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

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


Saturday, March 19, 2011

Ceftriaxone, a Beta-Lactam Antibiotic, Reduces Ethanol Consumption in Alcohol-Preferring Rats

Changes in glutamatergic transmission affect many aspects of neuroplasticity associated with ethanol and drug addiction. For instance, ethanol- and drug-seeking behavior is promoted by increased glutamate transmission in key regions of the motive circuit. We hypothesized that because glutamate transporter 1 (GLT1) is responsible for the removal of most extracellular glutamate, up-regulation or activation of GLT1 would attenuate ethanol consumption. 

Alcohol-preferring (P) rats were given 24 h/day concurrent access to 15 and 30% ethanol, water and food for 7 weeks. During Week 6, P rats received either 25, 50, 100 or 200 mg/kg ceftriaxone (CEF, i.p.), a β-lactam antibiotic known to elevate GLT1 expression, or a saline vehicle for five consecutive days. Water intake, ethanol consumption and body weight were measured daily for 15 days starting on Day 1 of injections. We also tested the effects of CEF (100 and 200 mg/kg, i.p.) on daily sucrose (10%) consumption as a control for motivated behavioral drinking.  

Statistical analyses revealed a significant reduction in daily ethanol, but not sucrose, consumption following CEF treatment. During the post treatment period, there was a recovery of ethanol intake across days. Dose-dependent increases in water intake were manifest concurrent with the CEF-induced decreases in ethanol intake. Nevertheless, CEF did not affect body weight. An examination of a subset of the CEF-treated ethanol-drinking rats, on the third day post CEF treatment, revealed increases in GTL1 expression levels within the prefrontal cortex and nucleus accumbens.  

These results indicate that CEF effectively reduces ethanol intake, possibly through activation of GLT1, and may be a potential therapeutic drug for alcohol addiction treatment. 

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Minocycline Reduces Ethanol Drinking

Alcoholism is a disease characterized by continued alcohol consumption despite recurring negative consequences. Thus, medications that reduce the drive to consume alcohol can be beneficial in treating alcoholism. 

The neurobiological systems that regulate alcohol consumption are complex and not fully understood. 

Currently, medications are available to treat alcoholism that act either by causing accumulation of a toxic metabolite of ethanol, or by targeting specific transmitter receptors. 

The purpose of our study was to investigate a new potential therapeutic pathway, neuroimmune interactions, for effects on ethanol consumption. We hypothesized that neuroimmune activity of brain glia may have a role in drinking. We utilized minocycline, a second generation tetracycline antibiotic that has immune modulatory actions, to test our hypothesis because it is known to suppress microglia, and to a lesser extent astroglia, activity following many types of insults to the brain. Treatment with 50 mg/kg minocycline significantly reduced ethanol intake in male and female C57Bl/6J mice using a freechoice voluntary drinking model. Saline injections did not alter ethanol intake. Minocycline had little effect on water intake or body weight change. The underlying mechanism whereby minocycline reduced ethanol intake requires further study. 

The results suggest that drugs that alter neuroimmune pathways may represent a new approach to developing additional therapies to treat alcoholism.

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Opposite effects of acute ethanol exposure on GAP-43 and BDNF expression in the hippocampus versus the cerebellum of juvenile rats

The adolescent brain is particularly vulnerable to the effects of alcohol, with intoxications at this developmental age often producing long-lasting effects. 

The present study addresses the effects of a single acute ethanol exposure on growth-associated protein-43 (GAP-43) and brain-derived neurotrophic factor (BDNF) gene expression in neurons in the cerebellum and hippocampus of adolescent rats. 

Male postnatal day 23 (P23) Sprague–Dawley rats were exposed to ethanol vapors for 2h and after a recovery period of 2h, the cerebellum and hippocampus were harvested and samples were taken for blood alcohol concentration (BAC) determinations. 

We found that this exposure resulted in a mean BAC of 174mg/dL, which resembles levels in human adolescents after binge drinking. 

Analyses of total RNA and protein by quantitative reverse transcription PCR and western blotting, respectively, revealed that this single ethanol exposure significantly decreased the levels of GAP-43 mRNA and protein in the cerebellum but increased the levels of mRNA and protein in the hippocampus. 

BDNF mRNA and protein levels were also increased in the hippocampus but not in the cerebellum of these animals. 

In situ hybridizations revealed that GAP-43 and BDNF mRNA levels were primarily increased by alcohol exposure in hippocampal dentate granule cells and CA3 neurons. 

Overall, the reported alterations in the expression of the plasticity-associated genes GAP-43 and BDNF in juvenile rats are consistent with the known deleterious effects of binge drinking on motor coordination and cognitive function.

