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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, September 24, 2011

A naturalistic study of the associations between changes in alcohol problems, spiritual functioning, and psychiatric symptoms.

The study evaluated how spiritual and religious functioning (SRF), alcohol-related problems, and psychiatric symptoms change over the course of treatment and follow-up.

Problem drinkers (n = 55, including 39 males and 16 females) in outpatient treatment were administered questionnaires at pretreatment, posttreatment, and follow up, which assessed two aspects of SRF (religious well-being and existential well-being), two aspects of alcohol misuse (severity and consequences), and two aspects of psychiatric symptoms (depression and anxiety).

Significant improvements in SRF, psychiatric symptoms and alcohol misuse were observed from pretreatment to follow-up. Although SRF scores were significantly correlated with psychiatric symptoms at all three time points, improvement in the former did not predict improvement in the latter.

When measured at the same time points, SRF scores were not correlated with the measures of alcohol misuse. However, improvement in SRF (specifically in existential well-being) over the course of treatment was predictive of improvement in the alcohol misuse measures at follow-up.

These results suggest that the association between SRF, emotional problems, and alcohol misuse is complex.

They further suggest that patients who improve spiritual functioning over the course of treatment are more likely to experience improvement in drinking behavior and alcohol-related problems after treatment has ended.

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The influence of general identity disturbance on reports of lifetime substance use disorders and related outcomes among sexual minority adults with a

Previous research has shown that sexual minority (i.e., nonheterosexual) individuals report increased problematic substance use involvement, compared with their sexual majority counterparts.

We hypothesize that feelings of an unstable sense of self (i.e., identity disturbance) may potentially drive problematic substance use. The purpose of the current study is to examine identity disturbance among sexual minorities as a potential explanatory mechanism of increased sexual minority lifetime rates of substance dependence.

Measures of identity disturbance and three indicators of sexual orientation from lifetime female (n = 16,629) and male (n = 13,553) alcohol/illicit drug users in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined.

Findings generally showed that the increased prevalence of alcohol dependence, illicit drug dependence, and combined alcohol/illicit drug dependence as well as a younger age of alcohol use initiation among sexual minority women was associated with elevated levels of identity disturbance.

The results were consistent with a mediational role for identity disturbance in explaining the association between sexual minority status and substance dependence and were generally replicated among male sexual minority respondents.

The current research suggests that identity disturbance, a predictor of substance use, may contribute to heightened risk for substance dependence among certain subgroups of sexual minority individuals.

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Friday, September 23, 2011

Substance Abuse Costs WV’s Criminal Justice System More Than $429 Million

According to the latest report from the WV Prevention Resource Center (WVPRC), the financial impact of drug and alcohol abuse on West Virginia’s criminal justice system was $429,771,027 in 2010. This is more than a $50 million increase since 2009. The report projects costs could rise to more than $695 million by 2017. > > > > Read More

Expression pattern, ethanol-metabolizing activities, and cellular localization of alcohol and aldehyde dehydrogenases in human large bowel: associatio

Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are principal enzymes responsible for metabolism of ethanol. Functional polymorphisms of ADH1B, ADH1C, and ALDH2 genes occur among racial populations.

The goal of this study was to systematically determine the functional expressions and cellular localization of ADHs and ALDHs in human rectal mucosa, the lesions of adenocarcinoma and hemorrhoid, and the genetic association of allelic variations of
ADH and ALDH with large bowel disorders.

Twenty-one surgical specimens of rectal adenocarcinoma and the adjacent normal mucosa, including 16 paired tissues of rectal tumor, normal mucosae of rectum and sigmoid colon from the same individuals, and 18 surgical mixed hemorrhoid specimens and leukocyte DNA samples from 103 colorectal cancer patients, 67 hemorrhoid patients, and 545 control subjects recruited in previous study, were investigated.

The isozyme/allozyme expression patterns of ADH and ALDH were identified by isoelectric focusing and the activities were assayed spectrophotometrically. The protein contents of ADH/ALDH isozymes were determined by immunoblotting using the corresponding purified class-specific antibodies; the cellular activity and protein localizations were detected by immunohistochemistry and histochemistry, respectively. Genotypes of
ADH1B, ADH1C, and ALDH2 were determined by polymerase chain reaction-restriction fragment length polymorphisms.

At 33
mM ethanol, pH 7.5, the activity of ADH1C*1/1 phenotypes exhibited 87% higher than that of the ADH1C*1/*2 phenotypes in normal rectal mucosa. The activity of ALDH2-active phenotypes of rectal mucosa was 33% greater than ALDH2-inactive phenotypes at 200μM acetaldehyde. The protein contents in normal rectal mucosa were in the following order: ADH1>ALDH2>ADH3ALDH1A1, whereas those of ADH2, ADH4, and ALDH3A1 were fairly low. Both activity and content of ADH1 were significantly decreased in rectal tumors, whereas the ALDH activity remained unchanged. The ADH activity was also significantly reduced in hemorrhoids.

ADH4 and ALDH3A1 were uniquely expressed in the squamous epithelium of anus at anorectal junctions. The allele frequencies of
ADH1C*1 and ALDH2*2 were significantly higher in colorectal cancer and that of ALDH2*2 also significantly greater in hemorrhoids.

In conclusion, ADH and ALDH isozymes are differentially expressed in mucosal cells of rectum and anus. The results suggest that acetaldehyde, an immediate metabolite of ethanol, may play an etiological role in pathogenesis of large bowel diseases.

