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.


Thursday, August 2, 2012

Global Information System on Alcohol and Health (GISAH)

The WHO Global Information System on Alcohol and Health (GISAH) provides easy and rapid access to a wide range of alcohol-related health indicators. It is an essential tool for assessing and monitoring the health situation and trends related to alcohol consumption, alcohol-related harm, and policy responses in countries. For country profiles, maps, reports, and links please see the theme page by clicking on the "Analysis" tab above.

GISAH is overseen by a Steering Committee comprised of representatives from the WHO Department of Mental Health and Substance Abuse, and the Centre for Addiction and Mental Health (Canada). The financial support from the Valencian Autonomous Government, Spain is gratefully acknowledged.
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Commentary on Boschloo et al. (2012): Persistence, natural recovery and recurrence of those with alcohol use disorders – does treatment make a differe

Longitudinal studies of samples affected by alcohol use disorders are relatively rare. These studies suggest that most of those who have substance use problems recover without treatment, and most of those who receive treatment do not recover in the medium term [1,2]. While we have some understanding of the natural history of alcohol use disorders, and the evidence suggests that natural recovery from these disorders is the norm, the extent of natural recovery and the implications for policy and practice warrant more discussion.

In the current issue, Boschloo and colleagues [3] report the findings of a 2-year follow-up of a selectedsample of people who met the criteria for an alcohol use disorder. Boschloo et al. administered the Composite International Diagnostic Interview (CIDI) to assess whether the respondent had ever had an alcohol disorder.

At the 2-year follow-up they determined whether the alcohol use disorder was still present (i.e. persistent disorder) or whether it had remitted and/or subsequently recurred. Importantly, treatment could be excluded as a reason for remission, as only 4.8% of the sample reported
ever receiving treatment for their disorder. Boschloo et al. found that of those who had ever had an alcohol use disorder, 65.2% had remitted by the baseline interview, while 34.8% met the criteria for an alcohol disorder in the last year (persistent group). Of those who were classified
as remitted at baseline, 14.6% had a recurrence of their alcohol disorder in the 2-year follow-up. Male gender and the severity of the disorder were the main predictors of persistence and recurrence. > > > > Read More

Global Alcohol Policy Alliance

The Global Alcohol Policy Alliance
is a developing network of non-government organizations and people working in public health agencies who share information on alcohol issues and advocate evidence-based alcohol policies.

Resource centres affiliated to GAPA are already operating in the EU, USA, South America, India, South East Asia and Western Pacific regions. It is envisaged that the Alliance, in the not too distant future, will be able to establish centres in Africa.

IOGT International

IOGT International is a worldwide community of non-governmental organisations. The aim of IOGT International is the liberation of peoples of the world leading to a richer, freer and more rewarding life. As a means of attaining this aim, IOGT International promotes a lifestyle free of alcohol and other drugs.

The Asia Pacific Alcohol Policy Alliance is a network of NGOs committed to the development of effective alcohol policy in the Asia Pacific region. We aim to work with other organisations in reducing alcohol-related harm worldwide by promoting science-based policies independent of commercial interests.

Welcome to the
APAPA webste. Keep up to date on alcohol policy developments and take part in discussions with other members on related topics.

Hypocalcaemia, alcohol drinking and viroimmune responses in ART recipients

Metabolic perturbations associated with HIV and antiretroviral therapies are widespread. Unfortunately, research has predominantly focused in cardiometabolic problems, neglecting other important areas. In fact, the immune-calcium–skeletal interface has been understudied despite its potential relevance in people living with HIV (PLWH).

Using a case-control methodology, 200 PLWH receiving medical care were enrolled and stratified according to hazardous vs. non-hazardous alcohol intake (HAU vs. non-HAU) and calcium (Ca) levels by analyzing baseline data. The group was chosen to represent relatively "pure" HAU with minimal drug use and no psychiatric diagnoses.

With these narrow parameters in place, we found evidence that HAU significantly increases TNF-α levels compared to Non-HAU (2.8 ± 0.6 vs. 1.9 ± 0.3 pg/ml, p = 0.05) and decreases blood Ca levels (9 ± 0.6 vs. 9.4 ± 0.5, p = 0.03).

Our analyses also suggest that chronic inflammation, as indicated by increased TNF-α levels, is associated with hypocalcemia (hypoCa <8.6). Despite the limited prevalence of hypoCa, these findings are clinically significant given that hypoCA PLWH exhibited decreased CD4 (253 ± 224 vs. 417.7 ± 281, p = 0.02), B cells (147 ± 58 vs. 248 ± 151, p = 0.03) and NK cells (146.8 ± 90 vs. 229 ± 148, p = 0.008) and elevated CD8 (902.5 ± 438 vs. 699 ± 510, p = 0.09) compared to those with normal calcium.

Furthermore, calcium effects on viral load were also evident with hypoCA exhibiting the highest loads (140,187 ± 111 vs. 35,622 ± 7770 HIV copies, p = 0.01).

Multivariate analyses confirmed the significance of hypoCa in predicting viroimmune parameters.

This paper provides the first evidence that hypoCa accounts for some of the variation in viroimmune measures in HAART recipients and suggests that hypoCa may be mediating alcohol's deleterious effects.

