What's the damage? Negative health consequences of alcohol misuse in Wales

The results of a survey by Alcohol Concern Cymru show that many people in Wales remain ill-informed about the possible effects of alcohol on their health, and about what is sensible drinking.

Alcohol Concern Cymru commissioned a telephone survey of 1,000 drinkers in Wales. Amongst the main findings were:

Around half of respondents said they did not know the recommended daily maximum number of units of alcohol for a man or a woman

More than half were unable to correctly recall the number of units in either a standard pint of beer/lager or a standard glass of wine

Although 84% knew that liver disease was often directly linked to alcohol, 78% failed to mention the link between alcohol and cancer.

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Transition to Addiction Is Associated with a Persistent Impairment in Synaptic Plasticity

Chronic exposure to drugs of abuse induces countless modifications in brain physiology. However, the neurobiological adaptations specifically associated with the transition to addiction are unknown.

Cocaine self-administration rapidly suppresses long-term depression (LTD), an important form of synaptic plasticity in the nucleus accumbens.

Using a rat model of addiction, we found that animals that progressively develop the behavioral hallmarks of addiction have permanently impaired LTD, whereas LTD is progressively recovered in nonaddicted rats maintaining a controlled drug intake.

By making drug seeking consistently resistant to modulation by environmental contingencies and consequently more and more inflexible, a persistently impaired LTD could mediate the transition to addiction.


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Request Reprint E-Mail: olivier.manzoni@inserm.fr


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The language of motivational interviewing and feedback: Counselor language, client language, and client drinking outcomes.

Previous research has suggested that motivational interviewing (MI) may affect client language, which in turn predicts client drinking outcome.

In this study, we examined the relationship between counselor language and client language, personalized feedback and client language, and client language and client drinking outcome, in a sample of heavy-drinking college students.

MI was delivered in a single session with or without a personalized feedback report (MI with feedback [MIF]; MI only). Sessions were coded using the Motivational Interviewing Skill Code 2.1. A composite drinking outcome score was used, consisting of drinks per week, peak blood alcohol concentration, and protective drinking strategies.

We found three main results. First, in the MIF group, MI consistent counselor language was positively associated with client change talk. Second, after receiving feedback, MIF clients showed lower levels of sustain talk, relative to MI only clients. Finally, in the MIF group, clients with greater change talk showed improved drinking outcomes at 3 months, while clients with greater sustain talk showed poorer drinking outcomes.

These results highlight the relationship between counselor MI skill and client change talk, and suggest an important role for feedback in the change process.


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Request Reprint E-Mail: scott.walters@utsouthwestern.edu


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Longitudinal validation of the acquired preparedness model of drinking risk.

This paper reports on the first longitudinal test of the Acquired Preparedness (AP) model of alcoholism risk, which holds that individual differences in key personality traits influence drinking behavior by influencing alcohol-related learning (Smith and Anderson, 2001).

We studied 418 individuals making the transition to the independence of college across 3 longitudinal waves.

Each of 2 longitudinal models predicting typical drinking quantity provided support for the AP process.

In the first, drinking quantity at the end of the first year of college was predicted by positive urgency (the tendency to act rashly when experiencing extremely positive affect) at the start of college, and that predictive relationship appeared to have been mediated by expectancies that alcohol provides positive, arousing effects.

In the second, drinking quantity was predicted by negative urgency (the tendency to act rashly when experiencing extremely negative affect) at the start of college, and that relationship appeared to have been mediated by the motive to drink alcohol to cope with subjective distress.


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Request Reprint E-Mail: regan.settles@uky.edu


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Examining the associations among severity of injunctive drinking norms, alcohol consumption, and alcohol-related negative consequences: The moderating

This study examined a range of injunctive norms for alcohol use and related consequences from less severe behaviors (e.g., drinking with friends) to more severe behaviors (e.g., drinking enough alcohol to pass out), and their relationship with alcohol consumption and alcohol-related negative consequences among college students. In addition, this research aimed to determine whether these relationships between injunctive norms and consequences were moderated by alcohol consumption and level of identification with the typical same-gender college student.