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Knock down of GCN5 histone acetyltransferase by siRNA decreases ethanol-induced histone acetylation and affects differential expression of genes in human hepatoma cells

We have investigated whether Gcn5, a histone acetyltransferase (HAT), is involved in ethanol-induced acetylation of histone H3 at lysine 9 (H3AcK9) and has any effect on the gene expression. Human hepatoma HepG2 cells transfected with ethanol-metabolizing enzyme alcohol dehydrogenase 1 (VA 13 cells) were used. 

Knock down of Gcn5 by siRNA silencing decreased mRNA and protein levels of general control nondepressible 5 (GCN5), HAT activity, and also attenuated ethanol-induced H3AcK9 in VA13 cells. 

Illumina gene microarray analysis using total RNA showed 940 transcripts affected by GCN5 silencing or ethanol. 

Silencing caused differential expression of 891 transcripts (≥1.5-fold upregulated or downregulated). Among these, 492 transcripts were upregulated and 399 were downregulated compared with their respective controls. 

Using a more stringent threshold (≥2.5-fold), the array data from GCN5-silenced samples showed 57 genes differentially expressed (39 upregulated and 18 downregulated). Likewise, ethanol caused differential regulation of 57 transcripts with ≥1.5-fold change (35 gene upregulated and 22 downregulated). 

Further analysis showed that eight genes were differentially regulated that were common for both ethanol treatment and GCN5 silencing. Among these, SLC44A2 (a putative choline transporter) was strikingly upregulated by ethanol (three fold), and GCN5 silencing downregulated it (1.5-fold). The quantitative real-time polymerase chain reaction profile corroborated the array findings. 

This report demonstrates for the first time that (1) GCN5 differentially affects expression of multiple genes, (2) ethanol-induced histone H3-lysine 9 acetylation is mediated via GCN5, and (3) GCN5 is involved in ethanol-induced expression of the putative choline transporter SLC44A2.

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Impaired expansion and multipotentiality of adult stromal cells in a rat chronic alcohol abuse model

It is well established that bone maintenance and healing is compromised in alcoholics. Adult bone marrow–derived stromal cells (BMSCs) and adipose tissue–derived stromal cells (ASCs) likely contribute to bone homeostasis and formation. Direct and indirect alcohol exposure inhibits osteoprogenitor cell function through a variety of proposed mechanisms. 

The goal of this study was to characterize the effects of chronic alcohol ingestion on the native number and in vitro growth characteristics and multipotentiality of adult BMSCs and ASCs in a rat model. 

Adult male Sprague–Dawley rats received a liquid diet containing 36% ethanol or an isocaloric substitution of dextramaltose (control). After 4, 8, or 12 weeks of the diet, ASCs were harvested from epididymal adipose tissue and BMSCs from femoral and tibial bone marrow. Cell doublings (CDs) per day and doubling times (DTs) were determined for primary cells (P0) and cell passages 1 through 6 (P1–P6). Fibroblastic (CFU-F), adipogenic (CFU-Ad), and osteogenic (CFU-Ob) colony-forming unit (CFU) frequencies were assessed for P0, P3, and P6. 

The CDs and DTs were lower and higher, respectively, for ASCs and BMSCs harvested from ethanol versus control rats at all time points. 

The CFU-F, CFU-Ad, and CFU-Ob were significantly higher in ASCs harvested from control versus ethanol rats for P0, P3, and P6 at all times. 

Both CFU-Ad and CFU-Ob were significantly higher in P0 BMSCs harvested from control versus ethanol rats after 12 weeks of the diet. 

The CFU-Ob for P3 BMSCs from control rats was significantly higher than those from ethanol rats after 8 and 12 weeks on the diet. 

All three CFU frequencies in ASCs from ethanol rats tended to decrease with increasing diet duration. 

The ASC cell and colony morphology was different between control and ethanol cohorts in culture. 

These results emphasize the significant detrimental effects of chronic alcohol ingestion on the in vitro expansion and multipotentiality of adult mesenchymal stromal cells (MSCs). Maintenance of the effects through multiple cell passages in vitro suggests cells may be permanently compromised.

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The TTTAn aromatase (CYP19A1) polymorphism is associated with compulsive craving of male patients during alcohol withdrawal Pu

Alcoholism is associated with alterations of the hypothalamus–pituitary–gonadal hormone axis. We recently reported a leptin-mediated relation between the CAGn polymorphism of the androgen receptor and craving during alcohol withdrawal. 

This study investigated whether the TTTAn polymorphism of the aromatase (CYP19A1) is equally linked to craving.

An association between TTTAn and compulsive craving (p = 0.029) was revealed in our sample of 118 male alcohol addicts at day of hospital admission. 

Genotype-dependent subgroups showed differences in that the patients with short alleles suffered from lower compulsive craving during withdrawal than those with the longer alleles (p = 0.027). 