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Escalation of intake under intermittent ethanol access in diverse mouse genotypes

Experimental animals offered continuous 24-hour free choice access to ethanol rarely display voluntary ethanol consumption at levels sufficient to induce intoxication or to engender dependence. One of the simplest ways to increase voluntary ethanol intake is to impose temporal limitations on ethanol availability.

Escalation of ethanol intake has been observed in both rats and mice under a variety of different schedules of alternating ethanol access and deprivation. Although such effects have been observed in a variety of rat and mouse genotypes, little is known concerning possible genetic correlations between responses to intermittent ethanol access and other ethanol-related phenotypes.

In the present study, we examined the effects of intermittent ethanol access in mouse genotypes characterized by divergent responses to ethanol in other domains, including ethanol preference (C57BL/6J and C3H/HeJ mice), binge-like ethanol drinking (High Drinking in the Dark and HS/Npt mice) and ethanol withdrawal severity (Withdrawal Seizure-Prone and Withdrawal Seizure-Resistant mice).

Although intermittent ethanol access resulted in escalated ethanol intake in all tested genotypes, the robustness of the effect varied across genotypes.

On the other hand, we saw no evidence that the effects of intermittent access are correlated with either binge-like drinking or withdrawal severity, and only weak evidence for a genetic correlation with baseline ethanol preference.

Thus, these different ethanol-related traits appear to depend on largely unique sets of genetic mediators.

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Association of GATA4 sequence variation with alcohol dependence

To further explore reports of association of alcohol dependence and response to acamprosate treatment with the GATA4 rs13273672 single nucleotide polymorphism (SNP), we genotyped this and 10 other GATA4SNPs in 816 alcohol-dependent cases and 1248 controls.

We tested for association of alcohol dependence with the 11 SNPs individually and performed a global test for association using a principle components analysis.

Our analyses demonstrate significant association between GATA4 and alcohol dependence at the gene level (P = 0.009) but no association with rs13273672.

Further studies are needed to identify potential causal GATA4 variation(s) and the functional mechanism(s) contributing to this association.

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ICAP Periodic Review on Drinking and Culture - Issue 7

This issue of the Periodic Review is the first to include recent journal articles from Latin America, Africa, and Asia, in addition to articles from Europe. The 22 abstracts cover topics including alcohol policy, drink driving, consumption patterns in adults, pregnancy, and young people and drinking. This issue also features English translations of two articles in full text: an analysis of alcohol policy and consumption trends in Belarus from 1980–2009 and a sociological discussion of drinking motives in China during the country’s transition to a market economy since the late 1970s.

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Wednesday, August 1, 2012

Global Actions Auguzt 1, 2012

Key Recent Milestones:

· Nigeria: The second phase of Global Actions’ intervention in Apapa, Lagos began on July 23, 2012. The campaign is part of Global Actions Nigeria’s drink driving initiative to educate tanker drivers on the Lagos-Apapa route.

Global Actions in Focus: Self-Regulation in CARICOM Countries

The 15 nations that make up the Caribbean Community (CARICOM) are a region of focus for Global Actions Self-Regulation initiative. ICAP has been supporting the work of the Regional Beverage Alcohol Alliance (RBAA) to put in place effective compliance monitoring systems as set out in the European Advertising Standards Alliance (EASA) International Guide to setting up a self-regulatory organization.

In Barbados, Grenada, and St. Kitts, interim Board of Directors have been appointed and the process of registration for a Beverage Alcohol Alliance in each country is underway. In Suriname, an interim Chairperson and Board have been appointed.

Compliance monitoring allows self-regulatory organizations to demonstrate that even though the rules are self-regulatory, they are properly applied and enforced. In Trinidad & Tobago, ICAP recommended changes to the Trinidad &Tobago Beverage Alcohol Alliance (TTBAA) Code that were discussed and accepted by the Board.

“TTBAA members have brought this code alive in a systematic way, through regular handling of complaints, review of its provisions, and regular reports to its members and stakeholders,” said ICAP Senior Vice President Brett Bivans.

The “ONE” campaign led by TTBAA is underway with several actions launched during Carnival 2012. The campaign is meant to create awareness, engagement, and active participation from stakeholders, as well as encourage consumers to drink responsibly.

What’s Happening Next:

· Worldwide: The international conference Global Actions: Initiatives to Reduce Harmful Drinking will comprehensively report on the industry actions in support of the WHO Global Strategy to Reduce the Harmful Use of Alcohol on October 8 and 9, 2012 in Washington, DC. For more information or to register for the conference, visit

Low-Dose Alcohol Consumption Protects against Transient Focal Cerebral Ischemia in Mice: Possible Role of PPARγ

We examined the influence of low-dose alcohol consumption on cerebral ischemia/reperfusion (I/R) injury in mice and a potential mechanism underlying the neuroprotective effect of low-dose alcohol consumption.

