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, September 17, 2011

Battling high-risk drinking on campus


The rate of student alcohol abuse has remained unchanged for 30 years: Nearly 40 percent of 2010 U.S. college students still engage in high-risk alcohol consumption. That means, unfortunately, that binge drinking is as widespread among today’s freshmen as it was for their parents’ generation and potentially just as lethal. Each year, almost 2,000 U.S. college students die from alcohol-related causes. An estimated 600,000 others are injured while under the influence.

Loss of life is reason enough to act, but excessive drinking, as repeated studies have shown, can also lead to academic problems, unsafe sex and sexual abuse. New research confirms that alcohol can damage brain development among college-age men and women, impairing functions associated with focus, decision-making and impulse control. As a leader, a parent and a physician, I believe that this particular “given” of college life has led to far more deaths and harm than we should tolerate. > > > > Read More

Different Phenotypic and Genotypic Presentations in Alcohol Dependence: Age at Onset Matters


Several theoretical typology models have been proposed to classify alcoholism into more homogeneous subtypes using various criteria, for which age at onset of alcohol dependence is shared across many models. We investigated the evidence for the distinction between early- versus late-onset alcoholism by examining relevant phenotypic and genotypic variables.


Data are from 1,248 individuals with alcohol dependence, who were interviewed to collect detailed clinical information. Early versus late onset of alcohol dependence was defined by the age at onset of 22 years. Odds ratio (OR) and Cohen's d were calculated as effect size for comparisons of clinical features between the two groups. We adjusted interviewed age and gender in logistic regression models. Case-control genetic analyses were conducted for the association between HTR1B, SLC6A4, DRD2, and OPRμ1 genes and subgroups of alcohol dependence using a sample of 530 controls screened for alcohol problems.

Early-onset alcoholism exhibited significantly (p < .01) different clinical characteristics from late-onset alcoholism, including higher severity in alcohol dependence symptoms (d = 0.22) and maximum drinking quantity within 24 hours (d = 0.40), more rapid progression from regular drinking to meet alcohol dependence diagnosis (d = 1.73), higher expectancies for alcohol (d = 0.22–0.47), more comorbidity with externalizing disorders (ORs = 2.8–2.9), and greater prevalence of family alcohol use problems (d = 0.26–0.43). In addition, markers in the HTR1B and OPRμ1 genes showed genetic associations with subgroups of alcohol dependence (ORs = 1.5–2.4).

Our findings support that subgroups of alcohol dependence defined by onset age have phenotypic and genetic differences. The early-onset subgroup had more severe features for almost every aspect we examined. Coupled with genetic association findings, age at onset of alcohol dependence may serve as a simple but important clinical marker with implications for future etiological research and intervention.




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Request Reprint E-Mail: cprescot@usc.edu

Hospitalizations for Alcohol and Drug Overdoses in Young Adults Ages 18–24 in the United States, 1999–2008: Results From the Nationwide Inpatient Samp



Recent reports indicate an increase in rates of hospitalizations for drug overdoses in the United States. The role of alcohol in hospitalizations for drug overdoses remains unclear. Excessive consumption of alcohol and drugs is prevalent in young adults ages 18–24. The present study explores rates and costs of inpatient hospital stays for alcohol overdoses, drug overdoses, and their co-occurrence in young adults ages 18–24 and changes in these rates between 1999 and 2008.

Data from the Nationwide Inpatient Sample were used to estimate numbers, rates, and costs of inpatient hospital stays stemming from alcohol overdoses (and their subcategories, alcohol poisonings and excessive consumption of alcohol), drug overdoses (and their subcategories, drug poisonings and nondependent abuse of drugs), and their co-occurrence in 18- to 24-year-olds.

Hospitalization rates for alcohol overdoses alone increased 25% from 1999 to 2008, reaching 29,412 cases in 2008 at a cost of 266 million. Hospitalization rates for drug overdoses alone increased 55%, totaling 113,907 cases in 2008 at a cost of 737 million. Hospitalization rates for combined alcohol and drug overdoses increased 76%, with 29,202 cases in 2008 at a cost of 198 million.

Rates of hospitalizations for alcohol overdoses, drug overdoses, and their combination all increased from 1999 to 2008 among 18- to 24-year-olds. The cost of such hospitalizations now exceeds 1.2 billion annually. The steepest increase occurred among cases of combined alcohol and drug overdoses. Stronger efforts are needed to educate medical practitioners and the public about the risk of overdoses, particularly when alcohol is combined with other drugs.




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Request Reprint E-Mail: aaron.white@duke.edu

Psychosocial Correlates of Alcohol Use and Reduction for Individuals With Hepatitis C




Patients with hepatitis C virus (HCV) are advised to refrain from alcohol consumption. A questionnaire was developed to measure concepts associated with alcohol use for individuals with HCV.