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Drugs and drink in Asia: New perspectives from History

Event type:
22 June 2012 - 24 June 2012
Professor James Mills, Dr Yong-an Zhang, Dr. Joseph F. Spillane
Event Location:
Shanghai University, ChinaShanghai
Call for Papers details
Call for papers deadline:
15 December 2011

The centenary of the Hague Opium Convention in 1912 marks a hundred years of the development of international controls on commercial flows in psycho-active substances. This conference seeks to bring together those conducting new research on the origins and trajectory of that system in order to exchange recent conclusions and to address emerging questions. The focus will be on Asian contexts given that these were at the heart of the controversies that drove the emergence of the international drugs regulatory system. Among the questions to be considered are:

1. What has recent research revealed about historic markets for psycho-active substances in Asia?

2. How far were Asian consumers of psycho-active substances driving these markets or being led by them?

3. What were the chief concerns of governments and administrations in Asia when seeking to control these markets and consumers?

4. How significant was the place of psycho-active substances in both Asian and imperial commercial networks?

5. Were representations of Asian consumers of psycho-active substances more varied than previously thought, and if so what does this tell us? > > > > Read More

Alcohol and Drug Prevention in Nightlife Settings: A Review of Experimental Studies

This study examines the evidence regarding the effectiveness of interventions aimed at the prevention of harmful alcohol and drug use in nightlife settings.

A literature search was conducted in 2009. Of 161 studies, 17 experimental studies were included in the review, 15 alcohol-related and two drug-related studies.

The results show that preventive substance abuse interventions in nightlife settings can effectively reduce high-risk alcohol consumption, alcohol-related injury, violent crimes, access to alcohol by underage youth, and alcohol service to intoxicated people.

A combination of approaches such as enforcement activities seem to be facilitating factors. However, results should be considered cautiously as more gold standard (cost-) effectiveness research is required, in particular directed at drug prevention and educational interventions in nightlife settings.

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Acute Alcohol Consumption, Alcohol Outlets, and Gun Suicide

A case–control study of 149 intentionally self-inflicted gun injury cases (including completed gun suicides) and 302 population-based controls was conducted from 2003 to 2006 in a major US city.

Two focal independent variables, acute alcohol consumption and alcohol outlet availability, were measured. Conditional logistic regression was adjusted for confounding variables.

Gun suicide risk to individuals in areas of high alcohol outlet availability was less than the gun suicide risk they incurred from acute alcohol consumption, especially to excess.

This corroborates prior work but also uncovers new information about the relationships between acute alcohol consumption, alcohol outlets, and gun suicide. Study limitations and implications are discussed.

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The association between moral disengagement, psychological distress, resistive self-regulatory efficacy and alcohol and cannabis use among adolescent

The current study aimed to: (i) examine the estimated proportion of young Australian's using alcohol and cannabis, and (ii) investigate a number of individual risk factors associated with use.

A total of 1022 students aged between 12 and 15 years (86% male) were recruited from ten independent schools in Sydney, Australia. All participants completed a questionnaire measuring demographics, levels of moral disengagement,

psychological distress, self-regulatory efficacy to resist peer pressure to engage in transgressive behaviour, and alcohol and cannabis use.

Approximately 85% of participants reported having ever tried alcohol in their life, 31% reported having ever had a full serve of alcohol in their life, 9% reported binge drinking in the past 3 months, and 4% reported having ever tried cannabis in their life. Logistic regression analyses revealed higher moral disengagement and lower resistive self-regulatory efficacy were independent predictors of ever having a full serve of alcohol, binge drinking in the past 3 months and ever trying cannabis. Psychological distress was not associated with alcohol or cannabis use.

A better understanding of the factors associated with early alcohol and cannabis use may help identify groups who have difficulties controlling use and aid the development of targeted prevention strategies for reducing use and related harms.

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How do alcohol cues affect working memory? Persistent slowing due to alcohol-related distracters in an alcohol version of the Sternberg task Read M

Dual-process models of addiction suggest that addiction involves an imbalance between impulsive and reflective processing. That is, alcohol-approach associations may influence behavior, unless such influences are modulated by working memory processes.

However, working memory processes may themselves be affected by salient and incentive stimuli. Recent work suggests that temporal dynamics may play a central role in such effects.

A novel alcohol Sternberg task was used to further study such interference in social drinkers. Subjects had to keep a list of numbers in mind while performing secondary tasks involving alcoholic and non-alcoholic stimuli. Delays between the end of the secondary task and memory probes were varied to determine the persistence of interference over time.

Results showed a more persistent slowing of responses at recall following alcoholic versus non-alcoholic stimuli. At the short delay, no alcohol-related differences were found; at the longer delay, however, reaction time had decreased significantly over the delay period but only following non-alcoholic stimuli.

Alcohol-related stimuli thus appeared to cause relatively persistent interference with ongoing working memory processes.

The findings provide suggestions about the nature of alcohol-related effects on working memory. Further, the finding that alcohol-related effects may be dependent on the timing of trial events may be an important methodological consideration in future studies.

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Accuracy of Self-Reported Drinking: Observational Verification of ‘Last Occasion’ Drink Estimates of Young Adults

As a formative step towards determining the accuracy of self-reported drinking levels commonly used for estimating population alcohol use, the validity of a ‘last occasion’ self-reporting approach is tested with corresponding field observations of participants' drinking quantity. This study is the first known attempt to validate the accuracy of self-reported alcohol consumption using data from a natural setting.

A total of 81 young adults (aged 18–25 years) were purposively selected in Perth, Western Australia. Participants were asked to report the number of alcoholic drinks consumed at nightlife venues 1–2 days after being observed by peer-based researchers on 239 occasions. Complete observation data and self-report estimates were available for 129 sessions, which were fitted with multi-level models assessing the relationship between observed and reported consumption.

