New estimates of the number of children living with substance misusing parents: results from UK national household surveys

BMC Public Health 2009

The existing estimates of there being 250,000 - 350,000 children of problem drug users in the UK (ACMD, 2003) and 780,000 - 1.3 million children of adults with an alcohol problem (AHRSE, 2004) are extrapolations of treatment data alone or estimates from other countries, hence updated, local and broaderestimates are needed.

Whilst harm from parental substance use is not inevitable, the number of children living with substance misusing parents exceeds earlier estimates. Widespread patterns of binge drinking and recreational drug use may expose children to sub-optimal care and substance-using role models. Implications for policy, practice and research are discussed.

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Tories stick to plans to tax high strength alcohol


Higher taxes would be targeted at 'cheap drinks that fuel anti-social behaviour', shadow Home Secretary Chris Grayling announced at yesterday's Conservative party conference.

In his speech, Grayling said the Tories would "...start with the problem of fourteen year olds hanging around with bottles of super-strength beers or ciders. It's much too easy for them to get very drunk quickly and cheaply."

Grayling also announced the Tories would 'tear up this Government's lax licensing regime' by giving more powers to restrict and fine licensed premises.

According to the Conservative party website, measures would be brought in to include:

• 
  Significant tax increases including on alcopops, strong beer and strong cider that contribute to violence and disorder on our streets. As a result, a 4-pack of super-strength beer will be £1.30 more expensive, a 2-litre bottle of super-strength cider will be 84p more expensive and a large bottle of alcopops will be up to £1.50 more expensive.
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  Supermarkets and other retailers will be banned from selling alcohol below cost price. This will help tackle the ‘pre-loading’ trend – young people and binge drinkers consuming cheap alcohol at home before going to town centres.
  
• A much tougher licensing regime. Local councils and the police will be given new powers to restrict the large number of late licences awarded to shops, takeaways and other venues.

. . . . . .

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Process evaluation of the implementation of a screening and brief intervention program for alcohol risk in primary health care: An experience in Brazil

Drug and Alcohol Review Early View 5 Oct 2009

Screening and brief intervention (SBI) are considered good prevention strategies for alcohol-related problems in Primary Health Care (PHC).

The aim of this study was to evaluate the process of an SBI implementation program for alcohol risk use and evaluate the factors that facilitated or impeded this implementation, in two PHC settings at the Brazilian city of Juiz de Fora.

The barriers and facilitators were related to two main factors: organisational culture and personal attitudes. The action research provided the opportunity to bridge the gap between research and practice, but it also showed that SBI faces significant challenges before it can be implemented as a routine procedure in PHC settings in Brazil.

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Request Reprint E-Mail: mlformig@psicobio.epm.br

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Packages of Care for Mental, Neurological, and Substance Use Disorders in Low- and Middle-Income Countries: PLoS Medicine Series

PLoS Medicine Series. PLoS Med 6(10)

This Perspective introduces a new series in PLoS Medicine on mental health disorders in low- and middle-income countries that reviews the evidence for packages of care for ADHD, alcohol misuse disorders, dementia, depression, epilepsy, and schizophrenia.

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Relationship between Alcohol Consumption and Active Helicobacter pylori Infection

Alcohol and Alcoholism Advance Access published online on October 6, 2009

Helicobacter pylori (H. pylori) is a cause of chronic gastritis and maybe responsible for functional dyspepsia in a subset of patients. Many risk factors, such as alcohol consumption and smoking, may contribute to the colonization and infection of H. pylori in humans. However, studies on the relationship between H. pylori infection and drinking or smoking have produced conflicting results.

The aim of this study was to examine whether consumption of alcohol or smoking is associated with active H. pylori infection in functional dyspepsia patients.

H. pylori infection was positive in 27.3% of the 139 functional dyspepsia patients. Both age and gender were not significantly associated with H. pylori infection. A multiple logistic model found that alcohol consumption and pathology (active gastritis) were associated with H. pylori infection. Active gastritis was associated with alcohol consumption, smoking and age .

In patients with functional dyspepsia, there is no significant association between active H. pylori infection and smoking. However, alcohol consumption appears to be associated with H. pylori infection.

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Request Reprint E-Mail: talley.nicholas@mayo.edu

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The Long Arm of Expectancies: Adolescent Alcohol Expectancies Predict Adult Alcohol Use

Alcohol and Alcoholism Advance Access published online on October 6, 2009

Alcohol expectancies are strong concurrent predictors of alcohol use and problems, but the current study addressed their unique power to predict from adolescence to midlife.

Cohort members with more positive alcohol expectancies at age 16 reported greater alcohol quantity concurrently, increases in alcohol quantity relative to their peers between ages 16 and 35, and a higher likelihood of lifetime and previous year alcohol misuse at age 35, independent of gender, social class in family of origin, age of alcohol use onset, adolescent delinquent behavior and age 16 exam scores.

Alcohol expectancies were strong proximal predictors of alcohol use and predicted relative change in alcohol use and misuse across two decades into middle adulthood.

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Request Reprint E-Mail: meganpat@isr.umich.edu

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About HINARI

The Access to Research Initiative (HINARI) provides free or very low cost online access to the major journals in biomedical and related social sciences to local, not-for-profit institutions in developing countries.