A random sample (N = 1,002) of undergraduates (56.9% women) completed a Web-based survey that was comprised of measures of drinking behavior, perceived approval of drinking behaviors that ranged in severity (i.e., injunctive norms), and level of identification with the typical same-gender college student. Results suggest that the association between negative consequences and injunctive drinking norms depend on one's own drinking behavior, identification with other students, and the severity of the alcohol use and related consequences for which injunctive norms are assessed.

Findings are discussed in terms of false consensus and false uniqueness effects, and deviance regulation perspectives. Implications for preventive interventions are discussed.


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Request Reprint E-Mail: lewisma@u.washington.edu


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Two Sides of the Same Story: Alcohol Use and HIV Risk Taking in South India

This qualitative study examines the role of alcohol in sexual risk among male migrant workers and female sex workers in two South Indian states.

Most men reported using alcohol for increased energy and courage prior to their sexual experiences and to reduce feelings of loneliness and isolation. Sex workers, on the other hand, often stated that they avoided alcohol prior to sex in order to stay alert and reduce the risk of violence. Both groups reported that drinking often increased male aggression and reduced condom use.

Research is needed to examine the prevalence of these patterns as well as factors associated with sexual risk and violence, in order to develop targeted interventions for these groups.

Future risk reduction programs may benefit from addressing safer ways of meeting the needs expressed by the participants. This may include strategies to defuse volatile situations, safe ways of improving the sexual experience, and interventions aimed at alleviating loneliness and isolation for migrants.

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Request Reprint E-Mail: Maria.Ekstrand@ucsf.edu


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Spatial Dimensions of Research on Alcohol and Sexual Risk: A Case Example from a Mumbai Study

Alcohol’s role in unprotected sex is an important issue in the spread of HIV. Research on alcohol use in many countries has found complex relationships between individual characteristics, places where people drink, and consumption patterns.

Data on drinking and leisure time activities and locations from in-person surveys with 1,239 young men aged 18–29 living in low-income communities in Mumbai, India, were analyzed. For every pair of men, an index of association measured the degree of similarity in their reported activities in specific communities.

Multidimensional scaling of the similarity matrix revealed men who engaged in similar activities in the same communities. Hierarchical grouping classified men based on their activity dimensions.

The ten groups of men, distinguished by their activities in particular communities, also differed in alcohol consumption, number of non-spousal sex partners, and level of unprotected sex.

Understanding where activities take place is important in designing venue-based interventions to reduce health risk behaviors leading to the spread of HIV/AIDS.


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Request Reprint E-Mail: ellen.cromley@icrweb.org


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The Use of Qualitative Comparative Analysis for Critical Event Research in Alcohol and HIV in Mumbai, India

In this paper we use Qualitative Comparative Analysis (QCA) in critical event analysis to identify under what conditions alcohol is necessary in contributing to unprotected sex.

The paper is based on a set of in-depth interviews with 84 men aged 18 = 29 from three typical low income communities in Mumbai who reported using alcohol and having sex with at least one nonspousal partner once or more in the 30 days prior to the interview. The interviews included narratives of critical events defined as recent (past 30–60 day) events involving sexual behavior with or without alcohol.

The paper identifies themes related to alcohol, sexuality and condom use, uses QCA to identify and explain configurations leading to protected and unprotected sex, and explains the differences.

The analysis shows that alcohol alone is not sufficient to explain any cases involving unprotected sex but alcohol in combination with partner type and contextual factors does explain unprotected sex for subsets of married and unmarried men.


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Request Reprint E-Mail: Jean.schensul@icrweb.org


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Alcohol segmentation reports

A series of four reports utilising segmentation tools to discuss alcohol have been produced by the Liverpool John Moores University (JMU) Centre for Public Health.

The reports aim to synthesise the different data sources that identify at-risk groups as well as to provide an insight into related motivations and attitudes. . . . . . .

