Media Release - Drug Education; an Entitlement for All_______________________________________________________________
Saturday, November 1, 2008
Priory Embraces Web TV To Tackle Alcohol Abuse31 Oct 2008
The Priory Group is using its expertise to help GPs recognise and deal with the signs of problem and excessive drinking. The UK's leading independent provider of addiction treatment services has commissioned a series of web TV programmes to raise awareness of its specialist services to GPs and other medical practitioners and one of the first subjects tackled was alcohol addiction.
Just this week the National Audit Office (NAO) released startling figures on the growing alcohol problems in England. Hospital admissions for alcohol-related conditions such as liver disease cost the NHS £2.7bn a year. The NAO report also stated that GPs were in an ideal position to help the estimated seven million drinkers who were exceeding the recommended limits but not yet seeing their health affected.
The Priory Healthcare TV report addresses how to recognise the signs of alcohol abuse and what the danger signals are that should alert someone that their drinking is becoming a problem.
Dr. Dorcas Kingham, consultant at The Priory who participates in the programme said: "In the UK 20 per cent of patients attending general practice are drinking in an "at risk manner" while one in five acute medical admissions are related to alcohol. Consumption of alcohol has doubled in the past 40 years. This NAO report highlights the scale of the problems and also underlines the lack of co-ordination in providing alcohol services at a local level.
"The aim of our web TV reports is to present information and advice in a format that people are familiar with from everyday TV viewing which is an easy way to grab attention and bring difficult concepts to life.
"Priory Healthcare News is an innovative and exciting way of bringing the Priory's specialised services to a large audience and building awareness of some of the issues faced by medical practitioners every day."
The programme concerning alcohol addiction can be viewed at http://www.broadbandtvchannel.co.uk/clip.asp?clipid=320
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Editorial - Alcohol-related dementia: a 21st-century silent epidemic?The British Journal of PsychiatryThe British Journal of Psychiatry (2008) 193: 351-353
Evidence suggests a J-shaped relationship between alcohol consumption and cognitive impairment and other health indicators, with low levels of consumption having better outcomes than abstention or moderate to heavy drinking.
Most research to date has focused on the protective effects of drinking small amounts of alcohol.
As alcohol consumption is escalating rapidly in many countries, the current cohort of young and middle-aged people may face an upsurge of alcohol-related dementia. The dangers of heavy drinking and its effect on cognition require further attention.
Request Reprint E-Mail: sushamgupta@yahoo.com
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Autonomic responses to ethanol in adolescent and adult rats: a dose–response analysisAlcohol Article in Press, 25 October 2008
Athough the exact cause of the increase in ethanol consumption during adolescence is not known, age differences in sensitivity to some of ethanol's effects may play a contributory role.
Prior research has shown little difference in the expression of ethanol-induced tachycardia between adolescents and adults following ethanol inhalation. In contrast, there is mounting evidence of ontogenetic differences in ethanol-induced hypothermia, although the nature of the ontogenetic effect observed has been found to vary across studies and even within labs.
Relative ontogenetic differences in body temperature (BT) after ethanol administration appear to be driven in part by the amount of experimental perturbation associated with the test protocol, although differing ethanol exposure levels across studies may also have contributed to the variations in ontogenetic patterns that have been observed.
To explore the latter possibility, the present study assessed ethanol-induced hypothermia and tachycardia in adolescent and adult male Sprague-Dawley rats examined in their home cages in the presence of their housing partner following intraperitoneal administration of 0.5, 1.5, or 3.0 g/kg ethanol.
The results showed that, although adolescents did not show an adult-typical tachycardic effect at any dose, they proved more sensitive than adults to ethanol's hypothermic effects at the two highest doses. These findings suggest that not only the degree of experimental perturbation, but also the amount of ethanol exposure may differentially effect expression of age differences in ethanol-induced hypothermia, with adolescents showing greater hypothermia than adults at higher doses.