C57BL/6 J mice were fed a liquid diet without or with 1% alcohol for 8 weeks, orally treated with rosiglitazone (20 mg/kg/day), a peroxisome proliferator-activated receptor gamma (PPARγ)-selective agonist, or GW9662 (3 mg/kg/day), a selective PPARγantagonist, for 2 weeks. The mice were subjected to unilateral middle cerebral artery occlusion (MCAO) for 90 minutes. Brain injury, DNA fragmentation and nuclear PPARγ protein/activity were evaluated at 24 hours of reperfusion. We found that the brain injury and DNA fragmentation were reduced in 1% alcohol-fed mice compared to nonalcohol-fed mice. Rosiglitazone suppressed the brain injury in nonalcohol-fed mice, but didn't alter the brain injury in alcohol-fed mice. In contrast, GW9662 worsened the brain injury in alcohol-fed mice, but didn't alter the brain injury in nonalcohol-fed mice. Nuclear PPARγ protein/activity at peri-infarct and the contralateral corresponding areas of the parietal cortex was greater in alcohol-fed mice compared to nonalcohol-fed mice. Using differentiated catecholaminergic (CATH.a) neurons, we measured dose-related influences of chronic alcohol exposure on nuclear PPARγ protein/activity and the influence of low-dose alcohol exposure on 2-hour oxygen-glucose deprivation (OGD)/24-hour reoxygenation-induced apoptosis. We found that low-dose alcohol exposure increased nuclear PPARγ protein/activity and protected against the OGD/reoxygenation-induced apoptosis. The beneficial effect of low-dose alcohol exposure on OGD/reoxygenation-induced apoptosis was abolished by GW9662.

Our findings suggest that chronic consumption of low-dose alcohol protects the brain against I/R injury. The neuroprotective effect of low-dose alcohol consumption may be related to an upregulated PPARγ.

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Prenatal ethanol exposure impairs passive avoidance acquisition and enhances unconditioned freezing in rat offspring

Previous studies have suggested that ethanol exposure during brain development affects responses to fear and anxiety after maturity.

To clarify in detail the impaired behavior related to fear and anxiety seen in rat offspring prenatally exposed to ethanol, their behaviors were observed using an elevated T-maze (ETM) test, which allows assessment of passive avoidance acquisition and one-way escape separately, and an elevated open platform (EOP) test for the assessment of unconditioned freezing against innate fear.

The ETM test revealed that acquisition of passive avoidance was significantly inhibited in prenatally ethanol-exposed rats, while their escape behavior was not altered. In the EOP test, the duration of the freezing behavior was significantly elongated in prenatally ethanol-exposed offspring.

Thus, we concluded that prenatal ethanol exposure could impair acquisition of passive avoidance, while it could facilitate a response related to unconditioned fears in rat offspring.

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Role of mu, delta and kappa opioid receptors in ethanol-reinforced operant responding in infant rats

We recently observed that naloxone, a non-specific opioid antagonist, attenuated operant responding to ethanol in infant rats.

Through the use of an operant conditioning technique, we aimed to analyze the specific participation of mu, delta, and kappa opioid receptors on ethanol reinforcement during the second postnatal week. In Experiment 1, infant rats (PDs 14–17) were trained to obtain 5, 7.5, 10, or 15% ethanol, by operant nose-poking. Experiment 2 tested blood ethanol levels (BELs) attained by operant behavior. In Experiment 3, at PDs 16–18, rats received CTOP (mu antagonist: 0.1 or 1.0 mg/kg), naltrindole (delta antagonist: 1.0 or 5.0 mg/kg) or saline before training. In Experiment 4, rats received nor-binaltorphimine (kappa antagonist: 10.0 or 30.0 mg/kg, a single injection after completion of PD 15 operant training), spiradoline mesylate (kappa agonist: 1.0 or 5.0 mg/kg; at PDs 16–18) or saline (PDs 16–18), before the conditioning. Experiments 5 and 6 assessed possible side effects of opioid drugs in locomotor activity (LA) and conditioned taste aversion (CTA). Ethanol at 7.5 and 10% promoted the highest levels of operant responding. BELs were 12–15 mg/dl. In Experiment 3 naltrindole (dose–response effect) and CTOP (the lowest dose) were effective in decreasing operant responding. Nor-binaltorphimine at 10.0 mg/kg and spiradoline at 5.0 mg/kg also blocked ethanol responding.

The effects of opioid drugs on ethanol reinforcement cannot be explained by effects on LA or CTA. Even though particular aspects of each opioid receptor require further testing, a fully functional opioid system seems to be necessary for ethanol reinforcement, during early ontogeny.

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Selection for High Alcohol Preference Drinking in Mice Results in Heightened Sensitivity and Rapid Development of Acute Functional Tolerance to Alcoho

Propensity to develop acute functional (or within session) tolerance to alcohol (ethanol) may influence the amount of alcohol consumed, with higher drinking associated with greater acute functional tolerance (AFT).

The goal of the current study was to assess this potential correlated response between alcohol preference and AFT in second and third replicate lines of mice selectively bred for high (HAP2&3) and low (LAP2&3) alcohol preference drinking.

Male and female mice were tested for development of AFT on a static dowel task which requires that animals maintain balance on a wooden dowel in order to prevent falling. On test day, each mouse received one (1.75g/kg; Experiment 1) or two (1.75g/kg and 2.0g/kg; Experiment 2) injections of ethanol; an initial administration before being placed on the dowel and in Experiment 2, an additional administration after the first regain of balance on the dowel. Blood samples were taken immediately after loss of balance (when BECs were rising) and at recovery (during falling BECs) in Experiment 1, and after first and second recovery in Experiment 2.

It was found that HAP mice fell from the dowel significantly earlier and at lower BECs than LAP mice following the initial injection of ethanol and were therefore more sensitive to its early effects. Furthermore, Experiment 1 detected significantly greater AFT development (BECfalling - BECrising) in HAP mice as compared to LAP mice which occurred within ~30 min, supporting our hypothesis. However, AFT was not different between lines in Experiment 2, indicating that ~30-60 min following alcohol administration, AFT development was similar in both lines.

