The combined influence of leisure-time physical activity and weekly alcohol intake on fatal ischaemic heart disease and all-cause mortality
European Heart Journal Advance Access published online on January 9, 2008

To determine the combined influence of leisure-time physical activity and weekly alcohol intake on the risk of subsequent fatal ischaemic heart disease (IHD) and all-cause mortality.

Within both genders, being physically active was associated with lower hazard ratios (HR) of both fatal IHD and all-cause mortality than being physically inactive.

Further, weekly alcohol intake was inversely associated with fatal IHD and had a U-shaped association with all-cause mortality. Within level of physical activity, non-drinkers had the highest HR of fatal IHD, whereas both non-drinkers and heavy drinkers had the highest HR of all-cause mortality.

Further, the physically inactive had the highest HR of both fatal IHD and all-cause mortality within each category of weekly alcohol intake. Thus, the HR of both fatal IHD and all-cause mortality were low among the physically active who had a moderate alcohol intake.

Leisure-time physical activity and a moderate weekly alcohol intake are both important to lower the risk of fatal IHD and all-cause mortality.

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The CRF-1 Receptor Antagonist, CP-154,526, Attenuates Stress-Induced Increases in Ethanol Consumption by BALB/cJ Mice
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles) 21 Dec 2007

Corticotropin-releasing factor (CRF) signaling modulates neurobiological responses to stress and ethanol, and may modulate observed increases in ethanol consumption following exposure to stressful events.

The current experiment was conducted to further characterize the role of CRF₁ receptor (CRF₁R) signaling in stress-induced increases in ethanol consumption in BALB/cJ and C57BL/6N mice.

Importantly, BALB/cJ mice pretreated with the CRF₁R antagonist showed blunted stress-induced increases in ethanol intake, and the CRF₁R antagonist did not influence the ethanol drinking of non-stressed mice.

The present results provide evidence that CRF₁R signaling modulates the delayed increase of ethanol consumption stemming from repeated exposure to a stressful event in BALB/cJ mice.

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Parenting Mechanisms in Links Between Parents’ and Adolescents’ Alcohol Use Behaviors
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles)\ 21 Dec 2007

Adolescence has been identified as a critical period with regard to the initiation and early escalation of alcohol use. Moreover, research on familial risk and protective processes provides independent support for multiple domains of parental influence on adolescent drinking; including parents’ own drinking behaviors, as well as the practices they employ to socialize their children. Despite this prevalence of findings, whether and how these distinct associations are related to one another is still not entirely clear.

This study demonstrates that parenting is an important mediator of the association between parental and adolescent drinking practices. An important area for future research will be to study how adolescents can avoid alcohol-related problems despite being reared within a risk laden parenting environment and/or having parents who drink frequently.

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Ethanol Increases Fetal Human Neurosphere Size and Alters Adhesion Molecule Gene Expression
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles) 20 Dec 2007

Ethanol (ETOH) consumption by pregnant women can result in Fetal Alcohol Spectrum Disorder (FASD). To date, the cellular targets and mechanisms responsible for FASD are not fully characterized. Our aim was to determine if ETOH can affect fetal human brain-derived neural progenitor cells (NPC).

ETOH had no effect on NPC apoptosis but, resulted in more rapid coalescence and increased volume of neurospheres. Additionally, the expression of genes associated with cell adhesion was significantly altered. ETOH induced changes in NPC surface adhesion interactions may underlie aspects of neurodevelopmental abnormalities in FASD.

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The Reinforcing Properties of Salsolinol in the Ventral Tegmental Area: Evidence for Regional Heterogeneity and the Involvement of Serotonin and Dopamine
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles) 21 Dec 2007

Salsolinol (SAL), the condensation product of acetaldehyde and dopamine, may be a factor contributing to alcohol abuse. Previous research indicated that both ethanol and acetaldehyde are self-administered into the posterior ventral tegmental area (VTA).

The current study examined SAL self-infusions into the VTA, and determined the involvement of dopamine neurons and 5-HT₃ receptors in this process.

