Alcohol consumption, cardiovascular health, and endothelial function markers
Alcohol Volume 41, Issue 7, November 2007, Pages 479-488

Cardiovascular diseases are among the worldwide leading causes of shorter life expectancy and loss of quality of life. Thus, any influence of diet or life habits on the cardiovascular system may have important implications for public health.

Most world populations consume alcoholic beverages. Since alcohol may have both protective and harmful effects on cardiovascular health, the identification of biochemical mechanisms that could explain such paradoxical effects is warranted.

The vascular endothelium is the target of important mediating pathways of differential ethanol concentrations, such as oxidative stress, lipoproteins, and insulin resistance. Alcohol-induced endothelial damage or protection may be related to the synthesis or action of several markers, such as nitric oxide, cortisol, endothelin-1, adhesion molecules, tumor necrosis factor alpha, interleukin-6, C-reactive protein, and haemostatic factors.

The expression of these markers is consistent with the J-shaped curve between alcohol consumption and cardiovascular health. However, there is genetic and phenotypic heterogeneity in alcohol response, and despite the apparent beneficial biochemical effects of low doses of ethanol, there is not enough clinical and epidemiological evidence to allow the recommendation to consume alcoholic beverages for abstemious individuals.

Considering the potential for addiction of alcoholic beverage consumption and other negative consequences of alcohol, it would be worthwhile to identify substances able to mimic the beneficial effects of low doses of ethanol without its adverse effects.

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Request Reprint E-Mail: paulobau@gmail.com

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eNEWSLETTER 2 November 2007

Call for nominations We wish Faces & Voices board member and New England regional representative Rev. Hugh-Tudor Foley best wishes on his new assignment to St. Paul's Episcopal Church in Yuma, Arizona. His move creates an opening on the Faces & Voices board of directors to serve out his term through July, 2009. The deadline for applications is December 5. Recovery Voices Count Our Recovery Voices Count campaign is underway. The 2007-2008 Recovery Voices Count Guide to Non-Partisan Civic Engagement lays out the non-partisan voter registration, voter education and Get-out-the Vote strategies that we will be working on over the next year to raise issues of importance to the recovery community in the 2007-2008 election cycle. We have a PowerPoint presentation that has everything that you’ll need to know to make Recovery Voices Count. Come join us and recovery advocates and allies on December 2nd in Plaistow, NH for a Presidential Town Hall meeting, “A Healthier and Safer New Hampshire: Solving our Alcohol and Drug Problem.” NCADD-New Jersey has released its excellent seventh annual voter education campaign, Decision 2007, which includes an election guide and candidate survey. The guide highlights important issues and encourages voters to educate themselves about issues and share their views with candidates for public office. Check it out! Insurance Discrimination Update Thanks to Faces & Voices board member William Moyers and David Wellstone, co-founder of Wellstone Action, for authoring, “Mental Illness and Addiction Don’t Discriminate, but Insurance Policies Do,” which appeared in The Hill, a publication widely read on Capitol Hill in Washington, DC. And thanks to Bill Johnson, President of the Central Illinois Recovery Coalition (CILRC) in Springfield, IL and other advocates for getting your letters published in your local newspaper. No date has yet been set for a vote in the U.S. House of Representatives on H.R. 1424, the Paul Wellstone Mental Health and Addiction Equity Act of 2007. Faces & Voices’ interns Thanks to Holly Robertson who just completed her internship at Faces & Voices and welcome to Jennifer Taber, a senior at American University. Resources/Opportunities: Job Opening at the Legal Action Center for a Policy Associate for its Washington, DC office whose responsibilities will include advocacy and federal relations. Learn more… A 2005 national survey of participants in mutual-aid support groups by The Walsh Group found that active involvement in these groups improved individuals’ chances of sustaining their recovery. Learn more… White Bison's Wellbriety! Online Magazine for 2007 is now available. Voices for Recovery is a popular feature on the Recovery Month web site, where people can post their recovery stories so that others can learn about what recovery means to individuals in long-term recovery and their families. To post Learn more… Rally for Recovery! photographs are still coming in, check out what we’ve received so far! _____________________________________________________________________________

What is recovery? A working definition from the Betty Ford Institute
Journal of Substance Abuse Treatment
Volume 33, Issue 3, October 2007, Pages 221-228



There is an unknown but very large number of individuals who have experienced and successfully resolved dependence on alcohol or other drugs. These individuals refer to their new sober and productive lifestyle as “recovery.”