These data show that high alcohol drinking genetically associates with both high initial sensitivity and very early tolerance to the ataxic effects of ethanol.

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Naloxone prevents the rapid reacquisition but not acquisition of alcohol seeking.

Opioid receptors are involved in reinstatement of alcohol seeking, yet there are no reports of their role in reacquisition of an extinguished alcohol seeking response.

Here we investigated the effects of the opioid antagonist naloxone on reacquisition and compared these effects with those on acquisition.

Rats were trained, extinguished, then retrained to respond for alcoholic beer. Upon retraining, a second group of rats with no prior experience with the contingency between response and reinforcer was trained under the same conditions.

Reacquisition was faster than acquisition. Systemic injection of naloxone (1.25 or 5 mg/kg) reduced reacquisition but had no effect on acquisition.
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These results suggest that reacquisition and acquisition of alcohol seeking have dissociable neurochemical substrates.

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Alcohol self-administration, anxiety, and cortisol levels predict changes in delta opioid receptor function in the ventral tegmental area.

The delta opioid receptor (DOR) agonist DPDPE decreases ethanol (EtOH) consumption when injected into the ventral tegmental area (VTA). We previously showed that DPDPE inhibition of GABA A receptor-mediated inhibitory postsynaptic currents (GABA AR IPSCs) is associated with reduced EtOH consumption.

To determine whether self-administration of EtOH is required to change VTA DOR function, we compared the effects of passively administered (gavaged) and self-administered (two-bottle choice) EtOH. Because rats showed variability in DOR regulation of drinking and inhibition of GABA AR IPSCs, we examined whether these changes can be predicted before EtOH exposure by behavioral measures of anxiety or intoxication.

Functional DORs were seen with both gavaged and self-administered EtOH, although the magnitude of DPDPE-induced inhibition correlated with behavioral measures only when EtOH was self-administered.

Specifically, DPDPE-induced inhibition correlated with predrinking measures of open arm time in the plus maze (n = 19, R = .69, p = .001), with change in maximum fall latency on the rotarod (n = 17, R = .89, p = .000001), and with blood corticosterone (n = 17, R = .66, p = .004) in drinking animals. This DOR-mediated inhibition persisted for at least 14 days after EtOH access was terminated.

Together, these findings indicate that anxious animals and those with the greatest EtOH-induced motor impairment have the most robust DPDPE-induced inhibition of GABA AR IPSCs in VTA neurons.

These data also extend our understanding of the possible therapeutic value of the DOR for treatment of alcoholism by showing that its relevant synaptic action persists during abstinence.

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A Guide to the Alcohol Industry and Major Alcohol Sales Outlets

The McCusker Centre for Action on Alcohol and Youth has developed a guide to the alcohol industry in Australia and how it fits into the global alcohol industry, and a guide to the major alcohol sales outlets in Australia.

The guide to the alcohol industry in Australia outlines the major alcohol companies and the products they produce, own, distribute or market.

The information has been collated and summarised from a wide range of sources including alcohol company websites and annual reports. Due to the constantly changing nature of the industry, this document should be taken as a guide only. The information is accurate to the best of our knowledge and we welcome any comments or feedback to We will endeavour to regularly update the information.
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New video highlights NIH investment in zebrafish research

As they strive to develop new treatments for birth defects, or to prevent them, scientists at the National Institutes of Health have found a big ally in a small fish.

An NIH video shows how the zebrafish, Danio rerio, is a valuable resource for scientists trying to understand the intricate process by which a fertilized egg develops into a fully formed individual, and the numerous diseases and conditions that can result when even a tiny part of the process goes wrong.
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Monday, July 30, 2012

Alcohol abuse after weight loss surgery? Researchers gather at Radcliffe to investigate gut-brain communication

A small group of scientists gathered last week at the Radcliffe Institute for Advanced Study to share ideas about a medical mystery: the increasing evidence that some types of weight loss surgery affect not just the stomach, but the brain as well.

The procedures, two types of bariatric surgery known as gastric bypass and sleeve gastrectomy, physically bypass or remove a portion of the stomach. Used only for obese patients whose weight threatens their health, the surgeries have proven dramatically effective, reducing patients’ excess weight in the months and years following surgery by 50, 60, and even 80 percent.

The procedures were initially thought to work through simple physical means: Patients with smaller stomachs wouldn’t be able to eat as much, allowing them to lose weight and also giving them an opportunity to reform eating habits.

But in recent years, scientists have noticed side effects of the surgery that hint at something entirely different: that the surgery somehow affects not just the stomach, but the body’s broader metabolism and even the brain.

The Radcliffe event brought together scientists whose research is relevant to obesity and addiction to investigate an increased incidence of alcohol abuse among those who have had the surgery and, through that, the possible impact of the surgery on the brain circuits that control addiction. > > > > Read More

A Brief Intervention for Heavy Drinkers in Dental Settings: Rationale and Development


Although brief
alcohol interventions have proven effective in a variety of health care settings, the present article describes the development of the first brief intervention for heavy drinkers in dental practice.

Elements of motivational interviewing and personalized normative feedback were incorporated in a 3- to 5-minute intervention delivered by dental hygienists. The intervention is guided by a one-page feedback report providing personalized normative feedback regarding the patient’s current oral health practices, their drinking in comparison to others, and oral cancer risk associated with current smoking and drinking.