SAL produces reinforcing effects in the posterior VTA of Wistar rats, and these effects are mediated by activation of DA neurons and local 5-HT₃ receptors.

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Characteristics of Grandmothers who have Grandchildren with Fetal Alcohol Syndrome or Incomplete Fetal Alcohol Syndrome
Maternal and Child Health Journal, Online First, 15 January 2008

Characteristics of Northern Plains American Indian maternal grandmothers who had grandchildren with fetal alcohol syndrome (FAS) or incomplete FAS are described to more effectively prevent fetal FAS and alcohol use during pregnancy.

Study 1 had 27 maternal grandmothers who had grandchildren with FAS and Study 2 had 18 grandmothers with grandchildren who had incomplete FAS (cases) which were compared with 119 maternal grandmothers who had grandchildren without FAS (controls). The grandchildren were born between 1981 and 1993 on the Northern Plains. Medical records were manually reviewed for each case and control grandmother. Data were analyzed using Mantel–Haenszel chi square.

Study 1 case grandmothers were more likely to experience medical problems (70.4%) including trauma (48.1%) and injuries (51.9%) than the controls. Most of the Study 1 and 2 case grandmothers (92.6% and 77.8%, respectively) had alcohol use documented in their medical records compared to less than half of the control grandmothers. Seven (15.6%) of the case grandmothers had more than one grandchild in either Study 1 or Study 2.

Maternal grandmothers who had grandchildren with FAS had significantly higher rates of alcohol use and alcohol-related medical problems than control grandmothers.

Antenatal care providers should screen pregnant women for alcohol use at their first visit. The provider needs to ask the women who are using alcohol about their mothers’ use of alcohol to provide appropriate care and counseling for the women and prevent FAS.

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Memory patterns of acquisition and retention of verbal and nonverbal information in children with fetal alcohol spectrum disorders
Can J Clin Pharmacol Vol 15(1) Winter 2008:e44-e56; January 9, 2008

Previous research indicates that children with FASD have both memory and learning deficits. However, there is no consensus about whether the deficits identified from a pattern of impairment, and whether this pattern is consistent with the current theories regarding the organization of memory. Thus, the goal of this study was to further explore memory functions and expose possible patterns that may exist in children with FASD.

A significant difference between types of verbal memory in the FASD sample was identified. Specifically, recall of word pairs was found to be more impaired than that for stories. In addition to this, recall of immediate word pairs was significantly more impaired than that for delayed word pairs, implying the presence of encoding deficits in this area.

Children and adolescents with FASD displayed specific types of verbal memory deficits and these deficits were greater for immediate rather than delayed memory. These data are consistent with previous studies that describe deficits in immediate memory, and suggest that deficits in delayed memory are better accounted for by encoding deficits. Furthermore, their greatest difficulty arose with those items in which the phonological loop was required, which would have facilitated learning though internal recitation and adequate phonological storage.

Further research into these distinctions in memory is warranted, as is exploration into educational techniques that could account for delayed encoding in children with FASD.

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Fetal alcohol syndrome related knowledge assessment and comparison in New Jersey health professional groups
Can J Clin Pharmacol Vol 15(1) Winter 2008:e57-e65; January 9, 2008

There is a need to educate health professionals in regard to Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders across many health and allied health fields.

Conduct evaluations of educational programs designed to assess knowledge, attitudes and beliefs in relation to Fetal Alcohol Spectrum Disorders (FASD) among health and allied health professionals in the northeastern United States.

FASD related educational efforts were carried out and evaluated in New Jersey for various health-related professional groups over a four-month period using a common set of materials. Pre and post-test evaluation comprised 20 questions on FASD recognition, diagnosis, treatment, and prevention. Groups surveyed included nurses, social workers, counselors, therapists, clinicians and allied health professionals comprising physician assistants, dieticians, physical therapists, occupational therapists.

Results showed that a majority of health care professionals in New Jersey possess basic knowledge related to FASD and the effects of alcohol on a child in utero. They also had significant awareness of the importance of early diagnosis and the importance of reducing secondary disabilities. The study did however reveal areas for improvement in some professional groups.

