Heavy in utero ethanol exposure is associated with the use of other drugs of abuse in a high-risk population

Many ethanol dependent women also use other drugs of abuse that may affect pregnancy outcome and long-term child neurodevelopment.

This study investigated the association between drugs of abuse and concurrent use of ethanol in pregnancy.

A study cohort of neonates with FAEE levels above 2nmol per gram meconium, indicative of heavy in utero ethanol exposure, was identified (n=114). Meconium and hair analyses for the presence of other drugs of abuse were obtained for some of these neonates and the rates of drug exposure were compared with the rates in a cohort of neonates who were tested negative (FAEE below 2nmol per gram meconium) for ethanol exposure (n=622). Odds ratios (ORs) for various drugs were calculated with ethanol exposure.

A 15.5% positive rate for intrauterine ethanol exposure was detected. A high rate of in utero drug exposure was detected in neonates with and without in utero ethanol exposure, 60.5% versus 62.7% respectively.

Neonates with heavy in utero ethanol exposure were almost twice as likely to be exposed to narcotic opiates (OR=1.90; 95% confidence interval [CI]: 1.13–3.20) and 3.3 times as likely to be exposed to amphetamine (OR=3.30; 95% CI 1.06–10.27) when compared to neonates with no ethanol exposure.

Exposure to cannabinoids predicted less likely exposure to ethanol (OR=0.61; 95% CI: 0.38–0.98) and no significant difference was noted in the exposure to cocaine (OR=1.24, 95% CI: 0.81–1.91).

Neonates suspected of heavy in utero ethanol exposure should be tested for other drugs of abuse and vice versa. Early detection of drug exposures can facilitate early intervention to both the neonate and the mother, thus decreasing the risk of long-term neurodevelopmental outcomes for the child, including secondary disabilities associated with fetal alcohol spectrum disorder.

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Request Reprint E-Mail: gkoren@sickkids.ca
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A neurodevelopmental framework for the development of interventions for children with fetal alcohol spectrum disorders

Despite considerable data published on cognitive and behavioral disabilities in children with fetal alcohol spectrum disorders (FASD), relatively little information is available on behavioral or pharmacological interventions for alcohol-affected children.

The main goals of this article, therefore, are to summarize published intervention studies of FASD and to present a neurodevelopmental framework, based on recent findings from a number of disciplines, for designing new therapies for alcohol-affected children.

This framework assumes a neuroconstructionist view, which posits that reciprocal interactions between neural activity and the brain's hardware lead to the progressive formation of intra- and interregional neural connections. In this view, behavioral interventions can be conceptualized as a series of guided experiences that are designed to produce neural activation.

Based on evidence from cognitive neuroscience, it is hypothesized that specific interventions targeting executive attention and self-regulation may produce greater generalizable results than those aimed at domain-specific skills in children with FASD.

In view of reciprocal interactions between environmental effects and neural structures, the proposed framework suggests that the maximum effects of interventions can eventually be achieved by optimally combining behavioral methods and cognition-enhancing drugs.

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Request Reprint E-Mail: pkodituwakku@salud.unm.edu
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Implementation of a shared data repository and common data dictionary for fetal alcohol spectrum disorders research

Many previous attempts by fetal alcohol spectrum disorders researchers to compare data across multiple prospective and retrospective human studies have failed because of both structural differences in the collected data and difficulty in coming to agreement on the precise meaning of the terminology used to describe the collected data.

Although some groups of researchers have an established track record of successfully integrating data, attempts to integrate data more broadly among different groups of researchers have generally faltered. Lack of tools to help researchers share and integrate data has also hampered data analysis. This situation has delayed improving diagnosis, intervention, and treatment before and after birth.

We worked with various researchers and research programs in the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CI-FASD) to develop a set of common data dictionaries to describe the data to be collected, including definitions of terms and specification of allowable values. The resulting data dictionaries were the basis for creating a central data repository (CI-FASD Central Repository) and software tools to input and query data. Data entry restrictions ensure that only data that conform to the data dictionaries reach the CI-FASD Central Repository.