Together with previous findings, these data contribute to the emerging picture that age differences in autonomic effects of ethanol appear to be particularly sensitive to dosing parameters and experimental protocols, unlike the generally more consistent ontogenetic findings observed across studies when using behavioral measures of ethanol sensitivity.
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Request Reprint E-Mail: lspear@Binghamton.edu
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Dual Diagnosis: Prevalence, Risk Factors, and Relationship With Suicide Risk in a Nationwide Sample of French PrisonersAlcoholism: Clinical and Experimental Research Published Online: 31 Oct 2008
Axis I psychiatric disorders (PD) and substance use disorders (SUD) are common in prison, but only few studies have focused on their association in this setting. Dual diagnosis (DD) (the co-occurrence of a SUD and any axis I disorder) is known to have a poorer prognosis and to require more intense supportive care.
The objectives of this study were (1) to describe prisoners with DD (prevalence and characteristics); (2) to compare DD prisoners with 3 other groups of prisoners: no diagnosis (ND), SUD alone, or other isolated PD; and (3) to evaluate the impact of DD on suicide risk in prison.
Of the prisoners, 26.3% had a DD. DD prevalence was almost 80% in prisoners with SUD, while only one-third of the prisoners with an axis I PD had co-morbid SUD. No significant differences were observed in drug use patterns between DD and SUD without co-morbid PDs. DD showed the strongest association with suicide risk [OR = 5.7 (1.7–4.6)].
DD is very frequent in prison and is a major risk factor for suicide. Systematic psychiatric/SUD screening of prisoners with either a SUD or an axis I PD should be encouraged.
Request Reprint E-Mail: michael.lukasiewicz@gmail.com
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Alterations in Brain Serotonin Synthesis in Male Alcoholics Measured Using Positron Emission TomographyAlcoholism: Clinical and Experimental Research Published Online: 31 Oct 2008
A consistent association between low endogenous 5HT function and high alcohol preference has been observed, and a number of serotonergic manipulations (uptake blockers, agonists) alter alcohol consumption in animals and humans. Studies have also shown an inverse relationship between alcohol use and cerebrospinal fluid levels of serotonin metabolites, suggesting that chronic alcohol consumption produces alterations in serotonin synthesis or release.
Comparisons of the alcoholics and controls by SPM found that there were significant differences in the rate of serotonin synthesis between groups. Serotonin synthesis was significantly lower among alcoholics in Brodmann Area (BA) 9, 10, and 32. However, serotonin synthesis among the alcoholics group was significantly higher than controls at BA19 in the occipital lobe and around the transverse temporal convolution in the left superior temporal gyrus (BA41). In addition, there were correlations between regional serotonin synthesis and a quantity-frequency measure of alcohol consumption. Regions showing a significant negative correlation with QF included the bilateral rectus gyri (BA11) in the orbitofrontal area, the bilateral medial frontal area (BA6), and the right amygdala.
Current alcoholism is associated with serotonergic abnormalities in brain regions that are known to be involved in planning, judgment, self-control, and emotional regulation.
Request Reprint E-Mail: kathryn.gill@mcgill.ca
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The Hispanic Americans Baseline Alcohol Survey: Alcoholic Beverage Preference Across Hispanic National GroupsAlcoholism: Clinical and Experimental Research Published Online: 31 Oct 2008
U.S. Hispanics come from many countries in Latin America, which can lead to different beverage preferences in the United States. This paper examines choice for drinking wine, beer, and liquor across 4 Hispanic national groups: Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans.
Among men, beer drinkers consume the highest mean number of drinks per week in all national groups. Among women, this is true only of Puerto Ricans and Mexican Americans. Among men who drink beer, beer drinking constitutes 52 to 72% of total alcohol consumption. Among women who drink beer, beer consumption is associated with 32 to 64% of total consumption. Beer is the beverage most associated with binge drinking among Puerto Rican and Mexican American women, while among Cuban Americans and South/Central Americans this is seen for wine. Regression analyses showed no significant differences by national group in the likelihood of drinking 2 or fewer drinks (vs. no drinks) of wine, beer, or liquor. Puerto Ricans were more likely (OR = 1.47; 95% CI = 1.00–2.14) than Cuban Americans to drink 3 or more drinks (compared with no drinks) of beer. There was no association between the likelihood of binge drinking and Hispanic national group.
