Nearly Four Million California Adults Are Victims of Intimate Partner Violence

Nearly 1 in 6 adults in California, about 3.7 million persons, report experiencing physicalintimate partner violence (IPV) as adults. Over one million Californians were forced to have sex (5%) by an intimate partner during adulthood.

Overall, 17.2% of adults—nearly four million Californians—report being a victim of physical and/or sexual IPV as an adult (Exhibit 1). These acts of violence are not merely a criminal justice problem, but a public health problem with deep and lingering social, psychological and health-related costs.

Beyond the immediate trauma facing adult victims, IPV incidents may have a prolonged impact on the emotional and mental health of the victims, affect their ability to complete school or maintain employment, and result in adverse health behaviors to cope with the trauma, such as engaging in risky alcohol, tobacco or other drug use.

Violence that occurs between intimates or family members is especially damaging when it takes place in the presence of children; previous studies have shown that witnessing violence can lead to intergenerational cycles of violence.


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Alcohol blamed for kick-starting suicide bids

A new study has found that alcohol is to blame for most suicide attempts by overdosing.

Wellington Hospital emergency doctor Paul Quigley says at least 80 per cent of the 127 people who turned up at his emergency department last year after taking an overdose had alcohol as "the initiating agent".

Most (56 per cent) arrived at the weekend, mainly on the "party nights" of Friday and Saturday.

"When you analyse it, where their situation started from is the two bottles of wine they had to start with, or the four bottles of wine," he told the Alcohol Advisory Council's annual conference in Manukau yesterday. . . . . .

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Media Release - AER WELCOMES HENRY RECOMMENDATIONS ON ALCOHOL TAXATION ALCOHOL REFORM MUST BE PUT BACK ON THE FEDERAL GOVT AGENDA

The Alcohol Education and Rehabilitation Foundation (AER), Australia's leading alcohol harm minimisation body, today welcomed the Henry Review recommendations on alcohol taxation reform, but said it is disappointed with the Federal Government’s response. . . . . .

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Energized Alcohol

Vodka and Red Bull has been the choice of concert and club goers almost since it was launched in the U.S. back in 1997. With more than one billion cans sold worldwide every year, and a significant percentage of those mixed with booze, it was only a matter of time before enterprising liquors decided to spare us all the effort of mixing the two - bottling their own premixed energy drinks with varying amounts of alcohol. . . . . . .

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Treatment with Neuropeptides Attenuates c-fos Expression in a Mouse Model of Fetal Alcohol Syndrome

Fetal alcohol syndrome (FAS) is the most common nongenetic cause of mental retardation and is characterized by neurodevelopmental anomalies. C-fos is a cellular marker of transcriptional activity in the stress-signal pathway. Previously, we showed the treatment with NAP (NAPVSIPQ) + SAL (SALLRSIPA) reversed the learning deficit after prenatal alcohol exposure in FAS.

Our objective was to evaluate if the mechanism of actions of NAP + SAL involves the stress-signal pathway differentiating c-fos expression in mouse brains after prenatal alcohol exposure.

Adult treatment with NAP + SAL restored the down-regulation of c-fos in the hippocampus after prenatal alcohol exposure (p < class="ITALIC">c-fos expression in the cortex.

Adult treatment with NAP + SAL restored the down-regulation of c-fos expression in hippocampus attenuating the alcohol-induced alteration of the stress-signal pathway.

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Pen portraits: alcohol segmentation series report 4

To further understand population segmentation in alcohol misuse, the North West Public Health Observatory has published a series of four reports utilising segmentation tools to discuss alcohol consumption, attitudes and related admission.

The first three reports in the series discuss attitudes to alcohol consumption, consumption and related hospital admissions respectively.

This report, the fourth in the series, summarises the findings and presents them by classification in order to present an overview of the attitudes, consumption and harms experienced by each segmentation type.

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Alcohol-attributable hospital admission: segmentation series report 3

To further understand population segmentation in alcohol misuse, the North West Public Health Observatory has published a series of four reports utilising segmentation tools to discuss alcohol consumption, attitudes
and related admission.

This is the third report in the series and focuses on different types of alcohol-related hospital admissions.

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Alcohol consumption: segmentation series report 2

Approximately a fifth of the population in England are thought to drink at hazardous levels of consumption, and a further 5% at harmful levels. Such levels of consumption are associated with a wide range of health, crime and economic harms. However, neither consumption nor harms are universally experienced, and in order to effectively target interventions, it is vital to understand which populations are most at risk.

Segmentation tools are one way of doing this, allowing the grouping of populations by age, gender, lifestyle, attitude and motivation. To further understand population segmentation in alcohol misuse, the North West Public Health Observatory has published a series of four reports utilising segmentation tools to discuss alcohol consumption, attitudes and related admission.

This is the second report in the series and focuses on alcohol, consumption levels, quantities and types of drinks consumed.

