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Friday, August 5, 2011

Blood alcohol concentration at 0.06 and 0.10% causes a complex multifaceted deterioration of body movement control

Alcohol-related falls are recognized as a major contributor to the occurrence of traumatic brain injury. The control of upright standing balance is complex and composes of contributions from several partly independent mechanisms such as appropriate information from multiple sensory systems and correct feedback and feed forward movement control. Analysis of multisegmented body movement offers a rarely used option for detecting the fine motor problems associated with alcohol intoxication.

The study aims were to investigate whether (1) alcohol intoxication at 0.06 and 0.10% blood alcohol concentration (BAC) affected the body movements under unperturbed and perturbed standing; and (2) alcohol affected the ability for sensorimotor adaptation.

Body movements were recorded in 25 participants (13 women and 12 men, mean age 25.1 years) at five locations (ankle, knee, hip, shoulder, and head) during quiet standing and during balance perturbations from pseudorandom pulses of calf muscle vibration over 200
s with eyes closed or open. Tests were performed at 0.00, 0.06, and 0.10% BAC.

The study revealed several significant findings: (1) an alcohol dose-specific effect; (2) a direction-specific stability decrease from alcohol intoxication; (3) a movement pattern change related to the level of alcohol intoxication during unperturbed standing and perturbed standing; (4) a sensorimotor adaptation deterioration with increased alcohol intoxication; and (5) that vision provided a weaker contribution to postural control during alcohol intoxication.

Hence, alcohol intoxication at 0.06 and 0.10% BAC causes a complex multifaceted deterioration of human postural control.

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Alcohol Mixed with Energy Drinks: Consumption Patterns and Motivations for Use in U.S. College Students

Binge drinking in college students is widespread and known to cause significant harms and health hazards for the drinker. One factor that may be exacerbating hazardous drinking in young people is the new popular trend of consuming alcohol mixed with energy drinks (AmED). However, rates of AmED use and motivations for AmED consumption in college students have not been well established.

In this study, 706 undergraduate college students from a university in the United States participated in a web-based survey that queried self-reported alcohol, energy drink, and AmED use. In addition, motivations for using AmEDs were assessed.

The results indicated that for all participants, 81% reported that they have tried at least one energy drink in the past and 36% reported consumption of at least one energy drink in the past 2 weeks.

Alcohol consumption patterns were similar to findings from U.S. national surveys of college drinking, as 37% of respondents were classified as binge drinkers and 23% abstained from drinking. In the whole sample (including the alcohol abstainers), 44% reported trying AmED at least once and 9% reported AmED consumption at least once in the past 2 weeks. 78% of respondents agreed with the statement that AmEDs appeal to underage drinkers.

When AmED users were asked about various motivations for consuming AmEDs, users reported that they consumed these beverages to get drunk and reduce sedation compared to alcohol alone.

In conclusion, the consumption of AmEDs is common in U.S. college students. Motivations for using AmEDs include the reduction of the sedative effects of alcohol, an important interoceptive cue that one should stop drinking.

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New approach launched to reduce tribal alcohol and substance abuse problems

A new federal framework to assist American Indian and Alaska Native communities in achieving their goals in the prevention, intervention, and treatment of alcohol and substance abuse was announced Friday, Aug. 5 by the U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, Department of Interior (DOI) Secretary Ken Salazar, and Attorney General of the United States Eric Holder.

The framework, captured in a Memorandum of Agreement (MOA) signed by Secretary Sebelius, Secretary Salazar, and Attorney General Holder was published in the Federal Register today - It was called for in the Tribal Law and Order Act of 2010, which President Obama signed into law in July 2010.

The MOA describes how the Office of Indian Alcohol and Substance Abuse established in HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) will coordinate tribal substance abuse programs across the federal government with a special emphasis on promoting programs geared toward reaching youth and offering alternatives to incarceration. > > > > > Read More

Global Actions on Harmful Drinking

Global Actions Spotlight: Our Colombia Team

With the first PACTOS seminar approaching in Bogotá, this week’s focus is on our Colombia team. Pictured from left are Mario Lleras, Alberto Bouroncle, Claudia Puentes, and John Sullivan.

John Sullivan was commissioned by ICAP in 2010 to be the Mentor-Trainer for our Colombia initiatives. His expertise comes from many years in the field of traffic safety and DWI initiatives. John works closely with Mario to develop the Global Actions projects in Colombia.

Mario Lleras joined Global Actions in March 2011 as Country Coordinator for Colombia. Mario is working in partnership with Colombia’s Road Prevention Fund, Fondo de Prevención Vial (FPV), to advance the PACTOS initiatives of the Ministry of Social Protection and the United Nations Office on Drugs and Crime (UNODC). Mario coordinates all Global Actions work in Colombia, mainly focused on Drink Driving. This includes collaboration with Zonas Seguras (Safe Zones), a joint effort by municipal authorities, local police, the private sector, and the community to implement safety measures in Colombia’s party centers.

