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

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


Saturday, April 28, 2012

The great recession, somatic symptomatology and alcohol use and abuse

While most research has examined the long-term effects of alcohol consumption on health, the current study examines how health status impacts on drinking behavior.

Using data from a national study conducted between 2010 and 2011 to assess the impact of the recession on drinking behavior, this study examines how economic hardships linked to the recent economic recession affect physical health, and how physical health may in turn affect alcohol use. Structural equation models were used to test the predicted associations.

The data demonstrate that many of the economic stressors linked to the recession are associated with increased somatic symptoms. Somatic symptoms are also associated with increased drinking for men, but not for women.

These findings suggest that men may use alcohol to self medicate somatic symptomatology. The current findings are consistent with gender role-based explanations that account for gender disparities in the utilization of medical care.

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Results of a Transtheoretical Model-Based Alcohol, Tobacco and Other Drug Intervention in Middle Schools

Early use of alcohol, tobacco, and other drugs threatens the physical and mental well-being of students and continued use negatively affects many areas of development. An internet-based, tailored intervention based on the Transtheoretical Model of Behavior Change was delivered to middle school students to reduce alcohol, tobacco, and other drug use. This internet-based approach requires very little faculty and staff time, which is efficient given curricular demands.

Twenty-two middle schools in the United States were matched and randomly assigned to either the intervention or control conditions (N = 1,590) students who had ever used substances. Participants received one pre-test assessment, three thirty-minute intervention sessions over three months, and two post-test assessments (3 and 14 months after pre-test, respectively).

Random effects logistic models showed significant treatment effects for the intervention group when compared to the control group at the 3-Font sizemonth post-test.

This program has the potential to be applied as stand-alone practice or as part of more intensive interventions to promote substance use cessation.

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Good choices, great future: An applied theatre prevention program to reduce alcohol-related risky behaviours during Schoolies

The contextual and temporal factors of post-school celebratory events (‘Schoolies’) place young people at elevated risk of excessive drinking compared with other social occasions. This study investigates the impact of an applied theatre prevention program ‘Choices’ in reducing the risk of drinking and other risk behaviours during Schoolies celebrations.

Choices was delivered in the last term of Year 12 across 28 North Queensland schools. A total of 352 school leavers (43.1% male, mean age = 17.14 years) completed a questionnaire at Whitsunday Schoolies, Queensland, Australia on 23–24 November 2010. Nearly 49% of respondents had attended Choices. The survey included measures of alcohol use, illicit drug use and associated problems during Schoolies and a month prior to Schoolies.

After controlling for gender and pre-Schoolies drinking, school leavers who attended Choices were significantly less likely to report illicit drug use (OR = 0.51, P < 0.05) and problem behaviours (OR = 0.40, P < 0.01) than those who did not attend Choices. There was, however, no intervention effect in risky drinking (i.e. drank on 5 or more days, typical amount five or more standard drink and binge drank on 3 or more days) at Schoolies (OR = 0.92, P = 0.80).

Delivery of a youth-specific applied theatre prevention program employing a harm minimisation framework may be effective in reducing high-risk behaviours associated with alcohol consumption at celebratory events, even if young people expect to engage in excessive alcohol consumption.

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Social rank, chronic ethanol self-administration, and diurnal pituitary–adrenal activity in cynomolgus monkeys

This study aimed to determine whether diurnal pituitary–adrenal hormonal rhythms account for differences between social ranks in ethanol self-administration or are differentially affected by ethanol self-administration between social ranks.

During alternating individual (n = 11–12) and social (n = 3 groups) housing of male cynomolgus monkeys (Macaca fascicularis), diurnal measures of cortisol and adrenocorticotropic hormone (ACTH) were obtained from plasma samples three times per week. Social rank was determined, ethanol (4 %, w/v) self-administration was induced, and then the monkeys were allowed a choice of water or ethanol for 22 h/day for 49 weeks.

For all social ranks, plasma ACTH was elevated during social housing, but cortisol was stable, although greater among dominant monkeys. Ethanol self-administration blunted the effect of social housing, cortisol, and the diurnal rhythm for both hormones, regardless of daily ethanol intake (1.2–4.2 g/kg/day). Peak ACTH and cortisol were more likely to be observed in the morning during ethanol access. Ethanol, not vehicle, intake was lower during social housing across social ranks. Only dominant monkeys showed significantly lower blood–ethanol concentration during social housing.

There was a low threshold for disruption of diurnal pituitary rhythms by ethanol drinking, but sustained adrenal corticosteroid rhythms. Protection against heavy drinking among dominant monkeys may have constrained ethanol intoxication, possibly to preserve dominance rank.

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Social Inequalities and Gender Differences in the Experience of Alcohol-Related Problems

To examine the influence of country-level characteristics and individual socio-economic status (SES) on individual alcohol-related consequences.

Data from 42,655 men and women collected by cross-sectional surveys in 25 countries of the Gender, Alcohol and Culture: An International Study study were used. The individual SES was measured by the highest attained educational level. Alcohol-related consequences were defined as the self-report of at least one internal or one external consequence in the last year. The relationship between individuals’ education and alcohol-related consequences was examined by meta-analysis. In a second step, the individual level data and country data were combined in multilevel models. As country-level indicators, we used the purchasing power parity of the gross national income (GNI), the Gini coefficient and the Gender Gap Index.