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Attitudes to alcohol: segmentation report series 1

Approximately a fifth of the population in England are thought to drink at hazardous levels of consumption, and a further 5% at harmful levels. Such levels of consumption are associated with a wide range of health, crime and economic harms. However, neither consumption nor harms are universally experienced, and in order to effectively target interventions it is vital to understand which populations are most at risk.

Segmentation tools are one way of doing this, allowing the grouping of populations by age, gender, lifestyle, attitude and motivation. To further understand population segmentation in alcohol misuse, the North West Public Health Observatory has published a series of four reports utilising segmentation tools to discuss alcohol consumption, attitudes and related admission.

This is the first report in the series and focuses on attitudes and motivations around consumption. The second and third report discuss,consumption and hospital admissions respectively, whilst the fourth report in the series summarises the findings and presents them by classification in order to present an overview of the attitudes, consumption and harms experienced by each segmentation type.

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BRIEF ALCOHOL INTERVENTION RESEARCH AND PRACTICE—TOWARDS A BROADER PERSPECTIVE

The researchers who responded to my overview of brief alcohol intervention and implementation challenges for research and practice [1] seemed to agree with me on most issues. Perhaps there is little within this subject that is up ‘for debate’, then. Nevertheless, I would like to comment on some of the issues addressed by Allamani [2], Kaner [3] and Moyer & Finney [4]. . . . . .

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MEETING THE CHALLENGES FOR RESEARCH AND PRACTICE FOR BRIEF ALCOHOL INTERVENTION

Nilsen’s excellent essay [1] on remaining challenges in implementing brief intervention (BI) for hazardous and harmful drinkers calls for efforts to consider the context in which BIs occur, particularly at the organizational level, and to expand BI’s targets and reach. Here we note promising examples of steps toward meeting these challenges. . . . . . .

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UNEXPLORED TERRITORIES

The conclusions on future challenges for brief intervention (BI) research and for BI dissemination into practice [1], as well as the summary of key BI research findings that the text provides, raise some stimulating issues. As found in the past, a major consideration when interpreting research findings is the difference between northern and southern Europe regarding alcohol research [2], and particularly research into BIs. As the references Nilsen’s paper demonstrate, there is no published BI material generated in southern European countries, even if there are a few exceptions that focus upon primary health care [3–5] or emergency rooms [6]. This i due probably to a combination of both little tradition of alcohol studies and less concern about drinking in southern Europe, where the meaning of alcohol beverages, drinking patterns and presumably hazardous drinking is divergent from other European regions and Englishspeaking countries.

As a consequence, it is worth asking whether further research on the effectiveness of BI is needed for southern Europe,where such a cultural diversity in drinking exists. This may be particularly useful when ‘obtaining knowledge for . . . understanding . . . under what conditions’ BI implementation interventions may work. . . . . . .

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BRIEF ALCOHOL INTERVENTION: TIME FOR TRANSLATIONAL RESEARCH

Heavy drinking is the third greatest risk to public health in developed countries [1], although most of this risk is avoidable [2]. In the United Kingdom, a quarter of the population is affected adversely by their drinking behaviour [3]. Thus, preventing alcohol-related harm is a key public health imperative. This conclusion was reached by the World Health Organization (WHO) some 30 years ago, and it led to the emergence of screening and brief intervention techniques to help reduce heavy drinking. A veritable industry of research has ensued, and there have
now been more than 60 controlled trials of brief alcohol interventions spanning two decades [4,5]. Hence, Nilsen’s review [6] is a timely stock-take of this substantial evidence base and directions for future research and practice. . . . . .

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Brief alcohol intervention—where to from here? Challenges remain for research and practice

Brief intervention (BI) is intended as an early intervention for non-treatment-seeking, non-alcohol-dependent, hazardous and harmful drinkers.

This text provides a brief summary of key BI research findings from the last three decades and discusses a number of knowledge gaps that need to be addressed.

Five areas are described: patient intervention efficacy and effectiveness; barriers to BI implementation by health professionals; individual-level factors that impact on BI implementation; organization-level factors that impact on BI implementation; and society-level factors that impact on BI implementation.

BI research has focused largely upon the individual patient and health professional levels, with the main focus upon primary health care research, and studies are lacking in other settings. However, research must, to a larger degree, take into account the organizational and wider context in which BI occurs, as well as interaction between factors at different levels, in order to advance the understanding of how wider implementation of BI can be achieved in various settings and how different population groups can be reached.

It is also important to expand BI research beyond its current parameters to investigate more ambitious long-term educational programmes and new organizational models. More widespread implementation of BI will require many different interventions (efforts, actions, initiatives, etc.) at different interlinked levels, from implementation interventions targeting individual health professionals' knowledge, skills, attitudes and behaviours concerning alcohol issues,

BI and behaviour change counselling to efforts at the organizational and societal levels that influence the conditions for delivering BI as part of routine health care.

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Bioavailability in vivo of naltrexone following transbuccal administration by an electronically-controlled intraoral device: A trial on pigs.

