To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.


Saturday, May 1, 2010

Working together to reduce harmful drinking - Google Books

This book is intended to contribute to the World Health Organization's (WHO) global strategy to reduce the harmful use of alcohol.

It explores areas where alcohol producers' technical competence can and does make a positive contribution to reducing harmful drinking and where industry input has been welcomed by WHO.

The book describes each of these areas: producing beer, wine, and spirits; addressing availability of noncommercial beverages; pricing, marketing, and selling beverage alcohol; encouraging responsible choices; and working with others. The final chapter sets out views of how alcohol producers can contribute to reducing harmful drinking in countries where they are present.

The messages recurring throughout the book are that reasonable regulation provides the context for good alcohol policy, excessive regulation often leads to unintended negative consequences, leading producers have a proud record of making positive contributions to implementing effective alcohol policies' but there are opportunities to do much more.

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Paying the tab: the economics of alcohol policy - Google Books

What drug provides Americans with the greatest pleasure and the greatest pain? The answer, hands down, is alcohol. The pain comes not only from drunk driving and lost lives but also addiction, family strife, crime, violence, poor health, and squandered human potential. Young and old, drinkers and abstainers alike, all are affected. Every American is paying for alcohol abuse.

Paying the Tab, the first comprehensive analysis of this complex policy issue, calls for broadening our approach to curbing destructive drinking. Over the last few decades, efforts to reduce the societal costs--curbing youth drinking and cracking down on drunk driving--have been somewhat effective, but woefully incomplete.

In fact, American policymakers have ignored the influence of the supply side of the equation. Beer and liquor are far cheaper and more readily available today than in the 1950s and 1960s. Philip Cook's well-researched and engaging account chronicles the history of our attempts to "legislate morality," the overlooked lessons from Prohibition, and the rise of Alcoholics Anonymous. He provides a thorough account of the scientific evidence that has accumulated over the last twenty-five years of economic and public-health research, which demonstrates that higher alcohol excise taxes and other supply restrictions are effective and underutilized policy tools that can cut abuse while preserving the pleasures of moderate consumption.

Paying the Tab makes a powerful case for a policy course correction. Alcohol is too cheap, and it's costing all of us.

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Truth About Addiction and Recovery - Google Books

In this revolutionary analysis of addiction, Peele and Brodsky draw on years of research to refute the contention that addictions are biologically based diseases that last a lifetime. Examining addiction within the context of people's lives, they show that addictive behavior is a way of coping with situational stress--and that it can be overcome without medical treatment or 12-step groups.

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Commentary on Britton et al. (2010): The dangers of declining drink

The real significance of the Britton et al. [1] paper is overlooked by the authors themselves. Alcohol intake varies in the same individuals over time, declining with increasing age in many countries [2–7]. This decline has been shown to occur among those individuals most vulnerable to morbidity and mortality [8–10]. People most likely to be stable in their drinking—the light or moderate drinkers—tend to have the most favourable health characteristics [11,12]. Britton et al. acknowledge these findings by stating that it is well established that the nondrinking group often includes former drinkers who terminated consumption due to ill health. . . . . .

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Commentary on Kelly et al. (2010): Alcoholics Anonymous, alcoholism recovery, global health and quality of life

Scientific studies to evaluate the effectiveness of Alcoholics Anonymous (AA) have increased significantly in number and methodological sophistication [1]. Early AA studies focused narrowly on drinking outcomes, but more recent studies reflect growing interest in the effects of AA participation on the larger arenas of emotional/behavioral health and quality of life [2–4].

Current efforts to define recovery for research and clinical purposes similarly include the elements of global health and citizenship in addition to the resolution of alcohol and other drug problems [5]. These trends are congruent with AA’s view of itself.

A central tenet of AA is that recovery from alcoholism involves far more than the removal of alcohol from an otherwise unchanged life. AA’s 12 Steps and core concepts within the culture of AA (e.g. dry drunk, emotional sobriety, spiritual awakening) convey a vision of recovery as a radical transformation in character, identity and interpersonal relationships. AA’s ‘promises’ speak not of an escape from drunkenness but from fear, selfishness, self-pity and regret and the acquisition of freedom, happiness, serenity, peace, confidence and authentic connection to others [6].

Kelly et al. [7] have added to the literature of the effects of AA on global health through their study of changes in depression as a mediator of the influence of AA participation on drinking outcomes. The authors begin with two foundational points: (1) depression can predate the onset of alcohol use disorders (AUD), be exacerbated by AUD or emerge as a consequence of AUD; and (2) depression constitutes an obstacle to recovery and a risk factor for relapse following recovery initiation.

Kelly and colleagues’ finding that AA participation alters drinking patterns (via increased abstinence and lowered intensity and duration of relapse episodes), in part, by decreasing negative affect and depression adds an important new contribution to the existing literature on mechanisms of change in AA. They also add nuance to the question of whether factors such as decreased depression are peripheral outcomes of changes in drinking behavior or the driving force behind changes in drinking behavior. The lagged design of this study allows a clearer suggestion of causation related to the latter influence. Hopefully, future studies of mechanisms of change in AA will similarly distinguish mediators of change from outcomes of change. . . . . . .

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Population Differences in Dysmorphic Features Among Children With Fetal Alcohol Spectrum Disorders

To examine the variation in significant dysmorphic features in children from 3 different populations with the most dysmorphic forms of fetal alcohol spectrum disorders, fetal alcohol syndrome (FAS), and partial fetal alcohol syndrome (PFAS).

