Such a comprehensive study has never been done in California.

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The DRAM Vol. 4(6) – Self-help(ful) or harmful?

The Internet is rife with self-help options for people dealing with addiction (e.g., Your First Step to Change). However, there is a danger in utilizing self-help programs that researchers have not tested. Untested programs could make things better; however, these programs also might make matters worse, do nothing, or mitigate problems for someone seeking help from addiction. This week, the DRAM examines a recent study by Riper et al. (2008) of an online self-help program for people in the general public who consume high levels of alcohol.

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A licence for disorder and dangerous drinking


Attempting to locate even a trace of logic or consistency in the Government's approach to alcohol abuse is a near-impossible task.

Here is an administration that enacted round-the-clock pub opening and liberalised the sale of alcohol from retail outlets, and then seems surprised that our streets and public places are frequently awash with inebriates.

In the 2003 Licensing Act, the Government severed the link between pubs and the criminal justice system by transferring licensing powers from magistrates to councils, and now wonders why public houses do not keep better order.

It allows perfectly good legislative curbs on alcohol abuse to lie barely used on the statute book, and then wrings its hands over why our hospitals are struggling to cope with the hordes damaged by excessive drinking.

Dawn Primarolo, the public health minister, disingenuously blamed the drink industry yesterday for not doing more to encourage "responsible drinking". That's a little like blaming the car industry for not encouraging motorists to drive less. It's not really its job.

The Government, of course, could change the nation's drinking habits at a stroke by trebling the price of alcohol through higher excise duties (the strategy it uses to discourage smoking). It will not attempt such a politically suicidal strategy, nor should it.

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News Release - Tougher laws for drinks industry could be imminent

£2.7 billion: new estimated cost of alcohol to the NHS

Mandatory regulation and labelling could be on the cards for the alcohol industry following a major consultation about England's drinking culture, launched today by Public Health Minister Dawn Primarolo.

The Department of Health consultation is published together with independent reviews showing that the drinks industry is not adhering to its own voluntary standards, and new evidence suggesting that alcohol is a far wider cause of damage to people's health than previously suspected. New calculations released today put the cost of alcohol misuse to society at £17.7 billion to £25.1 billion per year, with a cost to the NHS of £2.7 billion.

The consultation proposals would mean that the current voluntary retailing code could become mandatory. This would mean retailers could have to:

- restrict the way alcohol is sold such as offering drinks in small as well as large glasses or measures - too often only one size is offered or a large is automatically given;

- restrict happy hours or irresponsible price based promotions - women 'drink for free' promotions are still all too common;

- display alcohol in off-licence premises in separate areas - no more displays by the checkout;

- give point of sale information eg. on units, allowing customers to make an informed choice; and

- train staff in shops and venues to recognise and refuse alcohol to underage or drunk customers.

Manufacturers will be given until the end of the year to put the required warnings and advice on bottles and cans. If not, Government will move to put a mandatory scheme in place. This would require health and unit information on all drinks containers.

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Diageo welcomes alcohol consultation

22 July, 2008

But drinks firm says using existing laws are the way forward

Diageo, the world’s largest drinks firm, says using current laws around alcohol and wider information campaigns are the way forward for tackling misuse.

Responding to the announcement today of a government consultation on the UK’s drinking culture, Diageo UK said it “welcomed” it and shared the government’s concerns about alcohol harm.

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Tuesday, July 22, 2008

Using Metaphors to Explore the Experiences of Powerlessness among Women in 12-Step Recovery
Substance Use & Misuse, Volume 43, Issue 8 & 9 July 2008 , pages 1027 - 1044

12-Step programs of substance abuse1 recovery are the most utilized mutual-help models in the United States. A pivotal aspect of 12-Step is the often-controversial idea of powerlessness. There is debate about the usefulness of the concept of powerlessness, especially for women in recovery.

This study used a metaphor-elicitation interviewing technique to examine the experiences of powerlessness among 13 women of varied racial, ethnic, and socioeconomic backgrounds, ages 21 to 60, who had an average of 9.5 years of recovery. Interviews were conducted during a 6-month span between 2004 and 2005 in the Washington, DC metropolitan area. Open and axial coding was used to determine emergent themes.