Subjects with HCV (N = 527) completed a telephone survey. Eligible respondents had screened negative for current abuse/dependence disorders (Alcohol Use Disorders Identification Test [AUDIT] ≤ 10). Measures of personality, self-efficacy, knowledge, readiness, coping styles, stigma, and symptoms were examined for associations with alcohol use.

Factor analysis supported a measurement structure of 105 items in 35 subdomains. A total of 26 subdomains had significant bivariate associations with alcohol use. Higher self-efficacy for resisting drinking in social situations was associated with lower alcohol use (r = -.68, p < .001), as was knowledge of alcohol and HCV (r = -.27, p < .001). Although agreeableness and marital status are typically associated with lower current drinking in samples of those with alcohol use problems, in our study agreeableness (β = .13, p < .01) and marital status (β = .08, p < .05) were modestly associated with higher current drinking. The final multivariate R-squared was .55.

The pattern of associations suggests the importance of the social aspects of drinking for drinking decisions. Existing brief interventions will need to be tailored to a contextualized psychosocial model for medical patients with HCV and AUDIT scores ≤ 10 to optimize effectiveness. Such future interventions should emphasize the potential medical hazards of drinking for persons with HCV, the maintenance of social relationships in the absence of alcohol use, and strategies for building confidence for resisting drinking in specific situations.




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Request Reprint E-Mail: Adam.Perzynski@case.edu

Racial/Ethnic Differences in the Etiology of Alcohol Use Among Urban Adolescents



We examined relations between neighborhood context, home and family management practices, deviant peer affiliations, beliefs favorable to use, and alcohol use among urban African American and Hispanic adolescents.

The sample comprised 4,027 African American and Hispanic adolescents who were 50% boys and 75% low income. Participants completed surveys in 2002–2005 and 2008–2009. Structural equation modeling assessed direct and indirect relations between neighborhood context in 6th grade, home and family management practices in 7th grade, deviant peer affiliations and beliefs favorable to use in 8th grade, and alcohol use in 12th grade.

There was significant variation in structural models across race/ethnicity but not gender. Differences included the influence of neighborhood and school strength and, where similarities existed, differences in effect magnitude. Similarities included significant correlations among measurement components; the indirect influence of alcohol advertisement exposure, gender, area deprivation, and home alcohol access on alcohol use; direct influence of deviant peer affiliations and beliefs favorable to use on alcohol use; and indirect effects highlighting the importance of preventing home alcohol access, deviant peer affiliations, and beliefs favorable to use and promoting protective family management practices.

Neighborhood and school strength may be particularly important in preventing alcohol use among African Americans, whereas preventing early onset of alcohol use among Hispanics remains important. Preventive efforts may wish to focus on neighborhood deprivation, exposure to alcohol advertisements, and home risks and protective factors because they have direct and indirect effects on intrapersonal factors and alcohol use.
Link


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Request Reprint E-Mail: alt@ichp.ufl.edu

Friday, September 16, 2011

Psychometric Performance of DSM-IV Alcohol Use Disorders in Young Adulthood: Evidence From an Australian General Population Sample



The current study investigates the performance of alcohol use disorders in young adults using item response theory and differential item functioning (DIF).

The 1997 National Survey of Mental Health and Wellbeing (Australia) sample was based on a stratified, multistage area probability sample of people ages 18 years and older in the Australian population. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), alcohol use disorders were assessed in all current alcohol users (N = 7,746; 44.2% female). The psychometric properties of the DSM-IV alcohol use disorder criteria in young adults were assessed using item response theory. Age-based DIF was also assessed in each of the DSM-IV criteria for alcohol use disorders. The presence of age-based DIF in subgroups defined by sex and consumption was also examined.

Overall, problems were identified in the use in hazardous situations, persistent desire/inability to quit/cut down, and tolerance criteria in young adults. However, the DIF identified at the criterion level had little impact on total information provided by the criteria across the two age groups. Subgroup analyses indicated that for the female-only and non-heavy using subgroups, DIF was no longer detected in the use in hazardous situations criterion. The alcohol use disorder criteria were found to provide maximum information about moderate to severe pathology among young adults. There was little evidence for the DSM-IV abuse/dependence distinction in young adulthood.

Some of the DSM-IV alcohol use disorder criteria appear problematic when applied to young adults, and future research needs to focus on clarifying young adults' understanding of these problematic criteria. Although DIF was identified in three of the alcohol use disorder criteria, the total information provided by these criteria was largely the same among younger and older age groups.




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Request Reprint E-Mail: louisem@unsw.edu.au

Multisite Cost Analysis of a School-Based Voluntary Alcohol and Drug Prevention Program



This article estimates the societal costs of Project CHOICE, a voluntary after-school alcohol and other drug prevention program for adolescents. To our knowledge, this is the first cost analysis of an after-school program specifically focused on reducing alcohol and other drug use.