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Addiction Research Centres and the Nurturing of Creativity The National Institute on Alcohol Abuse and Alcoholism

The aim of this paper is to present a concise account of the history, mission, structure and some recent achievements of the US National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Created by the US Congress 40 years ago, the NIAAA has evolved from an entity charged mainly with building a national system of alcoholism treatment services to one with responsibility for developing, nurturing and supporting the biomedical and behavioral science foundation necessary to reduce the significant domestic and global public health impact of alcohol use disorders.

The NIAAA is unique in that it functions both as a funding agency, supporting research at universities and other external, or 'extramural' research institutions, and is also a research institution itself, where alcohol research is carried out in-house, or 'intramurally'. Of a $450.2 million 2009 Congressional Appropriation, approximately 90% was devoted toward the former and approximately 10% towards the latter objective.

The current NIAAA Strategic Plan builds on a new organizing principle for long-range research planning, based on a life-span perspective that recognizes that human biology and behavior continue to change throughout life and changes occurring throughout the life-span affect individuals' drinking patterns as well as the decisions they may make to change their drinking habits or to seek help for alcohol use problems.

Within this framework, major efforts are currently being devoted to educating practitioners on clinically useful, science-based assessment and treatment methods that exist today, and development of personalized new treatments for tomorrow.


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Request Reprint E-Mail: mheilig@mail.nih.gov


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5-HTTLPR genotype and associations with intoxication and intention to drive: results from a field study of bar patrons

The serotonin transporter promoter polymorphism (5-HTTLPR) has been linked to a number of human behavioral traits and disorders. The variants of 5-HTTLPR are commonly reported in three forms, L/L, S/L and S/S, with the latter most often associated with emotional distress and/or behavioral dysfunction. Missing from the research literature are investigations that assess event-level associations between 5-HTTLPR genotype and specific incidents of risk behavior in natural drinking settings.

This study reports associations between 5-HTTLPR, alcohol intoxication and intention to drive among young adult patrons exiting on-premise drinking establishments (i.e. bars) at night.

Self-report measures, breath alcohol concentration (BrAC) readings and saliva samples for DNA analysis were collected from 477 bar patrons. Analyses were performed on 225 patrons likely to be near their peak intoxication level for the night.

Results from a linear regression revealed that the 5-HTTLPR genotype was associated with exiting patron BrAC, after adjusting for random and fixed effects of other variables.

An interaction effect involving 5-HTTLPR and bar-sponsored drink specials also had an independent association with BrAC, suggesting that selection of price-discounted alcoholic beverages increased intoxication in patrons with an L allele.

In addition, results from logistic regression indicated that patrons with the S/S genotype were three times more likely to intend to drive a motor vehicle (after drinking on the night of study participation) compared with those with the L/L genotype.

The 5-HTTLPR genotype may play an important role in the etiology of problems associated with on-premise drinking establishments.


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Request Reprint E-Mail: dthombs@phhp.ufl.edu


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Systemic κ-opioid receptor antagonism by nor-binaltorphimine reduces dependence-induced excessive alcohol self-administration in rats

Altered dynorphin opioid peptide systems contribute to increased ethanol self-administration during withdrawal following chronic alcohol exposure.

We previously identified that the κ-opioid receptor antagonist nor-binaltorphimine (nor-BNI) selectively reduced ethanol self-administration in dependent animals.

The purpose of this study was twofold: (1) determine whether peripherally administered nor-BNI could reduce dependence-induced ethanol self-administration and (2) confirm the selective κ-opioid effects of nor-BNI by administering it 24 hours prior to ethanol self-administration sessions occurring during acute withdrawal.

Nor-BNI decreased ethanol self-administration in ethanol-dependent animals, with no effect in nondependent animals.

Thus, the κ-opioid/dynorphin system is a viable pharmacotherapeutic target for the treatment of alcoholism.


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Request Reprint E-Mail: b_walker@wsu.edu

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Glutamatergic regulation of ghrelin-induced activation of the mesolimbic dopamine system

Recently, we demonstrated that the central ghrelin signalling system, involving the ghrelin receptor (GHS-R1A), is important for alcohol reinforcement. Ghrelin targets a key mesolimbic circuit involved in natural as well as drug-induced reinforcement, that includes a dopamine projection from the ventral tegmental area (VTA) to the nucleus accumbens.