Beverage preference across Hispanic national groups is similar. Beer is the preferred beverage. Alcohol control policies such as taxation and control of sales availability should apply equally to beer, liquor, and wine. Prevention interventions directed at different Hispanic national groups in the United States can be relatively uniform in their focus on the dangers associated with drinking different types of alcoholicRead Full Abstract
Request Reprint E-Mail: Raul.Caetano@UTSouthwestern.edu
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When What You See Isn't What You Get: Alcohol Cues, Alcohol Administration, Prediction Error, and Human Striatal DopamineAlcoholism: Clinical and Experimental Research Published Online: 31 Oct 2008
The mesolimbic dopamine (DA) system is implicated in the development and maintenance of alcohol drinking; however, the exact mechanisms by which DA regulates human alcohol consumption are unclear. This study assessed the distinct effects of alcohol-related cues and alcohol administration on striatal DA release in healthy humans.
Subjects underwent 3 PET scans with [
Relative to baseline, striatal DA concentration decreased during CUES, but increased during EtOH.
While the results appear inconsistent with some animal experiments showing dopaminergic responses to alcohol's conditioned cues, they can be understood in the context of the hypothesized role of the striatum in reward prediction error, and of animal studies showing that midbrain dopamine neurons decrease and increase firing rates during negative and positive prediction errors, respectively. We believe that our data are the first in humans to demonstrate such changes in striatal DA during reward prediction error.
Request Reprint E-Mail: dkareken@iupui.edu
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National conference on alcohol prevention in Malawi 12 November 2008The Ministry of Home Affairs and Internal Security and FORUT – The Norwegian Campaign for Development and Solidarity invite Malawian civil society organizations and government institutions to a conference in Lilongwe, the capital of Malawi.
The conference will focus on alcohol problems as an obstacle to development and welfare in Malawi. Key development issues will be discussed as a part of this; HIV/AIDS, gender, gender-based violence, children at risk.It will provide opportunities for sharing of experiences between Malawian NGOs/ government agencies and corresponding institutions from Sri Lanka, Nepal, India, Tchad, Uganda, Kenya, Sweden and Norway, as FORUT is holding its annual partner meeting in Malawi in November.
An updated and detailed program for the conference can be downloaded here.
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Increase taxes on alcohol, activists urge Government Friday, 31st October, 2008
THE Government should increase taxes on alcoholic products so as to reduce its consumption and curb traffic accidents and alcohol-related ailments afflicting the masses, activists have said.
At a public lecture organised by the Uganda Youth Development Link (UYDEL) on Wednesday, there were also calls for the blood alcohol limit for drivers to reduced to zero. The lecture, under the theme: “Stay alive, say no to alcohol”, took place at Statistics House in Kampala. It followed the launch of the State of alcohol abuse in Uganda report by UYDEL early this month.
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Friday, October 31, 2008
Alcohol Availability and Intimate Partner Violence Among US CouplesAlcoholism: Clinical and Experimental Research Published Online: 31 Oct 2008
We examined the relation between alcohol outlet density (the number of alcohol outlets per capita by zip code) and male-to-female partner violence (MFPV) or female-to-male partner violence (FMPV). We also investigated whether binge drinking or the presence of alcohol-related problems altered the relationship between alcohol outlet density and MFPV or FMPV.