FASD is the most important preventable cause of mental retardation. Health professionals attending workshops typically had a good basic understanding of FASD, though with some weaknesses specific to their discipline. Educational efforts in regard to FASD should be sensitive to the various health professionals engaged in preventing, diagnosing and treating FASD.

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Increased MCP-1 and microglia in various regions of the human alcoholic brain
Experimental Neurology, Article in Press, Corrected Proof 3 December 2007


Cytokines and microglia have been implicated in anxiety, depression, neurodegeneration as well as the regulation of alcohol drinking and other consumatory behaviors, all of which are associated with alcoholism. Studies using animal models of alcoholism suggest that microglia and proinflammatory cytokines contribute to alcoholic pathologies

Alcoholics were found to have brain region-specific increases in microglial markers. In cingulate cortex, both Iba-1 and GluT₅ were increased in alcoholic brains relative to controls. Alternatively, no detectable change was found in amygdala nuclei. In VTA and midbrain, only GluT₅, but not Iba-1 was increased in alcoholic brains.

These data suggest that the enhanced expression of MCP-1 and microglia activities in alcoholic brains could contribute to ethanol-induced pathogenesis.

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Primary Care Intervention to Reduce Alcohol Misuse Ranking Its Health Impact and Cost Effectiveness
American Journal of Preventive Medicine, Volume 34, Issue 2, February 2008, Pages 143-152.e3

The U.S. Preventive Services Task Force (USPSTF) has recommended screening and behavioral counseling interventions in primary care to reduce alcohol misuse. This study was designed to develop a standardized rating for the clinically preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services.

A systematic review of the literature from 1992 through 2004 to identify relevant randomized controlled trials and cost-effectiveness studies was completed in 2005. Clinically preventable burden (CPB) was calculated as the product of effectiveness times the alcohol-attributable fraction of both mortality and morbidity (measured in quality-adjusted life years or QALYs), for all relevant conditions. Cost effectiveness from both the societal perspective and the health-system perspective was estimated. These analyses were completed in 2006.

The calculated CPB was 176,000 QALYs saved over the lifetime of a birth cohort of 4,000,000, with a range in sensitivity analysis from −43% to +94% (primarily due to variation in estimates of effectiveness). Screening and brief counseling was cost-saving from the societal perspective and had a cost-effectiveness ratio of $1755/QALY saved from the health-system perspective. Sensitivity analysis indicates that from both perspectives the service is very cost effective and may be cost saving.

These results make alcohol screening and counseling one of the highest-ranking preventive services among the 25 effective services evaluated using standardized methods. Since current levels of delivery are the lowest of comparably ranked services, this service deserves special attention by clinicians and care delivery systems.

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Effect of chronic alcohol consumption on brain damage following transient focal ischemia
Brain Research, Article in Press, Corrected Proof 7 December 2007



Chronic alcohol consumption impairs cerebral vasoreactivity, and thus, may result in an increase in ischemic brain damage.

The goal of this study is to examine the influence of chronic alcohol consumption on transient focal ischemia-induced brain damage.

Dilation of pial arterioles in response to hypoxia and hypercapnia was significantly reduced in alcohol-fed rats. Alcohol-fed rats had significantly larger infarct volumes and worse neurological outcomes than non-alcohol-fed rats under ketamine/xylazine or isoflurane anesthesia. In addition, rCBF measurement indicated that alcohol-fed rats had less regulatory rebound increase in rCBF after the initial drop in rCBF at the onset of MCAO.

Our findings suggest that chronic alcohol consumption exacerbates transient focal ischemia-induced brain damage. Increased ischemic brain damage during alcohol consumption may be related to an impaired cerebral vasoreactivity.

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Differential effects of acute alcohol on EEG and sedative responses in adolescent and adult Wistar rats
Brain Research, Article in Press, Corrected Proof 4 Dec 2007


Age-related developmental differences in sensitivity to the acute effects of alcohol may play an important role in the development of alcoholism.