The article uses microcosting methods based on the societal perspective and includes a number of sensitivity analyses to assess how the results change with alternative assumptions. Cost data were obtained from surveys of participants, facilitators, and school administrators; insights from program staff members; program expenditures; school budgets; the Bureau of Labor Statistics; and the National Center for Education Statistics.

From the societal perspective, the cost of implementing Project CHOICE in eight California schools ranged from $121 to $305 per participant (Mdn = $238). The major cost drivers included labor costs associated with facilitating Project CHOICE, opportunity costs of displaced class time (because of in-class promotions for Project CHOICE and consent obtainment), and other efforts to increase participation. Substituting nationally representative cost information for wages and space reduced the range to $100–$206 (Mdn = $182), which is lower than the Substance Abuse and Mental Health Services Administration's estimate of $262 per pupil for the "average effective school-based program in 2002." Denominating national Project CHOICE costs by enrolled students instead of participants generates a median per-pupil cost of $21 (range: $14–$28).

Estimating the societal costs of school-based prevention programs is crucial for efficiently allocating resources to reduce alcohol and other drug use. The large variation in Project CHOICE costs across schools highlights the importance of collecting program cost information from multiple sites.




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Descriptive Drinking Norms: For Whom Does Reference Group Matter



Perceived descriptive drinking norms often differ from actual norms and are positively related to personal consumption. However, it is not clear how normative perceptions vary with specificity of the reference group. Are drinking norms more accurate and more closely related to drinking behavior as reference group specificity increases? Do these relationships vary as a function of participant demographics? The present study examined the relationship between perceived descriptive norms and drinking behavior by ethnicity (Asian or White), sex, and fraternity/sorority status.

Participants were 2,699 (58% female) White (75%) or Asian (25%) undergraduates from two universities who reported their own alcohol use and perceived descriptive norms for eight reference groups: "typical student"; same sex, ethnicity, or fraternity/sorority status; and all combinations of these three factors.

Participants generally reported the highest perceived norms for the most distal reference group (typical student), with perceptions becoming more accurate as individuals' similarity to the reference group increased. Despite increased accuracy, participants perceived that all reference groups drank more than was actually the case. Across specific subgroups (fraternity/sorority members and men) different patterns emerged. Fraternity/sorority members reliably reported higher estimates of drinking for reference groups that included fraternity/sorority status, and, to a lesser extent, men reported higher estimates for reference groups that included men.

The results suggest that interventions targeting normative misperceptions may need to provide feedback based on participant demography or group membership. Although reference group–specific feedback may be important for some subgroups, typical student feedback provides the largest normative discrepancy for the majority of students.




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Request Reprint E-Mail: larimer@u.washington.edu

They Drink How Much and Where? Normative Perceptions by Drinking Contexts and Their Association to College Students' Alcohol Consumption



Prior research has shown that normative perceptions of others' drinking behavior strongly relates to one's own drinking behavior. Most research examining the perceived drinking of others has generally focused on specificity of the normative referent (i.e., gender, ethnicity). The present study expands the research literature on social norms by examining normative perceptions by various drinking contexts. Specifically, this research aimed to determine if college students overestimate peer drinking by several drinking contexts (i.e., bar, fraternity/sorority party, non–fraternity/sorority party, sporting event) and to examine whether normative perceptions for drinking by contexts relate to one's own drinking behavior specific to these contexts.

Students (N = 1,468; 56.4% female) participated
in a web-based survey by completing measures assessing drinking behavior and perceived descriptive drinking norms for various contexts.


Findings demonstrated that students consistently overestimated the drinking behavior for the typical same-sex student in various drinking contexts, with the most prominent being fraternity/sorority parties. In addition, results indicated that same-sex normative perceptions for drinking by contexts were associated with personal drinking behavior within these contexts.

Results stress the importance of specificity of social norms beyond those related to the normative referent. Clinical implications are discussed in terms of preventions and intervention efforts as well as risks associated with drinking in a novel context.



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Request Reprint E-Mail: lewisma@u.washington.edu

Attachment Avoidance and Anxiety as Predictors of 12-Step Group Engagement



Twelve-step mutual help groups such as Alcoholics Anonymous (AA) rely heavily on social interactions and support to reduce drinking, but little is known about how individual differences in social behavior tendencies, such as adult attachment, affect 12-step group engagement and resulting benefits. This prospective study investigated relationships between the anxiety and avoidance dimensions of adult attachment and subsequent 12-step meeting attendance, program behaviors, sponsorship, and alcohol use.

Early 12-step group affiliates (N = 253) were recruited from community-based AA and from outpatient treatment. Participants completed baseline interviews that included the Relationship Questionnaire, measures of motivation and professional treatment, and measures of 12-step meeting attendance, practices, and sponsorship. Follow-up interviews were conducted at 3, 6, 9, 12, 18, and 24 months.