Lower educated men and women were more likely to report consequences than higher educated men and women even after controlling for drinking patterns. For men, this relation was significant for both internal and external problems. For women, it was only significant for external problems. The GNI was significantly associated with reporting external consequences for men such that in lower income countries men were more likely to report social problems.

The fact that problems accrue more quickly for lower educated persons even if they drink in the same manner can be linked to the social or environmental dimension surrounding problems. That is, those of fewer resources are less protected from the experience of a problem or the impact of a stressful life event.

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Alcohol consumption and ischemic heart disease mortality in Russia

It has been repeatedly emphasized that alcohol provides the most plausible explanation for both the high rate of cardiovascular mortality rate and its dramatic fluctuations in Russia over recent decades, while other traditional risk factors identified in epidemiological studies have little predictive value.

The aim of this study was to examine the relation between alcohol consumption and ischemic heart disease (IHD) mortality rates in Russia. A ge-standardized sex-specific male and female IHD mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means of ARIMA time series analysis.

The results of the analysis showed that alcohol consumption was significantly associated with both male and female IHD mortality rates: a 1-liter increase in overall alcohol consumption would result in a 3.9% increase in the male IHD mortality rate and a 2.7% increase in the female IHD mortality rate.

As a conclusion, the results of this study provide indirect support for the hypothesis that the drastic fluctuations in IHD mortality in Russia over recent decades are related to alcohol, as indicated by the close temporal association between number of deaths from IHD and overall alcohol consumption per capita.

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Friday, April 27, 2012

Drinking Concordance and Relationship Satisfaction in New Zealand Couples

The aim of the study was to examine alcohol consumption patterns in New Zealand couples and the associations of these patterns with time spent drinking together and the level of satisfaction with the relationship.

Cross-sectional survey of a nationally representative sample of New Zealand residents aged 18–70 on the combined electoral roll in 2007. Using reports of the respondents' own drinking patterns and their reports of their partners' drinking, couples were classified as concordant, mildly discordant or discordant for both their drinking frequency and quantity of alcohol consumed per typical drinking occasion. The level of concordance was compared by demographic characteristics and relationship type. Ordinal logistic regression models were used to examine the associations between levels of concordance and both time spent drinking as a couple and level of happiness in the relationship (both reported by the respondent).

The largest proportion of couples was lassified as concordant for both frequency and quantity of alcohol consumed per typical drinking occasion regardless of the relationship type. For both drinking frequency and quantity per occasion, couples identified as discordant or mildly discordant were less likely to report having spent a large amount of time drinking with their partner (odds ratio 0.2–0.5). Reported level of happiness with the relationship was also associated with the degree of concordance of both drinking frequency and quantity.

These findings suggest that drinking frequency and quantity of alcohol consumed per typical drinking occasion are concordant in most intimate partnerships and that discordance in either is associated with a lower level of happiness within the relationship.

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The relationship between subjective wellbeing, low income and substance use among schoolchildren in the north west of England: a cross-sectional study

The consumption of tobacco, alcohol and illegal drugs by young people is a public health concern. This study aimed to explore the associations between subjective wellbeing, living in a low-income household and substance use by schoolchildren.

Data were analysed from a nationally representative cross-sectional survey of schoolchildren in England (Tellus4, 2009). Participants were 3903 children aged 10 and 15 years from two local authorities in the North West. Eligibility for free school meals provided a proxy for living in a low-income household. Multiple logistic regression was conducted with the main outcome measure, a composite indicator of self-reported regular substance use.

More boys than girls had experimented with drugs or alcohol, but in the fourth year of secondary education, girls were significantly more likely than boys to have been drunk (P ≤ 0.001). In the multivariate analysis, older age was the most important factor associated with the consumption of substances. Living in a low-income household was associated with substance use, adjusting for age and subjective wellbeing (adj. OR = 1.78, 95% CI = 1.36–2.34). Respondents who reported being happy (adj. OR = 0.67, 95% CI = 0.52–0.86) or able to communicate with their family (adj. OR = 0.51, 95% CI = 0.39–0.65), were less likely to be regular users.

Interventions to prevent regular substance use should be carefully targeted by age. Policies aimed at social determinants may be an important adjunct to individual-level interventions to reduce some inequalities in health associated with substance misuse.

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Validation of the French version of the alcohol, smoking and substance involvement screening test (ASSIST) in the elderly

Substance use disorders seem to be an under considered health problem amongst the elderly. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), was developed by the World Health Organization to detect substance use disorders. The present study evaluates the psychometric properties of the French version of ASSIST in a sample of elderly people attending geriatric outpatient facilities (primary care or psychiatric facilities).

One hundred persons older than 65 years were recruited from clients attending a geriatric policlinic day care centre and from geriatric psychiatric facilities. Measures included ASSIST, Addiction Severity Index (ASI), Mini-International Neuropsychiatric Interview (MINI-Plus), Alcohol Use Disorders Identification Test (AUDIT), Revised Fagerstrom Tolerance Questionnaire-Smoking (RTQ) and MiniMental State(MMS).

Concurrent validity was established with significant correlations between ASSIST scores, scores from ASI, AUDIT, RTQ, and significantly higher ASSIST scores for patients with a MINI-Plus diagnosis of abuse or dependence. The ASSIST questionnaire was found to have high internal consistency for the total substance involvement along with specific substance involvement as assessed by Cronbach's alpha, ranging from 0.66, to 0.89 .

The findings demonstrate that ASSIST is a valid screening test for identifying substance use disorders in elderly.