HINARI was launched in January 2002, with some 1500 journals from 6 major publishers: Blackwell, Elsevier Science, the Harcourt Worldwide STM Group, Wolters Kluwer International Health & Science, Springer Verlag and John Wiley, following the principles in a Statement of Intent signed in July 2001. Since that time, the numbers of participating publishers and of journals and other full-text resources has grown continuously. Today more than 150 publishers are offering more than 6,200 journals in HINARI and others will soon be joining the programme. . . . . .

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Alcohol consumption in homicide victims in the city of São Paulo

Addiction Early View 5 Oct 2009

To assess the association between alcohol use and victimization by homicide in individuals autopsied at the Institute of Legal Medicine in São Paulo, Brazil.

Alcohol was detected in blood samples of 43% of the victims, and mean BAC levels were 1.55 ± 0.86 g/l. The prevalence of positive BAC levels was higher among men (44.1%) than women (26.6%). Firearms caused most of the deaths (78.6%), and alcohol consumption was greater among victims of homicide by sharp weapons .

A greater proportion of victims with positive BAC were killed at weekends compared to weekdays (56.4 and 38.5%, respectively;, and the correlation between homicide rates and the average BAC for the central area of the city was positive .

These results highlight alcohol as a contributing factor for homicide victimization in the greatest urban center in South America, supporting public strategies and future research aiming to prevent homicides and violence related to alcohol consumption.

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Request Reprint E-Mail: gabriel.biousp@gmail.com

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Anxiety and depression among abstainers and low-level alcohol consumers. The Nord-Trøndelag Health Study

Addiction Volume 104 Issue 9, Pages 1519 - 1529

The aim of this study was to examine the levels of anxiety and depression among individuals consuming low levels of alcohol.

A U-shaped association between alcohol consumption and the risk of anxiety and depression was found. Abstention was related to increased odds for both case-level anxiety and depression ). This association was accounted for partly by adjustments for socio-economic status, social network, somatic illness, age (depression only), gender (anxiety only) and 'sick-quitting'.

We also identified significant differences between participants who label themselves as abstainers compared to those who report no usual alcohol consumption, but who do not label themselves as abstainers.

The risk of case-level anxiety and depression is elevated in individuals with low alcohol consumption compared to those with moderate consumption. Individuals who label themselves as abstainers are at particularly increased risk. This increased risk cannot fully be explained by somatic illness, social activity or 'sick-quitting'.

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Request Reprint E-Mail: arnstein.mykletun@uib.no

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Relationship of heavy drinking, lipoprotein (a) and lipid profile to infrarenal aortic diameter

Vascular Medicine, Vol. 14, No. 4, 323-329 (2009)

The objective of this study was to examine the association of alcohol drinking and lipid profile with infrarenal aortic dimension. The diameter of the infrarenal aorta was measured using ultrasound in 395 individuals (mean 66.6 ± 10.3 years) with atherosclerotic diseases or risk factors. The associations between heavy drinking, serum lipoprotein (a) levels, lipid profile and infrarenal aorta diameters were examined.

Heavy drinking and lipoprotein (a) were positively related with infrarenal aortic dimension, while low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C), LDL-C and total cholesterol (TC)/HDL-C were negatively associated with infrarenal aortic diameter

In addition, there were negative associations of LDL-C/HDL-C, TC/HDL-C and positive associations of HDL-C and apolipoprotein AI (Apo AI) with heavy drinking.

In conclusion, there was a positive association between infrarenal aortic diameters and heavy drinking, as well as lipoprotein (a) levels. Furthermore, the novel and unexpected inverse association between LDL-C/HDL-C, LDL-C, TC/HDL-C and abdominal aortic diameter may suggest a possible role for anti-atherogenic lipid profile (characterized by a higher level of HDL-C and lower level of LDL-C) in aortic dilatation processes, which need to be clarified by further studies.

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Request Reprint E-Mail: jian_an_wang@yahoo.com

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Methodological Assessment of Economic Evaluations of Alcohol Treatment: What Is Missing?

Alcohol and Alcoholism Advance Access published online on October 6, 2009

The aim of this study is to review the methodology that has been adopted in previous economic evaluations of alcohol treatment and offer research recommendations with a view to enhancing the consistency and harmonization of economic evaluations in the alcohol field.

Twenty- seven studies were selected. Almost half of the studies did not include society-level consequences in their analysis. Some consequences of alcohol treatment at a societal level, such as the impact of treatment on health-related quality of life of family and friends of the drinker, have never been considered in the economic analysis. There was no agreement regarding the individual health consequences used in the evaluations. Measures capturing life years and morbidity have not been extensively used in the alcohol field. The level of reporting treatment costs on the reviewed studies is generally well detailed.

The literature is still rather sparse in this area and further research is required to fulfil the gaps. If a common methodology is adopted in future economic evaluations of alcohol treatment, more stable cost-effectiveness estimates will be produced and informed decisions for resources allocation to alcohol treatments will be possible.

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Request Reprint E-Mail: cppb500@york.ac.uk

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Towards DSM-V: Exploring Diagnostic Thresholds for Alcohol Dependence and Abuse

Alcohol and Alcoholism Advance Access published online on October 6, 2009

The expected release of the DSM-V in 2012 has renewed the longstanding debate around whether alcohol use disorders are best conceptualized as dimensional or categorical constructs.