Participants accurately estimated their consumption when engaging in light to moderate drinking (eight or fewer drinks in a single session), with no significant difference between the mean reported consumption and the mean observed consumption. In contrast, participants underestimated their own consumption by increasing amounts when engaging in heavy drinking of more than eight drinks.

It is suggested that recent recall methods in self-report surveys are potentially reasonably accurate measures of actual drinking levels for light to moderate drinkers, but that underestimating of alcohol consumption increases with heavy consumption. Some of the possible reasons for underestimation of heavy drinking are discussed, with both cognitive and socio-cultural factors considered.

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Alcohol consumption, problem drinking, abstention and disability pension award. The Nord-Trøndelag Health Study (HUNT)

To examine associations of abstention, alcohol consumption and problem drinking with subsequent disability pensioning (DP), and whether previous excessive consumption (‘sick-quitting’) could explain some of the increased risk for DP among abstainers.

Prospective population-based study.

Data were from two waves of the Nord-Trøndelag Health Study (HUNT) linked with the national insurance database. The two main analyses included 37 729 (alcohol consumption) and 34 666 (problem drinking) participants.

Alcohol consumption was measured by self-reported consumption, while problem drinking was assessed by the Cut down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire. Information on subsequent DP, including diagnosis for which the DP was awarded, was gathered from the national insurance database. Covariates included somatic illness and symptoms, mental health, health-related behaviour, socio-economic status and social activity.

Those reporting the highest level of alcohol consumption were not at increased risk for DP [hazard ratio (HR) 1.12, 95% confidence interval (CI): 0.92–1.38], whereas problem drinking was a strong predictor (HR 2.79, 95% CI: 2.08–3.75) compared to their corresponding reference groups. Alcohol abstainers were also at increased risk for DP, but among them, the previous consumers (HR 1.95, 95% CI: 1.48–2.57) and previous excessive consumers (HR 1.67, 95% CI: 1.01–2.74) were at higher risk for DP than constant abstainers.

Problem drinking is linked to subsequent requirement for a disability pension but mere alcohol consumption is not. This is partly explained by ‘sick-quitting’.

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Intelligence quotient (IQ) in adolescence and later risk of alcohol-related hospital admissions and deaths—37-year follow-up of Swedish conscripts

To investigate the relationship between intelligence measured at ages 18–19 and later alcohol-related hospital admission and mortality among men, while controlling for possible confounders.

Cohort study.

A total of 49 321 Swedish men who were conscripted for military training in 1969–70 and followed until 2007.

Intelligence quotient (IQ) measured at conscription is the exposure, while alcohol-related hospital admission and death are the two outcomes. Adjustments for following variables were made: early life circumstances [childhood socio-economic position (SEP), father's drinking], mental health, social adjustment and behavioural factors measured at age 18 (psychiatric diagnosis, contact with police and child care, low emotional control, daily smoking, risky use of alcohol) and adult social position (attained education, SEP and income at age 40).

IQ had an inverse and graded association with later alcohol-related problems. For alcohol-related hospital admissions the crude hazard ratio (HR) was 1.29 (95% CI = 1.26–1.31) and for alcohol-related mortality it was 1.21 (95% CI = 1.17–1.24) for every one point decrease on the nine-point IQ scale. Adjustment for risk factors measured at age 18 attenuated the association somewhat for both outcomes. After adjustment for social position as adult, the HR was considerably lower resulting in a HR of 1.06 (95% CI = 1.02–1.10) for alcohol-related hospital admissions and 1.01 (95% CI = 0.95–1.08) for alcohol-related mortality.

In Swedish men there is an association between IQ in early adulthood and later alcohol-related hospital admission and death. Social position as adult could be an important contributory factor.

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Working hours and alcohol problems in early adulthood

To examine the associations between working hours and alcohol-related problems during early adulthood.

Longitudinal study of a birth cohort born in Christchurch, New Zealand in 1977 and studied to age 30.

A total of 1019 participants with data available for working hours and alcohol-related problems at either age 25 or 30.

Weekly working hours in paid employment; frequent alcohol use; diagnosis of alcohol abuse/dependence; number of symptoms of alcohol abuse/dependence. Associations between working hours and alcohol-related problems were adjusted for covariates including measures of: parental and family background; personality and behaviour; IQ and educational achievement; recent negative life events; recent mental health problems; and current partner and family circumstances.

Longer work hours were associated significantly with more frequent alcohol use (P < 0.0001), higher rates of alcohol abuse/dependence (P = 0.0001) and a greater number of alcohol abuse/dependence symptoms (P = 0.01). These associations were adjusted for a wide range of confounding factors. After adjustment there remained significant (P < 0.05) associations between working hours and alcohol-related problems, with those working 50 or more hours per week having rates of alcohol-related problems 1.8–3.3 times higher than those who were not working. The associations between work hours and alcohol use were similar for males and females.

Longer work hours appear to be associated with higher rates of alcohol-related problems, including more frequent alcohol use, higher rates of alcohol abuse/dependence and a greater number of alcohol abuse/dependence symptoms. These associations remain even after extensive adjustment for confounding.

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The Örebro prevention programme revisited: a cluster-randomized effectiveness trial of programme effects on youth drinking

This study aimed to assess the effectiveness of the Örebro prevention programme (ÖPP), an alcohol misuse prevention programme that aims to reduce youth drinking by changing parental behaviour.

Cluster-randomized trial, with schools assigned randomly to the ÖPP or no intervention.

