Aims

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.

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Saturday, August 14, 2010

Substate Estimates from the 2006-2008 National Surveys on Drug Use and Health


This report presents estimates of the prevalence of substance use in substate regions based on data from the combined 2006-2008 National Surveys on Drug Use and Health (NSDUHs).

An annual survey of the civilian, noninstitutionalized population aged 12 or older,
NSDUH is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). It collects information from persons residing in households, noninstitutionalized group quarters (e.g., shelters, rooming houses, dormitories), and civilians living on military bases.

In 2006-2008, NSDUH collected data from 204,408 respondents aged 12 or older and was
designed to obtain representative samples from all 50 States and the District of Columbia. The survey was planned and managed by SAMHSA's Office of Applied Studies (OAS), and data collection was conducted under contract with RTI International.

This report marks the fourth time that detailed estimates for substate regions (also referred to as planning regions, substate areas, or regions) in all 50 States and the District of Columbia have been presented by SAMHSA. The first report to provide such estimates used data from the 1999-2001 surveys (OAS, 2005b). The second report presented estimates for 22 measures or outcomes based on the 2002-2004 NSDUHs (OAS, 2006). The third report presented estimates for 23 measures or outcomes based on the 2004-2006 NSDUHs (OAS, 2008).

This report presents estimates for 21 measures of substance use based on the 2006-2008
NSDUHs among persons 12 or older.

Additionally, it presents estimates for underage (12 to 20)
alcohol use and binge alcohol use.

These reports provide a more detailed perspective on the
variations in substance use rates both within and across States than is possible with State reports (e.g., Hughes, Muhuri, Sathe, & Spagnola, 2010; Hughes, Sathe, & Spagnola, 2009).



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Alcohol consumption and harm among elderly Europeans: falling between the cracks


The ageing of Europe means that the absolute number of older Europeans with alcohol use disorders will rise and the consequences of these changes must be considered early. However, little is currently known about the health, social and economic impacts of alcohol consumption by this cohort. We do know that the elderly are more sensitive to alcohol’s negative health effects compared to younger adults and are more prone to fall injuries. Research also suggests that alcohol use disorders among the elderly are frequently misdiagnosed or overlooked. > > > >


Request Reprint E-Mail: mats.hallgren@ki.se

Prevalence and correlates of DSM-IV alcohol abuse and dependence in Australia: findings of the 2007 National Survey of Mental Health and Wellbeing


To report nationally representative data on the prevalence and correlates (including psychiatric comorbidity and treatment) of DSM-IV alcohol abuse and dependence in Australian adults.

The 2007 National Survey of Mental Health and Wellbeing (NSMHWB).

Australian nationally representative household survey.

8841 Australian adults (16–85 years).

Interview schedule that assessed symptoms of the most prevalent DSM-IV mental disorders in the life-time and the past 12 months.

Prevalence of life-time and 12-month disorders was 18.3% and 2.9% for alcohol abuse and 3.9% and 1.4% for alcohol dependence. Current alcohol abuse and dependence was significantly more common in males and younger adults. There were significant associations between current alcohol use and other drug use disorders (OR 18.2) and between anxiety disorders and alcohol use disorders (OR 2.6). Only 22.4% of those with alcohol use disorders were treated for their alcohol disorder.

Alcohol use disorders are highly prevalent, especially among young adult males. Comorbidity between anxiety and other drug use disorders is common and remains a significant challenge for the delivery of effective health-care services and treatment. The low rate of effective interventions for alcohol problems is a significant public health concern


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Request Reprint E-Mail: m.teesson@unsw.edu.au

Estimating the Socioeconomic Costs of Alcohol Drinking Among Adolescents in Korea


The purpose of this study was to estimate the socioeconomic costs resulting from alcohol drinking among adolescents as of 2006 from a societal perspective.

The costs were classified into direct costs, indirect costs, and other costs. The direct costs consisted of direct medical costs and direct non-medical costs. The indirect costs were computed by future income losses from premature death, productivity losses from using medical services and reduction of productivity from drinking and hangover. The other costs consisted of property damage, public administrative expenses, and traffic accident compensation.

The socioeconomic costs of alcohol drinking among adolescents as of 2006 were estimated to be 387.5 billion won (0.05% of GDP). In the case of the former, the amount included 48.25% for reduction of productivity from drinking and hangover, 39.38% for future income losses from premature death, and 6.71% for hangover costs.

The results showed that the socioeconomic costs of alcohol drinking among adolescents in Korea were a serious as compared with that of the United States. Therefore, the active interventions such as a surveillance system and a prevention program to control adolescents drinking by government and preventive medicine specialist are needed.