At baseline, participants reported elevated attachment anxiety relative to a college population. Lagged analyses demonstrated that, as predicted, high attachment avoidance was related to lower rates of 12-step meeting attendance, practice of behaviors prescribed by 12-step organizations, and lower probability of acquiring a sponsor. Attachment anxiety did not predict any of these aspects of subsequent 12-step group engagement. Contrary to predictions, baseline attachment avoidance did not moderate the relationship between early sponsorship and alcohol use.

Findings support the hypothesis that social demands of behaviors prescribed by 12-step groups may deter high-avoidance individuals from fully engaging in them. Perhaps because of instability in attachment avoidance in this population, however, baseline attachment avoidance did not predict drinking outcomes or moderate sponsor benefits
.



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Request Reprint E-Mail: chrisoej@unm.edu

Twelve-Step Program Attendance and Polysubstance Use: Interplay of Alcohol and Illicit Drug Use

The primary aim of this study was to advance understanding of the efficacy of 12-step programs by determining the temporal relationships between alcohol and illicit drug use among 12-step program affiliates.

A total of 253 early 12-step affiliates without extensive histories of Alcoholics Anonymous (AA) attendance were recruited from substance use treatment and community-based AA. A majority of the sample met criteria for a diagnosis of alcohol dependence, reported lifetime use of illicit drugs, and reported illicit drug use in the 90-day period before recruitment. After informed consent, participants were interviewed at intake and in 3-month increments for 1 year.

Preliminary analyses indicated that 12-step attendance was predictive of reductions in substance use and that such reductions were not moderated by illicit substance use disorder diagnosis or alcohol problem severity. Lagged hierarchical linear models indicated that illicit drug use was a robust predictor of later use of alcohol, although the frequency and intensity of drinking were contingent on whether participants sustained 12-step program affiliation. Alcohol use did not predict later illicit drug use among participants who sustained 12-step program participation.

Findings suggest that 12-step participation may serve as a protective factor after substance use occurs. Although our results suggest that the initiation of illicit drug use may undermine efforts to achieve and sustain abstinence from alcohol, our findings do not suggest that alcohol use necessarily mobilizes relapse across different substances among 12-step program affiliates.




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Request Reprint E-Mail: jtonigan@unm.edu

Gender Differences in Outcome at 2-Year Follow-Up of Treated Bipolar and Depressed Alcoholics



Alcohol dependence and affective disorders are significant health problems, and their co-occurrence is mutually detrimental. There are few long-term studies on the impact of treatment on the prognosis of these comorbid disorders. We wished to study if the impact of effective inpatient integrated treatment for these co-occurring disorders was maintained 2 years after discharge from the hospital.

A total of 189 patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for alcohol dependence and either bipolar disorder or depression were recruited, assessed, and assigned to an inpatient treatment unit. Following intensive integrated treatment that was designed to integrate psychotherapy with pharmacotherapy, affective disorder with substance use disorder treatment, and inpatient with outpatient therapy, this population was followed for 2 years after discharge.

Treatment improvements above baseline that were achieved over the course of the 4-week intensive inpatient treatment were essentially maintained over a 2-year outpatient period. Depression, elation, anxiety, and craving scores all fell, as did all drinking outcome measures in both depressed and bipolar alcohol-dependent groups. Findings suggested that women with a diagnosis of bipolar disorder reported higher levels of depression and anxiety symptoms than male bipolar patients at 2-year follow-up. More women than men remained abstinent at 2 years after treatment, with this difference mainly in the depressed sample.

Comorbid bipolar alcoholics and depressed alcoholics can be treated successfully together on an integrated inpatient treatment program, and the benefits can last for up to 2 years. There also appeared to be significant gender differences in treatment outcomes
.



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Request Reprint E-Mail: cfarren@stpatsmail.com

Fire Fatality and Alcohol Intake: Analysis of Key Risk Factors



After a brief review of the literature on the role of alcohol in residential fire deaths, a comparison of different risk factors for residential fire fatality was undertaken by closely analyzing the circumstances of fire victims as a function of alcohol intake.

Analyses were based on Australian coroners' fire fatality records for the state of Victoria (1998–2006) and considered demographic, behavioral, and environmental factors for the 95 adult fire victims who were tested for alcohol (64 male, 31 female).

Most (58%) had a positive blood alcohol concentration (BAC) test, with 31% of the total sample having a BAC of more than 0.20 gm per 100 ml. Odds ratio analyses showed that four variables were significantly more associated with victims who had consumed alcohol compared with sober victims. In descending odds ratio order, these variables were as follows: (a) being aged 18–60 years, (b) involving smoking materials (e.g. cigarettes, pipes), (c) having no conditions preventing escape, and (d) being male. An important new finding is that fire fatalities with positive BAC levels were more than three times less likely to have their clothing alight or exits blocked than sober fire victims.