The additional inclusion of leptin revealed no further significant association in the present study.

Our finding is a further step on the way to elucidate the genesis of craving for alcohol with its extensive underlying interactions of different genetic and non-genetic factors.

Future investigations should enroll women and consider sex hormone levels for further clarification of the observed TTTAn-craving relationship.

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The social network of alcohol users undergoing treatment in a mental health service

The treatment of alcohol and drug users requires an extended reflection on the influence of the family and other social network groups of these individuals. 

Thus, this study, results of a qualitative study, aimed at investigating the presence of drug users in the social network of individuals undergoing treatment and the possible interventions of the mental health services in the social network of four users of alcohol in the municipality of Alegrete/RS. 

Interviews with users and families, genograms and eco-maps were used. 

The results indicated the presence of drug users in the family and in the other social network groups, and that the group for chemical dependants was the main intervention in these social networks. 

These results demonstrate the need for directing the actions of mental health to develop healthy bonds, to expand the social network and structure of the group in order to provide benefits which favor effective psychosocial rehabilitation.

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Friday, March 18, 2011

The role of Alcoholics Anonymous in mobilizing adaptive social network changes: A prospective lagged mediational analysis

Many individuals entering treatment are involved in social networks and activities that heighten relapse risk. Consequently, treatment programs facilitate engagement in social recovery resources, such as Alcoholics Anonymous (AA), to provide a low risk network. While it is assumed that AA works partially through this social mechanism, research has been limited in rigor and scope. 

This study used lagged mediational methods to examine changes in pro-abstinent and pro-drinking network ties and activities.

Adults (N = 1726) participating in a randomized controlled trial of alcohol use disorder treatment were assessed at intake, and 3, 9, and 15 months. Generalized linear modeling (Generalized linear modeling) tested whether changes in pro-abstinent and pro-drinking network ties and drinking and abstinent activities helped to explain AA's effects.

Greater AA attendance facilitated substantial decreases in pro-drinking social ties and significant, but less substantial increases in pro-abstinent ties. Also, AA attendance reduced engagement in drinking-related activities and increased engagement in abstinent activities. Lagged mediational analyses revealed that it was through reductions in pro-drinking network ties and, to a lesser degree, increases in pro-abstinent ties that AA exerted its salutary effect on abstinence, and to a lesser extent, on drinking intensity.

AA appears to facilitate recovery by mobilizing adaptive changes in the social networks of individuals exhibiting a broad range of impairment. Specifically by reducing involvement with pro-drinking ties and increasing involvement with pro-abstinent ties. These changes may aid recovery by decreasing exposure to alcohol-related cues thereby reducing craving, while simultaneously increasing rewarding social relationships.

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Different Methods of Early Identification of Risky Drinking: A Review of Clinical Signs

To review the literature on detection of risky drinking to compare early identification based on everyday clinical encounters with systematic screening. We also reviewed specific clinical signs that have been suggested to be used as indicators of risky drinking.  

A literature review was performed in PubMed and CINAHL of articles up to November 2010.  

Systematic screening and semi-systematic methods in various forms detected more risky drinkers than non-systematic identification during clinical encounter, but there was a lack of studies comparing the various means of identifying risky drinking. It may be too early to completely rule out the possibility of using non-systematic methods as an effective strategy to identify risky drinking. The earliest signs of risky drinking suggested in the literature are psychological distress and social problems.  

From a public health perspective, there is a lack of evidence that non-systematic or semi-systematic methods can substitute systematic screening in terms of numbers of risky drinkers detected. If early signs are going to be used to identify risky drinkers, or those to be screened for risky drinking, more focus should be on psychological and social signs because they appear earlier than somatic signs. 

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Drinking Motives among Spanish and Hungarian Young Adults: A Cross-National Study

To investigate differences and similarities in college students’ drinking motives in Spain and in Hungary.

A total of 550 Spanish (mean age 22.7, SD = 3.2) and 997 Hungarian (mean age 22.4, SD = 2.7) college students completed the Drinking Motive Questionnaire Revised Short Form (DMQ-R SF) and answered other alcohol-related questions. Data were analyzed by confirmatory factor analysis, t-test and structural equation modeling.  

The DMQ-R SF demonstrated good psychometric properties in both countries. The rank order of the motives (social > enhancement > coping > conformity) was identical in the two countries. However, Hungarian students scored higher on enhancement, social and coping motives than Spanish students. In both the Hungarian and the Spanish population, enhancement motives were associated with drinking frequency and drunkenness, while coping motives were associated with alcohol-related problems. Among Spanish students, a significant relationship was found between alcohol-related problems and enhancement motives as well.  

