Self-mutilation among male patients with alcohol dependency: the role of dissociation
Comprehensive Psychiatry Volume 49, Issue 5, September-October 2008, Pages 489-495

The aim of this study was to investigate the relationship of self-mutilative behavior with dissociative experiences among men who are alcohol dependent.

A sizable proportion of patients (29.0%) reported self-mutilation (SM). Childhood abuse, younger age, early onset of alcoholism, and dissociative taxon membership predicted SM. The overall severity of clinical condition and the frequency of suicide attempts among those who reported SM were higher than those of the remaining patients. The Dissociative Experiences Scale-Taxon item “auditory verbal hallucinations” and the Symptom Checklist-Revised dimension “hostility” were predictors of SM.

There is a complex relationship between dissociation, alcohol use, and SM. Increased awareness among clinicians on this relationship may increase the effectiveness of treatment interventions.

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CADCA Survey Finds Alcohol Top Problem Facing Communities

August 14, 2008

According to CADCA´s 2007 Annual Survey of Coalitions, 68 percent of community anti-drug coalitions across the country ranked alcohol as the number one problem facing their community. The Annual Survey of Coalitions (formerly known as the National Coalition Registry) is the only nationwide survey that targets community-based drug and alcohol abuse prevention organizations.
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Against the Booze Bans - and the Hyperregulation of Public Space

Mayor of London Boris Johnson has claimed the banning of alcohol on the London Tube as one of the great successes of his first 100 days in office. But it isn't just Boris - and it isn't just London. There has been a creeping introduction of alcohol bans in public spaces all around the UK - and throughout many other countries, from town centres in the Czech Republic, to beaches in New Zealand, Australia and the USA.

The Manifesto Club is launching a campaign Against the Booze Bans and the Hyperregulation of Public Space.

These bans are not the result of public demand, but the petty and anti-social concerns of police, politicians and local government, who are disconnected from the public. They see grown-ups regulating their own public life and imagine a threat to social cohesion and law and order. This runs hand in hand with an infantilising culture around alcohol – with the (UK) National Union of Students campaigning against student drinking, and the UK government considering raising the age at which young people can buy alcohol from 18 (when they can already vote!) to 21.

We believe public space should be exactly that - a place where we can come together as a public - to argue and campaign, to pursue our common goals, to chat with friends and socialise. It is a space in which we, the public, should set the rules.

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Differences in prevalence and patterns of substance use in schizophrenia and bipolar disorder
Psychological Medicine (2008), 38:1241-1249

Schizophrenia and bipolar disorder have partly overlapping clinical profiles, which include an over-representation of substance-use behaviour. There are few previous studies directly comparing substance-use patterns in the two disorders.

The objective of the present study was to compare the prevalence of substance use in schizophrenia and bipolar disorder, and investigate possible differences in pattern and frequency of use.

Patients with bipolar disorder had higher rates of alcohol consumption, while schizophrenia patients more often used centrally stimulating substances, had more frequent use of non-alcoholic drugs and more often used more than one non-alcoholic drug. Single use of cannabis was more frequent in bipolar disorder.

The present study showed diagnosis-specific patterns of substance use in severe mental disorder. This suggests a need for more disease-specific treatment strategies, and indicates that substance use may be an important factor in studies of overlapping disease mechanisms.

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Happy Hours and Other Alcohol Discounts in Cafés: Prevalence and Effects on Underage Adolescents
Journal of Public Health Policy (2008) 29, 340–352

Adolescents' alcohol-related attitudes and behaviors may be affected by marketing efforts of the alcohol industry, retailers, and the catering industry. Most research has focused on the effects of commercials and media exposure.

This article investigates another aspect of alcohol marketing in the Netherlands: the use of alcohol discounts by cafés. The prevalence of alcohol discounts was studied using unobtrusive café observations and website content analysis.

It is estimated that 39% of the cafés offer some kind of cash discount for alcoholic beverages. The effects of alcohol discounts were investigated in a survey among adolescents (14–17 years old, N=409). Adolescents reported using alcohol discounts eight times a year, and consuming more alcohol when discounts were offered.

Alcohol discounts, however, do not attract adolescents to visit particular cafés and/or to spend more money when going out. No differences were found between minors (16–17 years) and underage adolescents (14–15 years).