Future publications will present data regarding intervention effectiveness from an ongoing randomized trial.

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Alcohol News - 31/2012

The Baltic Course (Lithuania) - Suggestion in Lithuania: drunk drivers who cause car accidents always hold responsible
In order to reduce the number of drunk or otherwise intoxicated drivers in Lithuanian roads Lithuanian Member of Parliament Evaldas Jurkevicius proposes to strengthen the provisions of the law, when intoxicated people take part in a car accident.
The Baltic Course (Estonia) - Estonian courts sent 1,190 drunk drivers to prison in H1
Estonian courts sent 1,190 drunk drivers to prison in the first half of the year 2012, LETA/Eesti Päevaeht writes. While in the first half of last year, the police caught 3,029 drunk drivers, the number in the first half of this year was 3,336.
The Foreigner (Norway) - Norwegian alcohol consumption up and down
Norway’s inhabitants are drinking more wine but beer sales have decreased because of the bad summer weather. Statistics Norway (SSB) reported that in 2011 the turnover for wine was 77 million litres, 4 million litres more than in 2010, an increase of 5.6 percent.
Medical Daily (Sweden) - New Drug Compound to Treat Alcohol Dependence Takes the Pleasure Out of Drinking
Soon, a new drug might take the pleasure out of drinking in people who are excessively dependent on alcohol. Researchers have found a compound that could reduce alcohol dependence by balancing levels of a chemical messenger that makes people feel happy after drinking.
RedOrbit - Alcohol And Energy Drink Mixes Linked With Casual, Risky Sex
A new study from the University at Buffalo’s Research Institute on Addictions (RIA) has found a link between the consumption of caffeinated energy drinks mixed with alcohol and casual — often risky — sex among college-age adults.
Columbia Daily Tribune (USA) - More towns ban alcohol on beach
One South Carolina beach recently imposed a temporary ban on booze on its shores, and a nationally known beach expert says there are more shore towns that ban alcohol than permit it. He said the laws generally are passed to prevent rowdy gatherings and everything that goes with them, not to prevent folks from walking the sand with wine in a plastic cup.
Science Daily - Alcohol Could Intensify Effects of Some Drugs in the Body
Scientists are reporting another reason -- besides possible liver damage, stomach bleeding and other side effects -- to avoid drinking alcohol while taking certain medicines.
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Herald Sun (Australia) - Alcohol 'epidemic' devastates lives, says judge in Ebony Dunsworth case
A COUNTY Court judge who today jailed a driver who killed a teenage girl said alcohol abuse was at epidemic proportions in Victoria and was causing devastation on the roads. - Behavioral, Cognitive Challenges Define Fetal Alcohol Exposure
New research suggests the only sign of fetal alcohol exposure may be signs of abnormal intellectual or behavioral development.
Medical Xpress (UK) - True cost of alcohol related ambulance call-outs revealed
The study, by Newcastle University experts, working with the North East Ambulance service (NEAS) and the North East Alcohol Office (BALANCE) looked purely at the cost to the ambulance service and not at the total cost to the NHS.
Irish Independent (Ireland) - Don’t drink alcohol and swim water safety chiefs warn
THE dangers of mixing alcohol with swimming or sailing has been highlighted by water safety chiefs. An average 140 people drown in Ireland every year, with alcohol consumption a contributory factor in several cases.
Himalayan Times (Nepal) - Draft alcohol control policy ready
Nepal Alcohol Policy Alliance (NAPA) is submitting a draft Alcohol Control Policy, which mainly covers the sale and consumption of alcohol, to the Ministry of Health and Population within 15 days. (New Zealand) - Govt needs to pass Alcohol Reform Bill
Auckland Council has taken further steps to deliver better local alcohol policies and is calling for the government to get on with passing the Alcohol Reform Bill so the community can have a greater say over efforts to address alcohol abuse.
Irish Times (Ireland) - Time to tackle Irish drink culture
The issue of the profoundly negative social impact of alcohol use and abuse in Ireland has engaged much discussion recently. The negative impact on health and premature death has been less discussed, but deserves more attention.
Prague Post (Chech Republic) - Czech teens top list of underage drinkers
Ask why they are drinking alcohol, and you get a range of answers. "It's fun and an opportunity to make friends," says František, 16, as he downs a bottle of lager with a group of classmates on Prague's Petřín Hill.
Hurriyet Daily News (Turkey) - University alcohol ban ignites reactions
Social media users have reacted to Turkish Prime Minister Recep Tayyip Erdoğan’s comments saying that a school campus is no place to go and “get drunk.”
Irish Times (Ireland) - The drinks industry will not do the right thing
THE NEW measures to reduce alcohol related harm proposed by Minister Róisín Shortall deserve support from all sectors of society. She wants to restrict drink advertising, phase out the sponsorship of sporting and cultural events by 2016, introduce minimum pricing, and impose a responsibility levy which will be used to change Ireland’s unhealthy drinking culture. International evidence shows that these measures are among the most cost-effective interventions to reduce harmful alcohol consumption.
Otago Daily Times (New Zealand) - Split drinking age proposal debated
A group of panelists invited to speak at the Otago University Debating Society's "great alcohol debate" last night presented a range of views on whether the age at which people can buy alcohol from off-licences should be raised.