The risk of dying in a fire for alcohol-affected people who are capable of being alerted and escaping may be reduced if they can be alerted more quickly and effectively. Suitable measures for improving smoke alarms via interlinking and the use of an alarm signal demonstrated to be more effective at waking sleepers, including those who are alcohol affected, are discussed.



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Thursday, September 15, 2011

Press Release - Social contacts, self-confidence crucial to successful recovery through Alcoholics Anonymous



Among the many ways that participation in Alcoholics Anonymous (AA) helps its members stay sober, two appear to be most important – spending more time with individuals who support efforts towards sobriety and increased confidence in the ability to maintain abstinence in social situations. In a paper that will appear in the journal Addiction and has been released online, researchers report the first study to examine the relative importance to successful recovery of the behavior changes associated with participation in AA. > > > > Read More

2ND International SAFFrance Colloquium, 15- 16 December 2011, Strasbourg


The second international conference of SAFFrance to be organised on the 15th and 16th of December in Strasbourg is linked to the first conference organised in the Senate in September 2009 to which the higher head of state participated.

Its aim will be to facilitate the professionals’ awareness on the link between prenatal alcohol, brain damage, difficulties to learn and social maladjustment and hence, on the way to prevent these issues. > > > > Read More

Drinkaware's 'why let good times go bad' returns for 2011


The industry funded body Drinkaware has re-launched its why let good times go bad? campaign to 'tackle binge drinking amongst young adults'.

Messages were placed on billboards, poster sites and in stations, supporting campaign activity taking place in pubs, clubs, bars and supermarkets 'ensuring that young adult drinkers are targeted at every stage of their night out'. The campaign includes 3 main tips:

  • 'It’s not a race, remember to pace'
  • 'Have something to eat to stay on your feet'
  • 'Try to make every third drink a soft one' > > > > Read More

Reinforcement of Smoking and Drinking: Tobacco Marketing Strategies Linked With Alcohol in the United States



We investigated tobacco companies’ knowledge about concurrent use of tobacco and alcohol, their marketing strategies linking cigarettes with alcohol, and the benefits tobacco companies sought from these marketing activities.

We performed systematic searches on previously secret tobacco industry documents, and we summarized the themes and contexts of relevant search results.

Tobacco company research confirmed the association between tobacco use and alcohol use. Tobacco companies explored promotional strategies linking cigarettes and alcohol, such as jointly sponsoring special events with alcohol companies to lower the cost of sponsorships, increase consumer appeal, reinforce brand identity, and generate increased cigarette sales. They also pursued promotions that tied cigarette sales to alcohol purchases, and cigarette promotional events frequently featured alcohol discounts or encouraged alcohol use.

Tobacco companies’ numerous marketing strategies linking cigarettes with alcohol may have reinforced the use of both substances. Because using tobacco and alcohol together makes it harder to quit smoking, policies prohibiting tobacco sales and promotion in establishments where alcohol is served and sold might mitigate this effect. Smoking cessation programs should address the effect that alcohol consumption has on tobacco use.


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Request Reprint E-Mail: pling@medicine.ucsf.edu

Alcohol Advertising at Boston Subway Stations: An Assessment of Exposure by Race and Socioeconomic Status



We investigated the frequency of alcohol ads at all 113 subway and streetcar stations in Boston and the patterns of community exposure stratified by

race, socioeconomic status, and age.

We assessed the extent of alcohol advertising at each station in May 2009. We measured gross impressions and gross rating points (GRPs) for the entire Greater Boston population and for Boston public school student commuters. We compared the frequency of alcohol advertising between neighborhoods with differing demographics.

For the Greater Boston population, alcohol advertising at subway stations generated 109 GRPs on a typical day. For Boston public school students in grades 5 to 12, alcohol advertising at stations generated 134 GRPs. Advertising at stations in low-poverty neighborhoods generated 14.1 GRPs and at stations in high-poverty areas, 63.6 GRPs.

Alcohol ads reach the equivalent of every adult in the Greater Boston region and the equivalent of every 5th- to 12th-grade public school student each day. More alcohol ads were displayed in stations in neighborhoods with high poverty rates than in stations in neighborhoods with low poverty rates.


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Request Reprint E-Mail: gentry.lisa@gmail.com

Low-Risk Lifestyle Behaviors and All-Cause Mortality: Findings From the National Health and Nutrition Examination Survey III Mortality Study



We examined the relationship between 4 low-risk behaviors—never smoked, healthy diet, adequate physical activity, and moderate alcohol consumption—and mortality in a representative sample of people in the United States.

We used data from 16958 participants aged 17 years and older in the National Health and Nutrition Examination Survey III Mortality Study from 1988 to 2006.