Although widely used, the lack of a standard definition for this term has hindered public understanding and research on the topic that might foster more and better recovery-oriented interventions.

To this end, a group of interested researchers, treatment providers, recovery advocates, and policymakers was convened by the Betty Ford Institute to develop an initial definition of recovery as a starting point for better communication, research, and public understanding.

Recovery is defined in this article as a voluntarily maintained lifestyle composed characterized by sobriety, personal health, and citizenship.

This article presents the operational definitions, rationales, and research implications for each of the three elements of this definition.

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Request Reprint E-Mail: Tmclellan@Tresearch.org

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NIAAA Expert Explains Impact of Alcohol Abuse on Justice System

Research shows that alcohol abuse costs the United States an estimated $184.6 billion a year, due to crime, medical consequences, lost earnings, lost productivity, motor vehicle crashes, and other social consequences. A large part of that can be attributed to the costs incurred by the criminal justice system—estimated at 6.2 billion. Here, Linda Chezem, a trial court judge by profession and former special assistant to Dr. Ting-Kai (T. K.) Li, M.D., Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), explores the impact that alcohol abuse has on the court system and how community coalitions can help lessen that impact.
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Read Full Interview
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Evidence Note 20 - Screening tools, detoxification and vitamin supplementation for alcohol dependence

Background

Alcohol misuse in Scotland is a significant problem and evidence shows that 27% of men and 14% of women are drinking more than the weekly recommended levels. The overall estimated cost to society is £1 billion per year. Alcohol dependence is defined as a cluster of physiological, behavioural and cognitive phenomena in which the use of alcohol assumes higher priority for an individual than other behaviours. The level of dependence can either be moderate or severe. The first step in helping people overcome their alcohol dependence is detoxification. Detoxification is deliberate alcohol withdrawal managed clinically in an inpatient or outpatient setting. This evidence note focuses on screening tools, detoxification, drugs and adjunctive vitamin supplementation for alcohol dependence. It provides the best available evidence from published secondary literature to inform planners and practitioners.

Key points

• Appropriate screening tools for detecting people with alcohol dependence that may need detoxification are Fast Alcohol Screening Test (FAST) in A&E settings and Cut down Annoyed Guilty Eye-opener (CAGE) plus or FAST in community settings.
• People with moderate alcohol dependence can be effectively and safely detoxified in community/home/outpatient settings. However, people with severe alcohol dependence will require care in an inpatient setting with close monitoring by specialists. Outpatient and home detoxification settings are clinically effective and less costly than inpatient settings.
• Benzodiazepines are the best choice of drugs and chlordiazepoxide is preferred for treating uncomplicated detoxification due to its reduced potential for dependency.
• High dose parenteral thiamine is an effective treatment for Wernicke’s encephalopathy.Vitamin supplements should be prescribed where nutritional deficiencies are likely.

Evidence Note 20 (PDF, 202KB, 29secs)

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How do college students view alcohol prevention policies?
Journal of Substance Use, Volume 12, Issue 6 December 2007 , pages 447 - 460

Despite research supporting comprehensive community prevention strategies, there has been relatively less done in the way of policy-orientated approaches to prevention on college campuses, in the face of powerful appeals to do so.

Among the likely reasons for this state of affairs is that college administrations are cautious about adopting new alcohol policies because of a general belief that such policies are held in very low favor among the students themselves. The sense that most alcohol policies will be met with universal opposition is largely unexamined, however, and it is entirely possible that student attitudes regarding alcohol polices are worthy of investigation in themselves.

The data reported here were collected via a mailed survey of a random sample of undergraduate students from the University of California. The questionnaire included a set of twenty alcohol problem prevention policies that were described as among those some college campuses have adopted or are thinking of adopting. Data were collected from 1648 students, with the sample comprising 33% Asians, 30% Whites, 14% multi-ethnic, 11% Hispanics, 5% African-Americans, and 6% other.

In all cases, the students' approval is higher than their perception of their peers' level of approval, particularly for "enforcement" policies. What we found was a universal tendency to underestimate support for prevention policies, particularly those with some "teeth" to them.