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Institutional trust and alcohol consumption in Sweden. The Swedish National Public Health Survey 2006.
BMC Public Health 2008, 8:283

Trust as a measure of social capital has been documented to be associated with health. Mediating factors for this association are not well investigated. Harmful alcohol consumption is believed to be one of the mediating factors. We hypothesized that low social capital defined as low institutional trust is associated with harmful alcohol consumption.

Independent of age, country of birth and socioeconomic circumstances, low institutional trust was associated with increased likelihood of harmful alcohol consumption (OR (men) = 1.52, 95% CI 1.34-1.70) and (OR (women) = 1.50, 95% CI 1.35-1.66). This association was marginally altered after adjustment for interpersonal trust.

Findings of the present study show that lack of trust in institutions is associated with increased likelihood of harmful alcohol consumption. We hope that findings in the present study will inspire similar studies in other contexts and contribute to more knowledge on the association between institutional trust and lifestyle patterns. This evidence may contribute to policies and strategies related to alcohol consumption.

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Alcohol and Tobacco Marketing Evaluating Compliance with Outdoor Advertising Guidelines
American Journal of Preventive MedicineVolume 35, Issue 3, September 2008, Pages 203-209

Historically, the alcohol and tobacco industries have been the biggest users of outdoor advertising. However, the 1999 Master Settlement Agreement (MSA) outlawed tobacco billboards and transit furniture (e.g., bus, bench) ads, and the Outdoor Advertising Association of America (OAAA) has pledged to voluntarily eliminate ads for alcohol and tobacco within 500 feet of schools, playgrounds, and churches.

Outdoor advertisements were observed (2004–2005) in a sample of urban census tracts (106 in pre-Katrina southern Louisiana and 114 in Los Angeles County) to evaluate tobacco and alcohol advertisers' compliance with the MSA and the OAAA Code of Industry Principles. Data were analyzed in 2007–2008.

More than one in four tobacco ads in Louisiana failed to comply with the MSA. In Los Angeles, 37% of alcohol ads and 25% of tobacco ads were located within 500 feet of a school, playground, or church; in Louisiana, roughly one in five ads promoting alcohol or tobacco fell within this distance. In Los Angeles, low-income status and the presence of a freeway in the tract were associated with 40% more alcohol and tobacco billboards near children. In Louisiana, each additional major roadway-mile was associated with 4% more tobacco ads—in violation of MSA—and 7% more small ads near schools, playgrounds, and churches; city jurisdiction accounted for 55% of MSA violations and more than 70% of the violations of OAAA guidelines.

Cities must be empowered to deal locally with violations of the MSA. Legislation may be needed to force advertisers to honor their pledge to protect children from alcohol and tobacco ads.

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Request Reprint E-Mail: mscott@rand.org

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A new genetic variant involved in genetic susceptibility to alcoholic liver cirrhosis: -330T>G polymorphism of the interleukin-2 gene.
European Journal of Gastroenterology & Hepatology. 20(9):855-859, September 2008.

Genetic factors may determine susceptibility to develop alcoholic liver cirrhosis, although it remains uncertain why only a minority of alcoholics suffers from this disease. A decrease in serum levels of interleukin-2 (IL-2) is usually found in alcoholic cirrhotics. In this study we examined the relationship between the -330T>G IL-2 gene (IL2) polymorphism and alcoholic liver cirrhosis.

We found an association between the -330T>G IL2 polymorphism and alcoholic liver cirrhosis: the frequency of the allele T carriers (genotype TT and GT) was significantly higher in alcoholics with cirrhosis (96.9%) than in those without liver disease (89.4%, P=0.043).

We report for the first time that the possession of the -330T allele of the IL2 is associated with a higher risk of developing alcoholic liver cirrhosis and this fact may favor the progression of alcoholic liver disease.

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Drunk Drivers Protest Brazil Crackdown as Traffic Deaths Plunge

By Carlos Caminada

Aug. 14 (Bloomberg) -- Ioram Finguerman's 36th birthday on June 27 was marked by a new question for partygoers in Brazil: Who gets to drink and who has to drive?

Responding to a traffic fatality rate nine times that of the U.S. and 14 times Australia's, Brazil a week earlier imposed some of the world's strictest drunk-driving penalties. Drivers caught after having two glasses of beer or the equivalent go to jail for six months to three years. One beer brings a 957-real ($600) fine and loss of license for a year.