Naltrexone (NLX), an opioid antagonist, is widely used in the treatment of opiate addiction, alcoholism and smoking cessation. Its current peroral administration induces various adverse side effects and has limited efficacy since bioavailability and patient compliance are poor. The development of a long-acting drug delivery system of NLX may overcome the current drawbacks and help in the improvement of treatment of addiction.

The primary endpoints of this study were: a) to compare the NLX bioavailability and pharmacokinetics after delivering a single transbuccal dose, released by a prototype of intraoral device, versus an intravenous (I.V.) bolus of the same drug dose; b) verify the functioning of a prototype of a new intraoral device in vivo; c) to evaluate the permeation enhancement effect of iontophoresis; d) to assess any histomorphological changes in the buccal mucosa after transbuccal delivery.

The system was tested on 6 pigs in a cross-over trial. Venous blood samples were drawn at a fixed timetable from the beginning of drug administration and analyzed for the presence of NLX, using an LC/MS/MS method. A punch biopsy was performed for histological analysis after the final experiment.

The administration of I.V. NLX induced a sharp increase in blood levels after 5 minutes and then a steep decrease. In contrast, transmucosal delivery resulted in a gradual increase in blood NLX levels, reaching its peak after 90 minutes, followed by a slow decrease. After 6 hours the blood levels of NLX delivered through the buccal mucosa were higher as compared to I.V. administration. No signs of flogosis or tissue damage were histologically highlighted.

These results suggest that buccal delivery by an intraoral electronic device could potentially induce long-lasting, continuous and controlled blood levels of NLX, avoiding at the same time spikes of drug plasma levels typical of the I.V. administration route.

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Differences in Substance Abuse Treatment Admissions between Mexican-American Males and Females

Among Mexican admissions, males reported alcohol as their primary substance of abuse more often than other substances, and females most commonly reported methamphetamine.

The majority of Mexican admissions reported that they first used their primary substance of abuse before the age of 18 (60.7 percent for males and 56.1 percent for females); overall, 7.4 percent reported using their first substance before the age of 12.

About three quarters of Mexican admissions had no health insurance (78.8 percent for males and 71.5 percent for females), a substantially higher proportion than non-Mexican admissions (62.6 percent for males and 50.9 percent for females).


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Evidence-based alcohol screening and brief intervention in Aboriginal Community Controlled Health Services: Experiences of health-care providers

Alcohol screening and brief intervention (SBI) is a cost-effective treatment for reducing alcohol misuse in non-Indigenous populations. To increase the likelihood of alcohol SBI proving cost-effective for Indigenous Australians in practice, strategies to increase its uptake in Aboriginal Community Controlled Health Services (ACCHSs) should be implemented.

The aim of this study is to describe the experiences of health-care providers supported to implement evidence-based alcohol SBI in two ACCHSs.

Pre- and post-surveys were administered to health staff (n = 32) participating in training workshops, followed by group interviews with health-care providers delivering alcohol SBI. Patient group interviews were also conducted. Survey results were summarised using descriptive statistics and interviews were analysed using a phenomenological approach.

Thirty-two per cent (n = 10) of workshop participants were confident or very confident at baseline to deliver alcohol SBI, increasing significantly to 81% (n = P < 25) post-training (McNemar Test,0.05). Fifty-seven per cent (n = 16) of health-care providers attending workshops reported delivering alcohol SBI in the following 6 months. Group interviews with health-care providers elicited five themes relating to their experiences of alcohol SBI delivery. Patients in group interviews expressed a preference to be screened for alcohol as part of health assessments.

Training workshops appear to be an acceptable initial strategy for disseminating alcohol SBI to ACCHSs. Outreach support is required to assist health-care providers to tailor guidelines and resources, and optimally integrate their clinical skills with evidence-based practice. Patients' needs should inform the tailoring process. Tailored collaborative and supportive strategies are probably required to optimally disseminate alcohol SBI in ACCHSs.

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Request Reprint E-Mail: a.shakeshaft@unsw.edu.au


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Comparison of Outcomes Among Moderate Alcohol Drinkers Before Acute Myocardial Infarction to Effect of Continued Versus Discontinuing Alcohol Intake

Light-to-moderate alcohol consumption has been previously associated with a lower risk of acute myocardial infarction (AMI) and mortality. The association of changes in drinking behavior after an AMI with health status and long-term outcomes is unknown.

Using a prospective cohort of patients with AMI evaluated with the World Health Organization's Alcohol Use Disorders Identification Test, we investigated changes in drinking patterns in 325 patients who reported moderate drinking at the time of their AMI. One-year alcohol consumption, disease-specific (angina pectoris and quality of life) and general (mental and physical) health status and rehospitalization outcomes, and 3-year mortality were assessed. Seattle Angina Questionnaire Angina Frequency and Quality of Life, Short Form-12 Mental and Physical Component Summary Scales were modeled using multivariable hierarchical linear models within site.

Of the initial 325 moderate drinkers at baseline, 273 (84%) remained drinking and 52 (16%) quit. In fully adjusted models, Physical Component Scale scores (beta 6.47, 95% confidence interval 3.73 to 9.21.