Advanced multiple regression techniques are used to determine the discriminating physical features in the diagnosis of FAS and PFAS among children from Northern Plains Indian communities, South Africa, and Italy.

Within the range of physical features used to identify children with fetal alcohol spectrum disorders, specifically FAS and PFAS, there is some significant variation in salient diagnostic features from one population to the next. Intraclass correlations in diagnostic features between these 3 populations is 0.20, indicating that about 20% of the variability in dysmorphology core features is associated with location and, therefore, specific racial/ethnic population. The highly significant diagnostic indicators present in each population are identified for the full samples of FAS, PFAS, and normals and also among children with FAS only.

A multilevel model for these populations combined indicates that these variables predict dysmorphology unambiguously: small palpebral fissures, narrow vermillion, smooth philtrum, flat nasal bridge, and fifth finger clinodactyly. Long philtrum varies substantially as a predictor in the 3 populations. Predictors not significantly related to fetal alcohol spectrum disorders dysmorphology across the 3 populations are centile of height (except in Italy) strabismus, interpupilary distance, intercanthal distance, and heart murmurs.

The dysmorphology associated with FAS and PFAS vary across populations, yet a particular array of common features occurs in each population, which permits a consistent diagnosis across populations.

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An Incomplete-Data Quasi-Likelihood Approach to Haplotype-Based Genetic Association Studies on Related Individuals

We propose an incomplete-data, quasi-likelihood framework for estimation and score tests that accommodates both dependent and partially observed data. The motivation comes from genetic association studies, where we address the problems of estimating haplotype frequencies and testing association between a disease and haplotypes of multiple, tightly linked genetic markers, using case-control samples containing related individuals.

We consider a more general setting in which the complete data are dependent with marginal distributions following a generalized linear model. We form a vector, Z, whose elements are conditional expectations of the elements of the complete-data vector, given selected functions of the incomplete data. Assuming that the covariance matrix of Z is available, we create an optimal linear estimating function based on Z, which we solve by an iterative method.

This approach addresses key difficulties in haplotype frequency estimation and testing problems in related individuals: (a) dependence that is known but can be complicated; (b) data that are incomplete for structural reasons, as well as possibly missing, with different amounts of information for different observations; (c) the need for computational speed to analyze large numbers of markers; and (d) a well-established null model but an alternative model that is unknown and is difficult to specify fully in related individuals.

For haplotype analysis, we give sufficient conditions for consistency and asymptotic normality of the estimator and asymptotic χ2 null distribution of the score test.

We apply the method to test for association of haplotypes with alcoholism in the GAW 14 COGA data set.

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An Association Test for Multiple Traits Based on the Generalized Kendall’s Tau

In many genetics studies, especially in the investigation of mental illness and behavioral disorders, it is common for researchers to collect multiple phenotypes to characterize the complex disease of interest. It may be advantageous to analyze those phenotypic measurements simultaneously if they share a similar genetic mechanism.

In this study, we present a nonparametric approach to studying multiple traits together rather than examining each trait separately. Through simulation we compared the nominal Type I error and power of our proposed test to an existing test, that is, a generalized family-based association test.

The empirical results suggest that our proposed approach is superior to the existing test in the analysis of ordinal traits.

The advantage is demonstrated on a dataset concerning alcohol dependence. In this application, the use of our methods enhanced the signal of the association test.

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Handbook of Implicit Cognition and Addiction - Google Books

For the first time, research on implicit cognitive processes relevant for the understanding of addictive behaviors and their prevention or treatment is brought together in one volume! The Handbook of Implicit Cognition and Addiction features the work of an internationally renowned group of contributing North American and European authors who draw together developments in basic research on implicit cognition with recent developments in addiction research. Editors Reinout W. Wiers and Alan W. Stacy examine recent findings from a variety of disciplines including basic memory and experimental psychology, experimental psychopathology, emotion, and neurosciences.

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Association of Polymorphisms in RGS4 and Expression of RGS transcripts in the Brains of Human Alcoholics

Chronic alcoholism leads to neurotoxic effects in the central nervous system. Neuroadaptive changes in the brain may lead to tolerance to, and dependence on, alcohol as a result of alterations in synaptic complexity. G-proteins are negatively regulated by RGS proteins, which are integral to many neural pathways that include neurotransmission, hormonal responses, and chemotactic signals.

These considerations, together with findings from microarray analyses of human autopsy brain, suggest that proteins involved in G-protein signalling, specifically the RGS protein family, may play an important role in the functioning of neural systems that are affected by chronic alcohol abuse.

We used Real Time PCR to measure the expression of two members of the RGS family, RGS4 and RGS7, in the superior frontal gyrus and primary motor cortex from alcoholic and non-alcoholic cases.

Overall, cirrhotic alcoholics had lower expression levels of RGS4 mRNA than controls and non-cirrhotic alcoholics.

We also report that the fourRGS4 SNPs (SNP1, 4, 7 and 18) may be associated with alcoholism in European Caucasians at the haplotype level.

The haplotype T-C-G (SNP1-4-18) may exert a protective effect against alcoholism.

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Zolmitriptan and human aggression: interaction with alcohol

The serotonin 1B/D (5-HT1B/D) receptor has shown potential as a target for decreasing aggression. The 5-HT1B/D agonist zolmitriptan's ability to reduce aggressive behavior in humans and its interaction with the well-known aggression-enhancing drug alcohol were examined.