While traffic casualties have fallen by more than half in Sao Paulo since the rules were enforced, they are too restrictive for a country known for its love of celebration, Finguerman said.

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Drinking Typography Established by Scheduled Induction Predicts Chronic Heavy Drinking in a Monkey Model of Ethanol Self-Administration
Alcoholism: Clinical and Experimental Research Published Online: 12 Aug 2008

We have developed an animal model of alcohol self-administration that initially employs schedule-induced polydipsia (SIP) to establish reliable ethanol consumption under open access (22 h/d) conditions with food and water concurrently available. SIP is an adjunctive behavior that is generated by constraining access to an important commodity (e.g., flavored food). The induction schedule and ethanol polydipsia generated under these conditions affords the opportunity to investigate the development of drinking typologies that lead to chronic, excessive alcohol consumption.

Drinking typographies during the induction of drinking 1.5 g/kg ethanol emerged that were highly predictive of the daily ethanol intake over the next 12 months. Specifically, the frequency in which monkeys ingested 1.5 g/kg ethanol without a 5-minute lapse in drinking (defined as a bout of drinking) during induction strongly predicted (correlation 0.91) subsequent ethanol intake over the next 12 months of open access to ethanol. Blood ethanol during induction were highly correlated with intake and with drinking typography and ranged from 100 to 160 mg% when the monkeys drank their 1.5 g/kg dose in a single bout. Forty percent of the population became heavy drinkers (mean daily intakes >3.0 g/kg for 12 months) characterized by frequent "spree" drinking (intakes >4.0 g/kg/d).

This model of ethanol self-administration identifies early alcohol drinking typographies (gulping the equivalent of 6 drinks) that evolve into chronic heavy alcohol consumption in primates (drinking the equivalent of 16 to 20 drinks per day). The model may aid in identifying biological risks for establishing harmful alcohol drinking.

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UK alcohol sales rise to buck trend

The Institute of Alcohol Studies (IAS) has reported alcohol sales rose by 1.8% in the last financial year 2007/08, reversing the previous two years' fall in sales. However IAS notes that whilst beer sales have continued to fall, quantities of wine, spirits and cider have continued to rise as off premises sales rose by 2% but pub and other licensed premises sales fell by 7.4%.

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Industry body releases guidance on tackling public underage drinking

The Wine and Spirit Trade Association has released a new guidance document ‘A New Way of Tackling Public Underage Drinking: Community Alcohol Partnerships' which claims to be a new model for local enforcement to tackle underage drinking. The guidance is based on a Community Alcohol Partnership (CAP) pilot scheme in St Neots that reduced underage public drinking and associated crime and disorder through better partnership working between retailers and enforcement agencies .

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In Vivo Evidence for Alcohol-Induced Neurochemical Changes in Rat Brain Without Protracted Withdrawal, Pronounced Thiamine Deficiency, or Severe Liver Damage
Neuropsychopharmacology advance online publication 13 August 2008;


Magnetic resonance spectroscopy (MRS) studies in human alcoholics report decreases in N-acetylaspartate (NAA) and choline-containing (Cho) compounds. Whether alterations in brain metabolite levels are attributable to alcohol per se or to physiological effects of protracted withdrawal or impaired nutritional or liver status remains unclear.

Longitudinal effects of alcohol on brain metabolites measured in basal ganglia with single-voxel MRS were investigated in sibling pairs of wild-type Wistar rats, with one rat per pair exposed to escalating doses of vaporized alcohol, the other to vapor chamber air. MRS was conducted before alcohol exposure and twice during exposure.

After 16 weeks of alcohol exposure, rats achieved average blood alcohol levels (BALs) of 293 mg per 100 ml and had higher Cho and a trend for higher glutamine+glutamate (Glx) than controls. After 24 weeks of alcohol exposure, BALs rose to 445 mg per 100 ml, and alcohol-exposed rats had higher Cho, Glx, and glutamate than controls. Thiamine and thiamine monophosphate levels were significantly lower in the alcohol than the control group but did not reach levels low enough to be considered clinically relevant. Histologically, livers of alcohol-exposed rats exhibited greater steatosis and lower glycogenosis than controls, but were not cirrhotic.

This study demonstrates a specific pattern of neurobiochemical changes suggesting excessive membrane turnover or inflammation, indicated by high Cho, and alterations to glutamate homeostasis in the rat brain in response to extended vaporized alcohol exposure.