Concepts of powerlessness were found to be process oriented and developmental. Some metaphors indicated positive emotions around powerlessness such as relief, whereas others indicated negative emotions such as fear.

Implications for future research and study strengths and limitations are included.

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Light in tunnel of addiction

July 17, 2008

The number of problem drinkers is increasing, but so are the options available for treating them, writes Kerry Coleman.

It was early afternoon and Eric, 45, was circling his drug dealer's block in his car, waiting for a fix. He'd just cracked open the last beer in the case that sat on the passenger seat when he hit a telegraph pole.

More than two million Australians drink at risky levels, and the number of people misusing alcohol increased by more than 5 per cent between 1995 and 2005, according to the Australian Bureau of Statistics.

But while alcohol abuse increases, so do the treatment options. Today, alcoholics like Eric can check into rehab like a Hollywood star, attend Alcoholics Anonymous meetings, or pop a pill to kill the cravings. They can even get counselling sessions sent by post.

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News Release - BBPA comments on Department of Health consultation

Commenting on today’s announcement by the Department of Health on further consultation on alcohol policy, Mark Hastings, BBPA Director of Communications, said:

“The Government’s approach should be to address the underlying culture and change attitudes, not just legislate and regulate. Legislation is a sledgehammer that will not crack the nut.

“There also needs to be the right balance between individual and corporate responsibility. We expect to be held to account for those things we can control, but companies cannot and should not be held to account for individual choices and behaviours that are beyond their ability to control.

“This is an industry that already bears the burden of one the heaviest tax and regulatory regimes in the world.

“With the economy in a precarious position, business under pressure, pubs closing at record rates and people feeling the pinch, now is not the time to be announcing a raft of new costs, regulations and restrictions on either businesses or individuals. The inevitable impact of such measures is to force up costs and prices and push more pubs towards penury.

“This seems to be a classic example of the Government’s tendency towards announcing new laws, rather than enforcing existing ones. There are plenty of laws and regulations to deal with irresponsible pubs and people. All agencies, including local government and the police should first focus on how to ensure these are enforced with greater rigour and consistency.

“We will look at the proposals and respond further when we have had a chance to consider them in detail.
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News Release - BBPA Comment on KPMG report leak

Commenting on the release of the Government’s release of the KPMG study into the drinks industry’s standards, Rob Hayward, Chief Executive of the Beer & Pub Association said:

“We have not yet seen the report, but from extracts we have seen, it seems long on anecdotal stories and short on hard empirical evidence.

“It totally ignores existing hard evidence from the repeated Government sting operations which have visited thousands of pubs in recent years. Those reports, while identifying some problems, have tracked consistent improvement in standards and high levels of good practice.
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A systematic review of emergency care brief alcohol interventions for injury patients
Journal of Substance Abuse Treatment Volume 35, Issue 2, September 2008, Pages 184-201

This article examines 14 studies that assessed the effectiveness of brief interventions (BIs) delivered to injury patients in emergency care settings.

The aims were to review findings concerning the effectiveness of providing BI in these settings and to explore factors contributing to its effectiveness.

Of the 12 studies that compared pre- and post-BI results, 11 observed a significant effect of BI on at least some of the outcomes: alcohol intake, risky drinking practices, alcohol-related negative consequences, and injury frequency. Two studies assessed only post-BI results.

More intensive interventions tended to yield more favorable results. BI patients achieved greater reductions than control group patients, although there was a tendency for the control group(s) to also show improvements. Five studies failed to show significant differences between the compared treatment conditions.

Variations in the study protocol, alcohol-related recruitment criteria, screening and assessment methods, and injury severity limit the specific conclusions that can be drawn.

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Reference-dose place conditioning with ethanol in mice: empirical and theoretical analysis
Psychopharmacology Online First 17 July 2008

A frequently expressed criticism of the conditioned place preference (CPP) procedure is that it sometimes lacks a graded dose–response curve for many drugs.