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Request Reprint E-Mail: saltz@prev.org
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P300 amplitude, externalizing psychopathology, and earlier- versus later-onset substance-use disorder.
Journal of Abnormal Psychology. 2007 Aug Vol 116(3) 565-577




P300 amplitude predicts substance use or disorder by age 21. Earlier- versus later-onset substance disorders may reflect different levels of an externalizing psychopathology dimension. P300 in adolescence may not be as strongly related to later-onset substance problems as it is to earlier-onset ones.

In the present study, visual P300 amplitude was measured at age 17 in a community-representative sample of young men. Substance and externalizing disorders were assessed at approximately ages 17, 20, and 24.

Earlier-onset (by age 20) substance disorder was associated with higher rates of externalizing disorders than were later-onset problems.

P300 amplitude was reduced in subjects with earlier-onset substance disorders, relative to later-onset and disorder-free subjects. Amplitude was also reduced in subjects with an externalizing disorder but no substance disorder. Earlier-onset subjects had reduced P300, even in the absence of an externalizing disorder. The results could not be attributed to a concurrent disorder or to recent substance use at the time of the P300 recording.

The findings are consistent with P300 indexing an externalizing spectrum. Earlier-onset substance disorders are more strongly related to P300 and externalizing than are later-onset problems.

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Request Reprint E-Mail: scarlson@psych.ubc.ca
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Declining Estimated Prevalence of Alcohol Drinking and Smoking among Young Adults Nationally: Artifacts of Sample Undercoverage?
American Journal of Epidemiology Advance Access published online on October 31, 2007



A growing concern in public health surveillance surveys that rely on random digit dialing for sampling is the exclusion of adults in cell-phone-only households. The purpose of this study was to examine whether recent increases in wireless substitution have affected estimates of tobacco and alcohol use in the Behavioral Risk Factor Surveillance System (BRFSS) in a subpopulation with notable cell-phone usage (i.e., young adults).

BRFSS data from 2001–2005 were examined. Analyses were limited to participants aged 18–24 years, and the sample contained approximately 18,500 persons in each year.

Prevalence estimates were generated with SUDAAN software for three health behaviors: cigarette smoking, binge drinking, and heavy alcohol consumption. In addition, the authors examined sample completeness for young adults relative to US Census estimates.

Overall, prevalences of all three health behaviors among young adults were fairly stable between 2001 and 2003 but significantly decreased between 2003 and 2005. These trends are not replicated in national surveys that use area probability samples. The authors found a declining trend in the sample completeness ratio for young adults; it declined from 0.32 in 2001 to 0.15 in 2005.

Given the high prevalence of wireless substitution among young adults and the declining sample completeness ratio, the authors suspect that the observed decreases in prevalence are artifacts of undercoverage.

<sup>Read Full Abstract

Request Reprint E-Mail:</sup> delnevo@umdnj.edu
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National Summit on Recovery Conference Report

On September 28-29, 2005, the Center for Substance Abuse Treatment (CSAT)
convened over 100 stakeholders to discuss transformative ideas and concrete
recommendations for moving the substance use disorders services field more
toward a recovery-oriented approach. At the Summit, leaders in the field
identified guiding principles of recovery and elements of recovery-oriented
systems for care for people with substance use disorders. This was the
first time a broad-based consensus on guiding principles of recovery and
elements of recovery-oriented systems of care was achieved on a national
level.

The Report from the CSAT National Summit on Recovery is being provided as a
reference document to assist individuals and organizations submitting
applications under the CSAT Request for Applicants (RFA) for the Addiction
Technology Transfer Centers (ATTC) Program. The ATTC RFA requires
applicants to discuss how they will help prepare the addictions workforce to
function in recovery-oriented systems of care. By providing background
information on the process and key findings of the CSAT National Summit on
Recovery, the Conference Report may be helpful to applicants.

National Summit on Recovery Report
Download Full Report (PDF)

Contributor: Don Phillips
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Efficacy and Tolerability of Naltrexone in the Treatment of Alcohol Dependence: Oral versus Injectable Delivery
Eur Addict Res 2007;13:201-206



Oral naltrexone, an opioid antagonist, reduces relapse and heavy drinking in alcohol-dependent patients. However, oral delivery is associated with poor compliance and adverse events. To enhance treatment outcome and reduce side effects, injectable extended-release naltrexone formulations have been developed. Currently, there are no studies available directly comparing oral and injectable formulations of naltrexone in alcohol-dependent patients.