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Presss Release - Turning popular opinion into public policy Overwhelming majority of Europeans support public policies to reduce alcohol harm

Just recently self-regulation of alcohol industry activities has been put forward as an important element in a new EU Alcohol Strategy. This suggestion comes surprisingly at a time when evidence has made two things clear:

1) Self-regulation does not work.

2) Europeans understand that alcohol is no ordinary commodity and “widely support public policies aimed at reducing alcohol-related harm.”

“The alcohol industry has had more than a fair chance to prove self-regulation can work”, says Andrea Lavesson, President of Active – sobriety, friendship and peace. “But all independent evidence shows that self-regulation does not work for preventing alcohol harm. In the face of the fact that Europeans overwhelmingly support policies like, among others, banning alcohol marketing that targets youth, it is time that policy makers turn public opinion into public policy. Europe deserves real regulation to reduce and prevent alcohol harm.”
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Prion Protein Is a Key Determinant of Alcohol Sensitivity through the Modulation of N-Methyl-D-Aspartate Receptor (NMDAR) Activity

The prion protein (PrP) is absolutely required for the development of prion diseases; nevertheless, its physiological functions in the central nervous system remain elusive. Using a combination of behavioral, electrophysiological and biochemical approaches in transgenic mouse models, we provide strong evidence for a crucial role of PrP in alcohol sensitivity.

Indeed, PrP knock out (PrP
−/−) mice presented a greater sensitivity to the sedative effects of EtOH compared to wild-type (wt) control mice. Conversely, compared to wt mice, those over-expressing mouse, human or hamster PrP genes presented a relative insensitivity to ethanol-induced sedation.

An acute tolerance (i.e. reversion) to ethanol inhibition of N-methyl-D-aspartate (NMDA) receptor-mediated excitatory post-synaptic potentials in hippocampal slices developed slower in PrP
−/− mice than in wt mice.

We show that PrP is required to induce acute tolerance to ethanol by activating a Src-protein tyrosine kinase-dependent intracellular signaling pathway. In an attempt to decipher the molecular mechanisms underlying PrP-dependent ethanol effect, we looked for changes in lipid raft features in hippocampus of ethanol-treated wt mice compared to PrP
−/− mice.

Ethanol induced rapid and transient changes of buoyancy of lipid raft-associated proteins in hippocampus of wt but not PrP
−/− mice suggesting a possible mechanistic link for PrP-dependent signal transduction.

Together, our results reveal a hitherto unknown physiological role of PrP on the regulation of NMDAR activity and highlight its crucial role in synaptic functions.

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Thursday, April 26, 2012

Alcohol abuse and glycoconjugate metabolism.

The relationship between alcohol consumption and glycoconjugate metabolism is complex and multidimensional.

This review summarizes the advances in basic and clinical research on the molecular and cellular events involved in the metabolic effects of
alcohol on glycoconjugates (glycoproteins, glycolipids, and proteoglycans).

We summarize the action of
ethanol, acetaldehyde, reactive oxygen species (ROS), nonoxidative metabolite of alcohol - fatty acid ethyl esters (FAEEs), and the ethanol-water competition mechanism, on glycoconjugate biosynthesis, modification, transport and secretion, as well as on elimination and catabolism processes.

As the majority of changes in the cellular metabolism of glycoconjugates are generally ascribed to alterations in synthesis, transport, glycosylation and secretion, the degradation and elimination processes, of which the former occurs also in extracellular matrix, seem to be underappreciated.

The pathomechanisms are additionally complicated by the fact that the effect of
alcohol intoxication on the glycoconjugate metabolism depends not only on the duration of ethanol exposure, but also demonstrates dose- and regional-sensitivity.

Further research is needed to bridge the gap in transdis
ciplinary research and enhance our understanding of alcohol- and glycoconjugate-related diseases.

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Computer based interventions: NHS Scotlands report explores potential

NHS Scotland have released a report on Computer based interventions: A report to rapidly assess the effectiveness evidence in relation to computer-based alcohol interventions.

Like recent and previous reviews, the report identifies potential for web-based interventions, but also limitations and the need for further research. The reports conclusion states:

Computer-based alcohol interventions delivered using the internet offer a potentially important new development for treatment and support, particularly for individuals unlikely to engage with traditional community-based services. Improvements in technology and increases in public access to the internet have increased the focus on the use of computer-based tools to deliver health information, education and intervention.

Despite this increased focus, the evidence on effectiveness and cost-effectiveness of these approaches to address alcohol misuse and related harm is limited... Potential harms to service-users can be minimised by ensuring security, quality and credibility issues are prioritised, and appropriate care-pathways are developed. Sustainability appears plausible over time, although this must be balanced against initial start up costs and funding required to appropriately market the intervention to those who could benefit from such an approach. > > > > Read More

Harm reduction, students and pleasure: An examination of student responses to a binge drinking campaign

Recent debates about ‘binge drinking’ in New Zealand have positioned alcohol consumption amongst young drinkers as of concern. Research notes that students drink more heavily than their peers and that they have a higher incidence of alcohol related harms. In response, a harm reduction campaign aimed at first year university students was developed at a New Zealand university.

This mixed methods study used questionnaires (225) and a small number of semi-structured interviews (4) to elicit student responses to the harm reduction campaign.

The majority of students in this study can be characterised as binge drinkers, although their drinking does not appear to cause them concern. The term ‘binge drinking’ is explored in three developed categories; ‘light’, ‘moderate’ and ‘heavy’ bingeing. Results are considered within a discussion of pleasure as a hindrance to harm reduction campaigns.