Thus, we provide novel in vivo evidence for alcohol exposure as causing changes in brain chemistry in the absence of protracted withdrawal, pronounced thiamine deficiency, or severe liver damage.


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Surveillance of Certain Health Behaviors and Conditions Among States and Selected Local Areas --- Behavioral Risk Factor Surveillance System (BRFSS), United States, 2006

Behavioral risk factors such as smoking, poor diet, physical inactivity, and excessive drinking are linked to the leading causes of death in the United States. Controlling these behavioral risk factors and using preventive health services (e.g., influenza vaccinations and cholesterol screenings) can reduce morbidity and mortality in the U.S. population substantially. Continuous monitoring both of health behaviors and of the use of preventive services is essential for developing health promotion activities, intervention programs, and health policies at the state, city, and county level.

This report indicates that substantial variations in health-risk behaviors, chronic diseases and conditions, and the use of preventive health services exist among adults from state to state and within states and underscores the continued need for prevention and health promotion activities at the local, state, and federal levels.

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August Webcast: "Accessing Prevention, Treatment, and Recovery Online "

With the advent of the Internet in the mid-1990s, the number of available options for finding addiction prevention, treatment, and recovery support services has grown exponentially. Today, one can search online and instantly find an extensive list of resources and locate providers immediately on an interactive map, read testimonials from people who are struggling with similar issues or have already overcome them, and find support in a sea of chat rooms and Web sites.

Today's youth, in particular, are more technologically savvy than ever. Youth-oriented social Web sites can serve as a forum for developing skills and abilities to stay away from addictive substances, for realizing one has a problem, and for offering avenues toward unprecedented treatment methods such as "e-therapy" and "virtual support groups." This program will highlight the state of recovery in the 21st century and examine how technology has revamped the field of substance use disorder prevention and addiction treatment.

Watch the Webcast Now

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Free Textbook - Collaborative Statistics


Collaborative Statistics was written by Barbara Illowsky and Susan Dean, faculty members at De Anza College in Cupertino, California. The textbook was developed over several years and has been used in courses offered by many California community colleges in regular and honors-level classroom settings and in distance learning classes. This textbook is intended for introductory statistics courses being taken by students at two– and four–year colleges who are majoring in fields other than math or engineering. Intermediate algebra is the only prerequisite. The book focuses on applications of statistical knowledge rather than the theory behind it.

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Alcohol outlet density, perceived availability and adolescent alcohol use: a multilevel structural equation model
Journal of Epidemiology and Community HealthJournal of Epidemiology and Community Health 2008;62:811-816

Perceived availability is commonly associated with adolescent alcohol use. Little is known about the factors which shape this perceived availability.

The present study investigates (1) whether perceived alcohol availability is related to the characteristics of the adolescents’ social environment and the per capita outlet density in the community and (2) whether adolescent alcohol use is related to perceived availability, social environment characteristics and outlet density.

Social environment characteristics, that is, having peers and siblings who drink, going out without parental knowledge of the adolescents’ whereabouts, drinking in public settings and the density of on-premises but not off-premises alcohol outlets, were related to perceived availability. Adolescent alcohol use increased with the permissiveness of social environment characteristics and with increasing perceived availability. Community-level perceived availability and the density of on-premises but not off-premises outlets were related to volume drinking but not to the frequency of risky drinking occasions.

Perceived availability and drinking volume appear to be shaped by the adolescents’ social and physical environments. Adolescents who have a variety of opportunities to obtain alcohol might develop the impression that underage drinking is common and socially endorsed. Consequently, preventive actions to curb adolescent alcohol consumption should take into account the social acceptance of drinking and the physical availability of alcohol in the community.

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Invited Commentary: Never, or Hardly Ever? It Could Make a Difference
American Journal of Epidemiology Advance Access published online on August 12, 2008


A paper showing that about one half of persons stating lifelong alcohol abstinence had previously reported drinking (Am J Epidemiol 2008;168(XX):000—000) reopens debate about the validity of this frequently used referent group in alcohol-health studies.

Misclassification of lifelong abstainers could result in underestimation of harmful effects of heavy drinking and overestimation of benefits of lighter drinking. Imprecise and unreliable ascertainment of alcohol intake is the rule in the area of alcohol epidemiology research. However, inaccurate ascertainment of past infrequent drinking may have less effect upon outcome estimates than the consequences of other measurement errors such as underreporting of intake.