Despite the substantial differences in the drinking culture of both countries, drinking motives showed overwhelming similarities (e.g. rank order of motives and the particular relationships between motives and alcohol outcomes). Only few differences (e.g. Hungarian college students indicated a higher level of motives) were found in cross-national comparison. Our results imply that programs targeting risky drinking motives are likely to be successfully adapted to different drinking cultures in Europe. 

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Level and Change in Alcohol Consumption, Depression and Dysfunctional Attitudes among Females Treated for Alcohol Addiction

To examine whether individual changes in alcohol consumption among female alcoholics under treatment are predicted by level of and changes in depression and dysfunctional attitudes. 

A total of 120 women who were treated for alcohol addiction at the Karolinska Hospital in Stockholm (Sweden) were assessed twice over a 2-year period using the Depression scale from the Symptom Checklist-90, the Alcohol Use Inventory and the Dysfunctional Attitude Scale (DAS). Latent growth curve analysis was used.  

Decrease in alcohol consumption, depression and dysfunctional attitude variables were found at group level. The results also showed significant individual variation in change. Changes in alcohol consumption were predicted by baseline alcohol drinking, as well as by level and changes in depression. Stronger reduction in depression was related to higher level of depression at baseline, and with reduction in dysfunctional attitudes. Different DAS sub-scales resulted in different magnitude of the model relations. Good treatment compliance was related to lower baseline level in depression, but also with higher baseline level in dysfunctional attitudes, and predicted stronger reduction in alcohol consumption.  
This paper shows the importance of incorporating both individual level and change in depression as predictors of change in alcohol consumption among subjects treated for alcohol addiction. Also, dysfunctional attitudes are both indirectly and directly related to treatment outcome. By incorporating alcohol consumption, depression and dysfunctional attitudes as targets of intervention, treatment compliance and outcome may be enhanced. 

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Dose–Response Effect of Baclofen in Reducing Daily Alcohol Intake in Alcohol Dependence: Secondary Analysis of A Randomized, Double-Blind, Placebo-Controlled Trial

To explore the effect of baclofen in a dose of 20 mg three times per day, compared with the already studied dose of 10 mg three times per day, in the treatment of alcohol dependence. 

We present a secondary analysis of a 12-week double-blind, placebo-controlled, randomized clinical trial with two doses of baclofen, specifically 10 mg t.i.d. and 20 mg t.i.d. Out of 94 subjects consecutively screened, 42 were randomized into the study. Fourteen of the 42 patients were randomly allocated to placebo, 14 to the group treated with baclofen 10 mg t.i.d. (B10 mg) and 14 to the group treated with baclofen 20 mg t.i.d. (B20 mg).

Compared with patients allocated to placebo, patients allocated to the B10 mg group had a 53% reduction in the number of drinks per day (< 0.0001) and patients allocated to the B20 mg group had a 68% reduction in the number of drinks per day (< 0.0001), with respect to the number of drinks per day during the 28 days before randomization. The effect of baclofen 20 mg t.i.d. was greater than that of baclofen 10 mg t.i.d. (= 0.0214, Wald test) showing a dose–effect relationship. Both doses of baclofen were well tolerated.  

This is provisional evidence of a dose–response effect for baclofen in the treatment of alcohol dependence. 

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Sociodemographic Correlates of Transitions from Alcohol Use to Disorders and Remission in the São Paulo Megacity Mental Health Survey, Brazil

To evaluate sociodemographic correlates associated with transitions from alcohol use to disorders and remission in a Brazilian population. 

Data are from a probabilistic, multi-stage clustered sample of adult household residents in the São Paulo Metropolitan Area. Alcohol use, regular use (at least 12 drinks/year), DSM-IV abuse and dependence and remission from alcohol use disorders (AUDs) were assessed with the World Mental Health version of the Composite International Diagnostic Interview. Age of onset (AOO) distributions of the cumulative lifetime probability of each alcohol use stage were prepared with data obtained from 5037 subjects. Correlates of transitions were obtained from a subsample of 2942 respondents, whose time-dependent sociodemographic data were available. 

Lifetime prevalences were 85.8% for alcohol use, 56.2% for regular use, 10.6% for abuse and 3.6% for dependence; 73.4 and 58.8% of respondents with lifetime abuse and dependence, respectively, had remitted. The number of sociodemographic correlates decreased from alcohol use to disorders. All transitions across alcohol use stages up to abuse were consistently associated with male gender, younger cohorts and lower education. Importantly, low education was a correlate for developing AUD and not remitting from dependence. Early AOO of first alcohol use was associated with the transition of regular use to abuse.  

The present study demonstrates that specific correlates differently contribute throughout alcohol use trajectory in a Brazilian population. It also reinforces the need of preventive programs focused on early initiation of alcohol use and high-risk individuals, in order to minimize the progression to dependence and improve remission from AUD. 