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Request Reprint E-Mail: lsm8711@nhic.or.kr

Naloxone Blocks Ethanol-Mediated Appetitive Conditioning And Locomotor Activation In Adolescent Rats


Age-related differences in ethanol sensitivity could put adolescents at risk for developing alcohol-related problems. Little information exists, however, about adolescent sensitivity to ethanol's appetitive effects and the neurobiological mechanisms underlying ethanol reinforcement during this developmental stage.

The present study assessed the role of the opioid system in adolescent rats in an appetitive second-order schedule of ethanol reinforcement and ethanol-induced locomotor stimulation.

On postnatal day 32 (PD32), animals were pretreated with the general opioid antagonist naloxone (0.0, 0.75, 1.50, or 2.5 mg/kg) and then given pairings of ethanol (0.0 or 2.0 g/kg, intragastrically) with intraoral pulses of water (conditioned stimulus 1 [CS1], first-order conditioning phase). CS1 delivery occurred 30-45 min after ethanol administration when the effect of ethanol was assumed to be appetitive.

On PD33, adolescents were exposed to CS1 (second-order conditioning phase) while in a chamber featuring distinctive exteroceptive cues (CS2). Preference for CS2 was then tested.

Adolescents given CS1-ethanol pairings exhibited greater preference for CS2 than controls, indicating ethanol-mediated reinforcement, but only when not pretreated with naloxone. Blood alcohol levels during conditioning were not altered by naloxone. Experiment 2 revealed that ethanol induced locomotor activation soon after administration, and naloxone dose-dependently suppressed this stimulating effect.

The present study indicates that adolescent rats are sensitive to ethanol's reinforcing and locomotor-stimulating effects. Both effects of ethanol appear to be mediated by endogenous opioid system activation.


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Request Reprint E-Mail: rpautassi@gmail.com

Contingency management treatments: controversies and challengesadd_2879 1507..


Contingency management (CM) refers to a behavioral therapy in which tangible positive reinforcers are provided to individuals who misuse substances contingent
upon objective evidence of abstinence. Usually, reinforcers are chances to win prizes of varying magnitudes or vouchers, exchangeable for retail goods and services. CM interventions have substantial evidence of efficacy in reducing drug use across a range of populations and settings,
and these treatments have been implemented
throughout the United States and in countries around the world. In meta-analyses and reviews CM treatments are associated with among the largest effect sizes, and they have consistently engendered positive outcomes in treating substance use disorders.
> > > >

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RESPONSE TO COMMENTARIES ‘CONTINUITIES AND CHANGES IN SELF-CHANGE RESEARCH’


The comments responding to our review provide an excellent and provocative agenda for future research. They put emphasis on the relative importance of self change from a macro-societal system perspective and raise important methodological issues. As noted in several of the comments, rather than replacing treatment, large-scale attempts at self-change would actually be likely to increase treatment use because presumably many individuals will not succeed on their own. In this regard, an important and virtually unstudied population is individuals who attempt but do not succeed at self change.
> > > >

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You have free access to this contentWHAT DOES SELF-CHANGE MEAN FOR HOW WE DELIVER TREATMENT?


Alcohol use disorders are common, and drug use disorders are less common than alcohol use disorders but still affect a substantial minority of adults in developed countries. For example, in the more recent surveys using DSM-IV criteria the prevalence of current alcohol abuse and dependence ranged from 1.9% to 4.3% and 1.2% to 4.4%, respectively; life-time prevalence ranged from 4.5% to 13.2% and 3.8% to 13.3%. Despite the relatively high rates of substance use disorders, treatment seeking among people with alcohol and other drug use disorders is consistently low and most likely to be sought from general practitioners. In the recent Australian National Survey of Mental Health and Wellbeing, only
one in five people with an alcohol use disorder in the last 12 months sought any help for that disorder. > > > >

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You have free access to this contentWHAT DO MARSHMALLOWS AND GOLF TELL US ABOUT NATURAL RECOVERY RESEARCH?


In this issue, Klingemann, Sobell & Sobell present a thought-provoking analysis of the evolution of selfchange
research in the addictions field. As established
experts on natural recovery, they offer much food for thought on current implications of this research and future research directions.

Their concern that, at this early point in our understanding of this phenomenon, we may be relying too much on controlled, quantitative investigations to the exclusion of qualitative and case studies is particularly noteworthy. Because we do not really know why people self-change, we need to partner with those who have experienced it to help us develop a grounded and testable
theoretical framework. As Orford has advocated
strongly,we can begin to take patients’ views and insights more s riously and ask them simply, ‘What were you thinking at the time you decided to change?’.
> > > >


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WHY IS NATURAL RECOVERY SO COMMON FOR ADDICTIVE DISORDERS?