Forty municipal schools in 13 counties in Sweden.

A total of 1752 students in the 7th grade and 1314 parents were assessed at baseline. Students' follow-up rates in the 8th and 9th grades were 92.1% and 88.4%, respectively.

Classroom questionnaires to students and postal questionnaires to parents were administered before randomization and 12 and 30 months post-baseline.

Two-level logistic regression models, under four different methods of addressing the problem of loss to follow-up, revealed a statistically significant programme effect for only one of three drinking outcomes under one loss-to-follow-up method, and that effect was observed only at the 12-month follow-up.

The Örebro prevention programme as currently delivered in Sweden does not appear to reduce or delay youth drunkenness.

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Alcohol use, heavy episodic drinking and subsequent problems among adolescents in 23 European countries: does the prevention paradox apply?

According to the prevention paradox, a majority of alcohol-related problems in a population can be attributed to low to moderate drinkers simply because they are more numerous than heavy drinkers, who have a higher individual risk of adverse outcomes. We examined the prevention paradox in annual alcohol consumption, heavy episodic drinking (HED) and alcohol-related problems among adolescents in 23 European countries.

Survey data from the 2007 European School Survey Project on Alcohol and Drugs (ESPAD) among 16-year-old students were analysed.

A total of 38 370 alcohol-consuming adolescents (19 936 boys and 18 434 girls) from 23 European countries were included.

The upper 10% and the bottom 90% of drinkers by annual alcohol intake, with or without HED, and frequency of HED, were compared for the distribution of 10 different alcohol-related problems.

Although the mean levels of consumption and alcohol-related problems varied largely between genders and countries, in almost all countries the heavy episodic drinkers in the bottom 90% of consumers by volume accounted for most alcohol-related problems, irrespective of severity of problem. However, adolescents with three or more occasions of HED a month accounted for a majority of problems.

The prevention paradox, based on measures of annual consumption and heavy episodic drinking, seems valid for adolescent European boys and girls. However, a minority with frequent heavy episodic drinking accounted for a large proportion of all problems, illustrating limitations of the concept. As heavy episodic drinking is common among adolescents, our results support general prevention initiatives combined with targeted interventions.

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Alcoholics Anonymous attendance, decreases in impulsivity and drinking and psychosocial outcomes over 16 years: moderated-mediation from a development

To examine whether decreases in impulsivity account for links between Alcoholics Anonymous (AA) attendance and better drinking and psychosocial outcomes, and whether these mediational ‘effects’ are conditional on age.

A naturalistic study in which individuals were assessed at baseline, and 1, 8 and 16 years later.

Participants initiated help-seeking through the alcohol intervention system (detoxification programs, information and referral centers).

Individuals with alcohol use disorders and no prior history of substance abuse treatment at baseline [n = 628; 47% women; mean age = 34.7 years (standard deviation = 9.4)].

Self-reports of impulsivity and drinking pattern at baseline and year 1, duration of AA (number of weeks) in year 1 and drinking (alcohol use problems, self-efficacy to resist drinking) and psychosocial outcomes (emotional discharge coping, social support) at baseline and follow-ups.

Controlling for changes in drinking pattern, decreases in impulsivity were associated with fewer alcohol use problems, better coping and greater social support and self-efficacy at year 1, and better coping and greater social support at year 8. Decreases in impulsivity statistically mediated associations between longer AA duration and improvements on all year 1 outcomes and indirect effects were moderated by participant age (significant only for individuals 25 years of age or younger).

Decreased impulsivity appears to mediate reductions in alcohol-related problems over 8 years in people attending Alcoholics Anonymous.

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News Release - NIH study finds hospitalizations increase for alcohol and drug overdoses

Hospitalizations for alcohol and drug overdoses – alone or in combination – increased dramatically among 18- to 24-year-olds between 1999 and 2008, according to a study by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health.

Led by Aaron M. White, Ph.D. and Ralph W. Hingson, Sc.D., of NIAAA’s division of epidemiology and prevention research, the study examined hospitalization data from the Nationwide Inpatient Sample, a project of the U.S. Agency for Healthcare Research and Quality designed to approximate a 20 percent sample of U.S. community hospitals. The findings appear in the September issue of the Journal of Studies on Alcohol and Drugs.

Drs. White, Hingson, and their colleagues report that, over the 10-year study period, hospitalizations among 18-24–year-olds increased by 25 percent for alcohol overdoses; 56 percent for drug overdoses; and 76 percent for combined alcohol and drug overdoses.> > > > Read More

Behavioral Pharmacogenetic Analysis on the Role of the α4 GABAA Receptor Subunit in the Ethanol-Mediated Impairment of Hippocampus-Dependent Contextua

A major effect of low-dose ethanol is impairment of hippocampus-dependent cognitive function. α4/δ -containing GABAARs are highly expressed within the dentate gyrus region of the hippocampus where they mediate a tonic inhibitory current that is sensitive to the enhancement by low ethanol concentrations. These receptors are also powerful modulators of learning and memory, suggesting that they could play an important role in ethanol’s cognitive impairing effects. The goal of this study was to develop a high-throughput cognitive ethanol assay, amenable to use in genetically modified mice that could be used to test this hypothesis.

We developed a procedure where preexposure to a conditioning chamber is used to rescue the “immediate shock deficit.” Using this task, ethanol can be specifically targeted at the hippocampus-dependent process of contextual learning without interfering with pain sensitivity or behavioral performance.