The concept of ‘determined drunkenness’ and the notion of pleasure are important in students’ motivations for drinking and may contribute to the resistance they have in viewing their alcohol consumption as concerning. It is argued that students already felt that they exercised control over their drinking for pleasure and this produced contradictions in responses towards the campaign compared to actual behaviour.

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The Effect of Low Survey Response Rates on Estimates of Alcohol Consumption in a General Population Survey

Response rates for surveys of alcohol use are declining for all modes of administration (postal, telephone, face-to-face). Low response rates may result in estimates that are biased by selective non-response. We examined non-response bias in the NZ GENACIS survey, a postal survey of a random electoral roll sample, with a response rate of 49.5% (n = 1924). Our aim was to estimate the magnitude of non-response bias in estimating the prevalence of current drinking and heavy episodic (binge) drinking.

We used the “continuum of resistance” model to guide the investigation. In this model the likelihood of response by sample members is related to the amount of effort required from the researchers to elicit a response. First, the demographic characteristics of respondents and non-respondents were compared. Second, respondents who returned their questionnaire before the first reminder (early), before the second reminder (intermediate) or after the second reminder (late) were compared by demographic characteristics, 12-month prevalence of drinking and prevalence of binge drinking.

Demographic characteristics and prevalence of binge drinking were significantly different between late respondents and early/intermediate respondents, with the demographics of early and intermediate respondents being similar to people who refused to participate while late respondents were similar to all other non-respondents. Assuming non-respondents who did not actively refuse to participate had the same drinking patterns as late respondents, the prevalence of binge drinking amongst current drinkers was underestimated. Adjusting the prevalence of binge drinkers amongst current drinkers using population weights showed that this method of adjustment still resulted in an underestimate of the prevalence.

The findings suggest non-respondents who did not actively refuse to participate are likely to have similar or more extreme drinking behaviours than late respondents, and that surveys of health compromising behaviours such as alcohol use are likely to underestimate the prevalence of these behaviours

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Alcoholism and partner aggression among gay and lesbian couples

The link between alcoholism and intimate partner violence (IPV) among heterosexual couples has received a great deal of attention in both the scientific and lay press.

However, relative to heterosexual couples, IPV among alcohol-disordered homosexual couples has been grossly understudied. Despite the limited knowledge based on this topic, previous studies suggest that homosexual couples may experience more problematic drinking behaviors, higher rates of IPV, and in general, display more negative factors associated with treatment-seeking behaviors than heterosexual couples. In addition, because the study of alcoholism and IPV among homosexuals is a relatively new phenomenon, research on alcohol use patterns, dyadic adjustment, and partner violence is greatly lacking.

Thus, the purpose of this review is to describe the prevalence of these comorbid conditions among lesbian and gay couples, discuss the link between alcohol misuse and partner violence in this population, identify factors that may reduce treatment-seeking behavior among same sex couples, and describe possible treatment

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3-year prevalence of alcohol-related disorders in German patients treated with high-potency opioids

In November 2010, the European Medicines Agency's Committee for Medicinal Products for Human Use completed a review of the safety and effectiveness of modified-release oral high-potency opioids (HPO). The reason for this referral procedure was the concern that some of these controlled-release systems may be unstable when co-ingested with alcohol and that the active substance would be released too quickly. The aim of this study was to estimate the prevalence of alcohol-related disorders (ARD) in German patients treated with HPO approved for pain therapy.

The source of data was the German Pharmacoepidemiological Research Database including more than 14 million members of four statutory health insurances. The age and sex standardized 3-year prevalence of ARD in patients treated with any type of HPO and in patients receiving modified-release oral HPO was compared with the prevalence of ARD in the general population excluding HPO-treated patients.

The age and sex standardized prevalence of ARD was significantly higher in patients treated with any type of HPO (5.5%, 95%confidence interval [CI]: 5.2%–5.9%) or with modified-release HPO (5.4%, 95%CI: 4.8%–5.9%) than in persons belonging to the general population (2.2%, 95%CI: 2.2–2.2%).

Interactions with alcohol in patients receiving modified-release HPO may be of relevance in a substantial number of patients. Physicians should be aware of this potentially dangerous interaction.

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Developmental Associations Between Adolescent Alcohol Use and Dating Aggression

Although numerous studies have established a link between alcohol use and partner violence in adulthood, little research has examined this relation during adolescence.

The current study used multivariate growth models to examine relations between alcohol use and dating aggression across Grades 8 through 12, controlling for shared risk factors (common causes) that predict both behaviors.

Associations between trajectories of alcohol use and dating aggression were reduced substantially when common causes were controlled.

Concurrent associations between the two behaviors were significant across nearly all grades but no evidence was found for prospective connections from prior alcohol use to subsequent dating aggression or vice versa.

Findings suggest that prevention efforts should target common causes of alcohol use and dating aggression.

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Wednesday, April 25, 2012

Metabolic profiling of an alcoholic fatty liver in zebrafish (Danio rerio)

Zebrafish (Danio rerio) is becoming a popular developmental biology model to study diseases and for drug discovery.

In this study, we performed proton nuclear magnetic resonance spectroscopy (
1H-NMR)- and gas chromatography–mass spectrometry (GC/MS)-based metabolic profiling of an alcoholic fatty liver using a zebrafish disease model.