Persistent moderate drinkers had a trend toward less angina (relative risk 0.65, 95% confidence interval 0.39 to 1.10, p = 0.11), fewer rehospitalizations (hazard ratio 0.79, 95% confidence interval 0.44 to 1.41, p = 0.42), lower 3-year mortality (relative risk 0.75, 95% confidence interval 0.23 to 2.51, p = 0.64), and better disease-specific quality of life (Seattle Angina Questionnaire Quality of Life, beta 3.88, 95% confidence interval −0.79 to 8.55, p = 0.10) and mental health (Mental Component Scale, beta 0.83, 95% confidence interval −1.62 to 3.27, p = 0.51) than quitters.

In conclusion, these data suggest that there are no adverse effects for moderate drinkers to continue consuming alcohol and that they may have better physical functioning compared to those who quit drinking after an AMI.

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Use (and Misuse) of the Responsible Drinking Message in Public Health and Alcohol Advertising: A Review

The objective is to present a comparative analysis examining the alcohol industry’s and scholarly researchers’ use of the concept "responsible drinking."

Electronic databases associated with health, education, sociology, psychology, and medicine were the date sources. Results were limited to English, peer-reviewed articles and commentaries specifically addressing "responsible drinking." Search descriptors included responsible, responsibility, drinking, alcohol, brewer, and campaign. Eighteen articles constituted the final sample.
The matrix method was utilized to organize and abstract pertinent information.

Misunderstanding stemming from the inconsistency and counterintuitive nature of brewer-sponsored "responsible drinking" campaigns is further compounded by researchers’ use of the term and concept of "responsible drinking" in their scholarly reports.

In articulating the definition of "responsible drinking," researchers employ subjective notions and personal ideas, thus not differentiating the construct’s meaning from the one acquired in brewer-sponsored campaigns. Researchers are consistently inconsistent when identifying specific health measures that promote and/or contradict responsible alcohol consumption.

To evade the subjective notions of researchers and restrictive impressions attached by the alcohol industry, the manner in which individuals interpret, perceive, and practice responsible drinking must be systematically explored and examined using theoretically based constructs.


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DUI Offenders Delay License Reinstatement: A Problem?

We examined the extent to which driving under the influence (DUI) offenders delay reinstatement, the reasons for that delay, and the relationship of the delay to recidivism. Analyzed were the driving records of 40 million drivers (3 million convicted of DUI) from 7 of the largest states spanning 7 to 14 years. License suspension effectively reduces, but does not eliminate, impaired driving. Apparently, many feel they can avoid apprehension for unlicensed driving; the limited research to date suggests that up to 75% of convicted offenders continue to drive and up to 84% delay reinstatement for 3 or more years.

ANOVA and regression procedures were used to determine the relationship of prior driving record and sentence length to the DUI offender's delay in reinstatement. Meta-analysis was used to summarize results across the 7 states and survival analysis to determine the effect of the delay on recidivism.

Forty-two percent of first offenders and 55% of multiple offenders convicted for DUI delay reinstatement for more than a year. For a third of the offenders, there were no records of their having reinstated within 5 years of becoming eligible. Both factors—more than one prior offense and the length of suspension imposed—were related to delay in reinstatement. Offenders who delayed reinstatement were more likely to recidivate both while they delayed before reinstating and after they reinstated.

DUI offenders who delay reinstatement after they become eligible are high-risk drivers. Offenders who reinstate, however, have lower recidivism rates than those who do not. This suggests that encouraging reinstatement but with continued controls, as some states have provided through laws requiring interlocks as a condition of reinstatement, may be effective if they do not motivate extended delays.

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Physical Health and Drinking Among Medical Inpatients With Unhealthy Alcohol Use: A Prospective Study

Unhealthy alcohol use is common in medical inpatients, and hospitalization has been hypothesized to serve as a "teachable moment" that could motivate patients to decrease drinking, but studies of hospital-based brief interventions have often not found decreases. Evaluating associations between physical health and subsequent drinking among medical inpatients with unhealthy alcohol use could inform refinement of hospital-based brief interventions by identifying an important foundation on which to build them.

We tested associations between poor physical health and drinking after hospitalization and whether associations varied by alcohol dependence status and readiness to change.

Participants were medical inpatients who screened positive for unhealthy alcohol use and consented to participate in a randomized trial of brief intervention (n = 341). Five measures of physical health were independent variables. Outcomes were abstinence and the number of heavy drinking days (HDDs) reported in the 30 days prior to interviews 3 months after hospitalization. Separate regression models were fit to evaluate each independent variable controlling for age, gender, randomization group, and baseline alcohol use. Interactions between each independent variable and alcohol dependence and readiness to change were tested. Stratified models were fit when significant interactions were identified.