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Alcohol Withdrawal Syndrome: Symptom-Triggered versus Fixed-Schedule Treatment in an Outpatient Setting

To investigate whether, in the treatment with chlordiazepoxide for outpatient alcohol withdrawal, there are advantages of symptom-triggered self-medication over a fixed-schedule regimen.  

A randomized controlled trial in outpatient clinics for people suffering from alcohol dependence (AD) and alcohol-related problems; 165 adult patients in an outpatient setting in a specialized alcohol treatment unit were randomized 1:1 to either a symptom-triggered self-medication or tapered dose, using chlordiazepoxide. Alcohol withdrawal symptoms, amount of medication, duration of symptoms, time to relapse and patient satisfaction were measured. Patients assessed their symptoms using the Short Alcohol Withdrawal Scale (SAWS). Patient satisfaction was monitored by the Diabetes Treatment Satisfaction Questionnaire. We used the Well-Being Index and the European addiction severity index for the 1-year follow-up.  

We found no differences in the quantity of medication consumed, time to relapse, well being or treatment satisfaction. 

Symptom-triggered self-medication was as safe as fixed-schedule medication in treating outpatients with AD and mild to moderate symptoms of AWS. The SAWS is a powerful monitoring tool, because it is brief and permits the subject to log the withdrawal symptoms.

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Monitoring and Evaluating Scotland’s Alcohol Strategy. Setting the Scene: Theory of change and baseline picture

NHS Health Scotland has been tasked by Scottish Government to lead the monitoring and evaluation of Scotland’s alcohol strategy.

This report sets the scene for this evaluation by describing the current strategy, its Theory of Change and the evaluation plan. It then describes the baseline trends for alcohol consumption, alcohol affordability and alcohol-related harms. The appendices are contained in the second document.

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Differences in Implicit Associations About Alcohol Between Blacks and Whites Following Alcohol Administration

Implicit cognitions about alcohol have been shown to be an important predictor of alcohol use. Relatively little research has been conducted on racial/ethnic differences in implicit cognitions or changes in implicit cognitions while intoxicated. 

This study examined differences between Blacks and Whites in positive and negative implicit associations about alcohol, as measured by the Implicit Association Test (IAT) and tested differences in IAT scores when participants were sober and intoxicated. 

One hundred thirty-five young adults (46% of Black descent) participated in an alcohol-administration study, receiving a moderate dose of alcohol (0.72 g/kg alcohol for men, 0.65 g/kg for women). The IAT was administered in two sessions, one in which alcohol was administered (30 minutes after alcohol consumption) and one in which it was not, approximately 1 week apart. 

Repeated-measures mixed-factorial analyses of variance were conducted separately for positive and negative IAT scores. Blacks held lower positive and negative implicit cognitions about alcohol compared with Whites. Positive and negative IAT scores did not change as a function of intoxication. Positive explicit expectancies and self-reported past-month drinking behavior were related to positive IAT scores. Positive and negative IAT scores were also related to acute subjective response to alcohol, and this association differed by race. 

Results extend previous studies by providing evidence for racial differences in implicit cognitions about alcohol and by showing the stability of the IAT while participants are intoxicated. Future studies are needed to determine what factors contribute to racial differences in implicit cognitions.

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Racial/Ethnic Differences in the Relationship Between Parental Education and Substance Use Among U.S. 8th-, 10th-, and 12th-Grade Students: Findings From the Monitoring the Future Project

Secondary school students' rates of substance use vary significantly by race/ethnicity and by their parents' level of education (a proxy for socioeconomic status). The relationship between students' substance use and race/ethnicity is, however, potentially confounded because parental education also differs substantially by race/ethnicity. 

This report disentangles the confounding by examining White, African American, and Hispanic students separately, showing how parental education relates to cigarette smoking, heavy drinking, and illicit drug use. 

Data are from the 1999-2008 Monitoring the Future nationally representative in-school surveys of more than 360,000 students in Grades 8, 10, and 12. 

(a) High proportions of Hispanic students have parents with the lowest level of education, and the relatively low levels of substance use by these students complicates total sample data linking parental education and substance use. 

(b) There are clear interactions: Compared with White students, substance use rates among African American and Hispanic students are less strongly linked with parental education (and are lower overall). 

(c) Among White students, 8th and 1 0th graders show strong negative relations between parental education and substance use, whereas by 12th grade their heavy drinking and marijuana use are not correlated with parental education. 

Low parental education appears to be much more of a risk factor for White students than for Hispanic or African American students. 

Therefore, in studies of substance use epidemiology, findings based on predominantly White samples are not equally applicable to other racial/ethnic subgroups. 

Conversely, the large proportions of minority students in the lowest parental education category can mask or weaken findings that are clearer among White students alone. 