In adjusted analysis, an increase of one alcohol outlet per 10,000 persons was associated with a 1.03-fold increased risk of MFPV (p-value for linear trend = 0.01) and a 1.011-fold increased risk of FMPV (p-value for linear trend = 0.48). An increase of 10 alcohol outlets per 10,000 persons was associated with 34% and 12% increased risk of MFPV and FMPV respectively, though the CI for the association with FMPV was compatible with no increased risk. The relationship between alcohol outlet density and MFPV was stronger among couples reporting alcohol-related problems than those reporting no problems (p-value for multiplicative interaction = 0.01).
We found that as alcohol outlet density increases so does the risk of MFPV and that this relationship may differ for couples who do and do not report alcohol-related problems. Given that MFPV accounts for the majority of injuries related to intimate partner violence, policy makers may wish to carefully consider the potential benefit of limiting alcohol outlet density to reduce MFPV and its adverse consequences.
Request Reprint E-Mail: christy.mckinney@utsouthwestern.edu
Alcohol and Self-Rated Health in a Mediterranean Country: The Role of Average Volume, Drinking Pattern, and Alcohol DependenceAlcoholism: Clinical and Experimental Research Published Online: 31 Oct 2008
The association between average alcohol consumption and self-rated ill-health is "J-shaped" in Scandinavian and Anglo-Saxon countries, but it has shown an inverse linear relationship in the few studies conducted in Mediterranean countries, based on average volume solely.
To examine the relationship between alcohol and self-rated health in the general population of a Mediterranean country, by simultaneously taking into account average volume, drinking pattern, and alcohol abuse.
In comparison with never-drinkers, suboptimal health was less frequent among occasional drinkers [odds ratio (OR) 0.72; 95% confidence interval (CI): 0.61 to 0.86], average moderate drinkers (OR 0.57; 95% CI: 0.48 to 0.69), and excessive drinkers (OR 0.51; 95% CI: 0.36 to 0.72), but more frequent among former drinkers with ≥1 year of abstinence (OR 1.30; 95% CI: 1.03 to 1.64). Frequency of suboptimal health was likewise higher in subjects with ≥3 episodes of binge drinking (OR 1.55; 95% CI: 1.12 to 2.14) or alcohol abuse (OR 1.47; 95% CI: 1.22 to 1.76). No differences were observed in suboptimal health according to beverage preference or drinking at mealtimes. Results in each gender were similar to those for total study participants.
Occasional, moderate, and excessive consumption of alcohol are associated with better self-rated health, even after adjustment for drinking pattern and alcohol abuse. In contrast, former-drinking, frequent binge drinking, and alcohol abuse are all associated with suboptimal self-rated health.
Request Reprint E-Mail: jose.valencia@uam.es
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An evaluation of alcohol attendances to an inner city emergency department before and after the introduction of the UK Licensing Act 2003.BMC Public Health 2008, 8:379
The Licensing Act 2003 was implemented on the 24th November 2005 across England and Wales. The Act allowed more flexible and longer opening hours for licensed premises. We investigated the effect of The Act on alcohol related attendances to an inner city emergency department in Birmingham, UK.
We compared the proportion and time of alcohol related emergency department attendances in one week periods in January 2005 and 2006, before and after the implementation of The Licensing Act 2003. An alcohol related attendance was defined as any attendance where there was any documentation of the patient having drunk before presenting to the emergency department, if they appeared intoxicated on examination, or if alcohol attributed to their final diagnosis.
The total weekly attendances increased slightly from 1,912 in 2005 to 2,146 in 2006. There was non-significant reduction in the proportion of alcohol related attendances between 2005 (3.6%) and 2006 (2.9%). A significantly greater proportion of attendances occurred at the weekend between 18.00 and 23.59 in 2005 (61.4%) than in 2006 (17.2%). There was a corresponding increase in the weekend proportion of attendances occurring between 03.00 to 05.59 in 2006.
The Licensing Act 2003 has changed the temporal distribution of alcohol related attendances to the emergency department and this has implications for delivery of emergency department services.