Our objective was to investigate zolmitriptan's potential to modify human aggression in a laboratory paradigm across a range of alcohol doses. Alcohol has been consistently associated with aggression and violence, thus we hoped to expand current understanding of alcohol's role in aggressive behavior via manipulation of the serotonin (5-HT) system

Eleven social drinkers, seven male, were recruited to participate in a research study lasting 3–4 weeks. Aggression was measured using the point-subtraction aggression paradigm (PSAP), a laboratory model widely used in human aggression studies. Subjects were administered 5-mg zolmitriptan and placebo capsules along with alcohol doses of 0.0, 0.4 and 0.8 g/kg in a within-subject, counterbalanced dosing design. Data were analyzed as the ratio of aggressive/monetary-earning responses, to account for possible changes in overall motor function due to alcohol.

There was a significant alcohol by zolmitriptan interaction on the aggressive/monetary response ratio. Specifically, compared to placebo, zolmitriptan decreased the aggressive/monetary ratio at the 0.4- and 0.8-g/kg alcohol doses.

A 5-mg dose of zolmitriptan effectively reduced alcohol-related aggression in an acute dosing protocol, demonstrating an interaction of 5-HT and alcohol in human aggressive behavior.

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Ethanol and general anesthetics are widely used drugs, but the mechanism of action of these compounds has remained uncertain despite intensive study. Biochemical and electrophysiological experiments have shown that these compounds alter the function of a large variety of receptors, ion channels, transporters and second messenger systems at physiological concentrations. Yet, the contribution of any of these potential targets to the intoxicating or behavioral effects of the drugs is unclear. Unbiased forward genetic screens for resistant or hypersensitive mutants represent an attractive means of identifying the relevant molecular targets or biochemical pathways mediating the behavioral effects of neuroactive compounds.

C. elegans has proven to be a particularly
useful system for such studies. The behavioral effects of ethanol and certain general anesthetics occur at equivalent tissue concentrations in mammals and in C. elegans, suggesting the existence of conserved drug targets in the nervous system.

This chapter reviews the results of studies directed toward determining the mechanisms of action of ethanol and general anesthetics. Studies of the neural adaptations that occur with prolonged drug exposure are also discussed. The methods used to characterize the actions of ethanol and anesthetics should be applicable to the characterizations of other compounds that affect the behavior of C. elegans.

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Friday, April 30, 2010

Substance use among secondary school students in an urban setting in Nigeria: prevalence and associated factors

Substance use continues to be major risk behaviour among youth, with consequent physical and /or mental health
complications. The current study aimed to establish the prevalence and associated factors of substance use among selected secondary school students in Lagos.

A total of 402 students were studied - of whom 43.5% (n=175)
were males and 56.5% (n=227) females. The mean age was 15.9 years. 83.1% (n=334) lived with their parents, 7.6% (n=31) with their\ relatives and 7.2% (n=29) with friends.

The commonest substances used by the subjects were caffeine (kolanut and coffee), mild
analgesics (paracetamol and aspirin) and the antimalarials, most especially chloroquine with lifetime use prevalence rates of 85.7%, 73.8% and 65.7% respectively. Generally, the prevalence rates for lifetime use of the substances varied from 3.8% (n=14) for Heroin and Cocaine to 85.7% (n=344) for psychostimulants; and for current use varying from 2% (n=8)to 56.5% (n= 213).

For the so called
“gateway drugs”: alcohol and tobacco, their lifetime use prevalence rates were 9.2% (n=34) and 5.2% (n=19) while the lifetime use prevalence rate for cannabis was 4.4% (n=16). In terms of gender, the prevalence rates for males were generally higher than for their female counterparts except for antibiotics, analgesics, heroin and cocaine.

Reasons for using substances included relief from stress,
43.5% (n=175), self medication to treat illness, 23.8% (n=96), and to stay awake at night to study, 14.9% (n=60).

use was found to be prevalent among students in this study involving over-the-counter and socially acceptable substances as well as the abuse of illicit substances. It is advocated that there is a need to review existing health educational programmes.

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Alcohol use patterns among Brazilian adults.

To describe patterns of alcohol consumption in the adult Brazilian population.

Multicluster random sample of 2,346 subjects 18 years of age or older, selected nationwide. Interviews were conducted in respondents' homes between November 2005 and April 2006

About 48% of the sample had not drunk alcoholic beverages in the past year, with variations by gender, age, marital status, education, income and region of the country. Among drinkers, 29% reported drinking 5 or more drinks per occasion (men, 38%). Sociodemographic variables are associated with the frequency and amount of drinking, alcohol problems, and alcohol abuse and dependence. Among the whole sample (including drinkers and non drinkers), 28% reported binge drinking, 25% reported at least one kind of alcohol related problem, 3% were alcohol abusers and another 9% were alcohol dependent.

Abstinence is high in the Brazilian population. However, elevated proportions of those who drink consume alcohol in a high risk pattern (binge-drinking), report a high level of alcohol problems, alcohol abuse and dependence. National public policies must consider these factors, as well as the regional Brazilian differences.

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Ethanol-induced activation of AKT and DARPP-32 in the mouse striatum mediated by opioid receptors

The reinforcing properties of ethanol are in part attributed to interactions between opioid and dopaminergic signaling pathways, but intracellular mediators of such interactions are poorly understood.

Here we report that an acute ethanol challenge induces a robust phosphorylation of two key signal transduction kinases, AKT and DARPP-32, in the striatum of mice. Ethanol-induced AKT phosphorylation was blocked by the opioid receptor antagonist naltrexone but unaffected by blockade of dopamine D2 receptors via sulpiride. In contrast, DARPP-32 phosphorylation was abolished by both antagonists.