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A Randomized Controlled Trial of Cognitive-Behavioral Treatment for Depression Versus Relaxation Training for Alcohol-Dependent Individuals With Elevated Depressive Symptoms

A previous pilot study found positive outcomes among alcohol-dependent individuals with elevated depressive symptoms who received cognitive-behavioral treatment for depression (CBT-D; n = 19) compared with a relaxation training control (RTC; n = 16). 

The current study represents a replication of this pilot study using a larger sample size and a longer follow-up assessment period. 

Patients entering a partial hospital drug and alcohol treatment program who met criteria for alcohol dependence and elevated depressive symptoms (Beck Depression Inventory score ≥ 15) were recruited and randomly assigned to receive eight individual sessions of CBT-D (n = 81) or RTC (n = 84). 

There were significant improvements in depressive and alcohol use outcomes over time for all participants.Compared with RTC, the CBT-D condition had significantly lower levels of depressive symptoms, as measured by the Beck Depression Inventory, at the 6-week follow-up. However, this effect was inconsistent because there were no differences in the Modified Hamilton Rating Scale for Depression between conditions at that time point and there were no significant differences at any other follow-up. No significant between-group differences on alcohol use outcomes were found. 

The current findings did not replicate the positive outcomes observed in the CBT-D condition in our previous pilot study. Possible explanations for why these findings were not replicated are discussed, as are theoretical and clinical implications of using CBT-D in alcohol treatment. 

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Depression's Moderation of the Effectiveness of Intensive Case Management With Substance-Dependent Women on Temporary Assistance for Needy Families: Outpatient Substance Use Disorder Treatment Utilization and Outcomes

Intensive case management (ICM) is effective for facilitating entry into and retention in outpatient substance use disorder treatment (OSUDT) for low-income substance-dependent women; however, no studies have specifically examined the moderating impact of depressive symptoms on ICM. 

The purpose of this study was to investigate whether depressive symptoms moderated ICM's effect on OSUDT engagement, attendance, and outcomes for substance-dependent women on Temporary Assistance for Needy Families (TANF). It was hypothesized that highly depressed women would demonstrate worse outcomes on all indicators. 

Logistic regression and generalized estimating equations were used to determine depression's moderating impact on ICM in a secondary analysis of data from a randomized controlled trial comparing the effectiveness of ICM to usual care provided by local public assistance offices in Essex County, NJ. Substance-dependent women (N = 294) were recruited while being screened for TANF eligibility and were followed for 24 months. 

Findings revealed that high levels of depressive symptoms moderated the effectiveness of ICM in unexpected directions for two outcome variables. Subjects with high levels of depressive symptoms in ICM were (a) significantly more likely to engage in at least one treatment program than those in usual care and (b) associated with the fewest mean drinks per drinking day across the 24-month follow-up period. Independent effects for high levels of depressive symptoms and ICM were also found to positively influence engagement, attendance, and percentage days abstinent. 

ICM is effective for substance-dependent women with a broad spectrum of depressive symptoms in enhancing OSUDT utilization and outcomes.

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Twenty-Year Alcohol-Consumption and Drinking-Problem Trajectories of Older Men and Women

The aim of this study was to describe older adults' 20-year alcohol-consumption and drinking-problem trajectories, identify baseline predictors of them, and determine whether older men and women differ on late-life drinking trajectory characteristics and predictors. 

Two-group simultaneous latent growth modeling was used to describe the characteristics and baseline predictors of older community-residing men's (n = 399) and women's (n = 320) 20-year drinking trajectories. Chi-square difference tests of increment in fit of latent growth models with and without gender invariance constraints were used to determine gender differences in drinking trajectory characteristics and predictors. 
Unconditional quadratic growth models best described older individuals' within-individual, 20-year drinking trajectories, with alcohol consumption following an average pattern of delayed decline, and drinking problems an average pattern of decline followed by leveling off. On average, older men declined in alcohol consumption somewhat later than did older women. The best baseline predictors of more rapid decline in alcohol consumption and drinking problems were drinking variables indicative of heavier, more problematic alcohol use at late middle age. 

The course of alcohol consumption and drinking problems from late middle age onward is one of net decline, but this decline is neither swift nor invariable. Gender differences in the timing of decline in drinking suggest that ongoing monitoring of alcohol consumption may be especially important for older men. Further research is needed to identify factors known at late middle age that prospectively explain long-term change in late-life use of alcohol.

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The effect of age on the discriminative stimulus effects of ethanol and its GABAA receptor mediation in cynomolgus monkeysThe Theory of Planned Behavior as a Predictor of Growth in Risky College Drinking

This study tested the Theory of Planned Behavior (TPB) as a predictor of growth in risky college drinking over a 3-month period. As predicted by the TPB model, it was hypothesized that attitudes, subjective norms, and perceived behavioral control would predict intention to engage in risky drinking, which would in turn predict growth in future risky drinking.
Participants were 837 college drinkers (64.2% female) who were randomly selected from two U.S. West Coast universities to participate in a larger study on college drinking norms. This study used latent growth analyses to test the ability of the TPB to predict baseline levels of as well as linear and quadratic growth in risky college drinking (i.e., heavy episodic drinking and peak drinking quantity).