Communication about alcohol-health relations would be improved if all research reports explicitly described queries and methods by which alcohol intake was categorized and if limitations were always frankly acknowledged.

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Request Reprint E-Mail: hartmavn@pacbell.net , arthur.klatsky@kp.org
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Are Lifetime Abstainers the Best Control Group in Alcohol Epidemiology? On the Stability and Validity of Reported Lifetime Abstention
American Journal of Epidemiology Advance Access published online on August 12, 2008


Lifetime abstainers have often been recommended as the comparison group in alcohol epidemiology.

The objective of this study was to provide insight into the validity and stability of lifetime abstention by using data derived from the National Alcohol Survey, a national probability survey of US households conducted in 1984, and its 2 follow-up surveys conducted in 1990 and 1992.

Results indicated that more than half (52.9%; all proportions were weighted to represent the US population) of those who reported never having a drink of any alcoholic beverage in the 1992 survey reported drinking in previous surveys. Depending on assumptions, this difference may result in an underestimation of alcohol-attributable mortality of 2%–15% in men and 2%–22% in women. Sociodemographic factors differentiated those who consistently reported lifetime abstention across surveys from the rest of the study population.

Results suggest that using reported lifetime abstainers as a sole comparison group is problematic, especially if reporting is based on 1 measurement only.

Establishing multiple measurement points and including irregular lifetime light drinkers with lifetime abstainers as the comparison group are recommended for future epidemiologic studies.

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The DASIS Report: First-Time and Repeat Admissions Aged 18 to 25 to Substance Abuse Treatment, 2006

Highlights:

• Based on SAMHSA's Treatment Episode Data Set (TEDS) on substance abuse treatment admissions in 2006, repeat admissions aged 18 to 25 were more likely than first-time admissions of the same age group to report heroin and other opiates as the primary substance of abuse (27% vs. 12%) and to report the use of multiple substances (67% vs. 56%).

• The South was unlike any other region in that a majority of all admissions aged 18 to 25 were first-time admissions instead of repeat admissions, regardless of the primary substance of abuse.

• The criminal justice system was the principal referral source to substance abuse treatment for all admissions aged 18 to 25 whether first-time substance abuse treatment admissions or repeat substance abuse treatment admissions.

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Adverse Childhood Experiences Predict Earlier Age of Drinking Onset: Results From a Representative US Sample of Current or Former Drinkers
PEDIATRICS Vol. 122 No. 2 August 2008, pp. e298-e304


Our goal was to determine whether adverse childhood experiences predicted the age at which drinking was initiated and drinking motives in a representative sample of current or former drinkers in the United States.

Sixty-six percent of respondents reported 1 adverse childhood experiences, and 19% reported experiencing 4. The most commonly reported adverse childhood experiences were parental separation/divorce (41.3%), living with a household member who was a problem drinker (28.7%), mental illness of a household member (24.8%), and sexual abuse (19.1%). Of the 10 specific adverse childhood experiences assessed, 5 were significantly associated with initiating drinking at 14 years of age (compared with at 21 years of age) after adjustment for confounders, including physical abuse, sexual abuse, having a mentally ill household member, substance abuse in the home, and parental discord or divorce.

Compared with those without adverse childhood experiences, respondents with adverse childhood experiences were substantially more likely to report that they drank to cope during the first year that they used alcohol.

Results suggest that children with particular adverse childhood experiences may initiate drinking earlier than their peers and that they may be more likely to drink to cope with problems (rather than for pleasure or to be social).

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Request Reprint E-Mail: erothman@bu.edu
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Call for proposals - Research on the Transmission of Drinking Cultures: Media Influence

There appear to be a number of key domains through which young people’s drinking cultures and habits are influenced. The key domains that we have identified are the family, teenage peer groups, geographical locality and the media. Under this call for proposals, we wish to fund one primary research project on the influence of the media on young people’s drinking cultures.

Deadline:	2pm on Wednesday, 24 September 2008
Timescale:	18 months maximum
Budget:	£100,000
Key contacts:	Charlie Lloyd (Principal Research Manager), charlie.lloyd@jrf.org.uk

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FDA warns of reactions to alcohol dependence drug

By Susan Heavey

WASHINGTON (Reuters) - Nearly 200 patients given Alkermes Inc's drug Vivitrol for alcohol dependence reported complications from the injection, including abscesses requiring surgical drainage, U.S. health regulators said on Tuesday.