These data suggest that ethanol acts via two distinct but potentially synergistic striatal signaling cascades. One of these is D2-dependent, while the other is not.

These findings illustrate that pharmacology of ethanol reward is likely more complex than that for other addictive drugs.

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Decreased beta2*-nicotinic acetylcholine receptor availability after chronic ethanol exposure in nonhuman primates

Ethanol associated behaviors have been linked to the 2-subunit containing nicotinic acetylcholine receptors (2*-nAChR); however, there is conflicting evidence on ethanol-induced changes in nAChR expression during and after chronic ethanol consumption.

In this study, five male animals orally self-administered ethanol for 18 ± 1 weeks. Animals were scanned with [
123I]5-IA-85380 and SPECT prior to ethanol self-administration, and at 24 h and 5-13 wks withdrawal.

2 *-nAChR availability was not significantly different from baseline at 24 h withdrawal, but was significantly decreased compared to baseline at 5-13 wks withdrawal throughout the cortex and in the thalamus, but not the midbrain.

The percent decrease in
2*-nAChR availability from baseline to 5-13 wks withdrawal in the parietal cortex was negatively correlated with total grams of ethanol consumed in lifetime and in the midbrain was negatively correlated with average daily ethanol consumption (g/kg).

Prolonged withdrawal from chronic ethanol consumption is associated with a decrease in
2*-nAChR availability.

The decrease in
2*-nAChR availability is influenced by alcohol consumption, suggesting the chronicity and severity of alcohol consumption may underlie persistent changes in 2*-nAChR availability.

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Thursday, April 29, 2010

0% drink driving (resolution)

That this meeting of RCN Congress urges Council to lobby for legislation which reduces to zero the permissible level of alcohol intake before driving.

As statistics show an increasing number of deaths or serious injuries related to drink-driving incidents, Carol Evans from the Cambridgeshire branch urged members to consider the need to change the law to reduce the permissible level of alcohol intake before driving to zero. She highlighted the public’s confusion surrounding the number of units currently allowed but noted that most people choose their drink not based on units but rather on colour, price and taste.

The resolution was seconded by Andy Frazer from the RCN Emergency Care Association who told members that in his work he had seen the results of many drink driving incidents. “You wouldn’t drink two pints of beer before going to work?” he asked Congress delegates, “a car is potentially a lethal weapon,” he warned. . . . . .

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NTA release national alcohol statistics report

'From 1st April 2008, the Department of Health commissioned the NTA to collect and analyse alcohol treatment data on its behalf using the NDTMS. This subset of the NDTMS is known as the National Alcohol Treatment Monitoring System (NATMS). NATMS forms a key part of The Department’s Alcohol Improvement Programme.

Download the NATMS Annual Statistical report 2008/2009

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A Comparison of Two Different Approaches to Characterizing the Heterogeneity Within Antisocial Behavior: Age-of-Onset versus Behavioral Sub-Types

There are two common approaches to sub-typing the well-documented heterogeneity within antisocial behavior: age-of-onset (i.e., child-onset versus adolescent-onset; see Moffitt, 1993) and behavioral (i.e., physical aggression versus nonaggressive rule-breaking).

These approaches appear to be intimately connected, such that aggression is particularly characteristic of child-onset antisocial behavior whereas rule-breaking is largely specific to adolescent-onset antisocial behavior (see Moffitt, 2003). Even so, it remains unclear which approach, if either, substantively drives these different manifestations of antisocial behavior.

We examined this question in a sample of 1,726 adults in treatment for alcoholism, evaluating the two approaches in regards to their prediction of anger and alcohol dependency.

Although age-of-onset predicted both outcomes when analyzed alone, these associations fully dissipated once we controlled for aggression and rule-breaking.

Such findings suggest that the behavioral sub-types may prove to be a stronger predictor of antisocial behavior outcomes than is age-of-onset.

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Physical functional health predicts the incidence of coronary heart disease in the European Prospective Investigation into Cancer-Norfolk prospective

Little is known about the relationship between physical functional health and long-term risk of coronary heart disease (CHD) independently of known risk factors in a general population.

Men and women aged 40–79 years at baseline who completed a health and lifestyle questionnaire and attended a health examination during 1993–97 participating in the European Prospective Investigation into Cancer-Norfolk who were free of myocardial infarction (MI), stroke and cancer were included. Eighteen months later, physical functional health was assessed using physical component summary (PCS) scores of Short-Form 36-item questionnaire (SF-36). The incidence of CHD was ascertained by death certification and hospital record linkage up to March 2008.

A total of 14 222 men and women were included in the study. There were 389 incident CHD (total person-years = 126 896 years). People who reported better physical functional health had significantly lower risk of CHD. Using Cox proportional hazard models adjusting for age, sex, body mass index, cholesterol, systolic blood pressure, smoking, alcohol consumption, physical activity, diabetes, family history of MI, social class and aspirin usage, it was found that men and women who were in the top quartile of SF-36 PCS had half the risk of CHD [relative risk (RR) = 0.46; 95% confidence interval (CI) = 0.32–0.65] compared with the people in the bottom quartile. The relationships remained essentially unchanged after excluding incident CHD within the first 2 years of follow-up (RR = 0.48; 95% CI = 0.33–0.70).

Physical functional health predicts subsequent CHD risk independently of known risk factors in a general population. People with poor physical functional health may benefit from targeted preventive interventions.