This paper reviews the efficacy and adverse events of oral versus injectable extended-release naltrexone. Therefore, data were extracted from two recently published reviews about oral naltrexone in the treatment of alcohol dependence. Pooled outcomes were compared with reported outcomes of recent studies on injectable extended-release naltrexone.

Injectable naltrexone seems to be effective in the management of alcohol dependence. Although inconclusive, the available results indicate that the expected advantages of injectable naltrexone over oral naltrexone still have to be proven.

Randomized studies with direct comparisons of oral and injectable naltrexone are urgently
needed.

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Request Reprint E-Mail: h.roozen@erasmusmc.nl
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Health-related consequences of problem alcohol use
Overview 6


The purpose of this Overview is to compile and analyse the available data on problem alcohol use in Ireland and its health-related consequences. This will help determine what approaches are likely to be effective in reducing alcohol-related harm in Ireland, and identify gaps in current knowledge so as to inform future research needs in this area.

Alcohol use in the general population in Ireland and among specific sub groups is described using published literature. Alcohol-related morbidity and mortality between 1995 and 2004 is analysed using previously unpublished data from the Economic and Social Research Institute and the Central Statistics Office. Alcohol treatment in Ireland from 2004 to 2005 is also described, using data from the Health Research Board.

Alcohol consumption among Irish people has increased by 17% over the past 11 years, from 11.5 litres per adult in 1995 to 13.4 litres in 2006. This rise in consumption has led to increases in alcohol-related harm and disease, and has resulted in more than 1,775 deaths. This, in turn, has created escalating pressures on our health and hospital services.

A comprehensive new overview, just published by the HRB, looks at the health-related consequences of problem alcohol use. A full copy of the report can be found in the publications section of the HRB website at www.hrb.ie/publications.
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Effects of training community staff in interventions for substance misuse in dual diagnosis patients with psychosis (COMO study)
The British Journal of Psychiatry (2007) 191: 451-452

A cluster randomised controlled trial was used to investigate the effectiveness of training staff in 13 London community mental health teams (CMHTs) to deliver substance misuse interventions to patients with psychosis and comorbid substance misuse (‘dual diagnosis’).

The primary hypotheses, which were that experimental group patients would spend fewer days in hospital over 18 months of follow-up and show reduced alcohol and drug consumption, were not confirmed, although confidence intervals were wide for some outcomes.

Current UK policy guidance advocates training CMHT professionals to deliver dual diagnosis interventions, but the effectiveness of this strategy has not so far been demonstrated.

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Request Reprint E-Mail: s.johnson@ucl.ac.uk

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Red meat and alcohol are major cancer causes
By Rebecca Smith, Medical Editor

01/11/2007

Millions of people are at risk of getting cancer unless they slash levels of alcohol and red meat in their diets, medical experts have warned in a landmark study.

The most comprehensive review of the evidence linking obesity, diet and physical activity to the chances of developing cancer recommends sweeping changes to our lifestyles if we are to combat rising cancer rates.

Current guidelines on the intake of alcohol and red meat should be nearly halved while people should try to be at the slimmer end of the recommended weight limits in order to lower their risk of developing the disease.

People must be leaner, take more exercise, eat more whole foods, virtually cut out alcohol, consume less red meat and eat no bacon or ham at all.
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Read Full Article
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WCRF/AICR Expert Report, Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective.






The production of the second expert report has been a huge undertaking for the WCRF global network, involving over 100 scientists from 30 different countries. WCRF/AICR commissioned and funded the report, but the content has been driven by an independent panel of 21 world renowned scientists. The Expert Panel worked for five years to assess the research and their conclusions and recommendations are firmly based on the scientific evidence.

The second expert report by chapter:

Introductory Pages

Part 1 Intro
Chapter 1: International variations and trends
Chapter 2: The cancer process
Chapter 3: Judging the evidence

Part 2 Intro
Chapter 4: Foods and drinks
Chapter 5: Physical activity
Chapter 6: Body composition, growth, and development
Chapter 7: Cancers
Chapter 8: Determinants of weight gain, overweight and obesity
Chapter 9: Cancer survivors
Chapter 10: Findings of other reports
Chapter 11: Research issues

Part 3 Intro
Chapter 12: Public health goals and personal recommendations

Appendix
Glossary
References
Index

Fold Outs:
The Panel's judgements
The cancer process and summary recommendations

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The Effect of Restricting Opening Hours on Alcohol-Related Violence
AJPH First Look, published online ahead of print Oct 30, 2007


We investigated whether limiting the hours of alcoholic beverage sales in bars had an effect on homicides and violence against women in the Brazilian city of Diadema. The policy to restrict alcohol sales was introduced in July 2002 and prohibited on-premises alcohol sales after 11 PM.