The number of low-risk behaviors was inversely related to the risk for mortality. Compared with participants who had no low-risk behaviors, those who had all 4 experienced reduced all-cause mortality (adjusted hazard ratio [AHR]=0.37; 95% confidence interval [CI]=0.28, 0.49), mortality from malignant neoplasms (AHR=0.34; 95% CI=0.20, 0.56), major cardiovascular disease (AHR=0.35; 95% CI=0.24, 0.50), and other causes (AHR=0.43; 95% CI=0.25, 0.74). The rate advancement periods, representing the equivalent risk from a certain number of years of chronological age, for participants who had all 4 high-risk behaviors compared with those who had none were 11.1 years for all-cause mortality, 14.4 years for malignant neoplasms, 9.9 years for major cardiovascular disease, and 10.6 years for other causes.

Low-risk lifestyle factors exert a powerful and beneficial effect on mortality.


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Request Reprint E-Mail: eford@cdc.gov

The Alcohol Identification and Brief Advice e-learning project (Alcohol IBA)


The Alcohol Identification and Brief Advice e-learning project (Alcohol IBA) helps professionals with identifying those individuals whose drinking might be impacting on their health and delivering simple, structured advice. It has been developed in partnership with the Department of Health's Alcohol Policy Team and e-Learning for Healthcare .

This e-learning course has been developed by NHS Portsmouth and e-Learning for Healthcare to provide the learning for hospital staff to identify and provide brief advice to those whose alcohol use may be impacting on their health. The course was conceived and designed by Iain Armstrong and builds on the successful courses for IBA in Primary Care and Community Pharmacy developed by the Department of Health. IBA e-learning in hospital settings is currently available on the Alcohol Learning Centre and will soon be available through National Learning Management System (NLMS) which is linked to the NHS Electronic Staff Record (ESR).

Alcohol IBA has been designed to provide the skills and understanding to deliver IBA in line with the National Occupational Standard AH10 - 'employ techniques to help individuals adopt sensible drinking behaviour'. > > > > Read More

Global Actions: September 14, 2011


Key Recent Milestones: Self-Regulation in India

The Advertising Standards Council of India (ASCI) has introduced a new process for companies wishing to file complaints regarding competitors’ advertisements. The Fast Track Complaints Redress Process was designed by the self-regulatory organization to provide speedier solutions to intra-industry complaints.

Along with other leading industry associations, the World Federation of Advertisers (WFA) and the Indian Society of Advertisers (ISA) are working to strengthen India’s long-standing self-regulatory system.

The new system enhances the efficiency and speed of handling of consumer complaints, now ensuring that all complaints are resolved within seven days, with a final decision from the Fast Track Complaints Council (FTCC). Four to six months from introduction, the ASCI board will review the Redress Process.

Global Actions in Focus: China

Drink drive training workshops for local staff and traffic police will be held September 16 through 25 in Xi’an and Nanjing, both prominent cities in Chinese history and culture, with populations of eight million and five million, respectively.


Global Actions’ partners/stakeholders in China include the China Center for Health Education (CCHE), Xi’an Center for Health Education, Jiangsu Center for Health Education, local government agencies, and beverage alcohol producers that include Diageo and Pernod Ricard. International road safety expert Ray Shuey will lead training of the enhanced enforcement program.

“Thanks to CCHE, local facilitators, and the alcohol industry, the projects are progressing,” said Global Actions China Country Coordinator James Yu. “We hope these workshops will encourage participants to implement interventions to reduce the rate of alcohol-related road traffic crashes in these major cities.”

“For the workshops, held separately in Xi’an and Nanjing, one program manager and one practitioner involved in local action of drink driving intervention will attend,” said CCHE’s Qian Ling. “ICAP and the CCHE team have invited health educators from more than 30 provincial institutes for health education to attend the workshops and learn skills about program design and evaluation.”

What’s Happening Next

· Advertising News: The Consolidated ICC Code website will launch globally on September 15. Visit www.codescentre.com for information on global best practice and self-regulation of advertising and marketing communications.

· Nigeria: September 20-21, Capacity-building program for the Lagos-Apapa intervention.

· Mexico: September 28-29, Drink drive summit in Mexico City.

· Ukraine: September 30, World Federations of Advertisers (WFA) will be participating in a self-regulation conference in Kiev.

Press Release - European Region has heaviest drinking in the world



The 53 countries in the WHO European Region meeting in Baku, Azerbaijan from 12 to 15 September 2011 are endorsing a plan to reduce the harmful use of alcohol. In this Region, alcohol is the second largest risk factor for the death and disease burden, just after tobacco use.

“The harmful use of alcohol is a priority public health concern. The evidence supporting this action plan is large, diverse and persuasive,” said Zsuzsanna Jakab, WHO Regional Director for Europe. “Countries are well aware of the expensive and devastating damage it causes and our action plan is intended to provide them with technical guidance and support on what can and should be done to reduce this harm.”