\We examined metabolic differences between the control and alcoholic fatty liver groups in zebrafish to determine how metabolism in an alcoholic fatty liver is regulated.

Multivariate statistical analysis showed a significant difference between the control and alcoholic fatty liver groups. The alcoholic fatty liver group showed increased excretion of isoleucine, acetate, succinate, choline, creatine, acetoacetate, 3-hydroxybutyrate (3HB), ethyl glucuronide (EtG), lactate/pyruvate ratio, fatty acids, and cholesterol, and decreased excretion of citrate, aspartate, tyrosine, glycine, glucose, alanine, betaine, and maltose. Metabolites identified in the fatty liver groups were associated with long-term alcohol consumption, which causes both oxidation–reduction (redox) changes and oxidative stress.

This study suggests that global metabolite profiling in a zebrafish model can provide insights into the metabolic changes in an alcoholic fatty liver.

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Global Actions April 25, 2012

Key Recent Milestones:

· Russia: ICAP held a second master class for stakeholders in Moscow in April and met with Social Projects, our partner NGO in the Global Actions drink driving initiative. We also finalized the date for a drink driving workshop in Russia, to be held on May 22.

Global Actions in Focus: Progress in CARICOM Region

The Caribbean countries that make up the CARICOM region are an area of focus for Global Actions’ Self-Regulation initiative.

We have been working closely with beverage alcohol producers to: build consensus about the need for self-regulation and codes that are customized for each market; offer training to industry members, trade associations, advertising agencies, regulatory bodies, and the media; and provide monitoring as deemed useful by local stakeholders.

Since 2010, the Regional Beverage Alcohol Alliance (RBAA) has worked to establish national beverage alcohol alliances in the CARICOM region. To date, the alliances are at various stages of completion in Barbados, Dominica, Grenada, Guyana, Jamaica, St. Kitts & Nevis, St. Lucia, St. Vincent & the Grenadines, and Suriname. RBAA is in the process of holding stakeholder consultations with the goal of establishing alliances in Antigua & Barbuda, Bahamas, and Belize.

“We are very pleased with the progress that has been made thus far in the CARICOM region in the area of Self-Regulation,” said ICAP’s Shushanna Mignott. “The Regional Beverage Alcohol Alliance has worked hard to develop Beverage Alcohol Alliances in the countries. This work is laying the foundation for the implementation of marketing Codes of Conduct and Code Review mechanisms in the coming months, which are critical to having an effective self-regulatory system.”

What’s Happening Next:

· Vietnam: The Global Actions workshop “Production, Consumption, and Use of Noncommercial Alcohol” is scheduled for April 27 in Hanoi.

Do lifestyle choices explain the effect of alcohol on bone mineral density in women around menopause

Moderate alcohol consumption has been shown to be positively associated with increased bone mineral density (BMD). However, other lifestyle choices have also been shown to have an effect on bone health.

The objective was to examine the association between alcohol intake and BMD in women around menopause in the United Kingdom and to determine whether any association is independent of other lifestyle choices.

Design: A cross-sectional study design was used to examine the relation between alcohol intake and BMD in a cohort of 3218 women aged 50–62 y from the Aberdeen Prospective Osteoporosis Screening Study. Women were grouped into clusters according to their lifestyle choices. ANCOVA was used to examine the effect of categorized alcohol intake on BMD adjusted for cluster of lifestyle and other baseline covariates. The ANCOVA was repeated for different types of alcoholic beverage (eg, beer, liquor, and wine) separately.

Three lifestyle clusters were identified and were based on different levels of the following 3 factors: smoking pack-years, fruit and vegetable intakes, and physical activity. In the lifestyle-adjusted models, women who consumed >1 drink/d of alcohol had a significantly greater femoral neck BMD (P = 0.008) and lumbar spine BMD (P = 0.007) than did those who never consumed alcohol. For separate alcoholic drinks, only beer had a positive significant effect on lumbar spine BMD after adjustment for lifestyle (P = 0.005).

Moderate alcohol intake appears to be positively associated with BMD independently of the type of lifestyle led by women around menopause.

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Conclusion new research: Introduction of a legal ban on alcohol advertising is the only real solution

The following report provides a comprehensive overview of the results of the monitoring work conducted by the NGOs in five European countries; Bulgaria, Denmark, Germany, Italy and The Netherlands.

The AMMIE project (Alcohol Marketing Monitoring in Europe) consists of NGOs from five EU countries (Bulgaria, Denmark, Germany, Italy and the Netherlands) that monitored alcohol advertising practices and marketing activities in 2010. The project started in 2009 and is partly funded by the European Commission. > > > > Read More

Commercial promotion of drinking in Europe Key

The following report provides a comprehensive overview of the results of the monitoring work conducted by the participating NGOs in five European countries; Bulgaria, Denmark, Germany, Italy and The Netherlands. It summarizes the individual findings of the five European countries on four different topics in alcohol marketing: trends, volume, complaints and sports sponsoring.

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A Brief Alternative for Identifying Alcohol Use Disorders

This study sought to evaluate the clinical utility of a brief assessment interview in accurately classifying inmates manifesting an alcohol use disorder (AUD) based on a structured diagnostic assessment interview.

Data were derived from routine clinical assessments of 7,672 inmates (89.6% male) incarcerated in the Minnesota Department of Corrections state prison system. An automated version of the
Substance Use Disorder Diagnostic Schedule-IV (SUDDS-IV), which included a subset of the items comprising the Triage Assessment for Addictive Disorders (TAAD), was administered to all inmates from 2000 to 2003.