The new restriction on drinking hours led to a decrease of almost 9 murders a month. Assaults against women also decreased, but this effect was not significant in models in which we controlled for underlying trends.

Introducing restrictions on opening hours resulted in a significant decrease in murders, which confirmed what we know from the literature: restricting access to alcohol can reduce alcohol-related problems. Our results give no support to the converse view, that increasing availability will somehow reduce problems

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Request Reprint E-Mail: duailibi@uol.com.br.
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Alcohol Consumption and Posttraumatic Stress After Exposure to Terrorism: Effects of Proximity, Loss, and Psychiatric History
AJPH First Look, published online ahead of print Oct 30, 2007

We examined the effects of exposure to or interpersonal loss resulting from a terrorist attack on posttraumatic stress and alcohol consumption after we controlled for psychiatric history assessed before the attack.

In regression models, interpersonal loss and past major depression, but not proximity to the World Trade Center, predicted posttraumatic stress symptoms. Proximity and past alcohol dependence, but not interpersonal loss, predicted high levels of post–September 11 alcohol consumption. Past alcohol dependence did not modify the proximity–drinking relationship, and past major depression did not modify the loss–posttraumatic stress relationship.

Participants’ responses to September 11 were specific to their type of exposure and not predetermined by their psychiatric history. A better understanding of responses to traumatic events should assist more-effective prevention and intervention efforts.

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Request Reprint E-Mail: dsh2@columbia.edu.

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A Longitudinal Study of Alcohol Use and Antisocial Behaviour in Young People
Alcohol and Alcoholism Advance Access published online on October 30, 2007

To examine the direction of causation between young people's antisocial behaviour and alcohol (mis)use in the longer and shorter term, together with their joint effects on alcohol-related trouble.

Overall, the results support the susceptibility hypothesis, particularly in the longer-term models. There is no support for ‘pure’ disinhibition. However, in the shorter-term and joint-effects models (i.e. as the time lag becomes shorter), there is evidence that in some gender, social class, or drinking contexts, in addition to antisocial behaviour causing alcohol (mis)use, the reverse also applies.

Antisocial behaviour is the main predictor of alcohol (mis)use and alcohol-related trouble, with alcohol (mis)use impacting only modestly on antisocial behaviour and alcohol-related trouble in the shorter term.

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Request Reprint E-Mail: robert@sphsu.mrc.ac.uk

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News Release - Antisocial behaviour in kids key to alcohol trouble in teens
30 October 2007

It is not levels of underage drinking, but early signs of antisocial behaviour that best predict future alcohol-related trouble and continued alcohol use by young people. This conclusion is drawn from a study led by Robert Young of the Medical Research Council Social and Public Health Sciences Unit in Glasgow.

Published in the Journal Alcohol and Alcoholism, the study reveals that the strongest predictor of alcohol-related trouble among 15 year-olds is a history of antisocial behaviour rather than their actual drinking habits.
. . . . . .

Read Full News Release
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CYP2E1 Rsa I polymorphism impacts on risk of colorectal cancer association with smoking and alcohol drinking.
World J Gastroenterol 2007 November;13(43):5725-5730

To investigate associations between the Rsa I polymorphism of CYP2E1 and risk of colorectal cancer. The proportional distribution of the CYP2E1 Rsa I c1/c1, c1/c2 and c2/c2 genotypes were 61.4%, 35.6% and 3.0% in controls, 60.6%, 33.7% and 5.8% in colon cancer cases, and 58.4%, 34.0% and 7.7% in rectal cancer cases, respectively. A significant difference was noted between controls and rectal cancer cases , the c2/c2 genotype being associated with elevated OR (adjusted age, sex and status of the smoking and alcohol drinking) for rectal cancer , but not for colon cancer. In interaction analysis between the CYP2E1 Rsa I genotype and smoking and drinking habits, we found a significant cooperative action between the c2/c2 genotype and alcohol drinking in the sex-, age-adjusted ORs for both colon and rectal cancers. Among non-smokers, the CYP2E1 Rsa I c2/c2 genotype was also associated with elevated ORs in the two sites . The results of the present study suggest that the CYP2E1 c2/c2 genotype increases susceptibility to rectal cancer and the gene-environmental interactions between the CYP2E1 polymorphism and smoking or alcohol drinking exist for colorectal neoplasia in general. Read Full Abstract Request Reprint E-Mail: ktajima@aichicc.jp __________________________________________________________________

Transcriptional response to alcohol exposure in Drosophila melanogaster
Genome Biology 2006, 7:R95

Alcoholism presents widespread social and human health problems. Alcohol sensitivity, the development of tolerance to alcohol and susceptibility to addiction vary in the population.