In their summary of the current state of self-change research, Klingemann, Sobell & Sobell recommended making comparisons of natural recovery ‘for different
types of problems and in different cultures’. Below are a few speculations about why natural recovery for addictive disorders is so common, based on clues distilled from epidemiological surveys comparing different disorders, in different groups and across decades.
> > > >

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TOWARDS A SELF-CHANGE-FRIENDLY TREATMENT AND POLICY FOR ADDICTIVE BEHAVIOURS

Dr Klingemann and his colleagues reviewed a substantial literature on the current state-of-the-art in natural recovery research, and concluded that natural recoveries from substance use disorders not only occur but are a major pathway to recovery. The results of self-change research have given rise to basic questions about the effectiveness of mainstream treatment modalities and drug policies on demand reduction.

However, research shows that, like other chronic diseases, drug addiction can be treated effectively and managed over its course. In addition, addiction treatment has also been shown to be an effective way to prevent the spread of diseases, such as human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and hepatitis.

This means that, contrary to the conclusions of Dr Klingemann, we believe recovery is happening in communities, families, hospitals, recovery centres, therapeutic communities, clinics, faith-based programmes and self-help groups in every corner of the world. Effective treatment occurs in a variety of settings, in many different forms and for different lengths of time.
> > > >

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Friday, August 13, 2010

Working Towards a Holistic Alcohol Strategy in Europe: Communication, Education and Public Awareness



Alcohol consumption is a growing public health issue in the EU.

Whilst drinking beer, wine and spirits is a fundamental part of the European tradition and an essential dimension of the European economy, alcohol is also a principle determinant of health risks and other problems such as domestic violence and crime and disorder. Indeed, alcohol is ahead of obesity and illicit drugs as the third highest causal factor leading to ill-health and death in the European Union.

EU citizens experience the highest rate of alcohol consumption in the world (11 litres of pure alcohol per adult each year), and on top of the already serious public health concerns over binge-drinking, statistics on alcohol-related violence make sobering reading:

  • 1 in 6 cases of child abuse is related to alcohol
  • Between 7 and 9 million children live in families adversely affected by alcohol
  • Up to 2 in 5 cases of domestic violence inflicted on women are linked to alcohol

On 24 October 2006, the European Commission adopted a milestone for reducing alcohol related harm with a key Communication setting out a strategy to support Member States and establishing an Alcohol and Health Forum, which would help in disseminating good practices. The Progress report, presented in September 2009, demonstrated that positive steps had been made to meet the 2012 objectives, however there is still much to be done.

This timely International Symposium seeks to harness actions which have been put in place to reduce alcohol-related harm and share good practices, as well as identify gaps where further progress can be made. In order to face up to this public health 'time-bomb', as well as redoubling efforts to raise general public awareness, the European Union is seeking to work closer together with stakeholders to synergise EU policy with the national health policies implemented by Member States. The symposium will examine the latest initiatives at both EU and national level, discuss the range of alcohol-focused projects supported by the World Health Organisation and consider recommendations for future actions to reduce the harmful effects of alcohol misuse.

The Centre for Parliamentary Studies welcomes the participation of all key partners, responsible authorities and stakeholders. The Symposium will support the exchange of ideas and encourage delegates to engage in thought-provoking topical debate


More Synposium Information

Alcohol misuse, sexual risk behaviour and adverse sexual health outcomes: evidence from Britain's national probability sexual behaviour surveys



Evidence for relationships between alcohol misuse, sexual risk behaviour and adverse sexual health outcomes exists from both population-level data and studies undertaken in specific groups. We examine changes in these associations using representative data from two consecutive surveys.

Probability surveys conducted in 1990/91 and again in 2000/01 involving interviews with British residents aged 16–44.

The proportion reporting being drunk as their main reason for first heterosexual intercourse increased from 2.5% among those born in 1946–49 to 6.4% of those born in 1980–84. These respondents were more likely to report intercourse before 16, that sex had occurred too soon, and contraception non-use. Usual alcohol consumption in excess of recommended limits (‘heavy drinkers’) was more common among those reporting larger partner numbers and unprotected sex with 2+ partners/past year but not with STD clinic attendance/diagnosis. Male heavy drinkers were more likely to report sexual function problems and female heavy drinkers using emergency contraception. The magnitude of these relationships did not significantly increase between 1990/91 and 2000/01.