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Drinking and child behaviourFriday October 31 2008
Blessing of a weekly tipple in pregnancy,” reports the Times today, claiming that expectant mothers who drink alcohol during pregnancy do not harm their unborn babies, but they ‘may even benefit’. The Daily Express featured the headline "wine during pregnancy 'helps control your child’." The papers’ claims are based on a study of over 12,000 children that found that mothers who drink lightly during pregnancy (one or two units, or a single drink a week) did not increase their risk of having offspring with mental impairment or behavioural problems.
This study did not show any overall benefits or “blessings” from drinking as a casual reader of the headline might think, and several design issues make it impossible to be confident in the finding that light drinking during pregnancy is not harmful.
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ICAP Periodic Review on Drinking and CultureAlcohol consumption is an integral part of the social fabric in many countries. Yet the role occupied by drinking is quite different across countries and cultures, and is reflected in local customs, patterns, and attitudes. Despite this wide diversity, the lingua franca of the alcohol field is English, as are the publications that provide the evidence base most commonly used in international policy discussions. As a result, much of the research published in other languages and reflecting different cultural contexts and approaches escapes broader notice.
The ICAP Periodic Review on Drinking and Culture is an electronic publication that seeks to help remedy this disparity. Its key objectives are to:
(1) give greater exposure to research not currently published or widely available in English;
(2) broaden the range of cultural perspectives and the evidence base used in the crafting of policy and prevention.
Each issue of the Periodic Review presents English translations of abstracts of articles appearing in language areas currently underrepresented in major English-lanage research databases. Coverage of the Periodic Review is limited to psychosocial and socio-cultural research, to focus on drinking culture, behavior, patterns, and psychosocial outcomes.
Identification and selection of key research to be featured and all editorial decisions are carried out by an Editorial Group, consisting of experts from diverse geographic, linguistic, and disciplinary areas
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What is the ICAP Periodic Review on Drinking and Culture? Background, objectives, and features. · Members of the Editorial Group · Guidelines for Editorial Group of ICAP Periodic Review on Drinking and Culture · ICAP Periodic Review on Drinking and Culture: ISSUE 1 The first issue of the Periodic Review features abstracts of journal articles published in the past five years in Central, Southern, and _________________________________________________________________________________________________
Transforming Mental Health and Substance Abuse Data Systems in the United StatesPsychiatr Serv 59:1257-1263, November 2008
State efforts to improve mental health and substance abuse service systems cannot overlook the fragmented data systems that reinforce the historical separateness of systems of care. These separate systems have discrete approaches to treatment, and there are distinct funding streams for state mental health, substance abuse, and Medicaid agencies.
Transforming mental health and substance abuse services in the United States depends on resolving issues that underlie separate treatment systems—access barriers, uneven quality, disjointed coordination, and information silos across agencies and providers.
This article discusses one aspect of transformation—the need for interoperable information systems. It describes current federal and state initiatives for improving data interoperability and the special issue of confidentiality associated with mental health and substance abuse treatment data.
Some achievable steps for states to consider in reforming their behavioral health data systems are outlined. The steps include collecting encounter-level data; using coding that is compliant with the Health Insurance Portability and Accountability Act, including national provider identifiers; forging linkages with other state data systems and developing unique client identifiers among systems; investing in flexible and adaptable data systems and business processes; and finding innovative solutions to the difficult confidentiality restrictions on use of behavioral health data.
Changing data systems will not in itself transform the delivery of care; however, it will enable agencies to exchange information about shared clients, to understand coordination problems better, and to track successes and failures of policy decisions.
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Request Reprint E-Mail: rosanna.coffey@thomsonreuters.com
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Column - Focus on Alcohol & Drug Abuse: Improving Service Delivery for Individuals With Co-occurring Disorders: New Perspectives on the Quadrant ModelPsychiatr Serv 59:1251-1253, November 2008
This column summarizes findings of a study that examined the usefulness of the quadrant model for improving service delivery for persons with co-occurring disorders.
The authors discuss treatment recommendations, goals and barriers related to delivering care, policy recommendations for implementing evidence-based interventions, and strengths and limitations of the model.