Vivitrol, an extended-release version of the generic drug naltrexone marketed by Cephalon Inc, was approved in 2006 to treat alcohol dependence in patients who show they can abstain from drinking prior to receiving the drug therapy.

Since then, the Food and Drug Administration said it received 196 reports of patients who were given Vivitrol and developed swelling, pain, bleeding and other complications. Sixteen required surgery to drain the injection site or to repair damaged tissue, the FDA said.

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Does remission from alcohol and drug use disorders increase the likelihood of smoking cessation among nicotine dependent young adults?
Social Psychiatry and Psychiatric Epidemiology Online 9 August 2008

This article tests the hypothesis that remission from substance use disorders is associated with smoking cessation in nicotine dependent young adults.

The sample was composed of 976 young adults with lifetime substance use disorders and nicotine dependence who were subjects in the national epidemiologic survey on alcohol abuse and related conditions (NESARC). The Associated Disabilities Interview Schedule-DSM-IV Version was used to assess lifetime and past year psychiatric disorders.

Past year nicotine cessation was obtained by self-report. Remission from substance use disorders was defined as the past year absence of DSM-IV substance use disorders . This study found that remission from substance use disorders increased the likelihood of smoking abstinence (OR = 1.7).

Our study found that remission from substance use disorders increased the likelihood of smoking abstinence in early adulthood. This finding is congruent with results from longitudinal studies.

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Request Reprint E-Mail: agostiv@pi.cpmc.columbia.edu
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Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment
JAMA. 2008;300(6):663-675.

High rates of alcohol misuse after deployment have been reported among personnel returning from past conflicts, yet investigations of alcohol misuse after return from the current wars in Iraq and Afghanistan are lacking.

To determine whether deployment with combat exposures was associated with new-onset or continued alcohol consumption, binge drinking, and alcohol-related problems.

Baseline prevalence of heavy weekly drinking, binge drinking, and alcohol-related problems among Reserve or National Guard personnel who deployed with combat exposures was 9.0%, 53.6%, and 15.2%, respectively; follow-up prevalence was 12.5%, 53.0%, and 11.9%, respectively; and new-onset rates were 8.8%, 25.6%, and 7.1%, respectively. Among active-duty personnel, new-onset rates were 6.0%, 26.6%, and 4.8%, respectively. Reserve and National Guard personnel who deployed and reported combat exposures were significantly more likely to experience new-onset heavy weekly drinking (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.36-1.96), binge drinking (OR, 1.46; 95% CI, 1.24-1.71), and alcohol-related problems (OR, 1.63; 95% CI, 1.33-2.01) compared with nondeployed personnel.

The youngest members of the cohort were at highest risk for all alcohol-related outcomes.

Reserve and National Guard personnel and younger service members who deploy with reported combat exposures are at increased risk of new-onset heavy weekly drinking, binge drinking, and alcohol-related problems.

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Request Reprint E-Mail: Isabel.Jacobson@med.navy.mil

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Trends in Alcohol- and Drug-Related ED and Primary Care Visits: Data from Three U.S. National Surveys (1995-2005)
The American Journal of Drug and Alcohol Abuse 12 August 2008


To evaluate trends in alcohol- and drug-related emergency department (ED) and primary care visits over the previous decade.

A trend analysis was conducted on substance-related health services visit data, based on self-reported drinking or drug use within six hours prior to an injury or illness event, from the 1995, 2000, and 2005 National Alcohol Surveys.

Although an upward trend was observed in alcohol-related ED visits from 1995 to 2005, this increase was not significant. A significant trend was found for drug-related ED visits from .6% in 1995 to 3.7% in 2005 (p < .01). In multiple logistic regression, year of survey (2000 vs. 1995) was positively predictive of drug-related ED visits, controlling for gender, age, ethnicity, and health insurance coverage; however, year of survey (2005 vs. 2000) was not significant.

These data suggest that drug-related ED visits are continuing to increase, although the increase has not been as substantial between 2000 and 2005 as that which was observed between 1995 and 2000 and highlight the opportunity provided by the ED and primary care settings for screening and brief intervention for substance-related problems.

These findings also suggest that Healthy People 2010 objectives calling for a reduction in substance-related visits may not be reached.