The current study aimed to validate the current diagnostic thresholds for alcohol dependence and abuse using epidemiological indicators including mental health, disability, psychological distress, functional impairment, service use, suicidality and early age of drinking onset.

There was some albeit limited support for the current diagnostic threshold of three criteria for alcohol dependence and one criterion for abuse. A number of other cut-offs also showed consistent variation for both disorders.

It is essential to define diagnostic thresholds in a systematic way. The current diagnostic thresholds for alcohol dependence and abuse are adequate but require further validation using a variety of methods and external indicators. Combining these disorders in some way may also prove useful as well as including other potential diagnostic criteria in future research.

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Request Reprint E-Mail: r.grove@unsw.edu.au

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Applying Health Care Reform Principles to Mental Health and Substance Abuse Services

JAMA. 2009;302(13):1463-1464.

The US political system is debating the desirability and feasibility of health care reform. Discussions focus on expanding coverage while reforming delivery to contain costs and ensure quality, but there has been little discussion about how to apply reform principles to mental health and substance abuse (MHSA) conditions and services.

The passage of federal parity bills for private plans and outpatient Medicare services underscores the policy interest in ensuring financial access and the timeliness of considering application of reform principles to these services.

This Commentary highlights features of MHSA conditions and services that affect onsideration of reform principles.

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Request Reprint E-Mail: kwells@ucla.edu

Endogenous Opiates and Behavior: 2008

Peptides Article in Press 29 September 2009

This paper is the thirty-first consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2008 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists.

The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurologic disorders (Section 11); electrical-related activity and neurophysiology (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration and thermoregulation (Section 16); and immunological responses (Section 17).

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Request Reprint E-Mail: richard.bodnar@qc.cuny.edu

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Modulation of alcohol and nicotine responses through the endogenous opioid system

Progress in Neurobiology Article in Press 1 Oct 2009

It has been estimated that more than 80% of alcoholics are also nicotine dependent and that, vice versa, the rate of alcoholism is substantially increased by a factor of 4 to 10 in the nicotine-dependent population. However, the cause for this very high degree of comorbidity is still largely unknown.

At the molecular and cellular level, both drugs have very different mechanisms of action. Nicotine specifically activates ligand-gated ion channels in the brain, which are normally gated by acetylcholine, while alcohol interacts with various neurotransmitter receptors. Despite this diversity, both drugs seem to engage the endogenous opioid system as a modulator of some of its pharmacological effect. An acute exposure to nicotine or alcohol leads to a release of opioids peptides in specific brain regions, thus resulting in an activation of their corresponding receptors. If the brain is exposed repeatedly or chronically to these drugs, adaptive changes in the level and expression of opioid peptides and receptors occur. These adaptive changes are thought contribute to the homeostatic or allostatic adaptations of the brain, which have been associated with drug dependence.

This review summarizes pharmacological and genetic studies in animal models and in humans that have addressed the role of specific opioid peptides and receptors in various stages of the addiction process.

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Request Reprint E-Mail: neuro@uni-bonn.de

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Matters of Substance August 2009 contents
Volume 19, Number 3

The Director's Cut
The Law Commission's liquor review presents a wonderful opportunity for constructive debate. it's time for New Zealand to get talking.

Cover Story - Alcohol in our lives: Travelling to a better place

The Law Commission has spent the last year gathering information about the extent of New Zealand's alcohol problems. Stage one of its liquor review is now complete, and it's time for public debate on potential solutions.

Counting the cost: The BERL report has put the social cost of alcohol and drug misuse at nearly $7b per annum, but there are those who say the report has got things terribly wrong.

Tackling sport's alcohol culture: New Zealanders play hard, and all too often they drink hard. Can anything be done to mend our boozy sporting ways?

It's our loss: Lianne Dalziel on what the Liquor licensing Authority said about loss-leading.

Guest Editorial - Let's offer treatment!
Michael Bird challenges the treatment sector to stop its navel gaing and start moving forward. He presents a 12-point plan to get things underway.

Opinion - It's time for the facts to get in the way of a good story
Liz Read, corporate Affairs Director of Lion Nathan, says it's wrong to blame the alcohol industry for New Zealand's binge drinking woes.
Making sense of Mexico's drug wars
Sanji Gunesekara writes about the political, economic and social background to Mexico's violent and bloody drug wars.
Research Update - Driving High: findings from the Great New Zealand Drug-Driving Survey
The results are in. What do kiwis think they know about drugs and driving?

Mythbusters - Busting alcohol policy myths
In this Mythbusters special, we counter some of the current myths about alcohol policy, by seeing what the evidence really says.

Mythbusters - Blown away: Defeating the breathylser

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Alcohol abuse and dependence symptoms: A multidimensional model of common and specific etiology.
Psychology of Addictive Behaviors. Vol 23(3), Sep 2009, 415-427

This study tested a theoretical model hypothesizing differential pathways from 5 predictors to alcohol abuse and dependence symptoms.

The participants were college students (N = 2,270) surveyed on 2 occasions in a 6-month prospective design. Social norms, perceived utility of alcohol use, and family history of alcohol problems were indirectly associated with Time 2 abuse and dependence symptoms through influencing level of alcohol consumption.