Among all participants, measures of physical health were not significantly associated with either abstinence or number of HDDs at 3 months. Having an alcohol-attributable principal admitting diagnosis was significantly associated with fewer HDDs in patients who were nondependent [adjusted incidence rate ratio (aIRR) 0.10, 95% CI 0.03–0.32] or who had low alcohol problem perception (aIRR 0.36, 95% CI 0.13–0.99) at hospital admission. No significant association between alcohol-attributable principal admitting diagnosis and number of HDDs was identified for participants with alcohol dependence or high problem perception.

Among medical inpatients with nondependent unhealthy alcohol use and those who do not view their drinking as problematic, alcohol-attributable illness may catalyze decreased drinking. Brief interventions that highlight alcohol-related illness might be more successful.

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Request Reprint E-Mail: emily.williams3@va.gov

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Role of the ghrelin system in alcoholism: Acting on the growth hormone secretagogue receptor to treat alcohol-related diseases

There exists a substantial need to identify new neuropharmacological targets to treat alcohol-dependent individuals. Ghrelin represents a gut-brain peptide, initially discovered as the endogenous ligand for the growth hormone secretagogue receptor (GHS-R).

The existing literature clearly demonstrates that ghrelin affects appetite and food intake. Both animal and human studies provide evidence that ghrelin not only influences hunger but also has a role in the search for rewarding substances, such as alcohol.

Animal studies provide evidence that ghrelin stimulates the reward system, acting on specific brain reward nodes, and that ghrelin signaling is required for stimulation of the reward system by alcohol.

Human studies show that ethanol acutely affects ghrelin levels. Interestingly, human studies with alcohol-dependent individuals suggest that higher ghrelin levels are associated with higher self-reported measurements of alcohol craving.

Altogether, these findings suggest that the ghrelin system plays a role in alcohol dependence. Ghrelin antagonists (i.e., GHS-R1a antagonists and/or inverse agonists) might affect alcohol-seeking behavior, thus having therapeutic potential in alcohol use disorders.

Future laboratory and clinical studies testing this hypothesis are warranted.


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Request Reprint E-Mail: Lorenzo_Leggio@brown.edu


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Maternal Alcohol Consumption during Pregnancy and Risk of Childhood Leukemia: Systematic Review and Meta-analysis

Leukemia is the most frequently occurring cancer in children. Although its etiology is largely unknown, leukemia is believed to result from an interaction between genetic and environmental factors. Among different potential risk factors, the possible role of maternal alcohol consumption during pregnancy has been questioned.

To assess the association between maternal alcohol consumption during pregnancy and childhood leukemia, a systematic review and meta-analysis of published studies was done.

Twenty-one case-control studies were included in categorical and dose-response meta-analyses. No cohort study was identified. Analyses were conducted by type of leukemia, children's age at diagnosis, and type of alcoholic beverage and trimester of pregnancy at alcohol use. Alcohol intake during pregnancy (yes versus no) was statistically significantly associated with childhood acute myeloid leukemia (AML) [odds ratio (OR), 1.56; 95% confidence interval (CI), 1.13-2.15] but not with acute lymphoblastic leukemia (OR, 1.10; 95% CI, 0.93-1.29). Heterogeneity between studies was observed. The OR of AML for an increase of a drink per week was 1.24 (95% CI, 0.94-1.64). The association of alcohol intake during pregnancy with AML was observed for cancers diagnosed at age 0 to 4 years (OR, 2.68; 95% CI, 1.85-3.89) in five studies without heterogeneity (I² ≤ 0.1%).

The results of case-control studies indicate that maternal alcohol consumption during pregnancy is associated with a significantly increased risk of AML in young children.

Avoidance of maternal alcohol drinking during pregnancy might contribute to a decrease in the risk of childhood AML.

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Request Reprint E-Mail: Paule.Martel@jouy.inra.fr

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A Differential Role for Neuropeptides in Acute and Chronic Adaptive Responses to Alcohol: Behavioural and Genetic Analysis in Caenorhabditis elegans P

Prolonged alcohol consumption in humans followed by abstinence precipitates a withdrawal syndrome consisting of anxiety, agitation and in severe cases, seizures. Withdrawal is relieved by a low dose of alcohol, a negative reinforcement that contributes to alcohol dependency. This phenomenon of ‘withdrawal relief’ provides evidence of an ethanol-induced adaptation which resets the balance of signalling in neural circuits.

We have used this as a criterion to distinguish between direct and indirect ethanol-induced adaptive behavioural responses in C. elegans with the goal of investigating the genetic basis of ethanol-induced neural plasticity.

The paradigm employs a ‘food race assay’ which tests sensorimotor performance of animals acutely and chronically treated with ethanol.

We describe a multifaceted C. elegans ‘withdrawal syndrome’. One feature, decrease reversal frequency is not relieved by a low dose of ethanol and most likely results from an indirect adaptation to ethanol caused by inhibition of feeding and a food-deprived behavioural state.

However another aspect, an aberrant behaviour consisting of spontaneous deep body bends, did show withdrawal relief and therefore we suggest this is the expression of ethanol-induced plasticity.