The present study was designed to evaluate the acute effects of alcohol on cortical electroencephalogram (EEG) in adolescent (P36) and adult (P78) Wistar rats.

Five minutes of EEG was recorded after administration of 0, 0.75 or 1.5 g/kg alcohol. The righting reflex was performed to measure the sedative effects of alcohol (3.5 g/kg) and total sleeping time for each rat.

Our results showed that alcohol (1.5 g/kg) increased power in the 1–2 Hz band and decreased the power in the 32–50 Hz band in the parietal cortical region of adolescent rats. Alcohol (1.5 g/kg) also increased stability of the EEG power in the slow-wave frequency bands (2–4 Hz, 4–6 Hz, and 6–8 Hz) of adolescent rats. In the frontal cortex of adult rats, but not in adolescent rats, alcohol (1.5 or 0.75 g/kg) decreased the power in the 16–32 Hz frequency band.

Alcohol (1.5 g/kg) differentially increased power in a multiple of slow-wave frequency bands (2–4 Hz and 4–6 Hz) in the parietal cortex of adult rats as compared to adolescent rats. Adolescent rats were shown significantly shorter sleeping time and higher blood alcohol levels after regaining reflex than adult rats.

Our results provide additional evidence of age-related differences in the effects of acute alcohol on cortical EEG, sedation and tolerance.

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Socioeconomic Differences in Alcohol-Specific Parenting Practices and Adolescents' Drinking Patterns
European Addiction Research 2008;14:26-37

The aim of this study was to investigate to what extent alcohol-specific parenting practices relate to adolescents' alcohol use, binge drinking, and alcohol-related problems, and whether these associations are moderated by socioeconomic status (SES), i.e. parents' education level and family income.

The results show that applying strict rules about alcohol use and having qualitative good conversations about drinking alcohol seem to prevent adolescents from heavy drinking patterns, whereas parental alcohol use seems to promote adolescents' drinking.

A positive association was found between frequency of alcohol communication and availability of alcohol at home on the one hand and adolescents' drinking on the other.

Some moderating effects of SES were found.

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Request Reprint E-Mail: R.Spijkerman@pwo.ru.nl

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College Students' Drinking Patterns: Trajectories of AUDIT Scores during the First Four Years at University
European Addiction Research 2008;14:11-18


Changes in AUDIT score trajectories were examined in a student population during their first 4 years at a university, including high-risk consumers and a subsample of low-risk consumers.

In the low-AUDIT group, five distinct trajectories were identified: three stable non-risky consumption groups (83%) and two increasing groups (17%; from non-risky to risky). In the high-AUDIT group, three groups were identified: two stable high groups (58%) and one decreasing group (from risky to non-risky consumption; 41%). In the integrated model, stable risky consumption comprised 16% of the total sample, decreasing consumption 11%, increasing consumption comprised 13% and stable non-risky consumption 60% of the sample. Gender influenced the trajectories.

The pattern of changes in risk consumption is similar to that found in corresponding US studies.

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Socioeconomic Differences in Alcohol-Specific Parenting Practices and Adolescents' Drinking Patterns
European Addiction Research 2008;14:26-37

The aim of this study was to investigate to what extent alcohol-specific parenting practices relate to adolescents' alcohol use, binge drinking, and alcohol-related problems, and whether these associations are moderated by socioeconomic status (SES), i.e. parents' education level and family income.

The results show that applying strict rules about alcohol use and having qualitative good conversations about drinking alcohol seem to prevent adolescents from heavy drinking patterns, whereas parental alcohol use seems to promote adolescents' drinking.

A positive association was found between frequency of alcohol communication and availability of alcohol at home on the one hand and adolescents' drinking on the other.

Some moderating effects of SES were found.