Poor behavioral control had a direct effect on alcohol abuse but not on dependence symptoms at Time 2, whereas affective lability exhibited a direct prospective effect on alcohol dependence but not on abuse symptoms. A multigroup analysis showed that high levels of poor control increased the strength of paths from both consumption level and affective lability to abuse symptoms.

Implications for prevention of alcohol problems among college students are discussed.

(PsycINFO Database Record (c) 2009 APA, all rights reserved)

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Request Reprint E-Mail: jsimons@usd.edu

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The alcohol industry and public interest science

Addiction Early View 5 Oct 2009

This report argues that the growing involvement of the alcohol industry in scientific research needs to be acknowledged and addressed. It suggests a set of principles to guide ethical decision-making in the future.

We review relevant issues with regard to relationships between the alcohol industry and the international academic community, especially alcohol research scientists. The guiding principles proposed are modelled after expert committee statements, and describe the responsibilities of governmental agencies, the alcohol industry, journal editors and the academic community. These are followed by recommendations designed to inform individuals and institutions about current 'best practices' that are consistent with the principles.

Growing evidence from the tobacco, pharmaceutical and medical fields suggests that financial interests of researchers may compromise their professional judgement and lead to research results that are biased in favour of commercial interests. It is recommended that the integrity of alcohol science is best served if all financial relationships with the alcoholic beverage industry are avoided. In cases where research funding, consulting, writing assignments and other activities are initiated, institutions, individuals and the alcoholic beverage industry itself are urged to follow appropriate guidelines that will increase the transparency and ethicality of such relationships.

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Request Reprint E-Mail: kerstin.stenius@thl.fi

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Association of IL-1B genetic polymorphisms with an increased risk of opioid and alcohol dependence

Pharmacogenetics and Genomics: POST AUTHOR CORRECTIONS, 1 October 2009

To examine the association between genetic variability of IL-1B, which encodes for the proinflammatory cytokine IL-1[beta] and the risk of developing opioid dependence. To confirm a previous study, we also examined the association between the IL-1B genetic polymorphism and alcohol dependence.

This study confirms the previous finding that IL-1B polymorphism is associated with altered risk of alcohol dependence. IL-1B single nucleotide polymorphisms at position -511 and -31, which increase IL-1[beta] production, occur at a higher frequency in opioid-dependent populations and may be associated, albeit weakly, with an increased risk of opioid dependence.

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Request Reprint E-Mail: mark.hutchinson@adelaide.edu.au

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EGFR may couple moderate alcohol consumption to increased breast cancer risk

Breast Cancer: Targets and Therapy 2009:1 31–38

Alcohol consumption is an established risk factor for breast cancer. Nonetheless, the mechanism by which alcohol contributes to breast tumor initiation or progression has yet to be definitively established.

Studies using cultured human tumor cell lines have identified signaling molecules that may contribute to the effects of alcohol, including reactive oxygen species and other ethanol metabolites, matrix metalloproteases, the ErbB2/Her2/Neu receptor tyrosine kinase, cytoplasmic protein kinases, adenylate cyclase, E-cadherins, estrogen receptor, and a variety of transcription factors. Emerging data suggest that the epidermal growth factor receptor (EGFR) tyrosine kinase may contribute to breast cancer genesis and progression.

Here we integrate these findings and propose three mechanisms by which alcohol contributes to breast cancer. A common feature of these mechanisms is increased EGFR signaling.

Finally, we discuss how these mechanisms suggest strategies for addressing the risks associated with alcohol consumption.

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Cessation of alcohol drinking, tobacco smoking and the reversal of head and neck cancer risk

IJE Advance Access published online on October 5, 2009

Quitting tobacco or alcohol use has been reported to reduce the head and neck cancer risk in previous studies. However, it is unclear how many years must pass following cessation of these habits before the risk is reduced, and whether the risk ultimately declines to the level of never smokers or never drinkers. \

Quitting tobacco smoking for 1–4 years resulted in a head and neck cancer risk reduction [OR 0.70, confidence interval (CI) 0.61–0.81 compared with current smoking], with the risk reduction due to smoking cessation after 20 years (OR 0.23, CI 0.18–0.31), reaching the level of never smokers. For alcohol use, a beneficial effect on the risk of head and neck cancer was only observed after 20 years of quitting (OR 0.60, CI 0.40–0.89 compared with current drinking), reaching the level of never drinkers.

Our results support that cessation of tobacco smoking and cessation of alcohol drinking protect against the development of head and neck cancer.

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Request Reprint E-Mail: hashibe@iarc.fr

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Young people's alcohol-related social norms in Sefton

'Understanding young people’s alcohol-related social norms in Sefton- Interim Report' has been released by the Liverpool John Moore University (JMU).

The report identifies that campaigns in the U.S aiming to tackle social norms were used as a way of reducing alcohol consumption amongst college students. The report was therefore commissioned by Sefton Primary Care Trust to investigate school pupils levels of alcohol consumption and prevailing attitudes and norms in order to effectively target a social norms campaign. A final sample of 149 pupils partook via an online survey, all aged between 14 to 16. The report explores areas such as drinking behaviour, motivations and perceptions of own and other's drinking. . . . . .

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Alcohol Drinking Pattern During Pregnancy and Risk of Infant Mortality.