The result is an effective system for centralized and unified management of the data collected and analyzed by the initiative, including a secure, long-term data repository. CI-FASD researchers are able to integrate and analyze data of different types, using multiple methods, and collected from multiple populations, and data are retained for future reuse in a secure, robust repository.

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Request Reprint E-Mail: aarenson@iupui.edu
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Zebrafish fetal alcohol syndrome model: effects of ethanol are rescued by retinoic acid supplement

This study was designed to develop a zebrafish experimental model to examine defects in retinoic acid (RA) signaling caused by embryonic ethanol exposure. RA deficiency may be a causative factor leading to a spectrum of birth defects classified as fetal alcohol spectrum disorder (FASD).

Experimental support for this hypothesis using Xenopus showed that effects of treatment with ethanol could be partially rescued by adding retinoids during ethanol treatment.

Previous studies show that treating zebrafish embryos during gastrulation and somitogenesis stages with a pathophysiological concentration of ethanol (100mM) produces effects that are characteristic features of FASD.

We found that treating zebrafish embryos with RA at a low concentration (10−9M) and 100mM ethanol during gastrulation and somitogenesis stages significantly rescued a spectrum of defects produced by treating embryos with 100mM ethanol alone.

The rescued phenotype that we observed was quantitatively more similar to embryos treated with 10−9M RA alone (RA toxicity) than to untreated or 100mM ethanol-treated embryos. RA rescued defects caused by 100mM ethanol treatment during gastrulation and somitogenesis stages that include early gastrulation cell movements (anterior–posterior axis), craniofacial cartilage formation, and ear development.

Morphological evidence also suggests that other characteristic features of FASD (e.g., neural axis patterning) are rescued by RA supplement.

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Request Reprint E-Mail: jmarrs@iupui.edu
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A 14-year retrospective maternal report of alcohol consumption in pregnancy predicts pregnancy and teen outcomes

Detecting patterns of maternal drinking that place fetuses at risk for fetal alcohol spectrum disorders (FASDs) is critical to diagnosis, treatment, and prevention but is challenging because information on antenatal drinking collected during pregnancy is often insufficient or lacking.

Although retrospective assessments have been considered less favored by many researchers due to presumed poor reliability, this perception may be inaccurate because of reduced maternal denial and/or distortion.

The present study hypothesized that fetal alcohol exposure, as assessed retrospectively during child adolescence, would be related significantly to prior measures of maternal drinking and would predict alcohol-related behavioral problems in teens better than antenatal measures of maternal alcohol consumption.

Drinking was assessed during pregnancy, and retrospectively about the same pregnancy, at a 14-year follow-up in 288 African-American women using well-validated semistructured interviews. Regression analysis examined the predictive validity of both drinking assessments on pregnancy outcomes and on teacher-reported teen behavior outcomes.

Retrospective maternal self-reported drinking assessed 14 years postpartum was significantly higher than antenatal reports of consumption. Retrospective report identified 10.8 times more women as risk drinkers (≥ one drink per day) than the antenatal report. Antenatal and retrospective reports were moderately correlated and both were correlated with the Michigan Alcoholism Screening Test.

Self-reported alcohol consumption during pregnancy based on retrospective report identified significantly more teens exposed prenatally to at-risk alcohol levels than antenatal, in-pregnancy reports.

Retrospective report predicted more teen behavior problems (e.g., attention problems and externalizing behaviors) than the antenatal report. Antenatal report predicted younger gestational age at birth and retrospective report predicted smaller birth size; neither predicted teen IQ. These results suggest that if only antenatal, in-pregnancy maternal report is used, then a substantial proportion of children exposed prenatally to risk levels of alcohol might be misclassified.

The validity of retrospective assessment of prior drinking during pregnancy as a more effective indicator of prenatal exposure was established by predicting more behavioral problems in teens than antenatal report.

Retrospective report can provide valid information about drinking during a prior pregnancy and may facilitate diagnosis and subsequent interventions by educators, social service personnel, and health-care providers, thereby reducing the life-long impact of FASDs.