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Improving the Measurement of State Alcohol Taxes – New Analysis Available

APIS Senior Social Scientist, Michael Klitzner, Ph.D., has prepared a new monograph that compares several indices of State alcohol taxes to determine whether there is a method for making cross-State comparisons of economic availability that is more precise than the specific excise tax, the variable used to index economic availability in most alcohol policy studies.

The results demonstrate that using specific excise taxes to index differences among States in economic availability of alcohol may not be the best measurement choice. Instead, using measures of specific excise taxes plus ad valorem excise taxes, or a total tax measure are more precise than using specific excise tax alone. Additionally, a total tax measure provides the most precision among the three indices.

Following the recommendations from this analysis can enhance future studies of the effects of alcohol taxes on alcohol-related public health harms such as traffic crashes, violence and crime, and issues on college campuses.

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Alcohol Consumption Trajectory Patterns in Adult Women with HIV Infection

HIV-infected women with excessive alcohol consumption are at risk for adverse health outcomes, but little is known about their long-term drinking trajectories.

This analysis included longitudinal data, obtained from 1996 to 2006, from 2,791 women with HIV from the Women’s Interagency HIV Study.

Among these women, the proportion in each of five distinct drinking trajectories was: continued heavy drinking (3 %), reduction from heavy to non-heavy drinking (4 %), increase from non-heavy to heavy drinking (8 %), continued non-heavy drinking (36 %), and continued non-drinking (49 %).

Depressive symptoms, other substance use (crack/cocaine, marijuana, and tobacco), co-infection with hepatitis C virus (HCV), and heavy drinking prior to enrollment were associated with trajectories involving future heavy drinking.

In conclusion, many women with HIV change their drinking patterns over time. Clinicians and those provi
Font sizeding alcohol-related interventions might target those with depression, current use of tobacco or illicit drugs, HCV infection, or a previous history of drinking problems.

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Alcohol use, alcohol problems, and problem behavior engagement among students at two schools in northern Mexico

This study examined the association between alcohol-use problem severity, defined by number of DSM-IV alcohol Abuse and Dependence symptoms and frequency of alcohol use, and problem behavior engagement among Mexican students.

A confidential survey was administered to 1229 students in grades 7–12 at two schools in a northern border city in Mexico. Youths were categorized into five groups based on their alcohol use frequency and symptoms of DSM-IV alcohol Abuse and Dependence, specifically: no lifetime alcohol use, lifetime alcohol use but none in the past year, past year alcohol use, one or two alcohol Abuse or Dependence symptoms, and three or more alcohol Abuse or Dependence symptoms. The association between five levels of alcohol-use problem severity and three problem behaviors, lifetime marijuana use, lifetime sexual intercourse, and past year arrest/law trouble, was examined using chi-square or Fisher's exact tests.

Several alcohol-use problem severity categories were significantly different with respect to rates of lifetime marijuana use, lifetime sexual intercourse, and past year arrest/law trouble. Higher alcohol-use problem severity was associated with greater endorsement of problem behaviors.

Knowing about variations in adolescent alcohol use and alcohol problems may be instrumental in determining if youths are also engaging in a range of other risk behaviors. Considering varying levels of alcohol use and alcohol problems is important for effective targeted prevention and treatment interventions.

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Opportunities for prevention of alcohol-related death in primary care: Results from a population-based cross-sectional study

The mortality rate from alcohol-related conditions has risen sharply in the United Kingdom and it is not known whether opportunities for preventive interventions could be improved. The purpose of our study was to identify opportunities to detect, assess, and manage alcohol problems in primary care according to evidence-based guidelines.

We carried out a cross-sectional study on patients who died from alcohol-related conditions in the calendar year 2003 within National Health Service Greater Glasgow Health Board area, Scotland (population 920,000). We described patient characteristics and care recorded in health service records, comparing it with best evidence-based practice in Scottish Intercollegiate Guidelines Network and Health Technology Board for Scotland recommendations on the management of harmful drinking and alcohol dependence.

501 deaths occurred from an alcohol-related cause. The mean age at death was 57.5 years and 72% were male. The most common causes of death, recorded by the International Classification of Diseases, revision 10, excluding accidents, were alcoholic liver disease (290, 57.9%) and mental and behavioural disorders due to alcohol (70, 14.0%).

Lifetime mean consultations at primary care general practitioner and hospital outpatient departments were 24 in males and 5 in females. All individuals who died from an alcohol-related cause had at least one biochemical or physical indicator suggestive of alcohol misuse. 21% (95% CI 13–33%) had no record of having been advised to abstain from alcohol and 23% (95% CI 15–35%) had received brief interventions. 58% (95% CI 46–70%) had been referred to specialist alcohol services but a third of them did not attend. The majority of patients (83%, 95% CI 72–90%) had no evidence of shared health service and social work care.

We concluded that individuals who died from alcohol-related conditions were usually in contact with statutory and voluntary services but further efforts were required to use these opportunities to detect, assess, and manage serious alcohol problems according to evidence-based guidelines.

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Ethanol-induced disruption of Golgi apparatus morphology, primary neurite number and cellular orientation in developing cortical neurons

Prenatal ethanol exposure disrupts cortical neurite initiation and outgrowth, but prior studies have reported both ethanol-dependent growth promotion and inhibition. To resolve this ambiguity and better approximate in vivo conditions, we quantitatively analyzed neuronal morphology using a new, whole hemisphere explant model. In this model, Layer 6 (L6) cortical neurons migrate, laminate and extend neurites in an organotypic fashion.