The aim of the present study was to determine whether it is possible to suppress ghrelin's effects on this mesolimbic dopaminergic pathway can be suppressed, by interrupting afferent inputs to the VTA dopaminergic cells, as shown previously for cholinergic afferents.

Thus, the effects of pharmacological suppression of glutamatergic, orexin A and opioid neurotransmitter systems on ghrelin-induced activation of the mesolimbic dopamine system were investigated.

We found in the present study that ghrelin-induced locomotor stimulation was attenuated by VTA administration of the N-methyl-D-aspartic acid receptor antagonist (AP5) but not by VTA administration of an orexin A receptor antagonist (SB334867) or by peripheral administration of an opioid receptor antagonist (naltrexone). Intra-VTA administration of AP5 also suppressed the ghrelin-induced dopamine release in the nucleus accumbens.

Finally the effects of peripheral ghrelin on locomotor stimulation and accumbal dopamine release were blocked by intra-VTA administration of a GHS-R1A antagonist (BIM28163), indicating that GHS-R1A signalling within the VTA is required for the ghrelin-induced activation of the mesolimbic dopamine system.

Given the clinical knowledge that hyperghrelinemia is associated with addictive behaviours (such as compulsive overeating and alcohol use disorder) our finding highlights a potential therapeutic strategy involving glutamatergic control of ghrelin action at the level of the mesolimbic dopamine system.


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Request Reprint E-Mail: elisabet.jerlhag@pharm.gu.se


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Prairie voles as a novel model of socially facilitated excessive drinking

Social relationships strongly affect alcohol drinking in humans. Traditional laboratory rodents do not exhibit social affiliations with specific peers, and cannot adequately model how such relationships impact drinking. The prairie vole is a socially monogamous rodent used to study social bonds.

The present study tested the prairie vole as a potential model for the effects of social affiliations on alcohol drinking.

Same-sex adult sibling prairie voles were paired for five days, and then either separated into individual cages, or housed in pairs. Starting at the time of separation, the voles received unlimited access to alcohol in a two-bottle choice test versus water.

Pair-housed siblings exhibited higher preference for alcohol, but not saccharin, than singly housed voles. There was a significant correlation between the amount of alcohol consumed by each member of a pair when they were housed together (r = 0.79), but not when housed apart (r = 0.20).

Following automated analysis of circadian patterns of fluid consumption indicating peak fluid intake before and after the dark phase, a limited access two-hour two-bottle choice procedure was established.

Drinking in this procedure resulted in physiologically relevant blood ethanol concentrations and increased Fos immunoreactivity in perioculomotor urocortin containing neurons (but not in nucleus accumbens or central nucleus of the amygdala).

The high ethanol preference and sensitivity to social manipulation indicate that prairie voles can serve to model social influences on excessive drinking.


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Request Reprint E-Mail: ryabinin@ohsu.edu


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AERC Research Priorities 2010 – 2011

The AERC has identified the following areas of particular current interest, but would also like to receive high quality proposals in other areas of alcohol research. All proposals will be considered on their merits.

Evidence-based alcohol policy

Governments and service local commissioners /planners frequently express support for evidence-based policy to prevent and reduce alcohol-related harm. However, the processes by which scientific evidence and other factors influence the formulation of policy in this field can be opaque. The AERC invites proposals for examining these processes and finding ways in which the role of scientific evidence in policy formulation can be enhanced.

Alcohol and health inequalities

Research has shown that people from lower socio-economic groups are much more likely to suffer alcohol-related harm than those from higher socio-economic groups, although there is no evidence of a difference in consumption between these groups. The AERC invites proposals that seek to clarify and explain this apparent paradox. These could include reviews, surveys or any other relevant form of research.