Validation of this task in C57BL/6 mice indicated that 1.0 g/kg ethanol and 10 mg/kg allopregnanolone disrupt contextual learning. Ro15-4513 reversed the effects of ethanol but not allopregnanolone, whereas it produced an impairment when given alone. The high-throughput nature of this task allowed for its application in a large cohort of α4 GABAAR KO mice. Loss of the α4 GABAAR subunit produced an enhanced sensitivity to the cognitive impairing effects of ethanol. This is consistent with the enhanced ethanol sensitivity of synaptic GABAARs that has been previously observed in the dentate gyrus in these mice, but inconsistent with the reduced ethanol sensitivity of extrasynaptic GABAARs observed in the same cells.

Overall, these findings are consistent with our hypothesis that ethanol acts directly at GABAA receptors to impair hippocampus-dependent cognitive function. Furthermore, validation of this high-throughput assay will allow for future studies to use anatomically and temporally restricted genetic manipulations to probe more deeply into the neural mechanisms of ethanol action on learning and memory circuits.

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Impact of Depressive Symptoms on Future Alcohol Use in Patients with Co-Occurring Bipolar Disorder and Alcohol Dependence: A Prospective Analysis in a

Bipolar disorders and alcohol use disorders commonly co-occur, yet little is known about the proximal impact of bipolar symptoms on alcohol use in patients with this comorbidity. The present study examined the impact of depressive symptoms and alcohol craving on proximal alcohol use in patients with co-occurring bipolar disorder and alcohol dependence.

Data were collected during an 8-week randomized controlled trial of acamprosate for individuals with co-occurring bipolar disorder and alcohol dependence (n = 30). Depressive symptoms and alcohol craving were assessed biweekly using the Montgomery Asberg Depression Rating Scale (MADRS) and the Obsessive Compulsive Drinking Scale (OCDS), respectively. Daily alcohol use data were available via administration of the Time-line Follow-back interview at baseline and at subsequent weekly study visits. Correlational analyses and hidden Markov modeling were used to examine the prospective relationships between depressive symptoms, alcohol craving, and alcohol use.

Depressive symptoms and alcohol craving were significantly correlated with proximal (i.e., 1 week later) alcohol use across a variety of alcohol consumption summary measures. In hidden Markov models, depressive symptoms (OR = 1.3, 95% credible interval = [1.1, 1.5]) and alcohol craving (OR = 1.6, 95% credible interval = [1.4, 1.9]) significantly predicted transitioning from a light to a heavy drinking state, or remaining in a heavy drinking state.

The results from the present study suggest that depressive symptoms and alcohol craving increase proximal risk for alcohol use in individuals with co-occurring bipolar and alcohol use disorders.

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A Limited Access Mouse Model of Prenatal Alcohol Exposure that Produces Long-Lasting Deficits in Hippocampal-Dependent Learning and Memory

It has been estimated that approximately 12% of women consume alcohol at some time during their pregnancy, and as many as 5% of children born in the United States are impacted by prenatal alcohol exposure (PAE). The range of physical, behavioral, emotional, and social dysfunctions that are associated with PAE are collectively termed fetal alcohol spectrum disorder (FASD).

Using a saccharin-sweetened ethanol solution, we developed a limited access model of PAE. C57BL/6J mice were provided access to a solution of either 10% (w/v) ethanol and 0.066% (w/v) saccharin or 0.066% (w/v) saccharin (control) for 4 h/d. After establishing consistent drinking, mice were mated and continued drinking during gestation. Following parturition, solutions were decreased to 0% in a stepwise fashion over a period of 6 days. Characterization of the model included measurements of maternal consumption patterns, blood ethanol levels, litter size, pup weight, maternal care, and the effects of PAE on fear-conditioned and spatial learning, and locomotor activity.

Mothers had mean daily ethanol intake of 7.17 ± 0.17 g ethanol/kg body weight per day, with average blood ethanol concentrations of 68.5 ± 9.2 mg/dl after 2 hours of drinking and 88.3 ± 11.5 mg/dl after 4 hours of drinking. Food and water consumption, maternal weight gain, litter size, pup weight, pup retrieval times, and time on nest did not differ between the alcohol-exposed and control animals. Compared with control offspring, mice that were exposed to ethanol prenatally displayed no difference in spontaneous locomotor activity but demonstrated learning deficits in 3 hippocampal-dependent tasks: delay fear conditioning, trace fear conditioning, and the delay nonmatch to place radial-arm maze task.

These results indicate that this model appropriately mimics the human condition of PAE and will be a useful tool in studying the learning deficits seen in FASD.

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Subjective Perceptions Associated with the Ascending and Descending Slopes of Breath Alcohol Exposure Vary with Recent Drinking History

The differentiator model predicts that individuals with a positive family history of alcoholism (FHA) or heavy alcohol consumers will feel more sensitive to the effects of alcohol on the ascending phase of the blood alcohol content while feeling less sedated on the descending phase. This study tested whether subjective perceptions are sensitive to the slope of breath alcohol concentration (BrAC) and whether that sensitivity is associated with an FHA and/or recent drinking history (RDH).

Family-history-positive (FHP, n = 27) and family-history-negative (FHN, n = 27) young adult nondependent drinkers were infused intravenously with alcohol in 2 sessions separated by 1 week. After 20 minutes, one session had an ascending BrAC (+3.0 mg%/min), while the other session had a descending BrAC (−1 mg%/min). The BrAC for both sessions at this point was approximately 60 mg%, referred to as the crossover point. Subjective perceptions of intoxication, high, stimulated, and sedation were sampled frequently and then interpolated to the crossover point. Within-subject differences between ascending and descending responses were examined for associations with FHA and/or RDH.