To selectively label L6 neurons, we performed
ex utero electroporation of a GFP expression construct at embryonic day 13 and allowed the explants to develop for 2 days in vitro. Explants were exposed to (400 mg/dL) ethanol for either 4 or 24 h prior to fixation. Complete 3-D reconstructions were made of >80 GFP-positive neurons in each experimental condition. Acute responses to ethanol exposure included compaction of the Golgi apparatus accompanied by elaboration of supernumerary primary apical neurites, as well as a modest (∼15%) increase in higher order apical neurite length.

With longer exposure time, ethanol exposure leads to a consistent, significant disorientation of the cell (cell body, primary apical neurite, and Golgi) with respect to the pial surface. The effects on cellular orientation were accompanied by decreased expression of cytoskeletal elements, microtubule-associated protein 2 and F-actin.

These findings indicate that upon exposure to ethanol, developing L6 neurons manifest disruptions in Golgi apparatus and cytoskeletal elements which may in turn trigger selective and significant perturbations to primary neurite formation and neuronal polarity.

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A comparison of the central nervous system effects of alcohol at pseudo-steady state in Caucasian and expatriate Japanese healthy male volunteers

In general, Japanese and Caucasians differ in their response to alcohol. To investigate these differences the alcohol clamping method can be used. This strictly controlled infusion regimen provides a reliable tool to study contrasts in central nervous system (CNS) effects and/or alcohol disposition.

In this study, twelve Japanese and twelve Caucasian healthy volunteers received two concentrations of intravenous alcohol or placebo using the alcohol clamp. Infusion rates during the steady state phase were used to compare alcohol clearance between the subgroups. Central nervous system (CNS) effects were frequently measured throughout the clamp.

On average, significantly lower amounts of alcohol were needed to maintain similar stable concentrations in the Japanese group. However, these differences disappeared when values were corrected for lean body mass.

The most pronounced pharmacodynamic differences between the groups
were observed on body sway and on the visual analogue scale for subjective alcohol effects, mainly at the highest dose level.

The alcohol clamp seems a useful method to compare differences in alcohol metabolism between groups.

Some CNS effects of alcohol differed clearly between Japanese and Caucasians, but others did not, even though alcohol levels were stable and similar between the two groups.

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Effects of chronic ethanol consumption on rat upper gastrointestinal system: Functional and histologic findings

The purpose of the present study was to determine the effect of chronic alcohol consumption on reactivity of esophageal tunica muscularis mucosae (TMM) and lower esophageal sphincter (LES) smooth muscle.

Six male rats in alcohol-fed group received ethanol (7.2% v/v) in a modified liquid diet for 4 weeks. Two control groups were used; six rats in the standard diet-fed group received rat chow and water for 4 weeks. Six rats in sucrose-fed group were given sucrose and received a liquid diet. The smooth muscle reactivity of TMM and LES strips from ethanol-fed and control animals was evaluated in organ chambers. Also histologic study was undertaken to show effects of chronic alcohol consumption.

Maximum contractile responses of TMM to KCl and carbachol were decreased in the ethanol-fed group compared to the control groups. Relaxant responses to serotonin were decreased in the ethanol-fed group compared to the control groups.

In TMM, isoproterenol- and papaverine-induced relaxant responses were similar in the ethanol-fed and control groups. In LES smooth muscle, relaxant responses to papaverine or isoproterenol were similar in the control groups and the ethanol-fed group.

There was no change in agonist potency among the groups. The relaxation response elicited by nicotine and sodium nitroprusside (SNP) or contractile response elicited by carbachol and 80 mM KCl was decreased with maximum responses and pD
2 values, in the ethanol-fed group compared to that of the control groups in LES. Decreased nNOS immunoreactivity in myenteric plexus was found in alcohol-exposed group compared to control groups.

Our findings suggest that chronic alcohol consumption impairs relaxant and contractile responses of both TMM and LES smooth muscle and it may contribute to gastroesophageal reflux commonly seen after alcohol binges.

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Dutch adolescent private drinking places: Prevalence, alcohol consumption, and other risk behaviors

The aim of this research was to explore the increasingly popular Dutch health phenomenon of ‘gathering in private peer group settings (barracks)’, with a focus on the prevalence and characteristics of barracks, alcohol consumption, and other (risk) behaviors of their visitors.

Three studies were conducted. The first consisted of field research in which 51 barracks were visited and group-interviews were held. The second was an Internet study in which 442 barracks' websites were analyzed using content analysis. The third consisted of a questionnaire completed by 1457 adolescents, aged 15–17, in order to explore differences in behavior between barracks visitors and non-visitors.

There was wide variation in barracks' characteristics and culture. Barracks' members and visitors also organize diverse activities that are publicly shown on the websites. Barracks are associated with various legal issues, such as alcohol sales to minors, lack of parental supervision, and illicit drug use. Barracks' visitors drink alcohol more frequently, drink more alcohol per occasion (up to fifteen bottles of beer a night), and have been drunk more frequently than non-visitors.

Policymakers must be aware of the barracks phenomenon and use their powers in adjacent political and legal areas (such as in binge drinking, illicit drug use, and public safety) to intervene and create solid, responsible, and tailor-made policies.