Genetic factors that predispose to alcoholism remain largely unknown due to extensive genetic and environmental variation in human populations. Drosophila, however, allows studies on genetically identical individuals in controlled environments. Although addiction to alcohol has not been demonstrated in Drosophila, flies show responses to alcohol exposure that resemble human intoxication, including hyperactivity, loss of postural control, sedation, and exposure-dependent development of tolerance.

We assessed whole-genome transcriptional responses following alcohol exposure and demonstrate immediate down-regulation of genes affecting olfaction, rapid upregulation of biotransformation enzymes and, concomitant with development of tolerance, altered transcription of transcriptional regulators, proteases and metabolic enzymes, including biotransformation enzymes and enzymes associated with fatty acid biosynthesis.

Functional tests of P-element disrupted alleles corresponding to genes with altered transcription implicated 75% of these in the response to alcohol, two-thirds of which have human orthologues.

Expression microarray analysis is an efficient method for identifying candidate genes affecting complex behavioral and physiological traits, including alcohol abuse. Drosophila provides a valuable genetic model for comparative genomic analysis, which can inform subsequent studies in human populations.

Transcriptional analyses following alcohol exposure in Drosophila implicate biotransformation pathways, transcriptional regulators, proteolysis and enzymes that act as metabolic switches in the regulation of fatty acid metabolism as important targets for future studies of the physiological consequences of human alcohol abuse.

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Kaskutas honored for contributions to addiction medicine






At the 38th Annual Medical Scientific conference of the American Society of Addiction Medicine Lee Ann Kaskutas Dr. P.H. delivered the keynote plenary address and received the 2007 Brinkley Smithers Distinguished Scientit Award for contributions to the field of addiction medicine.

The R. Brinkley Smithers Distinguished Scientist Award and Lecture was established by ASAM in 1995 as a lasting tribute to R. Brinkley Smithers who influenced American alcoholism policy, theory and treatment. Through his dedication and philanthropy he created a far greater understanding of this treatable disease.

The Award is to recognize and honor an individual who has made highly meritorious contributions in advancing the scientific understanding of alcoholism, its prevention and treatment.

The Award and Lecture is sponsored by the Christopher D. Smithers Foundation.

The Award is presented annually at ASAM’s Opening Plenary Session during its Annual Medical-Scientific Conference.

1991 Vincent P. Dole, M.D.
1992 Avram Goldstein, M.D.
1993 Floyd E. Bloom, M.D.
1994 Samuel B. Guze, M.D.
1995 Harold Kalant, M.D., Ph.D.
1996 Charles S. Lieber, M.D.
1997 Ting-Kai Li, M.D.
1998 Lee N. Robins, Ph.D.
1999 Mary Jeanne Kreek, M.D.
2000 Marc A. Schuckit, M.D.
2001 Charles P. O'Brien, M.D., Ph.D.
2002 Denise B. Kandel, Ph.D.
2004 A. Thomas McLellan, Ph.D.
2005 Herbert D. Kleber, M.D.
2006 Rudolf H. Moos, Ph.D.
2007 Lee Ann Kaskutas, Dr. P.H.
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Views of alcohol control policies in the 2000 National Alcohol Survey: What news for alcohol policy development in the US and its States?
Journal of Substance Use, Volume 12, Issue 6 December 2007 , pages 429 - 445

This article examines public opinion in US alcohol policies during the 1990s and their correlates in 2000, using five national telephone surveys.

Trend analyses of public opinion on 11 common alcohol policies is presented and factor-based policy scales, based on 14 items in 2000, are used to examine demographic correlates of support for various policy areas, using bivariate, linear (OLS) and logistic regression analyses.

With the exception of the alcohol warning label policy, national support for alcohol policies declined (eight policies) or was unchanged in the 1990s for 11 measured policies. In 2000, four meaningful policy opinion factors were found with adequate reliabilities (s 0.65-0.75) for three of four derived scales.