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B.C. announces ‘toughest’ drunk-driving laws in country

Two years ago, four-year-old Alexa Middelaer was killed by an alleged drunk driver as she fed a horse on a road in Delta. Yesterday her mother, Laurel Middelaer, hugged B.C.’s solicitor general and thanked him for a “gutsy” new law to make British Columbia the worst place in the country to get caught driving while impaired.

Solicitor General Mike de Jong said the law introduced yesterday honours the memory of Alexa by aiming to reduce the number of drunk driving fatalities by a third in the next three years.

“We need penalties that are clear, swift and severe,” Mr. de Jong said on the steps of the legislature, flanked by a dozen uniformed police officers, top officials from Mothers against Drunk Driving, and Alexa’s parents.

The new law, which will take effect this fall, gives police the authority to impose tougher roadside penalties for drivers who refuse a breath sample or are found with a blood alcohol level over the legal limit of 0.08 per cent. Drivers face an immediate, 90-day driving ban and a $500 fine plus their vehicle can be impounded for 30 days. They may also face criminal charges.

The new rules also create a “warning” category for drivers with blood alcohol levels between 0.05 and 0.08 per cent. Penalties include an immediate, three-day driving ban and a $200 fine for a first-time offence.

In both cases, drivers will pay more to restore their driving privileges, up to $3,750 following any roadside suspension. . . . . .

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Industry cool on proposals to restrict alcohol sales

THE DRINKS industry has expressed concern about new proposals to restrict the sale of alcohol which are emerging as part of the Government’s strategy for tackling substance abuse.

Draft proposals being examined by the steering group include minimum prices for alcoholic drinks, new charges on retailers selling large volumes and laws requiring alcohol to be sold separately from other products, The Irish Times understands.

The plans are being drawn up by the National Substance Misuse Strategy Steering Group, which the Government set up last year to draw up a new approach for dealing with alcohol misuse along the lines of actions being taken under the National Drugs Strategy. . . . . .

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Wednesday, April 28, 2010

Genome-wide association identifies candidate genes that influence the human electroencephalogram

Complex psychiatric disorders are resistant to whole-genome analysis due to genetic and etiological heterogeneity.

Variation in resting electroencephalogram (EEG) is associated with common, complex psychiatric diseases including alcoholism, schizophrenia, and anxiety disorders, although not diagnostic for any of them. EEG traits for an individual are stable, variable between individuals, and moderately to highly heritable.

Such intermediate phenotypes appear to be closer to underlying molecular processes than are clinical symptoms, and represent an alternative approach for the identification of genetic variation that underlies complex psychiatric disorders.

We performed a whole-genome association study on alpha (α), beta (β), and theta (θ) EEG power in a Native American cohort of 322 individuals to take advantage of the genetic and environmental homogeneity of this population isolate.

We identified three genes (
SGIP1, ST6GALNAC3, and UGDH) with nominal association to variability of θ or α power.

SGIP1 was estimated to account for 8.8% of variance in θ power, and this association was replicated in US Caucasians, where it accounted for 3.5% of the variance. Bayesian analysis of prior probability of association based upon earlier linkage to chromosome 1 and enrichment for vesicle-related transport proteins indicates that the association of
SGIP1 with θ power is genuine.

We also found association of
SGIP1 with alcoholism, an effect that may be mediated via the same brain mechanisms accessed by θ EEG, and which also provides validation of the use of EEG as an endophenotype for alcoholism.

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Moderate Ethanol Preconditioning of Rat Brain Cultures Engenders Neuroprotection Against Dementia-Inducing Neuroinflammatory Proteins: Possible Signal

There is no question that chronic alcohol (ethanol) abuse, a leading worldwide problem, causes neuronal dysfunction and brain damage.

However, various epidemiologic studies in recent years have indicated that in comparisons with abstainers or never-drinkers, light/moderate alcohol consumers have lower risks of age-dependent cognitive decline and/or dementia, including Alzheimer’s disease (AD). Such reduced risks have been variously attributed to favorable circulatory and/or cerebrovascular effects of moderate ethanol intake, but they could also involve ethanol “preconditioning” phenomena in brain glia and neurons.

Here we summarize our experimental studies showing that moderate ethanol preconditioning (MEP; 20–30 mM ethanol) of rat brain cultures prevents neurodegeneration due to β-amyloid, an important protein implicated in AD, and to other neuroinflammatory proteins such as gp120, the human immunodeficiency virus 1 envelope protein linked to AIDS dementia.

The MEP neuroprotection is associated with suppression of neurotoxic protein-evoked initial increases in [Ca+2]i and proinflammatory mediators—e.g., superoxide anion, arachidonic acid, and glutamate.

Applying a sensor → transducer → effector model to MEP, we find that onset of neuroprotection correlates temporally with elevations in “effector” heat shock proteins (HSP70, HSP27, and phospho-HSP27). The effector status of HSPs is supported by the fact that inhibiting HSP elevations due to MEP largely restores gp120-induced superoxide potentiation and subsequent neurotoxicity.

As upstream mediators, synaptic N-methyl-d-aspartate receptors may be initial prosurvival sensors of ethanol, and protein kinase C epsilon and focal adhesion kinase are likely transducers during MEP that are essential for protective HSP elevations.

Regarding human consumption, we speculate that moderate ethanol intake might counter incipient cognitive deterioration during advanced aging or AD by exerting preconditioning-like suppression of ongoing neuroinflammation related to amyloidogenic protein accumulation.