Recent moderate drinkers reported increased perceptions of feeling intoxicated (p < 0.023) and high (p < 0.023) on the ascending slope compared with the descending slope. In contrast, recent light drinkers felt more intoxicated and high on the descending slope.

Subjective perceptions in young adult social drinkers depend on the slope of the BrAC when examined in association with RDH. These results support the differentiator model hypothesis concerning the ascending slope and suggest that moderate alcohol consumers could be at risk for increased alcohol consumption because they feel more intoxicated and high on the ascending slope. Subjects did not feel less sedated on the descending slope, contrary to the differentiator model but replicating several previous studies.

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Characterization of Sialic Acid Index of Plasma Apolipoprotein J and Phosphatidylethanol During Alcohol Detoxification—A Pilot Study

Apolipoprotein J (ApoJ) is a component of plasma high-density lipoproteins. Previous studies have shown progressive recovery of ApoJ sialic acid content with increased duration of alcohol abstinence. Therefore, the sialic acid index of plasma apolipoprotein J (SIJ) seems to be a promising alcohol biomarker. Phosphatidylethanol (PEth) is a direct ethanol metabolite and has recently attracted attention as a biomarker of prolonged intake of higher amounts of alcohol. The aim of the pilot study was to explore sensitivity, specificity, and normalization of SIJ and PEth in comparison with traditional and emerging biomarkers.

Five male alcohol-dependent patients (International Classification of Diseases 10, F 10.25) were included (median: 40 years old; Alcohol Use Disorders Identification Test value, 30; alcohol consumption in the previous 7 days, 1,680 g). SIJ, PEth, urinary ethyl glucuronide (UEtG), urinary ethyl sulfate (UEtS), and gamma glutamyl-transpeptidase (GGT) were determined at days 1, 3, 7, 10, 14, 21, and 28.

At study entry, SIJ, PEth, UEtG, and UEtS were positive in all subjects, whereas GGT and mean corpuscular volume were positive in 3 of 5 (60%) of the subjects.

Individual SIJ levels increased between day 1 and 28 between 13.7 and 44.3%, respectively. For SIJ and PEth, the ANOVA (p < 0.005) showed a significant trend with the average subject’s SIJ and PEth changing 1.22 and 1.02, respectively, per week.

Our preliminary data suggest that SIJ and PEth might hold potential as markers of heavy ethanol intake.

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Thursday, September 22, 2011

Alcohol Care Teams QIPP to reduce acute hospital admissions and improve quality of care

An NHS Evidence QIPP case study is available on Alcohol Care Teams: to reduce acute hospital admissions and improve quality of care. The resource was published by The British Society of Gastroenterology and the Royal Bolton Hospital NHS Foundation Trust. > > > > Read More

New guide on drug and alcohol harms: 'A summary of the health harms of drugs'

A new guide summarising the health harms of drugs, including alcohol, has been published by the Department of Health and the National Treatment Agency. The guide is aimed at supporting non-medical practitioners working with substance misuse issues.

A summary of the health harms of drugs updates the 2003 Dangerousness of Drugs guide, outlining acute and chronic problems associated with each substance, as well as:

  • Factors that mediate or moderate the risk
  • Potential health risks linked to substances commonly added to illicit drugs
  • The influence of different circumstances of use, e.g poly-substance abuse > > > > Read More

Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS)

An updated analysis of data on alcohol sales and price in Scotland and England & Wales has been released as part of the evaluation of Scotland's alcohol strategy.

The analysis explores alcohol sales data to profile drinks sold at relatively lower prices, reflecting the Scottish Government's intentions over minimum pricing. In 2009 the University of Sheffield modeled the potential impact of minimum pricing for Scotland, now outlined as a key Government priority. > > > > Read More

Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings

This report presents the first information from the 2010 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older. The survey interviews approximately 67,500 persons each year. Unless otherwise noted, all comparisons in this report described using terms such as "increased," "decreased," or "more than" are statistically significant at the .05 level.

Alcohol Use

  • Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2010 survey (51.8 percent). This translates to an estimated 131.3 million people, which was similar to the 2009 estimate of 130.6 million people (51.9 percent).
  • In 2010, nearly one quarter (23.1 percent) of persons aged 12 or older participated in binge drinking. This translates to about 58.6 million people. The rate in 2010 was similar to the estimate in 2009 (23.7 percent). Binge drinking is defined as having five or more drinks on the same occasion on at least 1 day in the 30 days prior to the survey.
  • In 2010, heavy drinking was reported by 6.7 percent of the population aged 12 or older, or 16.9 million people. This rate was similar to the rate of heavy drinking in 2009 (6.8 percent). Heavy drinking is defined as binge drinking on at least 5 days in the past 30 days.
  • Among young adults aged 18 to 25 in 2010, the rate of binge drinking was 40.6 percent, and the rate of heavy drinking was 13.6 percent. These rates were similar to the rates in 2009.
  • The rate of current alcohol use among youths aged 12 to 17 was 13.6 percent in 2010, which was lower than the 2009 rate (14.7 percent). Youth binge and heavy drinking rates in 2010 (7.8 and 1.7 percent) were also lower than rates in 2009 (8.8 and 2.1 percent).
  • There were an estimated 10.0 million underage (aged 12 to 20) drinkers in 2010, including 6.5 million binge drinkers and 2.0 million heavy drinkers.
  • Past month and binge drinking rates among underage persons declined between 2002 and 2010. Past month use declined from 28.8 to 26.3 percent, while binge drinking declined from 19.3 to 17.0 percent.
  • In 2010, 55.3 percent of current drinkers aged 12 to 20 reported that their last use of alcohol in the past month occurred in someone else's home, and 29.9 percent reported that it had occurred in their own home. About one third (30.6 percent) paid for the alcohol the last time they drank, including 8.8 percent who purchased the alcohol themselves and 21.6 percent who gave money to someone else to purchase it. Among those who did not pay for the alcohol they last drank, 38.9 percent got it from an unrelated person aged 21 or older, 16.6 percent from another person younger than 21 years old, and 21.6 percent from a parent, guardian, or other adult family member.
  • In 2010, an estimated 11.4 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year. This percentage had dropped since 2002, when it was 14.2 percent. The rate of driving under the influence of alcohol was highest among persons aged 21 to 25 (23.4 percent).