The WHO European Region is the heaviest drinking region in the world, with a prevalence of heavy episodic drinking in over 20% of adults. Alcohol consumption reportedly decreased during the 1990s, then increased and stabilized at a higher level between 2004 and 2006. Consumption varies greatly among countries, with a European average of 9.24 litres of pure alcohol equivalent consumed per person per year. The overall tendency is that consumption has decreased in western Europe and increased in eastern Europe during the last 15 years, although there are huge differences among countries – see the European status report on alcohol and health 2010. > > > > Read More

Predicting university undergraduates’ binge-drinking behavior: A comparative test of the one- and two-component theories of planned behavior



This study provides a comparative test of the one- and two-component theories of planned behavior (TPB) in the context of university undergraduates’ binge-drinking.

Participants (N = 120) self-completed questionnaire measures of all TPB constructs at time 1 and subsequent binge-drinking at time 2 (two-weeks later). The data were analyzed using a combination of path analyses and bootstrapping procedures.

Both models accounted for a substantial proportion of the variation in behavior.

However, the two-component TPB provided a significantly better fit to the data, with the total direct and indirect effects accounting for 90% of the variance.

Intention was the only direct predictor of behavior. Instrumental attitude, affective attitude and self-efficacy had indirect effects.

Although health interventions could usefully target these cognitive antecedents, simulation analyses, modelling the effects of cognition change on behavior, showed that only large- (0.8 SD) sized changes to affective attitude, or moderate-sized changes to all of these cognitions in combination were sufficient to reduce binge-drinking.


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Request Reprint E-Mail: mark.a.elliott@strath.ac.uk

Memory associations between negative emotions and alcohol on the lexical decision task predict alcohol use in women



Implicit alcohol expectancies, or beliefs about alcohol which exist in the form of automatic memory associations, are thought to uniquely affect drinking behavior. Research also has indicated that there may be a distinctive relationship between negative reinforcement and alcohol use in women. However, the most common measures used to examine implicit alcohol cognitions may be insufficient to examine associations involving negative reinforcement.

The current study utilized the Lexical Decision Task (LDT) to examine the relationship between implicit alcohol cognitions and reported drinking in a sample of college women. Seventy-eight female participants completed a LDT including alcohol- and emotion-words, questionnaire measures of explicit alcohol expectancies, and a measure of drinking behavior at baseline and after two months.

Strong associations between negative emotion-words and alcohol-words (as measured by the LDT) were found to predict drinking at follow up, and to account for unique variance in drinking beyond the contribution of explicit measures.

In addition, women who reported heavier drinking in response to social conflict on an explicit measure showed stronger priming of alcohol words by negative emotion words, thus implying that the LDT may tap into implicit cognitions related to alcohol use as a method of coping.

These findings suggest that the LDT is sensitive to negative-reinforcement associations in a way that other measures are not.


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Request Reprint E-Mail: mailto:janellen@unm.edu

Personality and alcohol use: The role of impulsivity


Research has shown that personality traits associated with impulsivity influence alcohol use during emerging adulthood, yet relatively few studies have examined how distinct facets of impulsivity are associated with alcohol use and abuse.

We examine the influence of impulsivity traits on four patterns of alcohol use including frequency of alcohol use, alcohol-related problems, binge drinking, and alcohol use disorders (AUDs) in a community sample of young individuals (N = 190).

In multivariate regression analyses that controlled for peer and parental alcohol use, psychological distress, and developmental correlates (i.e., college, marriage, employment) in emerging adulthood, we found that urgency and sensation seeking were consistently related to all four constructs of alcohol use.

The present study suggests that distinct impulsivity traits may play different roles in escalation of alcohol use and development of AUDs during emerging adulthood.




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Request Reprint E-Mail: hshin@bu.edu

Wednesday, September 14, 2011

Joint Meeting of the NIDA and NIAAA Councils - September 2011



Monday, September 12, 2011
NIDA and NIAAA
Total Running Time: 03:10:27


View Video

NIAAA Spectrum Volume 3, Issue 3, September 2011


In This Issue

Features

1
NIAAA Advances Research on Fetal Alcohol Spectrum Disorders
2 Imaging Helps Researchers See Into Alcohol-Exposed Brains


Photo Essay
2 Brain scans Reveal the Damage of Fetal Alcohol Exposure


Charticle
4 One in Eight Pregnant Women Drinks


News From The Field
5 Receptor May Help Explain Susceptibility to Addiction
5 Heavily Advertised Alcohol Brands May Attract MoreUnderage Drinkers
6 Research Shows the Value of a Minimum Legal Drinking Age of 21
6 Evidence Mounts That Binge Drinking Harms Adolescent Brain Development

Questions With...
7 Kenneth Warren, Ph.D.



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Alcohol Awareness Week 2011: 14 - 20 November


Alcohol Awareness Week (AWW) will run from 14th November to 20th November 2011, during which Alcohol Concern will launch an 'Alcohol Charter' for a world free from alcohol harm.