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Request Reprint E-Mail: R.Spijkerman@pwo.ru.nl

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New DASIS Report: Male Admissions with Co-occurring Psychiatric and Substance Use Disorders: 2005

The Substance Abuse and Mental Health Services Administration's (SAMHSA) Office of Applied Studies (OAS) has released a new DASIS Report titled, Male Admissions with Co-occurring Psychiatric and Substance Use Disorders: 2005. The report provides statistical analysis on co-occurring disorders and the effects of such on substance abuse disorders in males.

The following are some highlights from the report:

• Among male admissions reporting alcohol, cocaine, marijuana, or stimulants as the primary substance of abuse, those with co-occurring disorders were more likely than those without co-occurring disorders to report daily use of these substances
• Sixty-two percent of male admissions with co-occurring disorders reported more than one substance of abuse compared with 52 percent of male admissions without co-occurring disorders
• Male admissions with co-occurring disorders were more likely than those without co-occurring disorders to report five or more prior substance abuse treatment episodes (17 vs. 10 percent)

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American Indian and Alaska Native Mental Health Research
The Journal of the National Center
Volume 14, Number 3, 2008




MENTAL HEALTH, HEALTH, AND SUBSTANCE ABUSE SERVICE NEEDS FOR THE NATIVE AMERICAN REHABILITATION ASSOCIATION NORTHWEST (NARA NW) IN THE PORTLAND, OREGON METROPOLITAN AREA
pp. 1-23

Consistent with results of previous needs assessments for urban American Indian and Alaska Native populations, a needs assessment in the Portland, Oregon metropolitan area for the Native American Rehabilitation Association Northwest revealed high levels of co-occurring conditions for American Indian and Alaska Native clients, often combining chronic health problems, substance abuse histories, and mental health diagnoses. Focus group results suggest the need for crisis care as well as specifi c needs of children and families, veterans, elders, and adults.

PREDICTORS OF RELAPSE FOR AMERICAN INDIAN WOMEN AFTER SUBSTANCE ABUSE TREATMENT
pp. 24-48

The objective of this study was to describe the predictors of substance use relapse of American Indian (AI) women up to one year following substance abuse treatment. Relapse is defi ned as any use of alcohol or drugs in the past 30 days at the follow-up points. Data were collected from AI women in a 45-day residential substance abuse treatment program. Predictors include distal (in time) proximal (recent), and intrapersonalfactors. Results indicated that intrapersonal factors showed the strongest relationship with relapse, followed by proximal and distal factors. Negative messages about using alcohol or drugs from the client's father while growing up may have had an impact on whether the client used alcohol at 6 months. Conflicts with other people and being in the company of alcohol or drug users were highly predictive of relapse. While craving was highly predictive of substance use at follow up, self-efficacy was highly predictive of no substance use. Knowledge about predictors of relapse among this population should be used as a guide toward individual treatment planning.

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Web-based self-help for problem drinkers: a pragmatic randomized trial
Addiction 103 (2), 218–227.

Self-help interventions for adult problem drinkers in the general population have proved effective. The question is whether this also holds for self-help interventions delivered over the internet.

At follow-up, 17.2% of the intervention group participants had reduced their drinking successfully to within the guideline norms; in the control group this was 5.4% [odds ratio (OR) = 3.66; 95% confidence interval (CI) 1.3–10.8; P = 0.006; number needed to treat (NNT) = 8.5]. The intervention subjects decreased their mean weekly alcohol consumption significantly more than control subjects, with a difference of 12.0 standardized units (95% CI 5.9–18.1; P <>

To our knowledge this is one of the first randomized controlled trials on a web-based self-help intervention without therapist guidance for self-referred problem drinkers among the adult general population. The intervention showed itself to be effective in reducing problem drinking in the community.

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[Commentary] A HARD NATURAL EXPERIMENT TO FATHOM: A TESTAMENT TO THE INCREASING DIFFICULTY OF CONDUCTING RELIABLE SURVEYS?
Addiction 103 (2), 192–193.