Epidemiology: POST AUTHOR CORRECTIONS, 29 September 2009

The safety of small amounts of alcohol drinking and occasional binge-level drinking during pregnancy remains unsettled. We examined the association of maternal average alcohol intake and binge drinking (>=5 drinks per sitting) with infant mortality, both in the neonatal and postneonatal period.

Among term infants, intake of at least 4 drinks of alcohol per week or binging on 3 or more occasions during pregnancy are associated with an increased risk of infant mortality, especially during the postneonatal period.

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Request Reprint E-Mail: kal@niph.dk

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Daily marijuana users with past alcohol problems increase alcohol consumption during marijuana abstinence

Drug and Alcohol Dependence Article in Press 23 September 2009

Drug abuse treatment programs typically recommend complete abstinence because of a fear that clients who stop use of one drug will substitute another. A within-subjects study investigated whether consumption of alcohol and other substances changes during marijuana abstinence.

A diagnosis of past alcohol abuse or dependence significantly moderated the alcohol increase from baseline to marijuana abstinence such that individuals with this diagnosis significantly increased alcohol use (52% increase) but those without this history did not (3% increase). Increases in marijuana withdrawal discomfort scores and alcohol craving scores from baseline to marijuana abstinence significantly and positively correlated with increases in alcohol use. Increases in cigarettes, caffeine, and non-marijuana illicit drugs did not occur.

This study provides empirical validation of drug substitution in a subgroup of daily marijuana users, but results need to be replicated in individuals who seek treatment for marijuana problems.

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Request Reprint E-Mail: erica.peters@yale.edu

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Alcohol Expectancies Among High School Students in Inner Mongolia, China

Asia-Pacific Journal of Public Health, Vol. 21, No. 4, 433-441 (2009)

This study examines differences in Chinese high school students’ alcohol expectancies by drinking status (nondrinker, occasional drinker, regular drinker) and gender (male, female).

The authors administered the Chinese Adolescent Alcohol Expectancy Questionnaire (CAEQ) to a convenience sample of 1244 high school students (M = 627; F = 617) from schools in Huhhot City and Tongliao City in Inner Mongolia, China.

Differences were found in the 8 CAEQ factors (3 negative and 5 positive factors). Regular drinkers had lower negative consequences and higher positive perception expectancies than nondrinkers or occasional drinkers. Nondrinkers had higher harm to person/reputation expectancies than occasional or regular drinkers. Occasional drinkers had higher beneficial/moderation and lower harm to person/ reputation expectancies than nondrinkers. Boys had higher positive perception expectancies than girls.

Expectancies are associated with Chinese adolescents’ drinking. Identifying the characteristics of alcohol consuming youth can inform the development of prevention interventions and alcohol policies.

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Request Reprint E-Mail: dshell2@unl.edu

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The role of alcohol in unintentional falls among young and middle-aged adults: a systematic review of epidemiological studies

Injury Prevention 2009;15:341-347;

To appraise the published epidemiological evidence quantifying the risk of falls associated with acute and usual alcohol consumption among young and middle-aged adults.

Alcohol use appears to be an important risk factor for falls among young and middle-aged adults. Controlled studies with sufficient power that adjust effect estimates for potential confounders (eg, fatigue, recreational drug use) are required to determine the population-based burden of fall-related injuries attributable to alcohol. This can help inform and prioritise falls prevention strategies for this age group.

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Request Reprint E-Mail: b.kool@auckland.ac.nz

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Periconceptional binge drinking and acculturation among pregnant Latinas in New Mexico

Alcohol Volume 43, Issue 6, September 2009, Pages 475-481

Binge drinking during pregnancy might lead to the development of Fetal Alcohol Spectrum Disorders in the offspring. Latinas are often considered a low-risk group for alcohol abuse, although recent reports indicate that the prevalence of alcohol consumption in this group is increasing due to changing cultural norms.

The predictors of alcohol consumption during pregnancy among Latinas are largely unknown. We explored predictors of periconceptional drinking among Latinas (n = 155) recruited into an ongoing cohort study at the University of New Mexico.

Results of multivariate analysis indicate that Latinas born in the United States have a much greater risk of binge drinking in the periconceptional period (odds ratio [OR] = 3.2; 95% confidence interval [CI]: 1.2, 8.9) compared with foreign-born Latinas. Similarly, Latinas who primarily speak English at home were at much greater risk (OR = 3.6; 95% CI: 1.3, 10.5) compared with primarily Spanish-speaking women. No other variables were identified as significant predictors in multivariable models.

Our results indicate that more acculturated Latinas are at much greater risk of binge drinking before conception and in early pregnancy compared with less acculturated Latinas. Culturally sensitive interventions should be developed to address risky alcohol consumption among Latinas of reproductive age.

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Request Reprint E-Mail: lbakhireva@salud.unm.edu

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Deficits in trace fear conditioning in a rat model of fetal alcohol exposure: dose–response and timing effects

Alcohol Volume 43, Issue 6, September 2009, Pages 465-474

In humans, prenatal alcohol exposure can result in significant impairments in several types of learning and memory, including declarative and spatial memory. Animal models have been useful for confirming that many of the observed effects are the result of alcohol exposure, and not secondary to poor maternal nutrition or adverse home environments. Wagner and Hunt (2006) reported that rats exposed to ethanol during the neonatal period (postnatal days [PDs] 4–9) exhibited impaired trace fear conditioning when trained as adolescents, but were unaffected in delay fear conditioning.