Approximately 99% of the DSM-IV dependence and no diagnosis cases were appropriately classified by the TAAD. Although the TAAD identified nearly all cases with any diagnosis, 20%–24% of cases classified as abuse by the TAAD were found to be dependent by the longer instrument. Similar findings were noted when DSM-5 criteria were applied.

The TAAD has the potential to provide a more clinically defensible means of identifying AUDs than brief screens when time constraints may preclude a comprehensive assessment.

Limitations and implications for routine clinical practice are discussed.

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Modeling the Dimensionality of DSM-IV Alcohol Use Disorder Criteria in a Nationally Representative Sample of College Students

This study examined the dimensionality of DSM-IV alcohol use disorder (AUD) criteria in a nationally representative sample of college students (N = 4,605) using latent variable techniques. We used data from the 2009 National Survey of Drug Use and Health and selected those who were currently enrolled in college and current drinkers.

Confirmatory factor analysis provided support for a one-factor solution of the AUD criteria. Item Response Theory analyses indicated that the alcohol abuse and dependence criteria severity parameters were intermixed along the AUD severity continuum with high discrimination parameters.

Findings support reformulating the current AUD diagnostic system for the DSM-V. Study's limitations are noted.

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Tuesday, April 24, 2012

Everyday, Everywhere: Alcohol Marketing and Social Media—Current Trends

To provide a snapshot content analysis of social media marketing among leading alcohol brands in the UK, and to outline the implications for both regulatory policies and further research.

Using screengrab technology, the complete Facebook walls and Twitter timelines for 12 leading UK alcohol brands in November 2011 were captured and archived. A total of 701 brand-authored posts were identified and categorized using a thematic coding frame. Key strategic trends were identified and analysed in the light of contextual research into recent developments in marketing practice within the alcohol industry.

A number of dominating trends were identified. These included the use of real-world tie-ins, interactive games, competitions and time-specific suggestions to drink. These methods reflect a strategy of branded conversation-stimulus which is favoured by social media marketing agencies.

A number of distinct marketing methods are deployed by alcohol brands when using social media. These may undermine policies which seek to change social norms around drinking, especially the normalization of daily consumption. Social media marketing also raises questions regarding the efficacy of reactive regulatory frameworks. Further research into both the nature and impact of alcohol marketing on social media is needed.

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Gene Expression Changes in C57BL/6J and DBA/2J Mice Following Prenatal Alcohol Exposure

Prenatal alcohol exposure can result in fetal alcohol spectrum disorders (FASD). Not all women who consume alcohol during pregnancy have children with FASD and studies have shown that genetic factors can play a role in ethanol teratogenesis. We examined gene expression in embryos and placentae from C57BL/6J (B6) and DBA/2J (D2) mice following prenatal alcohol exposure. B6 fetuses are susceptible to morphological malformations following prenatal alcohol exposure while D2 are relatively resistant.

Male and female B6 and D2 mice were mated for 2 hours in the morning, producing 4 embryonic genotypes: true-bred B6B6 and D2D2, and reciprocal B6D2 and D2B6. On gestational day 9, dams were intubated with 5.8 g/kg ethanol, an isocaloric amount of maltose dextrin, or nothing. Four hours later, dams were sacrificed and embryos and placentae were harvested. RNA was extracted, labeled and hybridized to Affymetrix Mouse Genome 430 v2 microarray chips. Data were normalized, subjected to analysis of variance and tested for enrichment of gene ontology molecular function and biological process using the Database for Annotation, Visualization and Integrated Discovery (DAVID).

Several gene classes were differentially expressed in B6 and D2 regardless of treatment, including genes involved in polysaccharide binding and mitosis. Prenatal alcohol exposure altered expression of a subset of genes, including genes involved in methylation, chromatin remodeling, protein synthesis, and mRNA splicing. Very few genes were differentially expressed between maltose-exposed tissues and tissues that received nothing, so we combined these groups for comparisons with ethanol. While we observed many expression changes specific to B6 following prenatal alcohol exposure, none were specific for D2. Gene classes up- or down-regulated in B6 following prenatal alcohol exposure included genes involved in mRNA splicing, transcription, and translation.

Our study identified several classes of genes with altered expression following prenatal alcohol exposure, including many specific for B6, a strain susceptible to ethanol teratogenesis. Lack of strain specific effects in D2 suggests there are few gene expression changes that confer resistance. Future studies will begin to analyze functional significance of the expression changes.

Translational behavior-genetic studies of alcohol: are we there yet?

In biomedical research, one key stage of translating basic science knowledge to clinical practice is the reconciliation of phenotypes employed for laboratory animal studies with those important for the clinical condition.

Alcohol dependence (AD) is a prototypic complex genetic trait. There is a long history of behavior genetic studies of AD in both human subjects and various genetic animal models.

This review assesses the state of the art in our understanding of the genetic contributions to AD. In particular, it primarily focuses on the phenotypes studied in mouse genetic animal models, comparing them to the aspects of the human condition they are intended to target.

It identifies several features of AD where genetic animal models have been particularly useful, and tries to identify understudied areas where there is good promise for further genetic animal model work.