We used a combination of standard and reference-dose CPP procedures to examine the dose–response curve for ethanol-induced CPP in DBA/2J mice

Standard procedures yielded similar levels of CPP at doses of 1.5, 2, and 4 g/kg, whereas 0.5 g/kg did not produce significant CPP. However, in the reference-dose procedure, exposure to the 0.5-g/kg dose interfered with CPP normally produced by 1.5 or 2 g/kg. Moreover, mice showed significant preference for the 4-g/kg-paired cue over the 1.5-g/kg-paired cue.

These studies show that a reference-dose procedure can reveal effects of low doses that are sometimes difficult to detect in a standard procedure. The reference-dose procedure may also uncover differences between higher doses that normally produce similar preference. Efficacy of the reference-dose procedure may be explained by a theoretical analysis that assumes the procedure places behavior between the extremes of the performance range, offering a more sensitive method for detecting effects of manipulations that produce small changes and/or differences in the rewarding effects of ethanol.

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Social rank and social separation as determinants of alcohol drinking in squirrel monkeys
Psychopharmacology Online First 19 July 2008

Alcohol may be self-administered for its anxiolytic effects to alleviate symptoms of stress, but different types of stressors have varying effects on alcohol intake. Social stress is particularly relevant to alcohol drinking, and a primate model of stress-induced alcohol self-administration would be useful.

The objective of the study is to determine if social stresses of different lengths and intensities affect voluntary alcohol intake in monkeys.
Materials and methods Subjects were adult male and female squirrel monkeys (Saimiri

Dominance rank was inversely correlated with alcohol intake during social housing but was not correlated with control fluid intake. Acute social separation abolished drinking of both fluids, accompanied by increased anxiety-like behavior. Extended social separation increased salivary cortisol and alcohol drinking but not control fluid intake in males. In females, drinking was unchanged by extended separation.

The chronic stress of social subordination is correlated with increased alcohol drinking. Acute social separation stress suppresses drinking behavior, while extended separation preferentially increases alcohol intake in a subset of individuals. These findings suggest that social stressors of different time-courses and intensities have opposing effects on alcohol self-administration.

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Call for action on alcohol abuse

By Jenny Wiggins

Published: July 22 2008 20:08

The drinks industry on Tuesday called on the government to launch a full-scale education campaign to tackle Britain’s binge drinking culture, claiming it was not responsible for soaring rates of alcohol abuse.

The salvo was fired as the government threatened retailers, alcohol producers and pubs with regulation that could force them to offer drinks in small glasses and provide mandatory health warnings on alcohol products.

Publishing new research that linked cheap alcohol to rising consumption, the government said it would not make a final decision about whether to push for more controls on the industry until later this year.

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Press Release - Model Launched For Underage Alcohol Project

21 July, 2008

The WSTA today publishes a blueprint for community action to tackle underage drinking.

A New Way of Tackling Public Underage Drinking: Community Alcohol Partnerships’, draws on the results of a successful Community Alcohol Partnership (CAP) coordinated by the Retail of Alcohol Standards Group with Cambridgeshire Trading Standards, providing a new model for local enforcement to combat underage drinking.

The publication is being submitted to Government departments and local enforcement agencies and is available via the WSTA website. RASG is keen to spread this example of good practice and happy to speak to any local authorities who think CAP can work in their area.

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July's Webcast: "Real People, Real Recovery: Effectively Delivering Recovery-Oriented Systems of Care"

In 2006, an estimated 22.6 million persons aged 12 or older were classified with substance dependence or abuse in the past year. Of these, only 4 million received some kind of treatment for a problem related to the use of alcohol or illicit drugs. Luckily, a host of services exists for those who need them.

From 12-step programs to inpatient and outpatient treatment, and from recovery-oriented housing to sober recreational activities like those celebrated each September during Recovery Month, there is an entire network of treatment and support services available for those dealing with substance abuse and mental health disorders. This Webcast will examine some of those services and explore ways to increase awareness and better deliver these services to those who need them.

Watch the Webcast Now

Cheap alcohol is fuelling binge drinking, study says

By Robert Winnett, Deputy Political Editor
22 Jul 2008

Cut price alcohol is causing young people to drink to excess, a Government-backed study has found.