In Britain, sexual risk behaviours and some adverse sexual health outcomes continue to be associated with excess alcohol consumption. These findings support addressing the link between alcohol misuse and sexual health in health services and through broader health promotion.


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Request Reprint E-Mail: cmercer@gum.ucl.ac.uk

Thursday, August 12, 2010

Conserved Role of unc-79 in Ethanol Responses in Lightweight Mutant Mice


The mechanisms by which ethanol and inhaled anesthetics influence the nervous system are poorly understood.

Here we describe the positional cloning and characterization of a new mouse mutation isolated in an N-ethyl-N-nitrosourea (ENU) forward mutagenesis screen for animals with enhanced locomotor activity.

This allele, Lightweight (Lwt), disrupts the homolog of the Caenorhabditis elegans (C. elegans) unc-79 gene.

While Lwt/Lwt homozygotes are perinatal lethal, Lightweight heterozygotes are dramatically hypersensitive to acute ethanol exposure. Experiments in C. elegans demonstrate a conserved hypersensitivity to ethanol in unc-79 mutants and extend this observation to the related unc-80 mutant and nca-1;nca-2 double mutants.

Lightweight
heterozygotes also exhibit an altered response to the anesthetic isoflurane, reminiscent of unc-79 invertebrate mutant phenotypes.

Consistent with our initial mapping results, Lightweight heterozygotes are mildly hyperactive when exposed to a novel environment and are smaller than wild-type animals. In addition, Lightweight heterozygotes exhibit increased food consumption yet have a leaner body composition.

Interestingly, Lightweight heterozygotes voluntarily consume more ethanol than wild-type littermates. The acute hypersensitivity to and increased voluntary consumption of ethanol observed in Lightweight heterozygous mice in combination with the observed hypersensitivity to ethanol in C. elegans unc-79, unc-80, and nca-1;nca-2 double mutants suggests a novel conserved pathway that might influence alcohol-related behaviors in humans.



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Development of a simulated drinking game procedure to study risky alcohol use.


The aim of the current study was to initiate and describe the development of a Simulated Drinking Game Procedure (SDGP), a safe, efficient, and alcohol-free laboratory protocol for studying drinking game behavior.

Fifty-two undergraduates completed the SDGP in a laboratory session, where participants played singles and/or doubles games of Beer Pong. Water was substituted for alcohol in all of the games. The number of drinks consumed during matches and 20-min play periods were coded during each session, and software was used to estimate the peak blood alcohol concentration (BAC) a participant would achieve if he or she had consumed actual alcohol while participating in the SDGP.

Results indicated that participation in Beer Pong can lead to rapid consumption of alcohol and an associated rise in BAC. Results also highlight additional risks for female participants associated with participation in drinking games.

The SDGP is a research tool capable of increasing our understanding of drinking games.



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Request Reprint E-Mail: correcj@auburn.edu

The Comprehensive Alcohol Expectancy Questionnaire: Confirmatory Factor Analysis, Scale Refinement, and Further Validation



The Comprehensive Alcohol Expectancy Questionnaire (CAEQ; Demmel & Hagen, 2003a, 2003b) is a self-report measure designed to assess an individual's alcohol expectancies.

In this study, we examined the CAEQ in a student sample (N= 932) and in a clinical sample of alcohol-dependent inpatients (N= 744).

The Five-factor structure was confirmed by means of confirmatory factor analysis. Convergent validity of the revised CAEQ was supported by showing significant relationships to quantity and frequency of drinking.

The results of this study suggest that the revised CAEQ appears to be a psychometrically sound tool for the assessment of alcohol expectancies among both students and alcohol-dependent inpatients.


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Request Reprint E-Mail: demmel@psy.uni-muenster.de

Youth Exposure to Alcohol Advertising in National Magazines, 2001-2008

Because there is growing evidence that youth* exposure to alcohol advertising increases the likelihood and quantity of underage drinking,1 reducing youth exposure is an important public health goal. Leading alcohol companies self-regulate their advertising practices, and in 2003 pledged to strengthen their standards from a maximum of 50 percent underage audience composition for publications in which they placed their advertising to a 30 percent maximum. Also in 2003, the National Research Council and Institute of Medicine recommended that the industry move toward a 15 percent maximum youth audience for its advertising placements, based on the percentage of young people ages 12 to 20 in the general population.

This report seeks to answer four questions regarding alcohol advertising in magazines: Did alcohol companies meet their 30 percent standard? Did youth exposure to alcohol advertising fall? Did the prevalence of youth exposure coming from overexposure (that is, the prevalence of advertising appearing in magazines where the percentage of youth in the readership exceeds their percentage in the general population) decline? What steps are needed to continue to reduce youth exposure and overexposure?