In 2000, support for specific policies varies. Warnings on labels and advertisements have highest support (>90%), then interventions like prevention, treatment, and responsible beverage service at 70% (with similar levels seen for improving access to treatment). Alcohol controls show varied, but lower support from 25% (raising minimum drinking age further), to above 60% for banning sales in corner stores; only about a third favor higher alcohol taxes (35%) and more restrictive hours of sale (32%).

In general, women and those with lower socio-economic status show higher alcohol policy support. Multivariate results show heavier drinkers are least supportive of alcohol policy, while ethnic minorities, especially Hispanics are more favorable to alcohol controls and raising alcohol taxes.

Since evidence-based alcohol control policies show mixed, but lower public support than treatment, prevention and consumer warnings, there is a need for community-based strategies to increase awareness of environmentally orientated alcohol policies and their public health benefits.

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Request Reprint E-Mail: tgreenfield@arg.org
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Alcohol Consumption and Lower Extremity Arterial Disease among Older Adults
American Journal of Epidemiology Advance Access published online on October 29, 2007




Few studies of the relation of alcohol intake to lower-extremity arterial disease (LEAD) have included clinical events and objective measurements repeated longitudinally.

As part of the Cardiovascular Health Study, a study of older adults from four US communities, 5,635 participants reported their use of beer, wine, and spirits yearly. Incident LEAD was identified by hospitalization surveillance. Technicians measured ankle-brachial index 6 years apart in 2,298 participants. A total of 172 cases of LEAD were documented during a mean of 7.5 years of follow-up between 1989 and 1999.

Compared with abstention, the multivariable-adjusted hazard ratios were 1.10 (95% confidence interval (CI): 0.71, 1.71) for <1> drink per week, 0.56 (95% CI: 0.33, 0.95) for 1–13 drinks per week, and 1.02 (95% CI: 0.53, 1.97) for 14 drinks per week (p for quadratic trend = 0.04). These relations were consistent within strata of sex, age, and apolipoprotein E genotype, and neither lipids nor inflammatory markers appeared to be important intermediates. Change in ankle-brachial index showed a similar relation (p for quadratic trend = 0.01).

Alcohol consumption of 1–13 drinks per week in older adults may be associated with lower risk of LEAD, but heavier drinking is not associated with lower risk.


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Request Reprint E-Mail: kmukamal@bidmc.harvard.edu
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Predictors of suicide attempters in substance-dependent patients: a six-year prospective follow-up
Clinical Practice and Epidemiology in Mental Health 2007, 3:20doi:10.1186/1745-0179-3-20

This is a six-year prospective follow-up of a former cross sectional study of suicide attempters in a sample of treatment-seeking substance-dependent patients.

The aims were to explore the frequency of patients with new suicide attempts (SA) during the six-year observation period, and to explore the predictive value of lifetime Axis I and II disorders, measured at index admission, on SA in the observation period, when age, gender and substance-use variables, measured both at admission and at follow-up, were controlled for.

The prevalence of patients with SA between T1 and T2 was 19% (30/160), with no difference between sexes or between patient type (alcohol-dependent versus poly-substance-dependent). Sober patients also attempted suicide. At the index admission, lifetime eating disorders, agoraphobia with and without panic disorder, and major depression were significantly and independently associated with SA.

Prospectively, only lifetime dysthymia increased the risk of SA during the following six years, whereas lifetime generalized anxiety disorder reduced the risk of SA. Individually, neither the numbers of Axis I and Axis II disorders nor the sum of these disorders were independently related to SA in the observation period.

Substance use measured at T1 did not predict SA in the follow-up period, nor did harmful use of substances at follow-up or in the preceding year.

A high prevalence of SA was found six years later, both in patients still abusing substances and in sober patients. To prevent SA, treatment of both affective disorders and substance abuse is important.

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Alcohol marketing and retailing: Public opinion and recent policy developments in Canada

Journal of Substance Use, Volume 12, Issue 6 December 2007 , pages 389 - 404



Recent developments in alcohol policy in Canada, particularly those pertaining to alcohol marketing and retailing, provide the context for this study of public opinion on alcohol policy topics.

There was considerable variation in support across policy topics, the rank order being similar from year to year. There was somewhat less support for those items, e.g. higher taxes or fewer outlets, considered to be effective by evaluation studies.