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Wednesday, September 21, 2011

Press Release - Diageo takes multi-million dollar global partnership with Facebook to the next level

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Diageo today announces plans to step-up their multi-million dollar strategic partnership with Facebook®, which will drive unprecedented levels of integration and joint business planning and experimentation between the two companies. > > > > Read More

Facebook deal with Diageo fuels under-age drinking fears

A multimillion-dollar deal agreed between Facebook and drinks company Diageo will fuel the under-age drinking epidemic by exposing increasing numbers of young people to alcohol marketing, health experts are warning.

Advertising to the predominantly young people who use Facebook has been hugely profitable for Diageo, which makes the drink of choice for most teenagers who can obtain it – Smirnoff vodka.

Announcing the deal, Diageo said Smirnoff had become "the number one beverage alcohol brand on Facebook worldwide". Its brands in the US had enjoyed a 20% increase in sales "as a result of Facebook activity". The deal will, said Diageo, "drive unprecedented levels of integration and joint business planning, and experimentation between the two companies".

Diageo said that more than 950 of its marketers had been trained in "Facebook boot camps" to build their social media capabilities and the company was recording "significant returns on investment" across a number of its brands. > > > > Read More

Social media guidelines drafted for alcohol brands

Alcoholic drinks brands looking to market their products through social media could will now have to follow a set of principles created by the European Forum for Responsible Drinking (EFRD) and the Distilled Spirits Council of the US (DISCUS).

The guidelines will come into effect in the US and Europe on September 30th and concern any alcohol brand wanting to use blogs, social networking sites, mobile apps and user-generated content

One of the key initiatives of the principles is to provide consistent age checking and monitoring of content, to ensure that it is being marketed at an appropriate audience and in a suitable way. > > > > Read More

Living Alone and Alcohol-Related Mortality: A Population-Based Cohort Study from Finland Kimmo Herttua and colleagues showed that living alone is asso

Social isolation and living alone are increasingly common in industrialised countries. However, few studies have investigated the potential public health implications of this trend. We estimated the relative risk of death from alcohol-related causes among individuals living alone and determined whether this risk changed after a large reduction in alcohol prices.

We conducted a population-based natural experimental study of a change in the price of alcohol that occurred because of new laws enacted in Finland in January and March of 2004, utilising national registers. The data are based on an 11% sample of the Finnish population aged 15–79 y supplemented with an oversample of deaths. The oversample covered 80% of all deaths during the periods January 1, 2000–December 31, 2003 (the four years immediately before the price reduction of alcohol), and January 1, 2004–December 31, 2007 (the four years immediately after the price reduction). Alcohol-related mortality was defined using both underlying and contributory causes of death. During the 8-y follow-up about 18,200 persons died due to alcohol-related causes. Among married or cohabiting people the increase in alcohol-related mortality was small or non-existing between the periods 2000–2003 and 2004–2007, whereas for those living alone, this increase was substantial, especially in men and women aged 50–69 y. For liver disease in men, the most common fatal alcohol-related disease, the age-adjusted risk ratio associated with living alone was 3.7 (95% confidence interval 3.3, 4.1) before and 4.9 (95% CI 4.4, 5.4) after the price reduction (p<0.001 for difference in risk ratios). In women, the corresponding risk ratios were 1.7 (95% CI 1.4, 2.1) and 2.4 (95% CI 2.0, 2.9), respectively (p ≤ 0.01). Living alone was also associated with other mortality from alcohol-related diseases (range of risk ratios 2.3 to 8.0) as well as deaths from accidents and violence with alcohol as a contributing cause (risk ratios between 2.1 and 4.7), both before and after the price reduction.

Living alone is associated with a substantially increased risk of alcohol-related mortality, irrespective of gender, socioeconomic status, or the specific cause of death. The greater availability of alcohol in Finland after legislation-instituted price reductions in the first three months of 2004 increased in particular the relative excess in fatal liver disease among individuals living alone.

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Deep brain stimulation in addiction: a review of potential brain targets

Deep brain stimulation (DBS) is an adjustable, reversible, non-destructive neurosurgical intervention using implanted electrodes to deliver electrical pulses to areas in the brain.

DBS is currently investigated in psychiatry for the treatment of refractory obsessive–compulsive disorder, Tourette syndrome and depressive disorder. Although recent research in both animals and humans has indicated that DBS may be an effective intervention for patients with treatment-refractory addiction, it is not yet entirely clear which brain areas should be targeted.

The objective of this review is to provide a systematic overview of the published literature on DBS and addiction and outline the most promising target areas using efficacy and adverse event data from both preclinical and clinical studies.

We found 7 animal studies targeting six different brain areas: nucleus accumbens (NAc), subthalamic nucleus (STN), dorsal striatum, lateral habenula, medial prefrontal cortex (mPFC) and hypothalamus, and 11 human studies targeting two different target areas: NAc and STN.