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Request Reprint E-Mail: j.hannigan@wayne.edu
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Collaborative initiative on fetal alcohol spectrum disorders: methodology of clinical projects

The Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) was created in 2003 to further understanding of fetal alcohol spectrum disorders.

Clinical and basic science projects collect data across multiple sites using standardized methodology.

This article describes the methodology being used by the clinical projects that pertain to assessment of children and adolescents.

Domains being addressed are dysmorphology, neurobehavior, 3-D facial imaging, and brain imaging.

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Request Reprint E-Mail: smattson@sunstroke.sdsu.edu
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The pros and cons of drinking: Weighing alcohol's effects on the body

A few months ago I received a book called "The Two Martini Diet" (Authorhouse, 2008), in which Jerry Sorlucco documents his success at losing more than 100 pounds without forgoing his daily cocktails. He doesn't break new diet-book ground: Sorlucco follows well-established practices such as controlling portion sizes, eating plenty of fruits and vegetables, and managing his calorie intake and expenditure to accommodate those drinks.

I've kept the book on my desk because I'm intrigued by the interplay between healthful eating and alcohol consumption. Is it really possible, I've wondered, to incorporate alcoholic beverages into a healthful diet and lifestyle, or are those of us who hope it is possible just fooling ourselves? . . . . .

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Stimulus Checkup A closer look at 100 projects funded by the American Recovery and Reinvestment Act.

As this and the last report, 100 Stimulus Projects: A Second Opinion suggest, billions of dollars of stimulus funding have been wasted, mismanaged, or directed towards silly and shortsighted projects. Many projects may not produce the types of jobs that most Americans had hoped for or expected. . . . . .

17. Buffalo Residents Paid to Keep Daily Journal of Malt Liquor and Marijuana Use ($389,357)

Researchers at the State University of New York at Buffalo will receive nearly $390,000 to study young adults who drink malt liquor and smoke marijuana,

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Hospital admissions data 08/09

The finalised 08/09 NI 39 hospital admissions data was published by the North West Public Health Observatory's (NWPHO) Local Alchol Profiles for England (LAPE) earlier this month. Their December E-bulletin highlighted some key findings in comparison with the previous year’s figures: . . . . .


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Polymorphisms in Alcohol Metabolizing Genes and the Risk of Head and Neck Cancer in a Brazilian Population

The incidence of head and neck cancer (HNC) in Brazil has increased substantially in recent years. This increase is likely to be strongly associated with alcohol and tobacco consumption, but genetic susceptibility also should be investigated in this population.

The aim of this study was to evaluate the association of polymorphisms in genes of alcohol metabolism enzymes and the risk of HNC.

Chronic alcohol intake increased approximately four times the risk of HNC. The mutant genotype ADH1B Arg⁴⁸His was more frequent in controls (12.7%) than HNC patients (5.8%) conferring protection for the disease , 0.21–0.85). Similar results were observed for individuals with ADH1B*2 or ADH1B*2/ADH1C*1 mutated haplotypes. Multiple regression analyses showed that individuals with the mutant genotype ADH1B Arg⁴⁸His who consume alcohol >30 g/L/day have more than four times the risk for HNC .

The fast alcohol metabolizing genotypes may prevent HNC when the amount of alcohol intake is <30.655>

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Request Reprint E-Mail: gfgattas@usp.br
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Dopamine D2 Receptor Genotype Is Associated with Increased Mortality at a 10-Year Follow-up of Alcohol-Dependent Individuals

Because the TAQ1 A1 allele may be associated with alcohol-related medical illnesses, and medical illnesses in alcohol-dependent individuals are associated with increased mortality, we test the hypothesis that the TAQ1 A1 allele of the DRD2 gene is associated with increased mortality in alcohol-dependent individuals.