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Childhood antecedents of adult violent offending in a group of female felons

The purpose of this study was to evaluate potential antecedents of violent felony arrest in a sample of female felons.

Among male populations, early onset conduct disorder (CD) with progression to adult anti-social personality disorder (ASPD) is associated with increased criminality and aggression. Conduct disorder is associated with a worsened trajectory of alcohol dependence in men. These factors likely have a synergistic contribution to male adult violent offending.

Existing work suggests that CD, ASPD, and severe alcohol dependence may represent an externalizing endophenotype, which is, at least in part, genetically conferred. These associations have not been well studied in female populations.

The author examined a sample (
N = 130) of female mid-sentence felons to determine associations between adult arrest for violent felony with child and young adult antecedents, including CD and alcohol dependence. Data were gathered through administration of the Semi-Structured Assessment for the Genetics of Alcoholism II (SSAGA II).

CD had high prevalence (40.8%), as did ASPD (31.4%) and alcohol dependence (43.8%). Women convicted of violent felonies were more likely to have CD with progression to ASPD, and alcohol dependence. Both alcohol dependence and CD were independently associated with violent offending.

These data suggest that the most serious female offenders have psychopathology similar to that of males and that the trajectory of disease and etiology of violent behavior may not be as gender specific as previously presumed.

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Combined effect of alcohol consumption and lifestyle behaviors on risk of type 2 diabetes

It has been suggested that the inverse association between alcohol and type 2 diabetes could be explained by moderate drinkers’ healthier lifestyles.

We studied whether moderate alcohol consumption is associated with a lower risk of type 2 diabetes in adults with combined low-risk lifestyle behaviors.

We prospectively examined 35,625 adults of the Dutch European Prospective Investigation into Cancer and Nutrition (EPIC-NL) cohort aged 20–70 y, who were free of diabetes, cardiovascular disease, and cancer at baseline (1993–1997). In addition to moderate alcohol consumption (women: 5.0–14.9 g/d; men: 5.0–29.9 g/d), we defined low-risk categories of 4 lifestyle behaviors: optimal weight [body mass index (in kg/m2) >30 min of physical activity/d), current nonsmoker, and a healthy diet [upper 2 quintiles of the Dietary Approaches to Stop Hypertension (DASH) diet].

During a median of 10.3 y, we identified 796 incident cases of type 2 diabetes. Compared with teetotalers, hazard ratios of moderate alcohol consumers for risk of type 2 diabetes in low-risk lifestyle strata after multivariable adjustments were 0.35 (95% CI: 0.17, 0.72) when of a normal weight, 0.65 (95% CI: 0.46, 0.91) when physically active, 0.54 (95% CI: 0.41, 0.71) when nonsmoking, and 0.57 (95% CI: 0.39, 0.84) when consuming a healthy diet.

When ≥3 low-risk lifestyle behaviors were combined, the hazard ratio for incidence of type 2 diabetes in moderate alcohol consumers after multivariable adjustments was 0.56 (95% CI: 0.32, 1.00).

In subjects already at lower risk of type 2 diabetes on the basis of multiple low-risk lifestyle behaviors, moderate alcohol consumption was associated with an {approx}40% lower risk compared with abstention.

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UK remains amongst top EU countries for binge drinking

A report 'EU citizens’ attitudes towards alcohol' has been released, continuing to show the UK and Ireland in particular as having the highest reported rates of binge drinking (EU definition* of five drinks or more on any one occasion). According to the report:

'Alcohol consumption in the EU is at a similar level to four years ago. Binge drinking (five drinks or more on any one occasion) affects all ages but young people aged 15-24 years are the most likely to binge drink every week.' . . . .

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Media Release - Study: Victorians aren’t aware alcohol causes cancer Call on

Call on govt review panel for better alcohol labelling

VIC: Research released today shows half of all Victorians don’t realise that alcohol causes cancer, prompting the Alcohol Policy Coalition to call for health advisory labels on all alcohol products to better inform consumers.

The Council of Australian Governments is today holding a public meeting in Melbourne to discuss overhauling Australia’s food and alcohol labelling laws.

“People need to know what they are drinking and how it can impact their health so that they can make an informed decision about the drinks they purchase and consume,” said Craig Sinclair, Director of the Cancer Prevention Centre, Cancer Council Victoria.

The VicHealth survey of 1,500 Victorians showed one in four people don’t believe that alcohol is a cause of cancer, while another twenty-five percent said they weren’t sure. . . . . .

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Tuesday, April 27, 2010

Prevalence of alcohol abuse and alcoholism in general population of Mostar region, Bosnia and Herzegovina.

The aim of this study was to determine the prevalence of alcohol abuse and alcoholism in the general population of Mostar region, Bosnia and Herzegovina.

This study was conducted on a stratified sample of 704 participants. The prevalence of alcohol abuse was determined using standardized questionnaire on alcohol consumption--Michigan Alcoholism Screening Test.

Prevalence of alcohol abuse with high risk for alcoholism was 9.9% and prevalence of alcohol addiction was 2.1%. In student population, there were 3.9% of alcohol addicts and 11.1% of persons with high risk of alcoholism. In high school population, there were 1.7% of alcohol addicts and 14.4% of persons with high risk of alcoholism.

In Mostar region there was a high prevalence of alcoholism and problematic drinking, especially in high school and student population.

There is a need for extensive preventive measures that have to include education, early diagnosis and intervention.

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Alcohol Taxes and Birth Outcomes

This study examines the relationships between alcohol taxation, drinking during pregnancy, and infant health.