The ‘alcohol charter’ campaign has the following goals:

  1. 100,000 people signing up to the charter
  2. All MPs and Peers signing up to the charter
  3. Charter adopted in forthcoming alcohol strategy
  4. Charter paves way for political discussion on precise goals and policies needed > > > > Read More

Determining the Relative Importance of the Mechanisms of Behavior Change within Alcoholics Anonymous: A Multiple Mediator Analysis



Evidence indicates AA participation reduces relapse risk but less is known about the mechanisms through which AA confers this benefit. Initial studies indicate self-efficacy, negative affect, adaptive social networks, and spiritual practices are mediators of this effect, but because these have been tested in isolation, their relative importance remains elusive.

This study tested multiple mediators simultaneously to help determine the most influential pathways.

Prospective, statistically controlled, naturalistic investigation examined the extent to which purported mechanisms (i.e., self-efficacy, negative affect, social networks, and spirituality/religiosity) mediated the effect of AA attendance on alcohol outcomes controlling for baseline outcome values, mediators, treatment, and other confounders.

Nine clinical sites within the United States.

Adults (N = 1,726) suffering from alcohol use disorder (AUD) with varying levels of severity initially enrolled in a randomized study with two arms: Aftercare (n = 774); and Outpatient (n-952) comparing three outpatient treatments (Project MATCH)

AA attendance during treatment; mediators at 9 months; and, outcomes (Percent Days Abstinent [PDA] and Drinks per Drinking Day [DDD]) at 15 months.

Among outpatients the effect of AA attendance on alcohol outcomes was explained primarily by adaptive social network changes and increases in social abstinence self-efficacy. Among more impaired aftercare patients, in addition to mediation through adaptive network changes and increases in social self-efficacy, AA lead to better outcomes through increasing spirituality/religiosity and by reducing negative affect .

The degree to which mediators explained the relationship between AA and outcomes ranged from 43%-67%.

AA facilitates recovery by mobilizing several processes simultaneously, including influential social change and spirituality/religiosity.



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Request Reprint E-Mail: jkelly11@partners.org

News Release - Public-Private Partnership Helps Teens Escape Drugs, Alcohol and Crime


Governor Bev Perdue today announced a partnership between state agencies and two North Carolina foundations that will expand the successful Reclaiming Futures program from a model to a statewide initiative that helps youths in the juvenile justice system beat problems with drugs and alcohol. This tested and proven program will help put teenagers on a path toward finishing high school ready, for a career, college or technical training. > > > > Read More

Live footage from Ireland's First Alcohol Free Comedy Club



'Ireland's First Alternative Alcohol Free Comedy Club was full to the rafters and a roaring success!' tweeted Dil Wickremasinghe, founder of Dublin's new club. We had 'great acts, great audience & a great venue, plus a full house'. Hosting Ireland's first alternative alcohol-free comedy club, Accents Lounge Dublin offered 'the most fun you can have with your clothes on' at the opening night, Monday 5th September.
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"Other teens drink and use marijuana but my kids don't," parents say in new poll


The latest C.S. Mott Children's Hospital National Poll on Children's Health finds that few parents (10 percent) believe their own teens, ages 13 to 17 years old, have used alcohol in the last year and even fewer (5 percent) believe their own teens have used marijuana in the last year.

Those levels are substantially below what teens themselves reported in the latest Monitoring the Future study, where 52 percent of 10th graders reported drinking alcohol in the last year and 28 percent of 10th graders reported using marijuana in the last year.


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Translational Magnetic Resonance Spectroscopy Reveals Excessive Central Glutamate Levels During Alcohol Withdrawal in Humans and Rats



In alcoholism, excessive glutamatergic neurotransmission has long been implicated in the acute withdrawal syndrome and as a key signal for dependence-related neuroplasticity. Our understanding of this pathophysiological mechanism originates largely from animal studies, but human data are needed for translation into successful medication development.

We measured brain glutamate levels during detoxification in alcohol-dependent patients (n = 47) and in healthy control subjects (n = 57) as well as in a rat model of alcoholism by state-of-the-art 1H-magnetic magnetic resonance spectroscopy at 3 and 9.4 T, respectively.

We found significantly increased glutamate levels during acute alcohol withdrawal in corresponding prefrontocortical regions of treatment-seeking alcoholic patients and alcohol-dependent rats versus respective control subjects. The augmented spectroscopic glutamate signal is likely related to increased glutamatergic neurotransmission because, enabled by the high field strength of the animal scanner, we detected a profoundly elevated glutamate/glutamine ratio in alcohol-dependent rats during acute withdrawal. All dependence-induced metabolic alterations normalize within a few weeks of abstinence in both humans and rats.

Our data provide first-time direct support from humans for the glutamate hypothesis of alcoholism, demonstrate the comparability of human and animal magnetic resonance spectroscopy responses, and identify the glutamate/glutamine ratio as potential biomarker for monitoring disease progression.



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Request Reprint E-Mail: wolfgang.sommer@zi-mannheim.de