Chi-square tests and fit indices indicated close fit for the final structural models. Self-efficacy, attitudes, and subjective norms significantly predicted baseline intention, which in turn predicted future heavy episodic drinking. Self-efficacy and attitudes were also related to intention in the model of peak drinking; however, subjective norms were not a significant predictor of intention in the peak drinking model. Mediation analyses showed that intention to engage in risky drinking mediated the effects of self-efficacy and attitudes on growth in risky drinking.

Findings supported the TPB in predicting risky college drinking. Although the current findings should be replicated before definitive conclusions are drawn, results suggest that feedback on self-efficacy, attitudes, and intentions to engage in risky drinking may be a helpful addition to personalized feedback interventions for this population.

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Epidemiology of Alcohol Use in Rural Men in Two Provinces of China

Alcohol use in China has substantially increased during the last three decades. 

The objectives of this study were to examine the sociodemographic patterning of alcohol consumption and to explore the relationship between (a) heavy drinking and frequent acute intoxication and (b) type of alcohol consumed. 

A cross-sectional survey of 18- to 60-year-old men in Hunan and Henan Provinces in 2007 used multistage, randomized clustered sampling to identify 11,884 subjects; 9,866 (83.0%) of them were interviewed. 

The weighted prevalence of 3-month drinking was 61.4% in Hunan and 68.2% in Henan. Among current drinkers, the median daily consumption of pure alcohol in Hunan and Henan were 16.5 ml and 17.9 ml, respectively; 16.6% in Hunan and 22.3% in Henan met criteria for heavy drinking (average daily pure alcohol consumption ≥ 50 ml); and 3.0% in Hunan and 7.3% in Henan reported frequent intoxication. Adult men with lower education in Hunan and those with higher family incomes in Henan were more likely to engage in heavy drinking; those who were unmarried in Hunan and those with higher incomes in Henan were more likely to be intoxicated frequently. In both provinces, those who consumed distilled spirits were at higher risk for heavy drinking and frequent intoxication. 

The majority of rural adult men in both provinces drink alcohol and a substantial minority — particularly those who consume distilled spirits — are heavy drinkers and report more frequent acute intoxication. The consumption of distilled spirits may be a useful target of intervention to reduce the prevalence of heavy drinking and the experience of intoxication.

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Alcohol and Suicide in Russia, 1870-1894 and 1956-2005: Evidence for the Continuation of a Harmful Drinking Culture Across Time?

Previous research suggests that a strong relation exists between alcohol consumption and suicide in Soviet and post-Soviet Russia. 

This study extends this analysis across a much longer historical time frame by examining the relationship between heavy drinking and suicide in tsarist and post-World War II Russia. 

Using alcohol poisoning mortality data as a proxy for heavy drinking, time-series analytical modeling techniques were used to examine the strength of the alcohol–suicide relation in the provinces of European Russia in the period 1870-1894 and for Russia in 1956-2005.

During 1870-1894, a decreasing trend was recorded in heavy drinking in Russia that contrasted with the sharp increase observed in this phenomenon in the post-World War II period. A rising trend in suicide was recorded in both study periods, although the increase was much greater in the latter period. The strength of the heavy drinking–suicide relation nevertheless remained unchanged across time, with a 10% increase in heavy drinking resulting in a 3.5% increase in suicide in tsarist Russia and a 3.8% increase in post-World War II Russia. 

Despite the innumerable societal changes that have occurred in Russia across the two study periods and the growth in the level of heavy drinking, the strength of the heavy drinking–suicide relation has remained unchanged across time. This suggests the continuation of a highly detrimental drinking culture where the heavy episodic drinking of distilled spirits (vodka) is an essential element in the alcohol–suicide association.

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Impact of a New Gender-Specific Definition for Binge Drinking on Prevalence Estimates for Women

Binge drinking accounts for more than half of the 79,000 deaths due to excessive drinking in the U.S. each year. In 2006, the Behavioral Risk Factor Surveillance System (BRFSS) lowered the threshold for defining binge drinking among women from ≥5 drinks to ≥4 drinks per occasion, in accordance with national recommendations.

To assess changes in binge-drinking prevalence among women.

The relative and absolute change in binge drinking among U.S. adult women was assessed using pooled BRFSS data from the 2 years before (2004–2005) and after (2006–2007) the implementation of the new gender-specific definition. Analyses were conducted in 2008–2009.