Our analysis of the literature suggests that the NAc is currently the most promising DBS target area for patients with treatment-refractory addiction. The mPFC is another promising target, but needs further exploration to establish its suitability for clinical purposes.

We conclude the review with a discussion on translational issues in DBS research, medical ethical considerations and recommendations for clinical trials with DBS in patients with addiction.

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Tuesday, September 20, 2011

Alcohol induced depressive-like behavior is associated with a reduction in hippocampal BDNF

Strong positive correlation between depression and alcoholism is evident in epidemiological reports. However, a causal relationship for this co-morbidity has not been established.

We have observed that chronic daily exposure to a relatively high dose of alcohol can induce depressive-like behavior in rats and that pretreatment with nomifensine or imipramine can block the “depressogenic” effects of alcohol.

Since brain derived neurotrophic factor (BDNF) is considered to play an important role in depressive-like behaviors and its elevation, particularly in the hippocampus, appears to be critical for the action of many antidepressants, we hypothesized that: 1. WKY rats, a putative animal model of depression, will show a lower hippocampal BDNF compared to their control Wistar rats, 2. Alcohol-induced depressive like behavior will be associated with a significant decrease in hippocampal BDNF and 3. Treatments with antidepressants will normalize hippocampal BDNF.

These postulates were verified by measuring hippocampal BDNF in Wistar and WKY rats at baseline, following chronic (10 day) treatment with alcohol and combination of alcohol with nomifensine or imipramine. Alcohol was administered via inhalation chamber (3 h/day) such that a blood alcohol level of approximately 150 mg% was achieved. Nomifensine (10 mg/kg) or imipramine (10 mg/kg) was administered i.p. daily immediately after alcohol exposure. BDNF was measured by standard ELISA kit.

The results support a role for central BDNF in depressogenic effects of alcohol and antidepressant effects of nomifensine and imipramine. Moreover, depression per se as manifested in WKY rats may be associated with a reduction in hippocampal BDNF.

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Neuroprotective effects of the 17β-estradiol against ethanol-induced neurotoxicity and oxidative stress in the developing male rat cerebellum: Biochem

During particular periods of central nervous system (CNS) development, exposure to ethanol can decrease regional brain growth and can result in selective loss of neurons. Unfortunately, there are few effective means of attenuating damage in the immature brain.

In this study, the possible antioxidant and neuroprotective properties of 17β-estradiol against ethanol-induced neurotoxicity was investigated.

17β-estradiol (600 μg/kg) was injected subcutaneously in postnatal day (PD) 4 and 5, 30 min prior to intraperitoneal injection of ethanol (6 g/kg) in rat pups. Ninety minutes after injection of ethanol, the activities of several antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (Gpx) in vermis of cerebellum were assayed. Thiobarbituric acid reactive substance (TBARS) levels were also measured as a marker of lipid peroxidation. Behavioral studies, including rotarod and locomotor activity tests were performed in PD 21–23 and histological study was performed after completion of behavioral measurements in postnatal day 23.

The results of the present work demonstrated that ethanol could induce lipid peroxidation, increase TBARS levels and decrease glutathione peroxidase levels in pup cerebellum.

We also observed that ethanol impaired performance on the rotarod and locomotor activities of rat pups. However, treatment with 17β-estradiol significantly attenuated motoric impairment, the lipid peroxidation process and restored the levels of antioxidants. Histological analysis also indicated that ethanol could decrease vermis Purkinje cell count and 17β-estradiol prevented this toxic effect.

These results suggest that ethanol may induce lipid peroxidation in the rat pups cerebellum while treatment with 17β-estradiol improves motor deficits by protecting the cerebellum against ethanol toxicity.

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Modeling binge-like ethanol drinking by peri-adolescent and adult P rats

Alcohol binge-drinking, especially among adolescents and young adults, is a serious public health concern. The present study examined ethanol binge-like drinking by peri-adolescent [postnatal days (PNDs 30–72)] and adult (PNDs 90–132) alcohol-preferring (P) rats with a drinking-in-the-dark-multiple-scheduled-access (DID-MSA) procedure used by our laboratory.

Male and female P rats were provided concurrent access to 15% and 30% ethanol for three 1-h sessions across the dark cycle 5 days/week.

For the 1st week, adolescent and adult female P rats consumed 3.4 and 1.6 g/kg of ethanol, respectively, during the 1st hour of access, whereas for male rats the values were 3.5 and 1.1 g/kg of ethanol, respectively. Adult intakes increased to ~ 2.0 g/kg/h and adolescent intakes decreased to ~ 2.5 g/kg/h across the 6 weeks of ethanol access.

The daily ethanol intake of adult DID-MSA rats approximated or modestly exceeded that seen in continuous access (CA) rats or the selection criterion for P rats (≥ 5 g/kg/day).

However, in general, the daily ethanol intake of DID-MSA peri-adolescent rats significantly exceeded that of their CA counterparts.

BELs were assessed at 15-min intervals across the 3rd hour of access during the 4th week. Ethanol intake was 1.7 g/kg vs. 2.7 g/kg and BELs were 57 mg% vs. 100 mg% at 15- and 60-min, respectively. Intoxication induced by DID-MSA in female P rats was assessed during the 1st vs. 4th week of ethanol access. Level of impairment did not differ between the 2 weeks (106 vs. 97 s latency to fall, 120 s criterion) and was significant (vs. naïve controls) only during the 4th week.

Overall, these findings support the use of the DID-MSA procedure in rats, and underscore the presence of age- and sex-dependent effects mediating ethanol binge-like drinking in P rats.

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