The research, carried out by Sheffield University, examined the impact of cheap supermarket deals on beer, wine and spirits and identified a link with binge drinking.

It is the first time academics have established a direct link and will add to pressure on supermarkets to stop selling alcohol as a "loss leader" - sometimes below its cost price.

The research also warned that cheap alcohol was leading to cancer and strokes and boosting the divorce rate.

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Industry warned of tougher action over binge drinking

By Jane Kirby, PA
Tuesday, 22 July 2008

The Government promised tougher action against the alcohol industry today unless it steps up efforts to encourage sensible drinking.

Research has shown the drinks trade is failing to adhere to its own voluntary code on providing alcohol unit information to consumers.

More than 10 years after industry and the Government agreed a way forward for clearer labelling, only 57 per cent of products contain details of the alcohol units in a drink.

Meanwhile, just 3 per cent of products contain all the information ministers want to see, including a warning to pregnant women to avoid alcohol.

The Government is considering banning happy hours, forcing pubs and clubs to serve drinks in smaller glasses as well as larger ones, and stopping off-licences and other retailers from displaying alcohol at checkouts.

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The Marshak Method: Merging Traditional 12-Step and Holistic Methods

Written by Dr. Jacob Marshak
Tuesday, 22 July 2008

In the early 1990s, after the break-up of the Union of Soviet Socialist Republics (USSR), the newly established Russian Federation faced a fast growing heroin epidemic, created by two factors: veterans returning from the war in Afghanistan; and the dramatic impact of a diet that consisted primarily of high-glycemic processed foods and fast foods, rich in sugars and corn syrup. In the USSR alcohol and drug abuse was officially minimized by the government, and addicts were neglected — the worst addicts, mainly alcoholics, were sent to forced labor camps.

Only after Mikhail Gorbachev’s 1986 economic restructuring, known as perestroika, were U.S. activists allowed to introduce 12-Step philosophy to Russia for the first time. I was personally invited to spend a year in the United States as a guest of American addiction professionals. When I returned to Russia as a certified addiction professional, I opened the country’s first private practice specializing in addiction medicine in 1991. My practice began with six heroin addicts. I combined the 12-Step program with a methodology I had personally developed 10 years earlier to stop myself from drinking. It is a holistic method, which allows an addict to quickly achieve sobriety without the help of pharmaceutical medications, and to rapidly improve his or her mood, so as to remain happy, positive and sober long term. A few years later the Marshak alumni “club” included about 30 sober, happy and creative members.
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Predictors of changes in alcohol-related self-efficacy over 16 years
Journal of Substance Abuse Treatment Volume 35, Issue 2, September 2008, Pages 148-155

Self-efficacy is a robust predictor of short- and long-term remission after treatment.

This study examined the predictors of self-efficacy in the year after treatment and 15 years later.

A sample of 420 individuals with alcohol use disorders was assessed five times over the course of 16 years.

Predictors of self-efficacy at 1 year included improvement from baseline to 1 year in heavy drinking, alcohol-related problems, depression, impulsivity, avoidance coping, social support from friends, and longer duration of participation in Alcoholics Anonymous (AA).

Female gender, more education, less change in substance use problems, and impulsivity during the first year predicted improvement in self-efficacy over 16 years.

Clinicians should focus on keeping patients engaged in AA, addressing depressive symptoms, improving patient's coping, and enhancing social support during the first year and reduce the risk of relapse by monitoring individuals whose alcohol problems and impulsivity improve unusually quickly.

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Circadian phenotype in patients with the co-morbid alcohol use and bipolar disorders
Alcohol and Alcoholism Advance Access published online on July 20, 2008

Alcohol misuse is associated with bipolar disorder. Abnormalities in the circadian clockwork play a role in the pathogenesis of bipolar disorder. Alcohol intake is likely to affect the circadian phenotype.

We aimed at analysing the behavioural trait of the preference to morning or evening hours for the daily activities in bipolar disorder patients with or without the co-morbid alcohol use.

Patients with the co-morbid alcohol use disorder were more of the morning type as compared with patients with bipolar disorder only.