Binge-drinking prevalence among women increased 2.6 percentage points (from 7.3% in 2004–2005 to 9.9% in 2006–2007), a 35.6% relative increase. The percentage of women who reported consuming exactly 4 drinks in 2006 (3.6%) was similar to the increase in the prevalence of binge drinking among women that was observed from 2005 to 2006 (absolute change=2.9 percentage points).

The new gender-specific definition of binge drinking significantly increased the identification of women drinking at dangerous levels. The change in prevalence among women was primarily due to the change in the definition and not to actual changes in drinking behavior. The new gender-specific definition of binge drinking can increase the usefulness of this measure for public health surveillance and support the planning and implementation of effective prevention strategies (e.g., increasing alcohol excise taxes).

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Parenthood, Alcohol Intake, and Drinking Contexts: Occasio Furem Facit

The aim of this study was to assess whether the effect of parenthood on alcohol intake varies according to the context in which the drinking act occurs.

The data were drawn from the Canadian Addiction Survey, a national telephone survey conducted in 2004. The analytical sample included 1,079 drinking occasions nested in 498 female drinkers and 926 drinking occasions nested in 403 male drinkers between 18 and 55 years of age. A multilevel linear statistical model was used to estimate the variance related to the drinking occasion (Level 1) and to the parental role (Level 2). 

Parenthood was not associated with alcohol intake per occasion. Drinking context variables brought great explanatory power to the study of alcohol intake, but, overall, the effect of parenthood on alcohol intake did not vary according to the context in which drinking occurs. Only one interaction between the parental role and contextual characteristics was found. 

Men's and women's alcohol intake within drinking contexts is more likely to be influenced by the immediate context in which drinking occurs than by their parental role. The explanation for alcohol behaviors within the general Canadian population may lie as much in the situation as in the person.

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Thursday, March 17, 2011

Is Reducing Drinking Always the Answer to Reducing Consequences in First-Year College Students?

Pre-college drinking has been shown to be a predictor of risky drinking and harmful outcomes in college. By contrast, less is known about how pre-college alcohol consequences influence subsequent consequences during the freshman year. 

The present study examined pre-college drinking and consequences in relationship to consequences experienced during the freshman year to better understand alcohol-related problems in this population. 

Incoming freshmen (N = 340, 58% female) were randomly selected and completed measures of drinking quantity, alcohol-related consequences, and drinking style behaviors at pre-college baseline and at 10-month follow-up. 

Pre-college consequences demonstrated a unique relationship with consequences at 10-month follow-up controlling for both pre-college and freshman-year alcohol consumption. 

Furthermore, pre-college consequences moderated the relationship between pre-college drinking and consequences at 10-month follow-up. For individuals who reported above-average pre-college consequences, no differences in 10-month follow-up consequences were observed across different levels of drinking. 

Finally, drinking style significantly mediated the relationship between the interaction between pre-college drinking and consequences and consequences at follow-up. 

The findings demonstrate the need to identify students who are at an increased risk of experiencing alcohol-related problems during their freshman year based on their history of consequences before college. 

Interventions aimed at these students may benefit from examining the usefulness of increasing protective behaviors as a method to reduce consequences in addition to reducing drinking quantity. 

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Alcohol Prevention on College Campuses: The Moderating Effect of the Alcohol Environment on the Effectiveness of Social Norms Marketing Campaigns

Evaluations of social norms marketing campaigns to reduce college student drinking have produced conflicting results. 

This study examines whether the effectiveness of such campaigns may be moderated by on-premise alcohol outlet density in the surrounding community. 

Multilevel analyses were conducted of student survey responses (N = 19,838) from 32 U.S. colleges that took part in one of two 4-year randomized, controlled trials completed for the Social Norms Marketing Research Project (SNMRP). In the models, students by year were nested within treatment (n = 16) and control group (n = 16) campuses, which were characterized by the on-premise outlet density in their surrounding community. The moderating effect of outlet density was introduced into the models as an interaction between the treatment effect (i.e., the effect of the social norms marketing campaigns over time) and outlet density. The models were also stratified by campus alcohol outlet density (high vs. low) to examine the effect of the intervention in each type of setting.

There was a significant interaction between the treatment effect and on-premise alcohol outlet density for one of the drinking outcomes targeted by the SNMRP intervention, the number of drinks when partying, and marginal evidence of interaction effects for two other outcomes, maximum recent consumption and a composite drinking scale. 

In stratified analyses, an intervention effect was observed for three of the four outcomes among students from campuses with lower on-premise alcohol outlet density, whereas no intervention effect was observed among students from campuses with higher on-premise alcohol outlet density. 

The findings suggest that the campus alcohol environment moderates the effect of social norms marketing interventions. Social norms marketing intervention may be less effective on campuses with higher densities of on-sale alcohol outlets.

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