Key findings of the analysis include:

• From 2001 to 2008, youth exposure to alcohol advertising in magazines fell by 48 percent. Adult (age 21 and above) exposure declined by 29 percent and young adult (ages 21 to 34) dropped by 31 percent.

• Alcohol advertising placed in publications with under 21 audiences greater than 30 percent fell to almost nothing by 2008.

• The 30 percent standard affected placements in only nine of the 160 magazines in which alcohol companies placed their advertising between 2001 and 2008.

• Youth exposure in magazines with youth age 12-to-20 audience composition above 15 percent declined by 48.4 percent. However, the percentage of youth exposure coming from this advertising increased from 69 percent to 78 percent.

• Continued declines in youth overexposure will depend on the actions of a small number of brands: In 2008, 16 brands (5 percent of the total 325 advertising in magazines) accounted for 50 percent of youth exposure in magazines with youth compositions above 15 percent, and 40 brands (13 percent) were responsible for 80 percent of youth exposure in these magazines.


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Wednesday, August 11, 2010

Emergency Department Visits Involving Underage Alcohol Use: 2008



  • In 2008, an estimated 188,981 alcohol-related emergency department (ED) visits were made by patients aged 12 to 20, accounting for about one third of all drug-related ED visits (32.9 percent) made by this age group
  • Of these ED visits, 70.0 percent involved alcohol only, and 30.0 percent involved alcohol in combination with other drugs
  • Nearly one in five (19.1 percent) alcohol-related ED visits made by patients aged 12 to 20 had evidence of follow-up care


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Alcohol Use and Older Adults


Adults of any age can have problems with alcohol. In general, older adults don't drink as much as younger people, but they can still have trouble with drinking. As people get older, their bodies change. They can develop health problems or chronic diseases. They may take more medications than they used to. All of these changes can make alcohol use a problem for older adults.


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Is There an Association Between Low-to-Moderate Alcohol Consumption and Risk of Cognitive Decline?


The authors evaluated the association of low-to-moderate alcohol consumption with risk of cognitive decline in a census-based cohort study of men and women aged ≥55 years conducted in Zaragoza, Spain (1994–1999).

Participants free of dementia at baseline (N = 3,888) were examined after 2.5 and 4.5 years of follow-up. Information on alcohol intake was collected with the EURODEM Risk Factors Questionnaire and the History and Aetiology Schedule.

The study endpoint was severe cognitive decline, defined as loss of ≥1 point/year on the Mini-Mental State Examination or a diagnosis of incident dementia (Diagnostic and Statistical Manual of Mental Disorders: DSM-IV, Text Revision criteria).

Compared with those for abstainers, the multivariate-adjusted odds ratios for severe cognitive decline for male drinkers of >12 g alcohol/day, drinkers of 12–24 g alcohol/day,
and former drinkers were 0.61 (95% confidence interval (CI): 0.31, 1.20), 1.19 (95% CI: 0.61, 2.32), and 1.03 (95% CI: 0.59, 1.82), respectively.

The corresponding odds ratios for women were 0.88 (95% CI: 0.45, 1.72), 2.38 (95% CI: 0.98, 5.77), and 1.03 (95% CI: 0.48, 2.23).

This study did not support the hypothesis that low-to-moderate alcohol consumption prevents cognitive decline.

The inverse association between low-to-moderate alcohol intake and cognitive decline observed in other studies may have been due to inclusion of former drinkers in the abstainers reference category.



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Request Reprint E-Mail: elobo@unizar.es


Relationship Among Alcohol Intake, Body Fat, and Physical Activity: A Population-Based Study


Aside from fat, ethanol is the macronutrient with the greatest energy density. Whether the energy derived from ethanol affects body composition and fat mass is debatable.

We investigated the relationship of alcohol intake, body composition, and physical activity in the U.S. population by using data from the Third National Health and Nutrition Examination Survey (NHANES III).

A total of 10,550 subjects met eligibility criteria and constituted our study cohort. Estimated percent body fat and resting metabolic rate were calculated on the basis of the sum of the skinfolds. Multivariate regression analyses were performed accounting for the study sampling weight.

In both sexes, moderate and hazardous alcohol drinkers were younger (p < .05) and had significantly lower body mass index.

Our results showed that alcoholics are habitually less active and that alcohol drinking is an independent predictor of lower percent body fat, especially in male alcoholics.