The potassium channel, slo-1, which is a candidate ethanol effector in C. elegans, is not required for the responses described here. However a mutant deficient in neuropeptides, egl-3, is resistant to withdrawal (although it still exhibits acute responses to ethanol). This dependence on neuropeptides does not involve the NPY-like receptor npr-1, previously implicated in C. elegans ethanol withdrawal. Therefore other neuropeptide pathways mediate this effect.

These data resonate with mammalian studies which report involvement of a number of neuropeptides in chronic responses to alcohol including corticotrophin-releasing-factor (CRF), opioids, tachykinins as well as NPY.

This suggests an evolutionarily conserved role for neuropeptides in ethanol-induced plasticity and opens the way for a genetic analysis of the effects of alcohol on a simple model system.


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Use of Alcoholic Beverages and Other Psychoactive Substances Among Women in Turkey: Medical, Biological, and Social Consequences. A Pilot Study

This research was planned for determining the genitourinary health problems of alcohol and other psychoactive substance-dependent women.

This research was conducted using a descriptive method at the Alcohol-Substance Research, Treatment and Education Center (ASRTEC). The research sample comprised 126 women who presented at ASRTEC clinic between September 15, 2006 and March 15, 2007, and were diagnosed as being alcohol/drug dependent according to DSM-IV. The data were collected using an Addicted Women's Genitourinary Health Evaluation Form and the Arizona Sexual Experiences Scale.

In this study 37.3% of the women were alcohol dependent and 62.7% were substance dependent. It was determined that alcohol and other psychoactive substance-dependent women experience a high rate of genitourinary health problems, such as unprotected sexual intercourse with multiple partners, irregular menstrual cycles, sexual dysfunction, unwanted pregnancies, and abortions.

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Request Reprint E-Mail: umranoskay@yahoo.com


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Social anxiety disorder and alcohol use disorder co-morbidity in the National Epidemiologic Survey on Alcohol and Related Conditions

To assess the prevalence and clinical impact of co-morbid social anxiety disorder (SAD) and alcohol use disorders (AUD, i.e. alcohol abuse and alcohol dependence) in a nationally representative sample of adults in the United States.

Lifetime prevalence of co-morbid AUD and SAD in the general population was 2.4%. SAD was associated with significantly increased rates of alcohol dependence [odds ratio (OR) 2.8] and alcohol abuse (OR 1.2).

Among respondents with alcohol dependence, SAD was associated with significantly more mood, anxiety, psychotic and personality disorders. Among respondents with SAD, alcohol dependence and abuse were most strongly associated with more substance use disorders, pathological gambling and antisocial personality disorders.

SAD occurred before alcohol dependence in 79.7% of co-morbid cases, but co-morbidity status did not influence age of onset for either disorder. Co-morbid SAD was associated with increased severity of alcohol dependence and abuse. Respondents with co-morbid SAD and alcohol dependence or abuse reported low rates of treatment-seeking.

Co-morbid lifetime AUD and SAD is a prevalent dual diagnosis, associated with substantial rates of additional co-morbidity, but remaining largely untreated. Future research should clarify the etiology of this co-morbid presentation to better identify effective means of intervention.

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Request Reprint E-Mail: bgrant@willco.niaaa.nih.gov

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Alcohol Consumption During Pregnancy and Risk of Placental Abruption and Placenta Previa

The purpose of this study was to examine the association between prenatal alcohol consumption and the occurrence of placental abruption and placenta previa in a population-based sample.

We used linked birth data files to conduct a retrospective cohort study of singleton deliveries in the state of Missouri during the period 1989 through 2005 (n = 1,221,310). The main outcomes of interest were placenta previa, placental abruption and a composite outcome defined as the occurrence of either or both lesions. Multivariate logistic regression was used to generate adjusted odd ratios, with non-drinking mothers as the referent category.

Women who consumed alcohol during pregnancy had a 33% greater likelihood for placental abruption during pregnancy (adjusted odds ratio (OR), 95% confidence interval (CI) = 1.33 [1.16–1.54]). No association was observed between prenatal alcohol use and the risk of placenta previa. Alcohol consumption in pregnancy was positively related to the occurrence of either or both placental conditions (adjusted OR [95% CI] = 1.29 [1.14–1.45]).

Mothers who consumed alcohol during pregnancy were at elevated risk of experiencing placental abruption, but not placenta previa.

Our findings underscore the need for screening and behavioral counseling interventions to combat alcohol use by pregnant women and women of childbearing age.

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Request Reprint E-Mail: hamisu.salihu@gmail.com


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News Release - Tackling the three main killers on the roads: countries progress – but too slowly

5 May 2010 - Today ETSC(1) has launched its 16th Road Safety PIN(2) Flash(3) measuring EU countries’ progress since 2001 in tackling excessive speed, drink driving and non-use of seat belts which remain the three main killers on EU roads. This update comes at a crucial time when the EU is discussing its priorities for the forthcoming EU Road Safety Action Programme for the next ten years. . . . . .