The prevalence of the A1 allele differed between the deceased and living patients and the controls: 47% of the deceased were A1+, compared to 37% of the living patients and 32% of the controls. The frequency of the TAQ1 A1/A2 genotype also differed between the groups. Thus, 43% had the A1/A2 genotype in comparison with 32% in the living patients and 29% in the controls. The TAQ 1 A1 allele frequency differed between the groups. The frequency of A1 allele was 25% in the deceased patients compared to 21% in the living patients and 17% in the controls.

The TAQ I A1 allele of the DRD2 gene (or DRD2 gene region) was associated with increased mortality over a 10-year period in alcohol-dependent individuals.

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Request Reprint E-Mail: Claudia.Fahlke@psy.gu.se
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Variant in PNPLA3 is associated with alcoholic liver disease

Two genome-wide association studies (GWAS) have described associations of variants in PNPLA3 with nonalcoholic fatty liver and plasma liver enzyme levels.

We investigated the contributions of these variants to liver disease in Mestizo subjects with a history of alcohol dependence.

We found that rs738409 in PNPLA3 is strongly associated with alcoholic liver disease and clinically evident alcoholic cirrhosis.

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Request Reprint E-Mail: david_hinds@perlegen.com
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Thinking about drinking: Need for cognition and readiness to change moderate the effects of brief alcohol interventions.

Research has demonstrated the efficacy of brief motivational interventions (BMI) and alcohol expectancy challenge (AEC) in reducing alcohol use and/or problems among college students. However, little is known about variables that may qualify the effectiveness of these approaches.

The present analyses tested the hypothesis that need for cognition (NFC), impulsivity/sensation seeking (IMPSS) and readiness to change (RTC) would moderate the effects of BMI and AEC.

Simple slopes analyses were used to probe these relationships and revealed that higher levels of NFC at baseline were associated with a stronger BMI effect on drinking outcomes over time. Similarly, higher levels of baseline RTC were associated with stronger AEC effects on alcohol use.

Future preventive interventions with this population may profit by considering individual differences and targeting approaches accordingly.


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Request Reprint E-Mail: Christy_Capone@brown.edu

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A method for mapping intralocus interactions influencing excessive alcohol drinking

Excessive alcohol (ethanol) consumption is the hallmark of alcohol use disorders. The F1 hybrid cross between the C57BL/6J (B6) and FVB/NJ (FVB) inbred mouse strains consumes more ethanol than either progenitor strain.

The purpose of this study was to utilize ethanol-drinking data and genetic information to map genes that result in overdominant (or heterotic) ethanol drinking.

About 600 B6 × FVB F2 mice, half of each sex, were tested for ethanol intake and preference in a 24-h, two-bottle water versus ethanol choice procedure, with ascending ethanol concentrations. They were then tested for ethanol intake in a Drinking in the Dark (DID) procedure, first when there was no water choice and then when ethanol was offered versus water. DNA samples were obtained and genome-wide QTL analyses were performed to search for single QTLs (both additive and dominance effects) and interactions between pairs of QTLs, or epistasis.

On average, F2 mice consumed excessive amounts of ethanol in the 24-h choice procedure, consistent with high levels of consumption seen in the F1 cross. Consumption in the DID procedure was similar or higher than amounts reported previously for the B6 progenitor.

QTLs resulting in heightened consumption in heterozygous compared to homozygous animals were found on Chrs 11, 15, and 16 for 24-h choice 30% ethanol consumption, and on Chr 11 for DID. No evidence was found for epistasis between any pair of significant or suggestive QTLs.

This indicates that the hybrid overdominance is due to intralocus interactions at the level of individual QTL.

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Request Reprint E-Mail: phillipt@ohsu.edu
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Prohibitin is expressed in pancreatic β-cells and protects against oxidative and proapoptotic effects of ethanol

Pancreatic β-cell dysfunction is a prerequisite for the development of type 2 diabetes. Alcoholism is a diabetes risk factor and ethanol increases oxidative stress in β-cells, whereas the mitochondrial chaperone prohibitin (PHB) has antioxidant effects in several cell types.

In the present study we investigated whether PHB is expressed in β-cells and protects these cells against deleterious effects of ethanol, using INS-1E and RINm5F β-cell lines.