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Request Reprint E-Mail: ccherpitel@arg.org
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A nationwide survey of American alcohol and drug craving assessment and treatment practices
Addiction Research & Theory 08 Ausust 2008


A four-page paper survey was mailed to 500 randomly-selected substance abuse treatment agencies listed in a national directory to evaluate how often specific methods are employed to assess and treat craving in American substance abuse agencies.

Of 426 eligible agencies, 149 (35%), located in 41 states, returned 152 usable replies.

Although counselors regularly assessed craving during intake evaluations, they rarely used published self-report questionnaires. Almost one-half of respondents made craving a target of treatment with at least a majority (and sometimes all) of their clients, and only 5% of respondents reported never making craving a target of treatment.

A variety of interventions are employed to address craving, including coping skills training, encouraging clients to avoid/leave situations where craving occurs, and providing clients with education about craving.

We recommend additional professional education and training to familiarize counselors with standardized craving instruments and exposure interventions that hold promise to ameliorate craving.


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Request Reprint E-Mail: mpinter@bgsu.edu
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Is alcohol consumption good for you? Results from the 2005 Canadian Community Health Survey
Addiction Research & Theory 04 August 2008

Data from the Statistics Canada 2005 Canadian Community Health Survey is used to test the hypothesis that classification errors of the type noted by Fillmore et al. (2006) could invalidate the statistical results on the effects of alcohol consumption on self-rated health and the incidence of heart disease and diabetes.

The results obtained in this study show that the beneficial effects of moderate alcohol use that so many studies have found, still appear even when the correct classification of alcohol use is employed.

However, parameter biases and inferential errors can occur when researchers fail to distinguish between former drinkers and never drinkers within the non-drinking group.

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Request Reprint E-Mail: jamesm@vax2.concordia.ca
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Genetic Bases of Addictive Behaviors
Scott D. Philibin, Kristine M. Wiren and John C. Crabbe

In: The Molecular and Genetic Basis of Neurologic and Psychiatric Disease. 4th Edition. Rosenberg RR, DiMauro S, Paulson H, Ptacek L, Nestler E (Eds), Lippincott, Williams & Wilkins, Philadelphia, in press.

Addiction is not a medical term, and the range of disorders included varies according to the beliefs of the beholder. Nonetheless, its lay usage and dictionary definitions reflect the common belief that at its core is surrender to habitual, self-destructive behavior. Like most psychiatric disorders, attempts to define diagnostic criteria must use terms and constructs from entirely different languages, descriptions of biological factors and descriptions of intrapsychic events whose basis is unknown. The term addiction does not appear in the Diagnostic and Statistical Manual-IV, but in that manual, “substance use disorders” would be on nearly everyone’s list of addictions, while such disorders as Bulemia Nervosa, Pathological Gambling, etc. would make the list for many .

This review will focus on drug addiction for several reasons. Most data on genetic contributions to addictive behaviors relates to drug dependence. Neurobiological insights have been derived almost entirely from rat and mouse studies employing genetic models of addiction. This is because drugs, given systematically in an experimentally controlled setting to genetically defined subjects, exert their effects in increasingly well-understood pharmacological pathways, often via specific neurotransmitter receptors. Many pharmacological agonist and antagonist drugs and genetic manipulations are available to the experimenter
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Development of a psychologically enhanced interactive online intervention for hazardous drinking
Alcohol and Alcoholism Advance Access published online on August 7, 2008


The content of novel interventions is often not well specified. We provide a detailed account of the rationale for and redevelopment of an Internet resource for hazardous drinkers—Down Your Drink (DYD) (www.downyourdrink.org.uk).

The detailed structure and content of the new version of the website is presented. This permits an appreciation of the intended interaction between the user and the intervention, and emphasizes both the freedom of choice available to the user to access diverse material for personal benefit and the value of a clear organizational structure.

Presentation of detailed information on the theoretical underpinning, content and structure of an intervention makes it easier to interpret the results of any evaluation and is likely to be of use to those developing other online interventions for alcohol or other health behaviours.

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Request Reprint E-Mail: stuart.linke@candi.nhs.uk
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Motor impairment: a new ethanol withdrawal phenotype in mice.
Behavioural Pharmacology. 19(5-6):604-614, September 2008.