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Alcohol intoxication in road traffic accidents leads to higher impact speed difference, higher ISS and MAIS, and higher preclinical mortality

Alcohol is one of the most important personal risk factors for serious and fatal injuries, contributing to approximately one third of all deaths from accidents. It is also described that alcohol intoxication leads to a higher mortality in the clinical course.

In this study, we hypothesized that alcohol intoxication leads to different accident kinematics, a higher ISS (Injury Severity Score), and higher preclinical mortality compared to sober patients.

A technical and medical investigation of alcohol intoxated road users was performed on the scene of the crash and at the primary admitting hospital. Alcohol testing was performed with either breath alcohol tests or measurement of blood alcohol concentration (BAC) in a standard laboratory test. Between 1999 and 2010, 37,635 road traffic accidents were evaluated by the Accident Research Unit.

Overall 20,741 patients were injured, 2.3% of the patients were killed. Among the injured patients, 2.2% with negative BAC were killed, compared to 4.6% fatal injuries in patients with a positive BAC (
p < 0.0001). Of the patients with a positive BAC, 8.0% were severely injured, compared to 3.6% in the BAC negative group (p < 0.0001).

Regarding the relative speed at impact (Δ
v for motorized drivers, vehicle collision speed for pedestrians and bikers), there was a significant higher difference for BAC positive patients (30 ± 20) compared to the BAC negative patients (25 ± 19, p < 0.0001).

Alcohol intoxication in trauma patients leads to higher preclinical mortality, higher impact speed difference, and higher injury severity. The subgroup analysis for different alcohol concentrations shows no difference in ISS, MAIS, and relative speed, but a correlation of increasing age of patients with higher alcohol concentrations.

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Global Actions July 25, 2012

Key Recent Milestones:

· Nigeria: The second phase of Global Actions’ intervention in Apapa, Lagos began on July 23. The campaign is part of Global Actions Nigeria’s drink driving initiative to educate tanker drivers on the Lagos-Apapa route.


Global Actions in Focus: Self-Regulation in Argentina Update

As part of the collaboration between The International Center for Alcohol Policies (ICAP) and the World Federation of Advertisers (WFA) on cross-industry self-regulation, Global Actions Argentina has seen recent progress. In the last few months, the local self-regulatory organization el Consejo de Autorregulación Publicitaria (CONARP) has undertaken a rigorous review of its own rules and procedures for handling advertising related complaints.

Once finalized and approved by the CONARP board, the review will lead to stronger rules on comparative promotions. The revision was undertaken in a broader context aimed at improving trust and credibility in the self-regulatory process in Argentina to encourage more widespread industry and consumer use of the system. The review is scheduled to be finalized in July 2012.

Argentina’s leading industry organizations, including CONARP, the Argentinean Chamber of Advertisers (CAA), and the Argentinean Association of Advertising Agencies (AAAP) are working towards further increasing trust in the existing self-regulatory system. Since 2010, the organizations have been working to bring the current system in line with the latest international best practice model on digital marketing communication.

CONARP is also engaging with media to promote recognition of the self-regulatory model within Argentinean government bodies and, with the steady growth of digital advertising, CONARP is defining how its existing advertising rules and guidelines will be interpreted and applied in the digital space.

What’s Happening Next:

· Mexico: In collaboration with Aguas con el Alcohol, Global Actions Mexico is holding a “Train the Trainers” workshop from August 27 to 31 in Puebla. The workshop is part of Global Actions drink driving initiative and will train Puebla police and other partners on reducing harmful drinking and how to raise awareness about the dangers of drink driving.

Sunday, July 29, 2012

Understanding Men's Aggression in Bars: Development of the Beliefs and Attitudes toward Male Alcohol-Related Aggression (BAMARA) Inventory

While several qualitative studies suggest that beliefs and attitudes are important in explaining men's alcohol-related aggression, no quantitative instrument measuring men's beliefs and attitudes about male alcohol-related aggression has been developed. The purpose of this study was to develop and test a theoretically based multidimensional inventory measuring Beliefs and Attitudes toward Male Alcohol-Related Aggression (BAMARA) consisting of 9 dimensions: (i) expected negative consequences; (ii) expected positive consequences; (iii) personal approval; (iv) perceived male peer approval; (v) perceived female peer approval; (vi) perceived normality; (vii) relaxed norms when drinking; (viii) alcohol as an excuse; and (ix) male honor/protection of masculinity.

A random sample of 1,343 young adult male college and university students participated in an online survey. Item analyses using confirmatory factor analytic (CFA) and item-response theory (IRT) procedures were conducted to select a refined pool of items promoting high internal consistency and discriminant validity of the 9 scales. We evaluated the criterion validity of the 9 scales, the BAMARA total score (BAMARA-Total), and a short form of the inventory (BAMARA-SF) in terms of their association with experiences of barroom aggression and other theoretically linked constructs.

CFA and IRT analyses resulted in a 53-item inventory consisting of the 9 scales with adequate model fit and good internal consistency indices. Criterion validity was demonstrated, with the BAMARA scales correlating well with reports of actual experiences of aggression in bars. BAMARA-Total and BAMARA-SF were found to be significantly associated with barroom aggression controlling for a number of important control variables.

This new instrument is expected to have many important applications in the male aggression literature, with the full BAMARA being employed for the assessment of specific beliefs and attitudes and the BAMARA-SF used as a general attitudinal measure.

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