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PURCHASING PATTERNS FOR LOW PRICE OFF SALES ALCOHOL : EVIDENCE FROM THE EXPENDITURE AND FOOD SURVEY.

Key points summary

• all income groups purchase low price off sales alcohol (figures 1 and 6).

• the relationship between income group and the amount of alcohol purchased at the cheapest price (below 30p a unit) is not straightforward. Although the lowest income group buys more than the highest at this price, there is little difference between the middle income groups and the lowest (figure 2).

• at prices of 30p to 40p and 40p to 50p the amount purchased tends to increase with income (figures 3 and 4).

• middle-to-higher income groups are the main purchasers of alcohol priced between 30p and 50p (figure 5).

• for individual alcohol types (beer, lager, table wine and spirits), the lowest income groups purchase less than the average number of units below 30p and below 40p (figure 7)

• low income households are less likely to purchase off sales alcohol at all (table 2 and figure 8)


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ADH1B*3 and Response to Alcohol in African-Americans

Variations in the alleles for the alcohol-metabolizing enzymes have been shown to influence risk for alcohol dependence. One variant, ADH1B*3, is observed almost exclusively in populations of African ancestry and has been shown to be associated with reduced rates of alcohol dependence. We conducted an alcohol challenge study to test whether ADH1B*3 is associated with differences in subjective and physiological response to alcohol.

We administered a moderate dose of alcohol (0.72 g/kg for males, 0.65 g/kg for females) to a sample of African-American young adults (n = 91; ages 21 to 26). Participants were genotyped for ADH1B, as well as additional polymorphisms that might contribute to alcohol response. Breath alcohol concentration, self-reported sedation and stimulation, and pulse rate were assessed prior to alcohol administration and for 2.5 hours following administration.

ADH1B*3 was associated with higher levels of sedation and a sharper increase in pulse rate immediately following alcohol consumption.

These findings suggest that the lower rates of alcohol dependence in those with ADH1B*3 alleles may be because of differences in alcohol response, particularly increased sedation.

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Request Reprint E-Mail: mccarthydm@missouri.edu

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Genes Associated With Alcohol Abuse and Tobacco Smoking in the Human Nucleus Accumbens and Ventral Tegmental Area

The incidence of alcohol and tobacco co-abuse is as high as 80%. The molecular mechanism underlying this comorbidity is virtually unknown, but interactions between these drugs have important implications for the development of and recovery from drug dependence.

We investigated the effects of chronic tobacco and alcohol abuse and the interaction of the 2 behaviors on global gene expression in the human nucleus accumbens using cDNA microarrays and 20 alcoholic and control cases, with and without smoking comorbidity. Changes in gene expression were established by factorial ANOVA. Unsupervised hierarchical clustering was utilized to probe the strength of the data sets. Applying real-time PCR differential expression of candidate genes was confirmed in the nucleus accumbens and explored further in a second core region of the mesolimbic system, the ventral tegmental area.

Subjecting the data sets derived from microarray gene expression screening to unsupervised hierarchical clustering tied the cases into distinct groups. When considering all alcohol-responsive genes, alcoholics were separated from nonalcoholics with the exception of 1 control case. All smokers were distinguished from nonsmokers based on similarity in expression of smoking-sensitive genes. In the nucleus accumbens, alcohol-responsive genes were associated with transcription, lipid metabolism, and signaling. Smoking-sensitive genes were predominantly assigned to functional groups concerned with RNA processing and the endoplasmic reticulum. Both drugs influenced the expression of genes involved in matrix remodeling, proliferation, and cell morphogenesis. Additionally, a gene set encoding proteins involved in the canonical pathway "regulation of the actin cytoskeleton" was induced in response to alcohol and tobacco co-abuse and included. Alcohol abuse elevated the expression of candidate genes in this pathway in the nucleus accumbens and ventral tegmental area, while smoking comorbidity blunted this induction in the ventral tegmental area.

The region-specific modulation of alcohol-sensitive gene expression by smoking may have important consequences for alcohol-induced aberrations within the mesolimbic dopaminergic system.

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Rquest Reprint E-Mail: t.flatscher-bader@uq.edu.au

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Binge Drinking in African American Males From Adolescence to Young Adulthood: The Protective Influence of Religiosity, Family Connectedness, and Close

We examined the contribution of culturally relevant protective factors (i.e., adolescent religiosity, family connectedness, and perceived close friends’ substance use) to the probability of young adult binge drinking among African American males.

Participants (n = 1,599) drawn from the National Longitudinal Study of Adolescent Health were high school age adolescents (14–18 years, M = 16) at Wave 1 and young adults (18–26, M = 22) at Wave 3.

Adolescent binge drinking was associated with all three protective factors. Perceived close friends’ substance use in adolescence was a protective factor in later binge drinking during young adulthood, and was moderated by age such that the effect was stronger for younger adolescents.

Implications for culturally relevant research and prevention are discussed.

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Request Reprint E-Mail: danelle.sw@gmail.com.