The paper by Mäkelä et al. [1] adds to the important tradition of studying ‘natural experiments’ in alcohol policy, a tradition that is especially strong in the Scandinavian countries [2]. Had the results followed the almost invariable pattern that reduced taxes lead to increased consumption, there would have been much less over which to discuss and puzzle. The authors are to be applauded for publishing these unexpectedly negative results. Arguably, studies such as this have unique value by forcing the field to question received wisdom and, I suggest, also traditional research methods.
. . . . .

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Changes in volume of drinking after changes in alcohol taxes and travellers' allowances: results from a panel study
Addiction 103 (2), 181–191.

The aim of this paper is to study short-term changes in alcohol consumption by subgroups of the population in Denmark, Finland and southern Sweden following large-scale decreases in alcohol taxation in Denmark and Finland and large increases in travellers' allowances in Finland and Sweden.

Consumption decreased or remained the same among women and men in all three study sites. Relative changes were similar across subgroups of age, gender and income in all countries. In absolute terms, there was a consistent differential change by age in Denmark, Finland and Southern Sweden, with the higher level of the young and lower level of the old converging. Women's and men's consumption converged in Finland and southern Sweden. The changes did not differ systematically by income. Changes were not larger among heavier drinkers.

The results did not confirm expectations: an increase in consumption larger than that in the control site could not be shown in any of the countries or subgroups of the population. If there has been an effect – as shown in aggregate data in Finland – it seems to have been stronger among the old than the young and, in Finland and southern Sweden, among women rather than men.

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Alcohol, Other Drugs, and Health: Current Evidence
Informing you of the latest clinically relevant research on alcohol, illicit drugs, and health

Current Issue: January-March 2008

View PDF of newsletter (Download Adobe Acrobat)

Assessments and Interventions

• Topiramate Reduces Drinking in Adults With Alcohol Dependence
• Methadone Maintenance Plus Syringe Exchange Reduces HIV and HCV Incidence
• Extended-Release Naltrexone Works Particularly Well for Abstinent Patients With Dependence
• Prevalence of Adolescent Substance Use Identified by Screening in Primary Care
• Melatonin, Benzodiazepines, and Sleep Quality Among Patients Receiving Methadone
• Inpatient Medical Care Plus Substance Use Treatment Improves Health Services Utilization
• Do Patient Characteristics Moderate Naltrexone’s Effects on Drinking?

Health Outcomes

• Prescription Opioid Use and Diversion
• Impact of Substance Use on Adherence to HIV Medications
• Combining Healthy Behaviors, Including Moderate Drinking, Reduces MI in Women
• Characteristics of Adolescents Who Use Cannabis But Not Tobacco
• Racial Differences in Alcohol Treatment Received and in Treatment Completed
• Moderate Drinking May Improve Fasting Glucose in People With Diabetes

Journal Alert

• Issues of Substance Abuse Dedicated to Screening and Brief Intervention

Slide Presentations

• Update on Alcohol, Other Drugs, and Health

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Differences in - and -Opioid Receptor Blockade Measured by Positron Emission Tomography in Naltrexone-Treated Recently Abstinent Alcohol-Dependent Subjects
Neuropsychopharmacology (2008) 33, 653–665


Blockade of brain -opioid receptor (-OR) and -opioid receptor (-OR) was investigated in recently abstinent alcohol-dependent subjects (N=21) maintained on naltrexone.

Naltrexone inhibition of [¹¹C]CAR BP was near maximal across all brain regions of interest with little variability across subjects (mean+SD% inhibition=94.9+4.9%). Naltrexone only partially inhibited the [¹¹C]MeNTI K_i and there was more variability across subjects (mean+SD% inhibition=21.1+14.49%).

Peak serum levels of naltrexone were positively correlated with % inhibition of -OR K_i in neocortex and basal ganglia. Peak serum levels of naltrexone were not correlated with % inhibition of -OR BP. Peak levels of 6--naltrexol were not significantly correlated with % inhibition of -OR BP or -OR K_i.

Thus, the FDA recommended therapeutic dose of naltrexone was sufficient to produce near complete inhibition of the -OR in recently abstinent alcohol dependent subjects. The lower percent inhibition of -OR and greater variability in -OR blockade by naltrexone across subjects may contribute to individual differences in treatment outcomes to naltrexone.