Merged data from the US Natality Detailed Files, as well as the Behavioral Risk Factor Surveillance System (1985–2002), data regarding state taxes on beer, wine, and liquor, a state- and year-fixed-effect reduced-form regression were used.

Results indicate that a one-cent ($0.01) increase in beer taxes decreased the incidence of low-birth-weight by about 1–2 percentage points. The binge drinking participation tax elasticity is −2.5 for beer and wine taxes and −9 for liquor taxes.

These results demonstrate the potential intergenerational impact of increasing alcohol taxes.

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Socio-economic status predicts drinking patterns but not alcohol-related consequences independently

To identify independent relationships between socio-economic status and drinking patterns and related consequences and to identify socio-economic groups at risk for heavier consumption.

Three comparable national telephone surveys were utilized: 1995, 2000 and 2004. The respondents were aged 18–65 years. Contextual information includes that a number of liberalized alcohol policy changes occurred over the time of the surveys.

Educational qualification, income and occupation were associated independently with alcohol consumption. There were indications that the different dimensions of drinking (quantity and frequency) had different relationships with socio-economic status (SES). For example, lower SES groups drank heavier quantities while higher SES groups drank more frequently. SES, however, did not play a major role predicting drinking consequences once drinking patterns were controlled for, although there were some exceptions. It was the lower-to-average SES groups that were at greater risk for drinking heavier quantities compared to other SES groups in the population (as they had sustained increases in the quantities they consumed over time where other SES groups did not).

Socio-economic status was related independently to drinking patterns and there re indications that SES interacted differently with the different dimensions of drinking (quantity and frequency). For the most part, socio-economic status was not related independently to the experience of alcohol-related consequences once drinking patterns were accounted for. It was the lower-to-average SES groups that were at greater risk for drinking heavier quantities compared to other SES groups in the population.

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Striatal Dysfunction Marks Preexisting Risk and Medial Prefrontal Dysfunction Is Related to Problem Drinking in Children of Alcoholics

Parental alcoholism substantially raises risk for offspring alcoholism, an effect thought to be mediated by a dysregulation in impulse control. Adult alcoholics have alterations in the frontostriatal system involved in regulating impulsive responses. However, it remains controversial whether these alterations reflect preexisting traits predisposing to problem alcohol use or are secondary to alcohol involvement.

Sixty-one 16 to 22 year olds were tested using a go/no-go task during functional magnetic resonance imaging. Forty-one were family history positive (FH+), having at least one parent with a diagnosis of alcohol use disorder (AUD), and 20 were family history negative (FH−). Two FH+ subgroups were created to disentangle alcohol involvement from preexisting risk: the FH+ control group (n = 20) had low alcohol problems, differing from the FH– group only by family history. The FH+ problem group (n = 21) had high alcohol problems.

The ventral caudate deactivated during successful inhibition in the FH– but not the FH+ groups, regardless of problem alcohol involvement. Regression analyses showed that ventral caudate deactivation was related to fewer externalizing problems as well as to family history. Orbital and left medial prefrontal regions were deactivated in both the FH– and FH+ control groups but not the FH+ problem group. Activation in these regions was associated with alcohol and other drug use.

These findings suggest a preexisting abnormality in ventral striatal function in youth at risk for AUD, which may lead to inappropriate motivational responding, and suggest that with alcohol use, the prefrontal “control” mechanism loses efficiency, further dysregulating the frontostriatal motivational circuitry.

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Monday, April 26, 2010

The Impacts of Liquor Outlets in Manukau City Summary Report

There has been significant recent debate over the impact of liquor outlets on communities in New

This report summarises the key results from a research project undertaken between 2008
and 2010.

Media analysis and research with community stakeholders confirm that the issue is a focus
of concern among communities in New Zealand.

In Manukau City, off-licence liquor outlets tend to be
located in areas of high social deprivation and high population density, while on-licence liquor outlets tend to be located in main centres and areas of high amenity value. Higher off-licence density is associated with lower alcohol prices and longer opening hours.

The density of both off-licence and onlicence
liquor outlets is associated with a range of social harms, including various police events and motor vehicle accidents.

However, these results are context specific and care should be taken in
applying them to other locations.

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Alcohol In Our Lives: Curbing the Harm

'Alcohol In Our Lives: Curbing the Harm' (NZLC R114, Wellington 2010) is the Commission’s final report on the review of New Zealand’s liquor laws. The terms of reference for the review required the Commission to consider a broad range of issues including: the adequacy of the current liquor licensing laws; alcohol taxation and pricing; advertising; age restrictions and the responsibilities of parents with respect to adolescent drinking.

The report contains 153 recommendations to Government and is divided into four parts. Part 1 summarises the public consultation findings and outlines the case for legal reform; Part 2 sets out the detailed framework for a new licensing system; Part 3 deals with alcohol taxation and pricing and the promotion of alcohol and Part 4 addresses alcohol offences, education and treatment.

The 32 page extracted Summary of the full report can be downloaded separately.

A limited number of hardcopies are available for purchase. The Report was tabled in Parliament on 27 April 2010. Review of the Regulatory Framework for the Sale and Supply of Liquor Submissions Analysis

A separate report on the 2,939 public submissions on the Commission’s Issues Paper, ('Alcohol In Our Lives' (NZLC IP15, Wellington 2009) is also available. This 48 page report prepared by independent consultants, Litmus, contains an analysis of all 2,939 submissions across seven key policy areas: licensing; opening hours; purchase/drinking age; off-licences; tax and price; advertising and drinking in a public place. It also contains an in depth analysis of different stakeholder positions across the full range of policy options.