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Request Reprint E-Mail: sliangpu@iupui.edu

Monday, August 9, 2010

Reactive and self-regulatory temperament dimensions in relation to alcohol use in adolescence


The present study investigated the cross-sectional relations of reactive [Behavioral Inhibition System (BIS) and Behavioral Activation System (BAS)] and self-regulatory [effortful control (EC)] temperament dimensions with alcohol use in a community sample of adolescents aged 14 to 20 years.

Participants completed the BIS/BAS Scales (Carver & White, 1994), the Effortful Control Scale of the Early Adolescent Temperament Questionnaire Revised (EATQ-R; Ellis & Rothbart, 2001) and a subset of questions based on from the Teen Addiction Severity Index (T-ASI; Kaminer, Bukstein, & Tarter, 1991).

Age of first use and quantity of alcohol use were predicted by the unique effect of BAS Fun Seeking.

Frequency and quantity of alcohol use were predicted by the BAS Fun Seeking × EC interaction: High BAS Fun Seeking was related to frequency and quantity of alcohol use only if EC was low.

Frequency of alcohol use was also predicted by the BAS Drive × EC interaction, but simple slope analysis revealed that the slopes were not significant, both at low EC and at high EC.

The findings of the present study confirm and extend previous research and add to the growing literature of temperamental vulnerability to alcohol use in young populations
.


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Request Reprint E-Mail: patricia.bijttebier@psy.kuleuven.be

Impaired Judgment The Failure of Control States to Reduce Alcohol-Related Problems

Should the Commonwealth of Virginia sell its Alcohol Beverage Control stores (“ABC stores”)?

These are state-owned and operated stores that sell packaged spirits, such as whiskey and vodka. Private merchants are prohibited by law from competing against Virginia’s ABC stores in the retailing or wholesaling of distilled spirits.


During the 2009 Virginia gubernatorial campaign, then-candidate and now Governor Bob McDonnell
proposed such a sale. Mr. McDonnell predicted that the sale of the ABC system would reap about $500 million for the state government, funds that he promised would be used to pay for transportation projects.

Currently in Virginia, consumers can buy spirits only from the state’s monopoly system.

In contrast, Virginians can buy packaged beer and wine from any retailer with a license to sell these beverages and
such licenses are readily available and held widely, including by supermarkets and big-box retailers such as Target and Walmart.

In short, in Virginia the sale of spirits, but not of beer and wine, is a government owned
and operated monopoly.

Opposition to the state government selling its ABC stores is based chiefly on public-health concerns.
Opponents argue that the sale of such stores will encourage the excessive consumption of spirits as well as more under-aged drinking. Because spirits have higher alcohol contents than do beer and wine, opponents insist that government has a special obligation to keep a tighter rein on spirits sales. Supposedly, the monopoly system of ABC stores provides government with the ability to keep this rein tight.

The presumption that alcohol consumption poses unusually high risks to public health is not
unreasonable. Consumed excessively, alcohol impairs its users’ judgment, making them more dangerous drivers and sometimes inciting them to violence. Excessive consumption of alcohol also can damage users’ physical and mental health.

However, such generalizations form far too weak a foundation to support the continuation of the ABC monopoly.

Not only is the above reasoning incomplete, it also is not supported by key facts.
In this short paper we summarize the factual evidence on some of the chief public-health concerns raised by those who oppose the liberalization of spirits retailing.

Fortunately, such evidence is readily available: it comes from the fact that 18 states, including Virginia, are “control” states; 32 states and the District of Columbia are “license” states – that is, jurisdictions that license private retailers and wholesalers to sell packaged spirits in competitive markets.


Such differences in policy regimes offer a “natural experiment” to test the claims of those who insist that government-monopoly retailing of packaged liquor provides public health benefits.


If government ownership and operation of monopolized spirits retailing or wholesaling really reduces alcohol-related problems, states with these government monopolies would have fewer such problems than
do states that allow spirits to be sold by private, competitive businesses.

In fact, however, the data show
that control states suffer just as many alcohol-related problems as do license states.


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Alcohol licensing consultation


Background to the consultation

Alcohol-related crime and disorder is thought to cost the taxpayer between £8bn - £13bn every year. There are 6.6 million attendances at hospital accident and emergency every year due to alcohol, costing £645m. In 2009-10 almost one million violent crimes were attributed to alcohol. The police are fighting a constant and expensive battle to stop this type of crime and antisocial behaviour.

While the majority of people drink responsibly, not enough has been done to help local communities take action against those people who do not drink responsibly. It is vital that communities have the powers they need to tackle alcohol-related crime and antisocial behaviour. Current legislation is not doing enough to deal with these problems, while local authorities have had their hands tied by an overly bureaucratic licensing regime.