Co-morbid patients preferred more the morning hours for their daily activities, indicative of alcohol consumption having an effect on the circadian clock.

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Safe, Sensible, Social – consultation on further action

22 July 2008

Pricing and promotion review

In Safe. Sensible. Social: next steps in the national alcohol strategy, the Department of Health committed to commission an independent review of the relationship between alcohol price, promotion and harm. The review is being conducted by the School of Health and Related Research at the University of Sheffield. This Phase 1 report is a comprehensive summary of international evidence. Phase 2, reporting in the autumn of 2008, will provide detailed policy models.


Monday, July 21, 2008

New Homelessness Resource Center Web Site Launched

SAMHSA's new Homelessness Resource Center (HRC) Web site launched this week. Targeted toward providers who work with people who are homeless, the Web site shares state-of-the art knowledge, evidence-based practices, and practical resources.

The Web site provides an interactive learning community for researchers, providers, consumers, and Government agencies at all levels. It is an easy-to-manage resource with content that informs, features that engage, and training that is useful. These elements are brought together to promote recovery-oriented and consumer-centered services for people who are homeless.

Read the related news release


Drinks industry regulations 'not fit for practice'

21 July 2008
Binge drinking strategy on rocks

Siobhain Ryan | July 21, 2008

LABOR risks falling off the wagon of its national binge drinking strategy after missing by three months its own deadline for tabling options to tackle alcohol abuse.

In May, a meeting of federal and state ministers with responsibility for drug strategy pledged to fast-track an interim report on binge drinking in recognition of the "urgency'' of the issue.

The document was to go before the Council of Australian Governments in July.
Last week, the ministers met again, with the July 3 COAG event behind them but no report at hand. A spokeswoman for Parliamentary Secretary Jan McLucas, representing the federal Government on drug strategy, attributed the delay to "extensive'' consultations with the alcohol industry and health groups.
. . . . . .

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Health, alcohol and EU law: understanding the impact of European single market law on alcohol policies
European Journal of Public HealthVolume 18, Number 4 Pp. 392-398

Many professionals in the alcohol field see the role of the the European Court of Justice (ECJ) as negative for health.

This review examines ECJ and European Free Trade Association (EFTA) case law in the context of two broader debates: firstly the extension of European Union (EU) law into alcohol policy (the ‘juridification’ of alcohol policy), and secondly the extent to which alcohol policy is an example of the dominance of ‘negative integration’ (the removal of trade-distorting policy) over ‘positive integration’ (the creation of European alcohol policies).

A comprehensive review of all ECJ/EFTA Court cases on alcohol, with interpretation aided by a secondary review on alcohol and EU law and the broader health and trade field.

From looking at taxation, minimum pricing, advertising and monopoly policies, the extension of the scope of the these courts over alcohol policy is unquestionable. However, the ECJ and EFTA Court have been prepared to prioritise health over trade concerns when considering alcohol policies, providing certain conditions have been met.

While a partial juridification of alcohol policy has led to the negative integration of alcohol policies, this effect is not as strong as sometimes thought; EU law is more health friendly than it is perceived to be, and its impact on levels of alcohol-related harm appears low. Nevertheless, lessons emerge for policymakers concerned about the legality of alcohol policies under EU law. More generally, those concerned with alcohol and health should pay close attention to developments in EU law given their importance for public health policy on alcohol.

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Alcohol-related adverse consequences: cross-cultural variations in attribution process among young adults European Journal of Public HealthVolume 18, Number 4 Pp. 386-391

Social norms around what is culturally accepted in terms of alcohol consumption and drunken comportment appear important regarding the acceptance of alcohol-related adverse consequences; however, investigations often neglect to consider differences in terms of attribution.

This study aims at assessing cross-cultural differences in the reporting of alcohol-related adverse consequences. It also considers differences across consequences that might explain which type of consequences (mainly acute or mainly chronic) are most affected by an attribution process.

Differences among the patterns of associations between countries and consequences were evident. The distinction between Nordic and other European countries was persistent. A higher variability of associations was observed for some consequences, namely the mainly acute instances. Finally, the Isle of Man and Switzerland showed specific trends with associations across consequences.