In ethanol-treated cells, MTT reduction and ATP production decreased, whereas reactive oxygen species, uncoupling protein 2 and cleaved caspase-3 levels increased. In addition, flow cytometry analysis showed an increase of apoptotic cells. Ethanol treatment increased PHB expression and induced PHB translocation from the nucleus to the mitochondria. PHB overexpression decreased the apoptotic effects of ethanol, whereas PHB knockdown enhanced these effects. The protective effects of endogenous PHB were recapitulated by incubation of the cells with recombinant human PHB.

Thus, PHB is expressed in β-cells, increases with oxidative stress and protects the cells against deleterious effects of ethanol.

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Request Reprint E-Mail: bnyomba@cc.umanitoba.ca

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Efficacy of Physician-delivered Brief Counseling Intervention for Binge Drinkers

Binge drinking is a common pattern of alcohol use in the US. However, no studies have evaluated the effectiveness of brief interventions targeting only binge drinkers.

This study provided evidence that screening and brief counseling delivered by a primary care physician as part of regular health care significantly reduced binge drinking episodes in binge drinkers.

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Request Reprint E-Mail: garuva@inica.es

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Brain metabolite changes in alcoholism: Localized proton magnetic resonance spectroscopy study of the occipital lobe

Chronic alcoholism is associated with altered brain metabolism, morphology and cognitive abilities. Besides deficits in higher order cognitive functions, alcoholics also show a deficit in the processing of basic sensory information viz. visual stimulation.

To assess the metabolic changes associated with this deficit, ¹H MRS was carried out in the occipital lobe of alcohol dependents.

A significant increase in Cho/Cr ratio (p <>

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Request Reprint E-Mail: skhushu@yahoo.com

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Brief Intervention conference presentations available

A large collection of presentations covering the most up to date international research, learning and developments in the in field of brief interventions for alcohol are now available . . . . .

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Patterns of alcohol consumption in diverse rural adults populations in the Asian region

Alcohol abuse, together with tobacco use, is a major determinant of health and social well-being, and is one of the most important of 26 risk factors comparatively assessed in low and middle income countries, surpassed only by high blood pressure and tobacco.

The alcohol consumption patterns and the associations between consumption of alcohol and socio-demographic and cultural factors have been investigated in nine rural Health and Demographic Surveillance System (HDSS) located in five Asian countries.

Alcohol was rarely consumed in five of the HDSS (four in Bangladesh, and one in Indonesia). In the two HDSS in Vietnam (Chililab, Filabavi) and one in Thailand (Kanchanaburi), alcohol consumption was common in men. The mean number of drinks per day during the last seven days, and prevalence of at-risk drinker were found to be highest in Filabavi. The prevalence of female alcohol consumption was much smaller in comparison with men. In Chililab, people who did not go to school or did not complete primary education were more likely to drink in comparison to people who graduated from high school or university.

Although uncommon in some countries because of religious and cultural practices, alcohol consumption patterns in some sites were cause for concern. In addition, qualitative studies may be necessary to understand the factors influencing alcohol consumption levels between the two sites in Vietnam and the site in Thailand in order to design appropriate interventions.

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A new definition of early age at onset in alcohol dependence

The accurate cut-off of an early onset of alcohol dependence is unknown. The objectives of this analysis are (1) to confirm that ages at onset variability in alcohol dependence is best described as a two subgroups entity, (2) to define the most appropriate cut-off, and (3) to test the relevancy of such distinction.

The best-fit model distinguished two subgroups of age at onset of alcohol dependence, with a cut-off point at 22 years. Subjects with an earlier onset of alcohol dependence (≤22 years old) reported higher lifetime rates of specific phobia, antisocial behaviors and nearly all addictive disorders.

The early onset of alcohol dependence is best defined as beginning before the age of 22 years.