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Genome-wide linkage scan of antisocial behavior, depression, and impulsive substance use in the UCSF family alcoholism study

Epidemiological and clinical studies suggest that the rates of antisocial behavior, depression, and impulsive substance use are increased among individuals diagnosed with alcohol dependence relative to those who are not. Thus, the present study conducted genome-wide linkage scans of antisocial behavior, depression, and impulsive substance use in the University of California at San Francisco Family Alcoholism Study.

Antisocial behavior, depressive symptoms, and impulsive substance use were assessed using three scales from the Minnesota Multiphasic Personality Inventory - 2nd ed.: the Antisocial Practices content scale, the Depression content scale, and the revised MacAndrew Alcoholism scale. Linkage analyses were carried out using a variance components approach.

Suggestive evidence of linkage to three genomic regions independent of alcohol and cannabis dependence diagnostic status was observed: the Antisocial Practices content scale showed evidence of linkage to chromosome 13 at 11 cM, the MacAndrew Alcoholism scale showed evidence of linkage to chromosome 15 at 47 cM, and all three scales showed evidence of linkage to chromosome 17 at 57-58 cM.

Each of these regions has shown previous evidence of linkage and association to substance dependence as well as other psychiatric disorders such as mood and anxiety disorders, attention-deficit hyperactivity disorder, and schizophrenia, thus suggesting potentially broad relations between these regions and psychopathology.

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Monday, April 23, 2012

How is an Electronic Screening and Brief Intervention Tool on Alcohol Use Received in a Student Population? A Qualitative and Quantitative Evaluation

A previous study among Antwerp college and university students showed that more male (10.2%–11.1%) than female (1.8%–6.2%) students are at risk for problematic alcohol use. The current literature shows promising results in terms of feasibility and effectiveness for the use of brief electronic interventions to address this health problem in college and university students. We evaluated this type of intervention and cite existing literature on the topic.
Objective: To develop a website,, to motivate college and university students with problematic alcohol use to reduce alcohol consumption and increase their willingness to seek help.

The website contained a questionnaire (Alcohol Use Disorders Identification Test [AUDIT]) for students to test their alcohol use. According to their answers, the students immediately received personalized feedback (personal AUDIT score and additional information on risks associated with alcohol use) and a suggestion for further action. Afterward, students could send an email to a student counselor for questions, guidance, or advice. To obtain in-depth qualitative information on the opinions and experiences of students, we held 5 focus group discussions. The topics were publicity, experiences, impressions, and effects of the website. We analyzed the quantitative results of the online test in SPSS 15.0.

More than 3500 students visited; over half were men (55.0%). A total of 34 students participated in the focus group discussions. The mixture of quantitative and qualitative methods to evaluate the intervention allowed a thorough analysis and provided complementary results. The intervention was well received by the student population. However, some minor aspects should be reconsidered, such as website publicity and providing students with options that were added after intermediate evaluation. The intervention increased the motivation of students to think about their alcohol use but could not stimulate them to change their behavior. The website attracted relatively more male than female students and more students in the high-risk group than in the low-risk group. The high-risk group was more inclined to seek advice or guidance (23/400, 6%; χ22 = 32.4, P < .001) than the low-risk group (34/1714, 2%; χ22 = 32.4, P < .001).

We gained unique insight into students’ experiences, opinions, and perceptions with regard to the intervention. The results show that the intervention was positively received in the population, and the willingness to seek help was increased. However, real behavior change needs further research. The results of this study can assist health providers and researchers in better understanding college and university students’ perceptions of eHealth initiatives.