They conclude that although the quadrant model is useful for conceptualizing systems-level factors for improving delivery, its further development is unlikely to result in improved care at the clinical level.
They call for research to develop and implement evidence-based practices targeted to specific populations of persons with co-occurring disorders.
Request Reprint E-Mail: keyser@rand.org
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ALCOHOL DRINKING AND RISK OF HOSPITALIZATION FOR COPDCHEST Meeting 2008; 134: 19004S.
COPD Evaluation and Outcomes
Tuesday, October 28, 2008
1:00 PM - 2:15 PM
Limited data suggest that moderate alcohol drinkers may be at lower risk of COPD than abstainers. Important potential confounders are smoking, concomitant coronary artery disease (CAD), and inclusion of former drinkers among abstainers. With more data needed, we performed a cohort study in a large multiethnic population.
We studied 126,263 men and women who supplied baseline data at 1978–85 health examinations. Through 2004 a subsequent primary hospitalization diagnosis of COPD (ICD-9 codes 491–6, except 493) was made in 760 persons. COPD risk was estimated by Cox proportional hazards models including age, sex, ethnicity, education, smoking, body mass index, and 7 alcohol intake categories. Some models included a yes vs. no composite CAD risk/symptoms covariate.
With lifelong abstainers as referent, adjusted relative risks (RR), 95 % confidence intervals (CI) for COPD were: exdrinkers = 1.29 (0.95–1.74), < day =" 0.83"> 1–2 dr/day = 0.76 (0.61–0.94, p = 0.01), 3–5 dr/day = 0.85 (0.65–1.12), and > 6 dr/day = 1.52 (1.04–2.24, p = 0.03). This alcohol-COPD J-curve was present in whites, African-Americans, ex-smokers, light smokers, heavy smokers, younger and older persons, and in subjects with either chronic bronchitis or other COPD diagnoses. However, the apparent benefit at moderate drinking levels was concentrated in women and subjects free of CAD history/symptoms. E.g., comparing persons reporting 1–2 drinks per day vs. lifelong abstainers, the RR (CI)'s were: men = 0.9 (0.7–1.3), women = 0.7 (0.5–0.9), CAD composite "yes" = 1.2 (0.6–2.5), and CAD composite "no" = 0.4 (0.1–1.1). Frequent wine drinking, both of red and white wine, was independently related to lower COPD risk. Covariate relations to COPD risk were as expected, with higher risk for older persons, men, smokers, and persons with low educational level.
These data show that, independent of smoking and CAD, moderate alcohol drinkers are at lower risk than lifelong abstainers of hospitalization for COPD.
Drinking moderate amounts of alcoholic beverages may have benefit for COPD.
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Thursday, October 30, 2008
ICAP Review 3: Noncommercial Alcohol in Three RegionsA significant portion of alcohol produced, sold, and consumed around the world is not reflected in official statistics. This ICAP Review focuses on the prevalence of "noncommercial alcohol" in Sub-Saharan Africa, central and eastern Europe, and southern Asia. "Noncommercial alcohol" is defined as traditional drinks produced for home consumption or limited local trade, unregistered and counterfeit products, and nonbeverage, or surrogate, alcohols.
The Review papers are written by regional experts familiar with local research and regional trends. Each paper provides a literature review and introduces new data. This ICAP Review contributes to a better understanding of the informal alcohol sector, identifies available local and international research, and highlights areas for further work.
Read Full Review (PDF)
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Light drinking in pregnancy may be good for baby boys, says study - The Guardian,
- Friday October 31 2008
Boys born to mothers who drank lightly during pregnancy are better behaved and score more highly in tests at the age of three than the sons of women who abstained, according to a study published today.
Researchers found there was no link between light drinking in pregnancy - defined as one to two units a week, or on occasion - and any behavioural or cognitive problems in children at the age of three.
Surprisingly, the University College London study found that some of the children of light-drinking mothers appeared to be doing better than the babies of those who abstained.
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