The present series of three experiments represent a more detailed analysis of ethanol-induced deficits in trace conditioning. In Experiment 1, the dose of ethanol given to neonates was varied (3.0, 4.0, or 5.0 g/kg/day). There was a dose-dependent reduction in trace conditioning, with the poorest performance observed in animals treated with the highest dose. In Experiment 2, it was found that the impairment in trace conditioning resulting from neonatal ethanol exposure was dependent on the duration of the trace interval used for training; less learning was evident in ethanol-exposed animals trained with longer trace interval durations. These results confirm other reports of delay-dependent memory deficits. Finally, Experiment 3 determined that ethanol exposure limited to the first half of the neonatal period (PDs 4–6) was more detrimental to later trace conditioning than exposure during the second half (PDs 7–9).

These results support the hypothesis that trace-conditioning impairments resulting from early ethanol exposure are due to the drug's teratogenic effects on the developing hippocampus, as the findings parallel those observed in animals with discrete hippocampal lesions.

Comparisons between delay and trace fear-conditioning performance in animals exposed to ethanol during the brain growth spurt provide a model system to study both selective learning impairments and possible treatment approaches for humans with fetal alcohol spectrum disorders.

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Request Reprint E-Mail:: pshunt@wm.edu

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Binge ethanol exposure in late gestation induces ethanol aversion in the dam but enhances ethanol intake in the offspring and affects their postnatal learning about ethanol

Alcohol Volume 43, Issue 6, September 2009, Pages 453-463

Previous studies show that exposure to 1 or 2 g/kg of ethanol during the last days of gestation increases ethanol acceptance in infant rats.

We tested whether prenatal exposure to 3 g/kg, a relatively high ethanol dose, generates an aversion to ethanol in both the dam and offspring, and whether this prenatal experience affects the expression of learning derived from ethanol exposure postnatally.

The answer was uncertain, because postnatal administration of a 3-g/kg ethanol dose induces an aversion to ethanol after postnatal day (PD) 10 but increases ethanol acceptance when administered during the first postnatal week.

In the present study, pregnant rats received intragastric administrations of water or ethanol (3 g/kg) on gestation days 17–20. On PDs 7–8 or 10–11, the offspring were administered water or ethanol (3 g/kg). Intake of ethanol and water, locomotor activity in an open field, and ethanol odor preference were evaluated in the pups, whereas the mothers were evaluated in terms of ethanol intake.

Results indicated an aversion to ethanol in dams that had been administered ethanol during gestation, despite a general increase in ethanol intake observed in their pups relative to controls. The prenatal ethanol exposure also potentiated the increase in ethanol intake observed after intoxication on PDs 7–8. Ethanol intoxication on PDs 10–11 reduced ethanol consumption; this ethanol aversion was still evident in infant rats exposed prenatally to ethanol despite their general increase in ethanol intake. No effects of prenatal ethanol exposure were observed in terms of motor activity or odor preference.

It is concluded that prenatal exposure to ethanol, even in a dose that induces ethanol aversion in the gestating dam, increases ethanol intake in infant rats and that this experience modulates age-related differences in subsequent postnatal learning about ethanol.

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Request Reprint E-Mail: g.chotro@ehu.es

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Reduced alcohol consumption in mice with access to a running wheel

Alcohol Volume 43, Issue 6, September 2009, Pages 443-452

Studies of the behavioral effects of alcohol in humans and rodent models have implicated a number of neurological pathways and genes. Separate studies have shown that certain regions of the brain are involved in behavioral responses to exercise.

The aim of this study was to determine whether mice which normally voluntarily consume high amounts of alcohol (C57BL/6 strain) would exhibit reduced alcohol consumption when given access to a running wheel under two different models of voluntary consumption: unlimited access two-bottle choice and limited access drinking in the dark (DID).

Under the two-bottle choice model, the animals voluntarily consumed less alcohol when a wheel was present in their cage. However, sex-specific differences emerged because female mice voluntarily consumed less alcohol when they have the opportunity to exercise on a running wheel, whereas male mice consumed less alcohol even if the running wheel was locked. There were no significant differences observed in alcohol metabolism or food consumption. Under the DID protocol, no differences in alcohol consumption were observed in the presence of a running wheel.

These results suggest that exercise may be a useful approach to consider for treatment for some types of chronic human alcohol problem behaviors, but may be less applicable to human binge drinking.

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Request Reprint E-Mail: marissa.ehringer@colorado.edu

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Positive relationship between dietary fat, ethanol intake, triglycerides, and hypothalamic peptides: counteraction by lipid-lowering drugs

Alcohol Volume 43, Issue 6, September 2009, Pages 433-441

Studies in both humans and animals suggest a positive relationship between the intake of ethanol and intake of fat, which may contribute to alcohol abuse. This relationship may be mediated, in part, by hypothalamic orexigenic peptides such as orexin (OX), which stimulate both consumption of ethanol and fat, and circulating triglycerides (TGs), which stimulate these peptides and promote consummatory behavior.

The present study investigated this vicious cycle between ethanol and fat, to further characterize its relation to TGs and to test the effects of lowering TG levels. .

These results support the existence of a vicious cycle between ethanol and fat, whereby each nutrient stimulates intake of the other. Within this vicious cycle, ethanol and fat act synergistically to increase TG levels, which in turn stimulate peptides that promote further consumption, and these phenomena are reversed by gemfibrozil, which lowers TG levels.