Alcoholism is a complex disorder with genetic and environmental risk factors. The presence of withdrawal symptoms is one criterion for alcohol dependence. Genetic animal models have followed a reductionist approach by quantifying various effects of ethanol withdrawal separately. Different ethanol withdrawal symptoms may have distinct genetic etiologies, and therefore differentiating distinct neurobiological mechanisms related to separate signs of withdrawal would increase our understanding of various aspects of the complex phenotype.

This study establishes motor incoordination as a new phenotype of alcohol withdrawal in mice. Mice were made physically dependent on ethanol by exposure to ethanol vapor for 72 h. The effects of ethanol withdrawal in mice from different genetic backgrounds were measured on the accelerating rotarod, a simple motor task.

Ethanol withdrawal disrupted accelerating rotarod behavior in mice. The disruptive effects of withdrawal suggest a performance rather than a learning deficit. Inbred strain comparisons suggest genetic differences in magnitude of this withdrawal phenotype. The withdrawal-induced deficits were not correlated with the selection response difference in handling convulsion severity in selectively bred Withdrawal Seizure-Prone and Withdrawal Seizure-Resistant lines.

The accelerating rotarod seems to be a simple behavioral measure of ethanol withdrawal that is suitable for comparing genotypes


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Women's Alcohol Use and Alcoholism in Korea
Substance Use & Misuse, Volume 43, Issue 8 & 9 July 2008 , pages 1078 - 1087

Recently South Korean society has experienced an increase in alcohol use related problems, as well as alcohol use among women.

The purpose of this paper is to describe the cultural context of and to summarize the current state of knowledge of women's drinking in South Korea.

Subscribing to Confucian principles, traditional Korean society has allowed drinking for men, but not for women. However, as society has changed, contemporary women drink at a younger age and consume larger amounts of alcohol than their prior generations.

The current trends suggest an urgent need for research on the etiology and trajectory of women's alcohol use among various populations and the need to develop intervention programs tailored to the specific needs of women.

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Estimating the prevalence of individuals likely to use publicly funded alcohol treatment services: an indirect estimation technique
Drug and Alcohol Review, Volume 27, Issue 5 September 2008 , pages 504 - 508


Determining prevalence estimates of illicit or stigmatised behaviours is problematic, due to under-reporting and difficulties in sampling adequately populations most at risk of engaging in such behaviours. This has led to the development of indirect prevalence estimation techniques such as multiplier methods, capture-recapture, multivariate indicator methods and back-calculation.

This study reports on the development of a treatment multiplier to estimate the number of clients estimated to seek treatment through publicly funded services annually.

This study uses a multiplier method of indirect prevalence estimation, using the number of clients receiving publicly funded treatment as the benchmark population. Data for the multiplier were collected through a drug and alcohol telephone information and referral helpline. Participants are callers seeking assistance for their own alcohol use.

Results indicate that up to 40 200 individuals (95% confidence interval: 34 900, 47 000) may seek treatment at these agencies annually. This estimate represents a 300% increase in current publicly funded treatment provision.

This method was cost-effective and resulted in estimates similar to those obtained through a population-based survey. This method can be adapted easily to areas with a complete registry of clients receiving publicly funded alcohol or drug treatment services and a helpline service with adequate geographic coverage.


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Are we becoming more alike? Comparison of substance use in Australia and the United States as seen in the 1995, 1998, 2001 and 2004 national household surveys
Drug and Alcohol Review, Volume 27, Issue 5 September 2008 , pages 473 - 481


This paper reports the results of the 1995, 1998, 2001 and 2004 Australian and US household surveys, with emphasis on changes since 2001.

The past-year use of 'any illicit drug', cannabis, cocaine, tranquillisers and injecting drugs decreased between 2001 and 2004 in Australia, but remained stable for all these drugs except ecstasy between 2002 and 2004 in the United States. The use of hallucinogens decreased in both countries. Alcohol and use of many illicit drugs by teenage girls in both countries increased to rates similar to or higher than boys, and teens in both countries reported binge and heavy drinking in the past month. Australians in their 20s had the highest rates of use, but in the United States, past-year use of many drugs was highest among teenagers.

More treatment services are needed, particularly for people dependent upon non-opiate drugs. The changes in acceptability of use of different drugs and their perceived availability are related to changes in prevalence rates. Even with the similarities in levels of use, there are differences in patterns of use and preferences for certain drugs in each country, and geographic proximity to drug sources is a factor.

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