Mobilising community resources

The mobilisation of community resources to prevent the development of excessive drinking or facilitate long-term recovery from alcohol dependence is frequently cited as having great potential to reduce alcohol-related harm. Unfortunately, there has been little research on this potential in the UK. The AERC invites proposals for research which examines the role of voluntary and community groups in reducing alcohol-related harm. This includes but is not limited to studies of the role and effectiveness of mutual help groups such as Alcoholics Anonymous, SMART Recovery and Moderation Management.

Read more about how to apply for an AERC grant


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Self-reported drunkenness among adolescents in four sub-Saharan African countries: associations with adverse childhood experiences

Consumption of alcohol is associated with acute and chronic adverse health outcomes. There is a paucity of studies that explore the determinants of alcohol use among adolescents in sub-Saharan Africa and, in particular, that examine the effects of adverse childhood experiences on alcohol use.

The paper draws on nationally-representative data from 9,819 adolescents aged 12-19 years from Burkina Faso, Ghana, Malawi, and Uganda. Logistic regression models were employed to identify correlates of self-reported past-year drunkenness. Exposure to four adverse childhood experiences comprised the primary independent variables: living in a food-insecure household, living with a problem drinker, having been physically abused, and having been coerced into having sex. We controlled for age, religiosity, current schooling status, the household head's sex, living arrangements, place of residence, marital status, and country of survey. All analyses were conducted separately for males and females.

Overall, 9% of adolescents reported that they had been drunk in the 12 months preceding the survey. At the bivariate level, all independent variables (except for coerced sex among males) were associated with the outcome variable. In general, respondents who had experienced an adverse event during childhood were more likely to report drunkenness. In the multivariate analysis, only two adverse childhood events emerged as significant predictors of self-reported past-year drunkenness among males: living in a household with a problem drinker before age 10, and being physically abused before age 10. For females, exposure to family-alcoholism, experience of physical abuse, and coerced sex increased the likelihood of reporting drunkenness in the last 12 months. The association between adverse events and reported drunkenness was more pronounced for females. For both males and females there was a graded relationship between the number of adverse events experienced and the proportion reporting drunkenness.

We find an association between experience of adverse childhood events and drunkenness among adolescents in four sub-Saharan African countries. The complex impacts of adverse childhood experiences on young people's development and behavior may have an important bearing on the effectiveness of interventions geared at reducing alcohol dependence among the youth.

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Culture Alcohol and Society Quarterly: Newsletter of Kirk/CAAS Collections at Brown

This newsletter is an outgrowth of a meeting held at Brown in 2002, for participants in the Kirk Collection Works-in- Progress Conference. The researchers were from the fields of literature, history, anthropology, social work, philosophy and editing, all dealing with the broad subject of alcoholism, and using the Brown Alcoholism and Addicition Studies Collections.

The goals of the newsletter are to continue to carry out the interdisciplinary interactions that grow out of the meeting, to provide a tool for reasearchers to inform and receive feedback from their colleagues about their research, and for the university to promote the Alcoholism and Addiction Studies Collections.

April - June 2009 (vol.4, no.3) (PDF)


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Should symptom frequency be factored into scalar measures of alcohol use disorder severity?

To evaluate whether weighting counts of alcohol use disorder (AUD) criteria or symptoms by their frequency of occurrence improves their association with correlates of AUD.

Design and participants Data were collected in personal interviews with a representative sample of US adults interviewed in 1991–92. Analyses were conducted among past-year drinkers (12+ drinks, n = 18 352) and individuals with past-year DSM-IV AUD (n = 2770).

Thirty-one symptom item indicators, whose frequency of occurrence was measured in eight categories, were used to create unweighted and frequency-weighted counts of DSM-IV past-year AUD symptoms and criteria. Correlates included density of familial alcoholism and past-year volume of ethanol intake, frequency of intoxication and utilization of alcohol treatment.

Although the AUD correlates were associated strongly and positively with the frequency of AUD symptom occurrence, weighting for symptom frequency did not strengthen their association consistently with AUD severity scores. Improved performance of the weighted scores was observed primarily among AUD correlates linked closely with the frequency of heavy drinking and among individuals with AUD. Criterion counts were correlated nearly as strongly as symptom counts with the AUD correlates.