Alberto Bouroncle was appointed by ICAP to help structure PACTOS evaluation tools. A Senior Research Associate at LTG Associates, his experience includes 19 years of International Development work, with emphasis in Public Health and Education.

Claudia Puentes, Director of Communications, Pedagogy, and Institutional Relations for Fondo de Prevención Vial (FPV), is another important contact in Colombia. FPV is our key local implementing partner for the initiative, and Claudia helps manage the projects that ICAP and FPV are collaborating on. Claudia also helps coordinate our efforts with other stakeholders.

What’s Happening Next:

· Vietnam: Drink Driving launch event on August 6 in Da Nang. Education Enforcement workshop August 16-18 in Da Nang.

· Colombia: PACTOS Seminar in Bogotá in August (date to be announced.)

· Trinidad: A training workshop on best practices in Self-Regulation will be hosted by the Trinidad and Tobago Beverage Alcohol Alliance (TTBAA) and held August 18 in Port-of-Spain, Trinidad.

· Mexico: Drink Drive launch event and training workshop in Guadalajara, early September date to be announced.

· China: Training workshops for local staff September 16-18 in Xi’an and September 20-22 in Nanjing. Training workshops for traffic police in Xi’an and Nanjing will be in September.

The role of parental alcohol consumption on driving under the influence of alcohol: Results from a longitudinal, nationally representative sample

Many studies have examined the role of peer and parental alcohol use on drinking behaviors among adolescents. Few studies, however, have examined parental influences on driving under the influence (DUI) of alcohol. The current study uses data from a longitudinal study to examine the role of parental alcohol use during adolescence on the risk for DUI among young adult men and women.

Data were derived from 9559 adolescents and young adults who participated in the National Longitudinal Study of Adolescent Health (Add Health) Waves I and III. Survey logistic regression was used to examine the relationship between multilevel risk and protective factors and self-reported DUI. Analyses were stratified by gender and frequency of parental alcohol consumption to understand the role of parental alcohol use on risk for DUI among their youth.

Risk and protective factors for DUI were very similar among men and women. Parental alcohol use significantly predicted DUI among women (OR = 1.39, p < 0.01) and men (OR = 1.33, p < 0.05). When parents did not report alcohol use, peer alcohol use significantly increased risk for DUI for both women (OR = 1.26, p < 0.05) and men (OR = 1.31, p < 0.001). When parents reported alcohol use, however, peer alcohol use was not a significant independent predictor.

Findings suggest remarkable similarities in risk and protective factors for DUI across gender groups. For men and women, parental alcohol consumption was a risk factor for DUI. Peers’ alcohol use predicted DUI only when parents did not use alcohol.

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Drugs related to motor vehicle crashes in northern European countries: A study of fatally injured drivers

The aim of this study was to find which drugs and drug combinations were most common in drivers who died, in particular, in single vehicle crashes where the responsibility for the crash would be referred to the driver killed.

The study included all available blood samples from drivers, who died within 24 h of the accident, in the years 2001 and 2002 in the five Nordic countries (total population about 24 million inhabitants). The samples were analysed for more than 200 different drugs in addition to alcohol, using a similar analytical programme and cut-off limits in all countries. In three countries (Finland, Norway and Sweden) blood samples were available for more than 70% of the drivers, allowing representative prevalence data to be collected.

60% of the drivers in single vehicle crashes had alcohol and/or drug in their blood samples, compared with 30% of drivers killed in collisions with other vehicles.

In single vehicle accidents, 66% of the drivers under 30 years of age had alcohol and/or drugs in their blood (alcohol only – 40%; drugs only – 12%; alcohol and drugs – 14%).

The drugs found were mostly illicit drugs and psychoactive medicinal drugs with warning labels (in 57% and 58% respectively of the drivers under 30 with drugs present).

Similar findings were obtained for drivers 30–49 years of age (63% with alcohol and/or drugs). In drivers aged 50 years and above, killed in single vehicle crashes (48% with alcohol and/or drugs) illicit drugs were found in only one case, and psychoactive medicinal drugs were detected less frequently than in younger age groups. In 75% of single vehicle crashes, the driver was under 50 years.

Thus, the majority of accidents where the drivers must be considered responsible, occurred with drivers who had recently used alcohol, or drugs, alone or in combination. The drugs involved were often illicit and/or psychoactive drugs with warning labels.

Therefore a large proportion of single vehicle accidents appear to be preventable, if more effective measures against driving after intake of alcohol and drugs can be implemented.