New agenda

The government's Coalition Agreement set out a clear agenda for reforming alcohol licensing, in order to deal with the crime and disorder commonly associated with drinking in our society. The agreement includes:

  • overhauling the Licensing Act to give local authorities and the police much stronger powers to remove licences from, or refuse to grant licences to premises that are causing problems
  • allowing councils and the police to permanently shut down any shop or bar that is repeatedly selling alcohol to children
  • doubling the maximum fine for those caught selling alcohol to minors to £20,000
  • allowing local councils to charge more for late-night licences, which will help pay for additional policing
  • banning the sale of alcohol below cost price

More Information

Alcohol News - 32/2010

Weekly newsletter of Alcohol News and Articles around the world. By Lauri Beekmann - Estonia.

USA Today (USA) - Report: Alcohol, drug use lower among Hispanic-Americans Hispanic-American adults have lower rates of alcohol and illicit drug use than the national averages, a federal government study has found. http://www.usatoday.com/news/health/2010-08-07-hispanic-drugs-alcohol_N.htm

Wales Online (Wales) -
Parents must take lead in educating children about alcohol Wales’ chief medical officer Dr Tony Jewell explains why it’s important parents talk to their children about alcohol. http://www.walesonline.co.uk/news/health-news/2010/08/09/parents-must-take-lead-in-educating-children-about-alcohol-91466-27022077/

Brandweek Magazine -
Social Media Is Murky Area For Marketers of Alcohol “Get drunk” reads a comment from a man named Jeffrey Dale Hoover Sr. on Coors Light’s Facebook page. The dictate, needless to say, is not the sort of thing that an alcohol brand would want to promote, even though Hoover’s decree was entered on July 31 and, as of last week, was still on the site. Meanwhile, on Bud Light Lime’s page, a fan named Jim Lenz confesses, “I have a problem having just one.” http://www.brandweek.com/bw/content_display/news-and-features/direct/e3ibe91a9657f6e904e5cf1f6317c1d5287

BBC News (Wales) -
Shock at drug and alcohol abuse by under-12s More than 120 children under the age of 12 in Wales were referred for specialist help for drug and alcohol problems, figures reveal. http://www.bbc.co.uk/news/uk-wales-10902558

Daily Mail (UK) - Revealed: the astonishing amount one fifth of British 15-year-olds drink... in a year As Britain's schoolchildren enjoy the freedom of the long summer break, an alarming new government report has revealed just how much alcohol they are drinking. http://www.dailymail.co.uk/health/article-1301433/Revealed-astonishing-fifth-British-15-year-olds-drink-year.html

The Guardian (UK) -
Raise liquor prices by 150% to beat binge-drinking, says Alcohol Concern The binge-drinking epidemic can be curbed only if the price of certain types of alcohol rises by more than 150%, according to one of the UK's leading authorities on tackling the problem. http://www.guardian.co.uk/society/2010/aug/08/binge-drinking-problem-price-rise

San Francisco Chronicle (USA) -
S.F. considers fee on alcoholic beverages Adding a new fee to alcohol sold in San Francisco would generate an estimated $16.3 million a year to help cover city-funded public health and paramedic costs associated with alcohol abuse. http://articles.sfgate.com/2010-08-05/bay-area/22205966_1_alcohol-city-hall-supervisor-john-avalos

Coventry Telegraph (UK) -
Coventry experts push for minimum price on alcohol COVENTRY experts believe putting a minimum price on alcohol could help win the city’s battle with the bottle. http://www.coventrytelegraph.net/news/coventry-news/2010/08/09/coventry-experts-push-for-minimum-price-on-alcohol-92746-27025665/

Daily Mail (Brazil) -
Brazil planning sober samba party with alcohol set to be banned for 2014 World Cup Brazil 2014 is set to be the first alcohol-free World Cup after organisers confirmed sales will be banned at games under anti-hooligan laws. http://www.dailymail.co.uk/sport/football/article-1301191/Brazil-plan-alcohol-ban-2014-World-Cup.html

eGovMonitor (Scotland) - Government Of Scotland Conducts Alcohol Summit A cross-party meeting addressing ways of tackling Scotland's unhealthy relationship with alcohol was held today. http://www.egovmonitor.com/node/37858

The Lancet - Alcohol: the forgotten drug in HIV/AIDS Alcohol has long been recognised as an important contributor to illness and injury, accounting for 4% of the global burden of disease. Yet alcohol remains conspicuously absent from the larger field of research and programming in HIV and substance use. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60884-7/fulltext?_eventId=login