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Ethanol-induced hyperactivity is associated with hypodopaminergia in the 22-TNJ ENU-mutated mouse

Alcohol Volume 43, Issue 6, September 2009, Pages 421-431

Characterization of neurochemical and behavioral responses to ethanol in phenotypically distinct mouse strains can provide insight into the mechanisms of ethanol stimulant actions. Increases in striatal dopamine (DA) levels have often been linked to ethanol-induced hyperactivity.

We examined the functional status of the DA system and behavioral responsiveness to ethanol, cocaine, and a DA-receptor agonist in an N-ethyl-N-nitrosourea-mutagenized mouse strain, 22-TNJ, generated by the Integrative Neuroscience Initiative on Alcoholism Consortium.

The 22-TNJ mouse strain exhibited greater locomotor responses to 2.25 g/kg ethanol and 10 mg/kg cocaine, compared with control mice. In vivo microdialysis showed low-baseline DA levels and a larger DA increase with both 2.25 g/kg ethanol and 10 mg/kg cocaine. In in vitro voltammetry studies, the 22-TNJ mice displayed increased Vmax rates for DA uptake, possibly contributing to the low-baseline DA levels found with microdialysis. Finally, 22-TNJ mice showed enhanced in vitro autoreceptor sensitivity to the D2/D3 agonist, quinpirole, and greater locomotor responses to both autoreceptor-selective and postsynaptic receptor-selective doses of apomorphine compared with controls.

Taken together, these results indicate that the dopaminergic system of the 22-TNJ mouse is low functioning compared with control, with consequent receptor supersensitivity, such that mutant animals exhibit enhanced behavioral responses to DA-activating drugs, such as ethanol.

Thus, the 22-TNJ mouse represents a model for a relatively hypodopaminergic system, and could provide important insights into the mechanisms of hyper-responsiveness to ethanol's stimulant actions.

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Differential activation of limbic circuitry associated with chronic ethanol withdrawal in DBA/2J and C57BL/6J mice Alcohol Volume 43, Issue 6, September 2009, Pages 411-420

Although no animal model exactly duplicates clinically defined alcoholism, models for specific factors, such as the withdrawal syndrome, are useful for identifying potential neural determinants of liability in humans. The well-documented difference in withdrawal severity following chronic ethanol exposure, between the DBA/2J and C57BL/6J mouse strains, provides an excellent starting point for dissecting the neural circuitry affecting predisposition to physical dependence on ethanol.

To induce physical dependence, we used a paradigm in which mice were continuously exposed to ethanol vapor for 72 h. Ethanol-exposed and air-exposed (control) mice received daily injections of pyrazole hydrochloride, an alcohol dehydrogenase inhibitor, to stabilize blood ethanol levels. Ethanol-dependent and air-exposed mice were killed 7 h after removal from the inhalation chambers. This time point corresponds to the time of peak ethanol withdrawal severity. The brains were processed to assess neural activation associated with ethanol withdrawal indexed by c-Fos immunostaining. Ethanol-withdrawn DBA/2J mice showed significantly (P < .05) greater neural activation than ethanol-withdrawn C57BL/6J mice in the dentate gyrus, hippocampus CA3, lateral septum, basolateral and central nuclei of the amygdala, and prelimbic cortex.

Taken together with results using an acute model, our data suggest that progression from acute ethanol withdrawal to the more severe withdrawal associated with physical dependence following chronic ethanol exposure involves recruitment of neurons in the hippocampal formation, amygdala, and prelimbic cortex.

To our knowledge, these are the first studies to use c-Fos to identify the brain regions and neurocircuitry that distinguish between chronic and acute ethanol withdrawal severity using informative animal models.

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News Release - Nation’s Leading Experts on Substance Abuse Outline New Research Agenda to Reduce Multi-Billion Dollar Burden on Health Systems and Society

WASHINGTON , DC , October 2—With substance abuse now accounting for one in 14 hospital admissions and generating billions in health care costs, leading scientists held a briefing on Capitol Hill today to present the evidence that we already have and the evidence we need in treating and preventing the use and abuse of alcohol, drugs and tobacco.

Scientists affiliated with the Robert Wood Johnson Foundation’s (RWJF) Substance Abuse Policy Research Program (SAPRP) identified steps that federal, state and local governments could take now to reduce the $2 billion healthcare burden from alcohol, drugs, and tobacco use and abuse. They also provided a roadmap for research over the next five years to deal with future challenges in reducing substance abuse. . . . . .

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Commentary: Drinking age of 21 saves lives

By Toben F. Nelson, Traci L. Toomey and co-authors

The national policy that set a minimum legal drinking age of 21 is being questioned by a group of 35 college and university presidents through an effort called the Amethyst Initiative.

In a September 16 commentary on CNN.com, Amethyst Initiative leader John McCardell, a ormer president of Middlebury College, proposes lowering the drinking age, which he suggests ill lead to less drinking and related problems among college students.

History and a comprehensive review of the research tell a much different story. The evidence is lear, consistent and compelling: A drinking age of 21 has led to less drinking, fewer injuries and fewer deaths.