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Request Reprint E-Mail: yann.lestrat@inserm.fr

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Empirically defined subtypes of alcohol dependence in an Irish family sample

Alcohol dependence (AD) is clinically and etiologically heterogeneous. The goal of this study was to explore AD subtypes among a sample of 1221 participants in the Irish Affected Sib Pair Study of Alcohol Dependence, all of whom met DSM-IV criteria for AD.

Variables used to identify the subtypes included major depressive disorder, antisocial personality disorder, illicit drug dependence (cannabis, sedatives, stimulants, cocaine, opioids, and hallucinogens), nicotine dependence, the personality traits of neuroticism and novelty seeking, and early alcohol use.

Using latent class analysis, a 3-class solution was identified as the most parsimonious description of the data. Individuals in a Mild class were least likely to have comorbid psychopathology, whereas a severe class had highest probabilities of all comorbid psychopathology. The third class was characterized by high probabilities of major depression and higher neuroticism scores, but lower likelihood of other comorbid disorders than seen in the severe class.

Overall, sibling pair resemblance for class was stronger within than between classes, and was greatest for siblings within the severe class, suggesting a stronger familial etiology for this class.

These findings are consistent with the affective regulation and behavioral disinhibition subtypes of alcoholism, and are in line with prior work suggesting familial influences on subtype etiology.

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Request Reprint E-Mail: cprescot@usc.edu

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Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings

The Australian Government Department of Health and Ageing funded the National Drug and Alcohol Research Centre (NDARC) to develop guidelines on the management of co-occurring mental health conditions in alcohol and other drug (AOD) treatment settings. The Guidelines are based on the best available evidence and draw upon the experience and knowledge of clinicians, researchers, consumers and carers.

The Guidelines aim to:

• Increase AOD workers’ knowledge and awareness of mental health conditions.
• Improve the confidence and skills of AOD workers working with clients with comorbid mental health conditions.
• Provide guiding principles for working with clients with comorbid mental health conditions.
• Improve AOD workers’ ability to identify mental health conditions.
• Provide practical information on the management of comorbid mental health conditions.
• Provide information regarding the treatment of comorbid mental health conditions.
• Provide information regarding referral processes.
• Provide resources that may be used to facilitate all of the above.

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News Release - Price hikes unlikely to reduce alcohol consumption

The urgent need to tackle Britain’s drink-fuelled violence and health problems has led to calls for a minimum retail price for alcohol. But rather than reduce consumption of alcohol, new research shows that if the price of alcohol was significantly increased in supermarkets, only 21% (just over 1 in 5) of adult British drinkers said they would buy less alcohol and spend the same amount as they do now.

The research is published today in the Wilson Drinks Report, a new research based report on industry trends and changing consumer attitudes relating to the sale and consumption of alcohol in the UK.

Although gaining support, minimum pricing may do little to cut consumption. Over half (52%) of adult drinkers said they would either spend more on the same amount of drink or look for cheaper alternatives, including switching to cheaper brands and drinks. . . . . .

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Does Bingeing Affect Earnings?

While excessive drinking is associated with lower earnings through adverse health effects, absenteeism and low productivity, moderate acohol consumption has been argued to generate positive wage effects. These positive wage premiums are usually expected to arise from the social effect of drinking and the beneficial health consequences of drinking in moderation.

Using unit-record data from the Australian National Drug Strategy Household Survey, this paper examines the impact of drinking patterns on individuals’ earnings, controlling for selectivity bias driven by the endogenous relationship between drinking and earnings.

In particular, a Multinomial Logit Selectivity model is estimated for four drinking statuses.

This study shows that frequent bingeing is associated with reduced earnings whilst non bingers and occasional bingers earn a positive premium over abstainers.

Further, a decomposition of the earnings differentials indicates that, across various occupations, abstainers are at least as, if not more, ‘productive’ than drinkers and frequent bingers are less ‘productive’ than non bingers and occasional bingers.

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Reforming Taxes and Improving Health: A Revenue-Neutral Tax

The aim of this paper is to analyse a tax reform consisting of an increment of the indirect taxes on alcohol and tobacco to finance the elimination of VAT on health and pharmaceutical services.