The Huffington Post (USA) -
Alcohol: The Savior of American Capitalism How is it possible that the most brilliant economic system on earth is still serving alcohol as the best delivery system for getting drunk in 2010? 2010! The number used to be synonymous with a decade after a computer would try to kill human beings. 2010 does not look like the dazzling future we hoped the new millennium would produce. http://www.huffingtonpost.com/matthew-cooke/alcohol-the-savior-of-ame_b_674150.html

New Zealand Herald (New Zealand) -
Queenstown crime almost all drunken Queenstown is in a league of its own when it comes to drunken crime, says a police chief. Crime in the resort town was "almost exclusively" alcohol related, Senior Sergeant John Fookes said. http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10664698

NTDTV (Israel) -
“Parents Patrol” Assists Drunken Youth In Israel According to research by the Israel Anti-Drugs Authority, there's an increase in alcohol consumption among teenagers in Israel. The Parents Patrol, made up of volunteer parents, was set up 4 years ago to try to combat this rising problem. http://english.ntdtv.com/ntdtv_en/ns_me/2010-08-09/550613305781.html

USA Today -
'Social drinking': Friends' alcohol influence may be in your genes Genetics may determine to what extent you're swayed by the alcohol consumption of people around you, new research suggests. http://www.usatoday.com/news/health/2010-08-03-social-drinking-alcohol_N.htm

Centre Daily Times -
U.S. alcohol report debunks myths on drinking in Europe A common misperception in American culture is that our young people drink more frequently and have more alcohol-related problems than those in Europe. http://www.centredaily.com/2010/08/04/2131556/us-alcohol-report-debunks-myths.html

The Guardian (Italy) -
Italy fears a boozy invasion of its exclusive beaches The mayors of some of Italy's most elegant resorts have expressed outrage at a new regulation introduced by Silvio Berlusconi's government that allows beachfront premises to stage drink-and-dance parties seven days a week. http://www.guardian.co.uk/world/2010/aug/08/italy-fears-boozy-beaches

Repeated ethanol administration modifies the temporal structure of sucrose intake patterns in mice: effects associated with behavioral sensitization


Neuroadaptations supporting behavioral sensitization to abused drugs are suggested to underlie pathological, excessive motivation toward drugs and drug-associated stimuli. Drug-induced sensitization has also been linked to increased appetitive responses for non-drug, natural reinforcers.

The present research investigated whether ethanol (EtOH)-induced neural changes, inferred from psychomotor sensitization, can modify consumption and intake dynamics for the natural reinforcer, sucrose.

The effects of EtOH-induced sensitization in mice on the temporal structure of sucrose intake patterns were measured using a lickometer system.

After sensitization, sucrose intake dynamics were measured for 1 hour daily for 7 days and indicated more rapid initial approach and consumption of sucrose in EtOH-sensitized groups; animals showed a shorter latency to the first intake bout and an increased number of sucrose bottle licks during the initial 15 minutes of the 1-hour sessions.

This effect was associated with increased frequency and size of bouts. For the total 1-hour session, sucrose intake and bout dynamics were not different between groups, indicating a change in patterns of sucrose intake but not total consumption.

When sensitization was prevented by the γ-aminobutyric acid B receptor agonist, baclofen, the increased rate of approach and consumption of sucrose were also prevented.

Thus, EtOH-induced sensitization, and not the mere exposure to EtOH, was associated with changes in sucrose intake patterns.

These data are consistent with current literature suggesting an enhancing effect of drug-induced sensitization on motivational processes involved in reinforcement
.


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Sunday, August 8, 2010

We're addicted to rehab. It doesn't even work.


Last week, Lindsay Lohan left jail and entered a drug and alcohol rehabilitation facility. If the scene inspired deja vu, it wasn't just because it was the fourth time she had headed to rehab in four years. It was because the spectacle of a celebrity entering a drug and alcohol treatment center, relapsing, then heading to rehab again -- and again and again -- has become depressingly familiar.

For decades, Americans have clung to a near-religious conviction that rehab -- and the 12-step model pioneered by Alcoholics Anonymous that almost all facilities rely upon -- offers effective treatment for alcoholism and other addictions.

Here's the problem: We have little indication that this treatment is effective. When an alcoholic goes to rehab but does not recover, it is he who is said to have failed. But it is rehab that is failing alcoholics. The therapies offered in most U.S. alcohol treatment centers are so divorced from state-of-the-art of medical knowledge that we might dismiss them as merely quaint -- if it weren't for the fact that alcoholism is a deadly and devastating disease. > > > >

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