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Auditory Brainstem Response (ABR) Abnormalities Across the Life Span of Rats Prenatally Exposed to Alcohol

Fetal alcohol syndrome (FAS) is a leading cause of neurodevelopmental impairments (NDIs) in developed countries. Sensory deficits can play a major role in NDI, yet few studies have investigated the effects of prenatal alcohol exposure on sensory function. In addition, there is a paucity of information on the lifelong effects of prenatal alcohol exposure. Thus, we sought to investigate the effects of prenatal alcohol exposure on auditory function across the life span in an animal model. Based on prior findings with prenatal alcohol exposure and other forms of adverse prenatal environments, we hypothesized that animals prenatally exposed to alcohol would show an age-dependent pattern of (i) hearing and neurological abnormalities as postweanling pups, (ii) a substantial dissipation of such abnormalities in young adulthood, and (iii) a resurgence of such abnormalities in middle-aged adulthood.

Pregnant rats were randomly assigned to an untreated control (CON), a pair-fed control (PFC), or an alcohol-treated (ALC) group. The ALC dams were gavaged with 6 mg/kg alcohol daily from gestation day (GD) 6 to 21. The PFC dams were gavaged daily from GD6 to GD21 with an isocaloric and isovolumetric water-based solution of maltose-dextrins and pair-fed to the ALC dams. The CON dams were the untreated group to which the ALC and CON groups were compared. Hearing and neurological functions in the offspring were assessed with the auditory brainstem response (ABR) at the postnatal ages of 22, 220, and 520 days.

In accord with our hypothesis, ABR abnormalities were first observed in the postweanling pups, largely dissipated in young adulthood, and then resurged in middle-aged adulthood. This age-related pattern suggests that the ALC pups had a developmental delay that dissipated in young adulthood and an enhanced age-related deterioration that occurred in middle-aged adulthood. Such a pattern is consistent with the fetal programming hypothesis of adult-onset diseases (the Barker hypothesis).

Our findings have important clinical implications for the assessment and management of (i) childhood hearing disorders and their comorbidities (i.e., speech-and-language, learning, and attention deficit disorders) and (ii) enhanced age-related hearing and neurological degeneration in middle-aged adulthood that can result from prenatal alcohol exposure. We recommend hearing evaluation be a part of any long-term follow-up for FAS patients and patients exposed to any adverse prenatal environment.

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Place conditioning with ethanol in rats bred for high (UChB) and low (UChA) voluntary alcohol drinking

The main goal of this study was to investigate the ability of an ethanol dose (1g/kg) administered intraperitoneally to induce conditioned place preference (CPP) and/or conditioned place aversion (CPA) in two lines of rats selectively bred for their high (UChB) or low (UChA) voluntary ethanol intake.

It was found that five pairings with ethanol induced CPA in ethanol-naïve rats of both lines, but the magnitude of avoidance was lower in the UChB relative to the UChA rats, indicating that ethanol was less aversive to naïve rats bred for high alcohol drinking.

After 2 months of high voluntary ethanol drinking (∼6–7
g/kg/day), in free choice between 10% ethanol and water, ethanol produced CPP in UChB rats, reflecting that ethanol had become rewarding to these rats.

By contrast, the low voluntary ethanol intake (<1
g/kg/day) displayed by UChA rats preexposed for 2 months in free choice did not change ethanol-induced CPA.

However, preexposure of UChA rats to forced ethanol drinking (∼5.7
g/kg/day) and the later inhibition of ethanol-derived acetaldehyde by 4-methylpyrazole (10mg/kg intraperitoneal), an inhibitor of the enzyme alcohol dehydrogenase, not only increased their voluntary ethanol intake in free choice, but also had a facilitating effect on the development of CPP.

Taken together, these results show that the expression of the reinforcing effects of ethanol required a period of voluntary ethanol intake in UChB rats, whereas in UChA rats, both prior exposure to forced ethanol drinking and reduction of high blood ethanol-derived acetaldehyde were required.

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Interactions of the LIPG 584C>T polymorphism and alcohol consumption on serum lipid levels

Both endothelial lipase gene (LIPG) 584C>T (rs2000813) polymorphism and alcohol consumption modulate serum lipid levels. But their interactions on serum lipid profiles are not well known.

The present study was undertaken to detect the interactions of
LIPG 584C>T polymorphism and alcohol consumption on serum lipid levels. Genotyping of the LIPG 584C>T was performed in 763 unrelated nondrinkers and 520 drinkers aged 15–85 years.