A major finding was a decline in support over time. Women, older respondents, and lighter drinkers and abstainers were more likely to be supportive of alcohol control policies. The analyses also revealed interaction between provinces and rate of change in declining support.

The authors hypothesize that intensive marketing and retailing of alcohol may be important factors in declining public support. Declining support for alcohol policy is expected to have implications for controlling damage and costs related to increasing alcohol consumption.

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Request Reprint E-Mail: norman_giesbrecht@camh.net
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Press Release - Alcohol and cancer -- recent research and prevention opportunities

Scientists working with the WHO International Agency for Research on Cancer (IARC) have now added breast cancer and colorectal cancer to the list of pernicious cancers where alcohol is a contributing cause. Even moderate consumption can pose a threat—for instance, just one drink a day increases a woman’s breast cancer risk by 7%-10%.

In light of this disturbing trend, the Toronto Cancer Prevention Coalition and the Centre for Addiction and Mental Health (CAMH) will bring the two Canadian IARC contributors together with cancer experts from Cancer Care Ontario, the Canadian Cancer Society and representatives of over 50 organizations for a half day seminar on Alcohol, Cancer and Public Policy, to address the recent research and emerging prevention opportunities. Experts and stakeholders representing liquor control agencies, alcohol retailers, public health, Ministry of Health Promotion, and many NGO’s are expected.
. . . . . . .

Read Full Press Release

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DRUG AND ALCOHOL FINDINGS MAGAZINE

From 27 October 2007 ISSUE 4 of the Drug and Alcohol Findings magazine became available free of charge as downloadable PDF (Adobe Acrobat) versions of the published content. Access the entire issue from http://findings.org.uk/issuesResults.php5 or by clicking th BROWSE MAGAZINE link on the home page. Search for documents from this and other issues by clicking SEARCH BY TOPIC on the home page. There are 14 Nuggets and three full articles to enjoy each with an underlying fully referenced text.

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IHRA NEWSLETTER

October 2007

Welcome ‘Harm Reduction 2008’ Delegate Fees Announced Abstract Submission: Only a Few Weeks Left! Sponsorship, Exhibition and Advertising Opportunities Nominations Invited for 2008 IHRA Awards 5th International Drugs and Harm Reduction Film Festival 2008 Harm Reduction Training Academy

Mentor UK Response to the English Drug Strategy Consultation, October 2007

In Mentor UK‟s view, there is a fundamental problem with the existing drug strategy that needs to be addressed. We believe that while the drug and alcohol strategies remain separate within government structures and systems, this will result in a lack of consistency of responses to the needs of individuals, families and communities, including in-balances of service provision, often affecting those most in need in our communities. There is overwhelming physical, psychological and social evidence that link drug and alcohol misuse behaviours. Alcohol and tobacco are often misused as precursors to and concurrently with illegal drugs. Mentor UK believes that for the purposes of strategic planning and service delivery it is foolish to split the substances, as consecutive UK governments have done. Government also needs to link up its strategy for dealing with illegal drugs by looking at research around addictive behaviours generally, including gambling addictions, as the same young people often engage in a range of
problematic behaviours and the solutions need to be holistic.

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UKCAPP: an evaluation of 3 UK Community Alcohol Prevention Programs
Final Report for the Alcohol Education & Research Council
October 2007

In the UK, alcohol-related harm has become a community concern over recent years, mirrored by an increase in community initiatives to tackle problems at a local level. In 2003-04 the Alcohol Education and Research Council prioritised community action to reduce alcohol-related harm, and part-funded three projects in the cities of Glasgow, Cardiff and Birmingham. The projects became jointly known as the UK Community Alcohol Prevention Programme (UKCAPP), and aimed to reduce alcohol-related harm and disorder. The projects were influenced by the approach championed by Holder (e.g. 2000, 2004), that efforts be directed toward policy-makers in positions to influence social, economic, and environmental structures in the local environment. In Glasgow and Cardiff the projects were city-centre focused, building on long-standing community partnerships. The Birmingham project was undertaken on a transport corridor across three southern suburbs, where community action had to be developed.

Evaluation
The AERC commissioned the Mental Health Research and Development Unit to ascertain the extent to which the projects adhered to the Holder model; identify barriers and solutions to implementation; draw conclusions about what worked and how; and combine individual project evaluations into a whole.

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