Further investigations on the relationship between individual differences in -OR blockade by naltrexone and clinical outcomes should be explored.

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Pharmacological Evidence for a Motivational Role of -Opioid Systems in Ethanol Dependence
Neuropsychopharmacology (2008) 33, 643–652


The purpose of this study was to test the hypothesis that activation of the dynorphin/kappa ()-opioid system has a role in the increased consumption of ethanol in dependent animals.

The effects of three opioid receptor antagonists with different effects on opioid receptors, naltrexone, nalmefene, and nor-binaltorphimine (nor-BNI), were compared in their ability to decrease ethanol self-administration in nondependent and ethanol-dependent male Wistar rats.

The results indicated that both nalmefene and naltrexone induced a significant dose-dependent decrease in the number of lever presses for ethanol in both groups of animals. However, in ethanol-dependent animals, nalmefene was significantly more effective in suppressing ethanol intake than naltrexone. Nor-BNI selectively attenuated ethanol-dependent self-administration while leaving nondependent ethanol self-administration intact. Because naltrexone is primarily selective for the -opioid receptor, and nalmefene is primarily selective for the - and -opioid receptor subtypes, the fact that nalmefene demonstrates more suppression in dependent animals suggests that opioid systems distinct from the -regulated portion may be involved in the increased drinking seen during withdrawal in dependent animals.

The results with nor-BNI confirm that -opioid receptor antagonism selectively decreases dependence-induced ethanol self-administration, which supports the hypothesis that dynorphin/-opioid systems are dysregulated in dependence and contribute to the increased drinking seen during acute withdrawal in dependent rats.

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Alcohol Preference Influences the Subthalamic Nucleus Control on Motivation for Alcohol in Rats Neuropsychopharmacology (2008) 33, 634–642;


In addition to its role in motor and attentional processes, the subthalamic nucleus (STN) has also been recently demonstrated to be involved in motivational function. Indeed, bilateral STN lesions modulate differentially the motivation for natural rewards and drugs of abuse, increasing motivation for food and decreasing motivation for cocaine in rats.

Here, we show that in outbred rats, the STN can modulate the motivation for alcohol according to alcohol preference, without affecting alcohol intake.

When performed on 'High-Drinker' rats, STN lesions enhanced the breaking point (BP) under a progressive ratio schedule of reinforcement and increased the time spent in the environment previously paired with alcohol access in the place preference paradigm. In contrast, when performed on 'Low-Drinker' rats, STN lesions decreased the BP and increased the time spent in the environment paired with water.

These results show that STN lesions enhance the motivation for alcohol in rats showing a high alcohol preference, whereas they decrease it in rats showing a low preference for alcohol

These results suggest that the STN plays a complex role in the reward circuit, that is not limited to a dissociation between motivation for natural rewards and drugs of abuse, but takes other factors, such as alcohol preference, into account.

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12-Step Treatment for Alcohol and Substance Abuse Revisited: Best Available Evidence Suggests Lack of Effectiveness or Harm
International Journal of Mental Health and Addiction Onlione First 11 Jan 2008


Approaches incorporating 12-Step beliefs and practices have dominated substance abuse treatment despite a lack of empirical support.

Recent claims for effectiveness relying on results from a large, multisite research project in the U.S. were re-evaluated based on critical analysis of design, methodology, and construction of outcome measures.

Contrary to claims, experimental design did not allow comparison of effectiveness of 12-Step versus cognitive–behavioral interventions but does allow evaluation of outcome measures for a single treatment intervention infused with 12-Step beliefs and teachings.

Corrected for design and methodological errors, results support estimated “remission” rates for alcohol abuse of at most 15–20% and for substance abuse of 0–15%.

Elements inherent in 12-Step practices and beliefs, including step work, run counter to accepted counseling and therapeutic factors believed to predict positive outcomes. Lack of effectiveness or outcomes less beneficial than no treatment are thus not unexpected for courses of treatment infused with 12-Step elements.

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