The levels of serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), apolipoprotein (Apo) AI, and the ratio of ApoAI to ApoB were higher in drinkers than in nondrinkers (
P<.01 for all). There were no significant differences in the genotypic and allelic frequencies between nondrinkers and drinkers. The levels of TC, HDL-C, and ApoAI in nondrinkers were different among the three genotypes (P<.05–.01), the subjects with CT genotype had higher TC, HDL-C, and ApoAI levels than the subjects with CC genotype. The levels of HDL-C and ApoAI in drinkers were different among the three genotypes (P<.001 and P<.05; respectively), the individuals with TT genotype had higher HDL-C and ApoAI levels than the individuals with CT and CC genotypes.

The interactions between
LIPG 584C>T genotypes and alcohol consumption on serum HDL-C (P<.01) and ApoAI levels (P<.05) were also detected by using a factorial regression analysis after controlling for potential confounders. The levels of TC in nondrinkers were correlated with LIPG 584C>T alleles (P<.05), whereas the levels of TG and HDL-C were associated with LIPG 584C>T alleles (P<.05) and genotypes (P<.05), respectively.

These results suggest that the subjects with TT genotype benefit more from alcohol consumption than the subjects with CT and CC genotypes in increasing serum HDL-C and ApoAI levels.

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ntegrating Spiritual and Western Treatment Modalities in a Native American Substance User Center: Provider Perspectives

Few studies examine how traditional Native American and Western healing practices are being integrated in Native American substance user treatment centers.

Data are presented from a 2008 study of providers of integrated substance user treatment for Native Americans at an urban Western US center. Nineteen semistructured interviews were conducted to examine 10 providers’ views of the integration of traditional and Western healing and the impact on recovery for clients.

We used a grounded theory approach to data analysis with manual and NVivo codes and themes developed. Limitations and implications for practice are discussed.

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Alcohol, Tobacco, and Illicit Drug Use Among Native American College Students: An Exploratory Quantitative Analysis

We examine alcohol, tobacco, and illicit drug use among US Native American college students by using 4 years of College Alcohol Study data (1993, 1997, 1999, and 2001; n = 267). To the authors’ knowledge, this is the first study to quantitatively examine this population using advanced statistical analyses and a nationally representative sample of US college students.

Descriptive and logistic regression analyses show that Native American college students have unique rates and patterns of substance use that must be addressed accordingly.

It is suggested that specialized future research and policy are needed to properly address alcohol and drug use among this population. Limitations of the study are noted.

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Brain region-specific gene expression changes after chronic intermittent ethanol exposure and early withdrawal in C57BL/6J mice

Neuroadaptations that participate in the ontogeny of alcohol dependence are likely a result of altered gene expression in various brain regions.

The present study investigated brain region-specific changes in the pattern and magnitude of gene expression immediately following chronic intermittent ethanol (CIE) exposure and 8 hours following final ethanol exposure [i.e. early withdrawal (EWD)]. High-density oligonucleotide microarrays (Affymetrix 430A 2.0, Affymetrix, Santa Clara, CA, USA) and bioinformatics analysis were used to characterize gene expression and function in the prefrontal cortex (PFC), hippocampus (HPC) and nucleus accumbens (NAc) of C57BL/6J mice (Jackson Laboratories, Bar Harbor, ME, USA). Gene expression levels were determined using gene chip robust multi-array average followed by statistical analysis of microarrays and validated by quantitative real-time reverse transcription polymerase chain reaction and Western blot analysis.

Results indicated that immediately following CIE exposure, changes in gene expression were strikingly greater in the PFC (284 genes) compared with the HPC (16 genes) and NAc (32 genes). Bioinformatics analysis revealed that most of the transcriptionally responsive genes in the PFC were involved in Ras/MAPK signaling, notch signaling or ubiquitination.

In contrast, during EWD, changes in gene expression were greatest in the HPC (139 genes) compared with the PFC (four genes) and NAc (eight genes). The most transcriptionally responsive genes in the HPC were involved in mRNA processing or actin dynamics. Of the few genes detected in the NAc, the most representatives were involved in circadian rhythms.

Overall, these findings indicate that brain region-specific and time-dependent neuroadaptive alterations in gene expression play an integral role in the development of alcohol dependence and withdrawal.

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Thursday, August 4, 2011

Protecting the unborn baby from alcohol, 7 September 2011, European Parliament, Brussels

Under the patronage of the President of the European Parliament Prof Jerzy Buzek

Hosted by MEP Elzbieta Lukacijewska (EPP, Poland)
Key note speaker European Commissioner for Health and Consumer Policy Mr John Dalli

Place: European Parliament – Brussels
Date: Wednesday 7th September
Time: 12h30 – 15h00
Room: A3 E2

This event is jointly organized by European Alcohol Policy Alliance (Eurocare) and the Polish State Agency for Prevention of Alcohol-Related Problems (PARPA) to mark International Foetal Alcohol Spectrum Disorders (FASD) Day.

Drinking alcohol during pregnancy is the leading known cause of birth defects and developmental disorders in the EU. > > > > Read More