We first estimate an Almost Ideal Demand System for the purpose of evaluating expenditure and price elasticities. We then micro-simulate the abolition of VAT on health services combined with a increment on alcohol and tobacco excise duties, so that total revenue remains unchanged.

This reform would generate small private and social welfare gains complemented with externalities derived from the tobacco and alcohol demand cut.

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Alcohol abuse and dependence symptoms: A multidimensional model of common and specific etiology

This study tested a theoretical model hypothesizing differential pathways from 5 predictors to alcohol abuse and dependence symptoms.

Social norms, perceived utility of alcohol use, and family history of alcohol problems were indirectly associated with Time 2 abuse and dependence symptoms through influencing level of alcohol consumption.

Poor behavioral control had a direct effect on alcohol abuse but not on dependence symptoms at Time 2, whereas affective lability exhibited a direct prospective effect on alcohol dependence but not on abuse symptoms.

A multigroup analysis showed that high levels of poor control increased the strength of paths from both consumption level and affective lability to abuse symptoms.

Implications for prevention of alcohol problems among college students are discussed.

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Request Reprint E-Mail: jsimons@usd.edu

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Local Routes: Guidance for developing alcohol treatment pathways

This document provides good practice guidance on the development of integrated care pathways for people with alcohol problems – alcohol treatment pathways (ATPs). It is illustrated with a number of examples but is not intended to provide an exhaustive resource of off-the-shelf pathways.

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Neuropeptide Y (NPY) suppresses yohimbine-induced reinstatement of alcohol seeking

Reinstatement of responding to a previously alcohol-associated lever following extinction is an established model of relapse-like behavior and can be triggered by stress exposure. Here, we examined whether neuropeptide Y (NPY), an endogenous anti-stress mediator, blocks reinstatement of alcohol-seeking induced by the pharmacological stressor yohimbine.

The analysis was focused on a network of structures previously implicated in yohimbine-induced reinstatement, comprised of central (CeA) and basolateral (BLA) amygdala and the shell of the nucleus accumbens (Nc AccS). Within this network, both yohimbine and NPY potently induced neuronal activation, and their effects were additive, presumably indicating activation of excitatory and inhibitory neuronal populations, respectively.

These results suggest that NPY selectively suppresses relapse to alcohol seeking induced by stressful events and support the NPY system as an attractive target for the treatment of alcohol addiction.

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Request Reprint E-Mail: markus.heilig@mail.nih.gov
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Pre-announcement: First European Conference on FASD

The aim of this conference is to bring together European researchers, public health workers, and FAS-related NGOs for the first time in order to share knowledge and promote collaborations. Presentations will cover latest developments worldwide, with an emphasis on European experience:

* Latest research on FASD in Europe
* Public health and preventions
* Diagnosis and intervention
* Consequences for justice and politics

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Perceived Need for Treatment for Alcohol Use Disorders: Results From Two National Surveys

Most individuals with alcohol use disorders receive no treatment for their disorder. Past research suggests that a major reason for this is that individuals with alcohol use disorders do not perceive a need for treatment. The research presented here had two objectives. First, to provide updated estimates of the percentage of individuals with alcohol use disorders who perceive a need for treatment, and among those, the percentage who receive any treatment for alcohol use disorders. And second, to investigate the determinants of perceived need for and utilization of treatment for alcohol use disorders.

In both surveys fewer than one in nine individuals with an alcohol use disorder perceived a need for treatment. In predicting perceived need, the explanatory power of diagnostic variables was much greater than that of demographic variables. Among those with perceived need, two out of every three persons reported receiving treatment in the past year.

Our results suggest that failure to perceive need continues to be the major reason that individuals with alcohol use disorders do not receive treatment. On the other hand, among those who perceived a need, a majority received treatment. It is likely that high levels of unmet need for treatment services for alcohol use disorders will persist as long as perceived need is low. Efforts are needed to increase levels of perceived need among those with alcohol use disorders.

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Request Reprint E-Mail: mjedlund@uams.edu
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