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Adolescent Propensity to Engage in Health Risky Behaviors: The Role of Individual Resilience

In this paper we create indices of resilience to identify adolescents at risk of smoking, drinking alcohol, and using illegal drugs.

Using data from the National Longitudinal Study of Adolescent Health, three manifestations of resilience were identified: overall-resilience, self/family-resilience, and self-resilience.

Our analysis reveals that the overall-resilient were less likely to engage in risky behaviors. The self/family resilient were more likely to engage in risky behaviors, but consumed less.

The self-resilient had reduced risk for smoking and drinking alcohol but elevated risk for using illegal drugs and being in an addictive stage of smoking and drinking, if participating.

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News Release - Scientists Find Genes That Influence Brain Wave Patterns

Scientists have identified new genes and pathways that influence an individual’s typical pattern of brain electrical activity, a trait that may serve as a useful surrogate marker for more genetically complex traits and diseases. One of the genes, for example, was found to be associated with alcoholism.

A report of the findings by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, appears online this week in the Proceedings of the National Academy of Sciences. . . . . . .

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Is It Important to Prevent Early Exposure to Drugs and Alcohol Among Adolescents?

Exposure to alcohol and illicit drugs during early adolescence has been associated with poor outcomes in adulthood. However, many adolescents with exposure to these substances also have a history of conduct problems, which raises the question of whether early exposure to alcohol and drugs leads to poor outcomes only for those adolescents who are already at risk.

In a 30-year prospective study, we tested whether there was evidence that early substance exposure can be a causal factor for adolescents' future lives.

After propensity-score matching, early-exposed adolescents remained at an increased risk for a number of poor outcomes. Approximately 50% of adolescents exposed to alcohol and illicit drugs prior to age 15 had no conduct-problem history, yet were still at an increased risk for adult substance dependence, herpes infection, early pregnancy, and crime.

Efforts to reduce or delay early substance exposure may prevent a wide range of adult health problems and should not be restricted to adolescents who are already at risk.

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Driving under the influence of alcohol: Examining ethno-specific rates and the mediating effects of psychological distress and harmful and problematic

This paper examines ethnic disparities in rates of driving under the influence of alcohol (DUIA) in a representative sample of Ontario adults. Data were drawn from the Centre for Addiction and Mental Health (CAMH) Monitor, a survey of 8276 Ontario adults aged 18 and older.

We considered 19 distinct ethnic groups based on participants’ self-identification of ethno-cultural heritage. Differences in the prevalence of DUIA across ethnic groups were limited. Relative to other ethnic groups, those adults who identified as Irish had a significantly higher rate of DUIA, while those of Italian and Chinese ethnicity had significantly lower rates of DUIA.

The mediating effects of psychological distress (General Health Questionnaire) and harmful and problematic drinking (Alcohol Use Disorders Identification Test [AUDIT] consumption, dependence and problems) on the direct relationship between ethnic identity and impaired driving were also considered. Mediation was observed as remaining ethnic differences in DUIA disappeared when AUDIT subscales were introduced.

These findings are interpreted in the context of patterns of alcohol consumption among ethnic populations and their impact on DUIA.

Implications of study findings are considered with respect to the role of ethnicity in impaired driving research and its impact on programs and policies directed at reducing impaired driving.

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Request Reprinrt E-Mail: Mark.Asbridge@dal.ca

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A population-based study on the prevalence and correlates of drinking and driving in Hong Kon

To examine the prevalence and correlates of drinking and driving in Hong Kong, an anonymous, random telephone survey was conducted on 9860 Chinese adults (18–70 years of age) from April to June 2006. Trained interviewers administered a structured interview consisting of questions on socio-demographic information, drinking pattern, drink-driving, and motor vehicle accidents.

The census age-standardized past-year prevalence of driving within 2 h of drinking was 5.2% among males and 0.8% among females. The prevalence across age showed an inverted U-shaped trend for males peaking at 8.2% between 41 and 45 years. For females the prevalence was fairly stable between the ages of 20 and 55.

The past-year prevalence of alcohol-related motor vehicle accidents was 0.1%, with the majority being in the 26–30 age group. For males who drank, the prevalence of drinking and driving was 5.0% among those without problem drinking, 14.8% among binge drinkers, 37.1% among alcohol abusers and 22.4% among the alcohol dependent. For females who drank, the corresponding figures were all lower at 1.2%, 6.9%, 12.1% and 12.5%, respectively.

Higher socio-economic status, weekly drinking, binge drinking and alcohol abuse were independently associated with higher likelihood of drinking and driving in both genders. Among drinking drivers, having a job that required drinking was the only predictor of having had a motor vehicle accident.

The elevated prevalence of drinking and driving among alcohol abusers, binge drinkers and the alcohol dependent may portend higher population-level rates of alcohol-related motor accidents in the future since the prevalence of problem drinking has previously been noted to be increasing rapidly in Hong Kong.

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Request Reprint E-Mail: siangriffiths@cuhk.edu.hk


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