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Alcohol News - 17/2012

Euractive (EU) - Health chief: We have never wanted 'drinking kills' labels
A re-think of the EU's alcohol strategy, due in 2013, will focus on stronger health warnings to consumers, the European Commission's health policy chief has told EurActiv in an interview. But the industry will first be given a chance to self-regulate.
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New York Daily News - Tattooed and pierced people consume more alcohol than non-tattooed and non-pierced: study
French scientists said Monday they have found evidence proving the stereotype that people who sport tattoos and piercings are heavier drinkers.
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The Canberra Times (Australia) - Fresh calls to tax alcohol per standard drink
WA medical experts have backed a submission to the Federal Budget calling for alcoholic drinks to be taxed according to their alcohol content, which would increase the cost of cleanskin and cask wine and traditional ciders.
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Medical Xpress (UK) - Minimum alcohol pricing shows 'significant impacts,' says expert
Government plans to impose a minimum price of 40p per unit of alcohol will have "significant impacts" including a 38,900 reduction in hospital admissions, a 1,149 reduction in deaths and a cut in alcohol consumption by 2.4%, says John Appleby, Chief Economist at the King's Fund, in an article published in the British Medical Journal today.
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Medical Xpress (India) - Alcohol use in Bollywood movies impacting alcohol use among Indian adolescents
Alcohol use in Bollywood movies is directly influencing the drinking habits of India's adolescents, according to a new study presented at the World Congress of Cardiology in Dubai.
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Sydney Morning Herald (Australia) - Study finds alcohol ads get to at least a quarter of kids
Half the alcohol ads shown on Australian television are shown at a time when at least 25 per cent of possible child viewers will be watching, new research led by the University of WA has found.
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U.S. News & World Report (USA) - Report: A Quarter of Teen Drinkers Get Alcohol From Family
For Jan Withers, Monday marked a grim 20-year anniversary: the day her 15-year-old daughter, Alisa, rode in a car with a teenage driver who had been drinking. Alisa was killed after the driver crashed into a guard rail.
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Times of India (India) - WHO drops plan to target alcohol use reduction
In a highly controversial move, the World Health Organisation (WHO) has dropped its plan to set a target for cutting down on alcohol use across the world over the next 13 years.
Read more - Many boomers abuse alcohol after age 48
A U.S. survey indicates depression or anxiety to be the main reason older adults -- baby boomers age 50 and older -- say they abuse drugs or alcohol.
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Bloomberg (Russia) - Putin Urges Gradually Raising Tobacco, Alcohol Excise Taxes
Prime Minister Vladimir Putin said the government should gradually raise excise taxes on alcohol and tobacco, coordinating measures to curb their harmful effects with Russia’s customs union partners Kazakhstan and Belarus.
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BBC News (Wales) - Pub landlords back minimum alcohol price, says Alcohol Concern Cymru study
Publicans in Wales back the introduction of a minimum price per unit of alcohol, a new study claims.
Read more (South Africa) - 80% of surveyed kids drink alcohol
Nearly 80 percent of a group of surveyed Gauteng high school pupils regularly consume alcohol, according to findings released by the Bureau for Market Research (BMR) on Sunday.
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New York Times (EU) - Europe Seeks to Curb Its Drinking Problem
Rising unemployment, austerity, shrinking growth: It’s enough to drive you to drink. Legislators and activists appear determined, however, to divert Europeans from seeking refuge from hard times in the bottle.
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Science Daily - Feelings of Immaturity Accompany Alcohol Misuse Into Adulthood
Tipping back one too many cocktails during an individual's early 20s doesn't correlate to a personal sense of immaturity; however if this habit doesn't stop as they reach age 30, young adults can feel psychologically underdeveloped, according to a University of Missouri study.
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The Independent (UK) - Introducing minimum alcohol price of 40p per unit would save 1,000 lives each year
Raising the price of ultra-cheap lager, gin and vodka will save more than 1,000 lives each year, according to new research today.
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World Health Organization (WHO) - Countries must recognize alcohol abuse as grave public health threat
Countries need to recognize that alcohol consumption is a big and growing public health threat and take appropriate action, experts concluded at a WHO regional meeting on the prevention and control of the noncommunicable diseases (NCDs) through reduction of alcohol-related harm.
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Wine Expertise Predicts Taste Phenotype

Taste phenotypes have been studied in relation to alcohol intake, dependence, and family history, with contradictory findings. However, on balance—with appropriate caveats about populations tested, outcomes measured, and psychophysical methods used—an association between variation in taste responsiveness and some alcohol behaviors is supported. Recent work suggests supertasting (operationalized via propylthiouracil [PROP] bitterness) associates not only with heightened response but also with more acute discrimination between stimuli.

This work examined relationships between food and beverage adventurousness and taste phenotype. A convenience sample of wine drinkers (n = 331) was recruited in Ontario and phenotyped for PROP bitterness via filter paper disk. The subjects also completed a short questionnaire regarding willingness to try new foods, alcoholic beverages, and wines as well as level of wine involvement, which was used to classify each one as a wine expert (n = 111) or a wine consumer (n = 220).

In univariate logisitic models, food adventurousness predicted trying new wines and beverages but not expertise. Likewise, wine expertise predicted willingness to try new wines and beverages but not foods.

In separate multivariate logistic models, willingness to try new wines and beverages was predicted by expertise and food adventurousness but not PROP.

However, mean PROP bitterness was higher among wine experts than wine consumers, and the conditional distribution functions differed between experts and consumers. In contrast, PROP means and distributions did not differ with food adventurousness.

These data suggest individuals may self-select for specific professions based on sensory ability (i.e., an active gene-environment correlation), but phenotype does not explain willingness to try new stimuli.

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Impulsiveness and insula activation during reward anticipation are associated with genetic variants in GABRA2 in a family sample enriched for alcoholi

Genetic factors, externalizing personality traits such as impulsivity, and brain processing of salient stimuli all can affect individual risk for alcoholism.

One of very few confirmed genetic association findings differentiating alcoholics from non-alcoholics is with variants in the inhibitory γ-amino butyric acid α2 receptor subunit (GABRA2) gene.

Here we report the association of two of these GABRA2 variants with measures of alcohol symptoms, impulsivity and with insula cortex activation during anticipation of reward or loss using functional magnetic resonance imaging (fMRI).

In a sample of 173 families (449 subjects), 129 of whom had at least one member diagnosed with alcohol dependence or abuse, carriers for the G allele in two single-nucleotide polymorphisms (SNPs) and haplotypes were more likely to have alcohol dependence symptoms (rs279858, P=0.01; rs279826, P=0.05; haplotype, P=0.02) and higher NEO Personality Inventory-Revised (NEO-PI-R) Impulsiveness scores (rs279858, P=0.016; rs279826, P=0.012; haplotype, P=0.032) with a stronger effect in women (rs279858, P=0.011; rs279826, P=0.002; haplotype, P=0.006), all P-values are corrected for family history and age.

A subset of offspring from these families (n=44, 20 females), genotyped for GABRA2, participated in an fMRI study using a monetary incentive delay task.

Increased insula activation during reward (r2=0.4; P=0.026) and loss (r2=0.38; P=0.039) anticipation was correlated with NEO-PI-R Impulsiveness and further associated with the GG genotype for both SNPs (P's<0.04).

Our results suggest that GABRA2 genetic variation is associated with Impulsiveness through variation of insula activity responses, here evidenced during anticipatory responses.

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