Reporting of alcohol-related adverse consequences seemed strongly affected by cultural norms. The latter may be exemplified by viewing drinking as ‘time-out’ behaviour. Respondents in countries with a stereotypical history of being ‘dry’ or with a stereotyped ‘binge’ drinking culture were more likely to attribute consequences to their alcohol consumption than people in ‘wet’ countries. This was particularly true for consequences that related to episodic ‘time-out’ heavy drinking.

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Sunday, July 20, 2008

Gamma-hydroxybutyric acid in male and female cynomolgus monkeys trained to discriminate 1.0 or 2.0 g/kg ethanol.
Behavioural Pharmacology. 19(4):317-324, July 2008.

Gamma-hydroxybutyric acid has been proposed as a pharmacotherapy for alcoholism in part based on similar discriminative stimulus effects as ethanol. To date, drug discrimination studies with [gamma]-hydroxybutyric acid and ethanol have exclusively used rodents or pigeons as subjects.

To evaluate possible differences between species, sex, and route of administration, this study investigated the substitution of [gamma]-hydroxybutyric acid (intragastrically or intramuscularly) for ethanol 30 or 60 min after administration in male (n=6) and female (n=7) cynomolgus monkeys trained to discriminate 1.0 and 2.0 g/kg ethanol. At least one dose of [gamma]-hydroxybutyric acid completely or partially substituted for ethanol in three of the 13 monkeys tested, with each case occurring in female monkeys.

Ethanol-appropriate responding did not increase with [gamma]-hydroxybutyric acid dose. Monkeys were more sensitive to the response rate decreasing effects of [gamma]-hydroxybutyric acid administered intramuscularly compared with intragastrically.

The lack of [gamma]-hydroxybutyric acid substitution for ethanol suggests that these drugs have different receptor bases for discrimination.

Furthermore, the data do not strongly support shared discriminative stimulus effects as the rationale for [gamma]-hydroxybutyric acid pharmacotherapy for alcoholism.

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Zolpidem Generalization and Antagonism in Male and Female Cynomolgus Monkeys Trained to Discriminate 1.0 or 2.0 g / kg Ethanol
Alcoholism: Clinical and Experimental ResearchPublished Online: 14 May 2008

The subtypes of γ-aminobutyric acid (GABA)A receptors mediating the discriminative stimulus effects of ethanol in nonhuman primates are not completely identified. The GABAA receptor positive modulator zolpidem has high, intermediate, and low activity at receptors containing α1, α2/3, and α5 subunits, respectively, and partially generalizes from ethanol in several species. The partial inverse agonist Ro15-4513 has the greatest affinity for α4/6-containing receptors, higher affinity for α5- and lower, but equal, affinity for α1- and α2/3-, containing GABAA receptors, and antagonizes the discriminative stimulus effects of ethanol.

Zolpidem (0.017 to 5.6 mg/kg, i.m.) completely generalized from ethanol (≥80% of total session responses on the ethanol-appropriate lever) for 6/7 monkeys trained to discriminate 2.0 g/kg and 4/10 monkeys trained to discriminate 1.0 g/kg ethanol. Zolpidem partially generalized from 1.0 or 2.0 g/kg ethanol in 6/7 remaining monkeys. Ro15-4513 (0.003 to 0.30 mg/kg, i.m., 5-minute pretreatment) shifted the zolpidem dose–response curve to the right in all monkeys showing generalization. Analysis of apparent pKB from antagonism tests suggested that the discriminative stimulus effects of ethanol common with zolpidem are mediated by low-affinity Ro15-4513 binding sites. Main effects of sex and training dose indicated greater potency of Ro15-4513 in males and in monkeys trained to discriminate 1.0 g/kg ethanol.

Ethanol and zolpidem share similar discriminative stimulus effects most likely through GABAA receptors that contain α1 subunits, however, antagonism by Ro15-4513 of zolpidem generalization from the lower training dose of ethanol (1.0 g/kg) may involve additional zolpidem-sensitive GABAA receptor subtypes (e.g., α2/3 and α5)

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