In the 1970s when many states reduced their drinking ages, drinking-related deaths among young people increased. When the drinking age of 21 was restored, deaths declined. This effect is not simply a historical artifact explained by advances in safety technology and other policies. . . . . . .

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Policies to Prevent Alcohol Problems:A Research Agenda for 2010-2015

The goal of alcohol prevention research is to reduce alcohol-involved problems at the family, neighborhood, community, state, and national levels. Alcohol problems are both acute (closely connected in time to the drinking event) and chronic (resulting from long-term exposure to thanol). Acute alcohol problems include (1) traffic crashes involving injury or death to the driver or others; (2) non-traffic injuries and fatalities, such as falls, fires, poisonings, or drowning, as well as violent events resulting from domestic conflict or public assaults in which ither the perpetrator or the victim has been drinking; and (3) the consequences of unprotected sex. Regular heavy consumption can lead to dependence and can substantially increase the risk of health problems, especially liver disease and certain cancers.

This research agenda for alcohol prevention should be viewed within the context of the “prevention paradox.” This paradox suggests that while alcohol dependent persons have the highest individual risk of alcohol problems, moderate and heavy nondependent drinkers account for more total alcohol problems, especially those of an acute nature, because there are o many more such drinkers compared to dependent drinkers. Therefore, a much wider public health perspective for policy research is essential, and this identification of research priorities has focused on alcohol-involved problems or high-risk drinking where the individual drinkers have not been identified by the recovery, treatment, or health screening systems. The biggest future challenge for alcohol policy research is population-level alcohol problem prevention (a public health perspective).

It is important to define alcohol policy. For the purposes of this document, alcohol policy at any level is aimed at reducing alcohol-involved problems; that is, the policy is used to produce changes in the drinking environment or setting. In turn, changes in the environment can cause changes in drinking behavior, such as drinking before or while driving, or underage drinking. Examples of alcohol policy approaches include establishing written policies and staff training for responsible alcoholic beverage service by a retail licensed establishment, or restrictions on local density and location of alcohol outlets. See reviews and discussions of alcohol policy effectiveness in Babor et al. (2003, in press), Wagenaar and Toomey (2000), and Toomey and Wagenaar (1999). These and other research reviews confirm that there is a considerable existing body of evidence concerning the effectiveness of specific national, state, and local alcohol policies.

The following summarizes key issues that should stimulate alcohol prevention policy research from 2010 to 2015. While many priorities exist and much more needs to be understood about the effectiveness of specific alcohol policies, the alcohol policy research priorities cited here reflect new or under-developed areas of research that are judged to be highly relevant to needed policy change. They are organized into domains identifying the highest alcohol policy research priorities at the international, national, state, provincial, and community levels.

I. International Trade Agreements

II. National/State/Provincial/Community Prevention

III. Retail Price of Alcohol

IV. Physical Availability of Alcohol

V. Prevention of Intoxication and Over-Service of Alcohol

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Sex Differences in Ethanol Intake and Sensitivity to Aversive Effects during Adolescence and Adulthood

Alcohol and Alcoholism Advance Access published online on September 19, 2009

The present experiments examined sex differences in ethanol intake and in the influence of a social context on aversive properties of ethanol in adolescent and adult Sprague-Dawley rats. Methods: Experiment 1 examined ethanol intake, with animals receiving daily 2-h access to ethanol and water for 8 days. Experiment 2 assessed the aversive effects of ethanol using a conditioned taste aversion (CTA) paradigm, with animals placed either alone or with a same-sex, same-age peer during the ethanol intoxication phase of conditioning.

These results suggest that age differences in ethanol intake in males and sex differences in intake during adolescence may be associated in part with the relative insensitivity of the male adolescents to ethanol's aversive properties, especially when intoxication occurred in a social context. However, the elevated ethanol intake observed in adult females relative to their male counterparts appears to be unrelated to the aversive properties of ethanol.

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Sexually Dimorphic Effects of Alcohol Exposure during Development on the Processing of Social Cues

Alcohol and Alcoholism Advance Access published online on September 19, 2009

The study used an animal model of fetal alcohol spectrum disorders (FASD) to investigate the impact of alcohol exposure during a period equivalent to all three trimesters in humans on social recognition memory. It was hypothesized that the effects on specific aspects of social recognition memory would be sexually dimorphic.

The results suggest that ethanol exposure during development caused a deficit in memory duration but not encoding in males and a deficit in encoding but not memory duration in females. The deficit in ethanol-exposed females may be related to changes in oxytocin receptors in the amygdala. .

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Gender Differences in Alcohol Impairment of Simulated Driving Performance and Driving-Related Skills

Alcohol and Alcoholism Advance Access published online on September 28, 2009

Considerable laboratory research indicates that moderate doses of alcohol impair a broad range of skilled activities related to driving performance in young adults. Although laboratory studies show that the intensity of impairment is generally dependent on the blood alcohol concentration, some reviews of this literature suggest that women might be more sensitive to the impairing effects of alcohol than men. The present study tested this hypothesis.

Alcohol significantly impaired all aspects of performance. Moreover, women displayed greater impairment than men on all behavioral tests and also reported higher levels of subjective intoxication compared with men.

Both biological and social–cultural factors have been implicated in gender differences in the behavioral responses to alcohol. The current evidence of heightened sensitivity to alcohol in women highlights the need for better understanding the biological and environmental factors underlying this gender difference.

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