The policies analysed in this report are those that were put forward as provisional options for public debate in the Commission’s Issues Paper published in July 2009.

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Report recommends 10pc rise in alcohol price

Raising the price of alcohol by 10 per cent and closing bars and restaurants by 4am are among a raft of recommendations to the Government made by the Law Commission.

The Commission's report, tabled in Parliament at midday, also included the anticipated recommendation of raising the alcohol purchasing age to 20.

Labelling alcohol reform as a "social battleground", the Law Commission has made 153 recommendations to the Government on liquor law reforms.

The Commission analysed the current liquor licensing system, alcohol pricing and promotions, the responsibility of parents and the negative effects of alcohol on health and crime statistics. . . . . .

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Influence of Individual and Combined Health Behaviors on Total and Cause-Specific Mortality in Men and Women

Physical activity, diet, smoking, and alcohol consumption have been shown to be related to mortality. We examined prospectively the individual and combined influence of these risk factors on total and cause-specific mortality.

The prospective cohort study included 4886 individuals at least 18 years old from a United Kingdom–wide population in 1984 to 1985. A health behavior score was calculated, allocating 1 point for each poor behavior: smoking; fruits and vegetables consumed less than 3 times daily; less than 2 hours physical activity per week; and weekly consumption of more than 14 units of alcohol (in women) and more than 21 units (in men) (range of points, 0-4). We examined the relationship between health behaviors and mortality using Cox models and compared it with the mortality risk associated with aging.

During a mean follow-up period of 20 years, 1080 participants died, 431 from cardiovascular diseases, 318 from cancer, and 331 from other causes. Adjusted hazard ratios and 95% confidence intervals (CIs) for total mortality associated with 1, 2, 3, and 4 poor health behaviors compared with those with none were 1.85 (95% CI, 1.28-2.68), 2.23 (95% CI, 1.55-3.20), 2.76 (95% CI, 1.91-3.99), and 3.49 (95% CI, 2.31-5.26), respectively (P value for trend, <.001). The effect of combined health behaviors was strongest for other deaths and weakest for cancer mortality. Those with 4 compared with those with no poor health behaviors had an all-cause mortality risk equivalent to being 12 years older.

The combined effect of poor health behaviors on mortality was substantial, indicating that modest, but sustained, improvements to diet and lifestyle could have significant public health benefits.

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A European study on alcohol and drug use among young drivers: the TEND by Night study design and methodology

Young individuals are the age group with the highest risk of car accidents. One of main explanations relies on the use of psychoactive substances (alcohol, illegal and medicinal drugs), which are known to be major risk factors of road accidents, and whose consumption is almost universally more common among younger drivers. Although the correlation between psychoactive substances use and decrease in driving performance has been established in controlled experimental or laboratory settings, few studies were conducted in naturalistic circumstances. The TEND by Night project has been designed to evaluate the relationship between driving performance and psychoactive substances assumption in young drivers enrolled at typical places of consumption.

The TEND by Night project, endorsed by the European Commission, is a multidisciplinary, multi-centric, cross-sectional study conducted in six European countries (Italy, Belgium/Netherlands, Bulgaria, Spain, Poland and Latvia). The study population consists of 5000 young drivers aged 16-34 years, attending recreational sites during weekend nights. The intervention is based on the portal survey technique and includes several steps at the entrance and exit of selected sites, including the administration of semi-structured questionnaires, breath alcohol test, several drug assumption test, and measurement of the reaction time using a driving simulator. The main outcome is the difference in reaction time between the entrance and exit of the recreation site, and its correlation with psychoactive substances use. As a secondary outcome it will be explored the relationship between reaction time difference and the amount of consumption of each substance. All analyses will be multivariate.

The project methodology should provide some relevant advantages over traditional survey systems. The main strengths of the study include the large and multicentric sample, the objective measurement of substance assumption (which is typically self-reported), the application of a portal survey technique and the simultaneous evaluation of several psychoactive substances.

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Early Adoption of Injectable Naltrexone for Alcohol-Use Disorders: Findings in the Private-Treatment Sector

The U.S. substance-abuse treatment system has been slow to adopt medications for the treatment of alcohol-use disorders (AUDs).

The objectives of this study are to (a) determine how the inherent characteristics of injectable naltrexone (i.e., relative advantage, complexity, trialability, observability, compatibility) shape organizational-level decisions to adopt the medication and (b) identify key predictors of adoption and barriers that impede adoption.

This study uses data from a nationally representative sample of 345 privately funded U.S. substance-abuse treatment programs to examine adoption (current use) of injectable naltrexone.

Sixteen percent of private treatment programs are early adopters of injectable naltrexone. Multivariate logistic regression models reveal that organizational size and percentage of patients paying with private insurance are significant predictors of adoption. The most salient predictor of adoption is innovation compatibility, measured by program use of other AUD pharmacotherapies. Barriers to adoption include cost, lack of access to prescribing physicians, and lack of knowledge about the medication. Injectable naltrexone, however, is addressing the patient compliance barrier, demonstrated by 70% of patients receiving at least 2 months of medication.

The adoption of AUD pharmacotherapies remains low, with only half of the sampled programs prescribing any AUD pharmacotherapies. Patterns of early adoption of injectable naltrexone are, however, promising. Results highlight innovation compatibility and relative advantage as explanations of organizational decisions to adopt injectable naltrexone.

Future research will move beyond issues of adoption and provide a more detailed examination of the implementation process.

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