Frequency weighting may add somewhat to the validity of AUD severity measures, especially those that are intended for use among individuals with AUD, e.g. in clinical settings. For studying the etiology and course of AUD in the general population, an equally effective and less time-consuming alternative to obtaining symptom frequency may be the use of unweighted criterion counts accompanied by independent measures of frequency of heavy drinking.

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Request Reprint E-Mail: ddawson@mail.nih.gov

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S.F. eyes alcohol tax to recover health costs

San Francisco would be the first local government in the state to impose a booze fee intended to recover health care costs associated with alcohol abuse now covered by taxpayers.

The fee, expected to generate more than $15 million a year, would cover such expenses as ambulance transport to the emergency room for public inebriates, unreimbursed hospital and clinic services for alcohol-related accidents and diseases, and Department of Public Health-funded programs aimed at preventing and treating alcoholism.> > > > Read More

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Substance Abuse Treatment Programs for Gays and Lesbians

The extent of substance abuse disorders among the lesbian, gay, bisexual, and transgender (LGBT) population is not well known, although a variety of research studies suggest that the rates may be 20 to 30 percent—rates which are higher than in the general population. Further, the clinical issues associated with LGBT clients may vary substantially within this population and in comparison with other clients.

The National Survey of Substance Abuse Treatment Services (N-SSATS) provides information on the extent to which special programs for LGBT clients are available through the Nation’s treatment network. Two characteristics of facilities—type of ownership and primary focus of the facility—are often associated with the available mix of services. In 2008, 777 of 13,688 (or 6 percent) of surveyed facilities offered these specialized programs


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Evaluation of a Community Approach to Address Substance Abuse in Appalachia

The purpose of this study was to evaluate a conference based program designed to enable 26 Appalachian teams to create intervention plans to address substance abuse in their communities.

In March 2006, 26 Appalachian teams attended a conference to address substance abuse in their region. Teams of four to seven stakeholders generated community plans. The teams were evaluated 8 months later using a framework based on an adaptation of the Health Belief Model. Team leaders participated in structured telephone interviews.

Results of this study found that the most common benefit to promulgating plans was community support. The most indicated barrier was time. The majority of teams believed that their community was susceptible to substance abuse problems. The cues that were most responsible for action were public awareness campaigns that emphasized the problems associated with substance abuse. The common denominator for team success was the ability to recruit key stakeholders and the ability to integrate with other organizations.

The results of this study suggest that substance abuse is a threat to the health of the region. More effort on the part of communities will be needed to solve this problem. It will not be solved by a single agency, philosophy or program strategy, but must include multiple stakeholder participation.


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Request Reprint E-Mail: dunn@etsu.edu



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15th Annual Mark Keller Lecture - October 26, 2010

Event:	15th Annual Mark Keller Lecture on "Alcohol and the Brain: From Molecules to Humans"
Location:	Lipsett Amphitheater NIH Clinical Center (Bldg. 10) Bethesda, MD
Start Date:	10/26/2010 1:30 PM
End Date:	10/26/2010 3:30 PM
Event Details:	Presented by: R. Adron Harris, Ph.D. Waggoner Center for Alcohol and Addiction Research University of Texas at Austin

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Guide to Mutual Aid Resources

Welcome to Faces & Voices Guide to Mutual Aid Resources. Find out about the growing number and scope of volunteer recovery mutual aid groups. This one-stop resource is for people in or seeking recovery from addiction, their families and friends and for addiction treatment service providers and other allied service professionals. Numerous research studies have shown that mutual aid groups play a significant role in the process of recovery. Here you can learn about the many varieties of online and in-person mutual aid groups that are helping people find and sustain their recovery from addiction to alcohol and other drugs.

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Drunken deputy incidents on the rise, new Sheriff's Department report finds

As Los Angeles County sheriff’s deputies evacuated residents during last year’s Station fire, a trainee with the department noticed one of her superiors acting strangely. The deputy was stumbling, then he fell over.

He later admitted he was drinking vodka concealed in a Gatorade bottle during the deadly blaze. That incident and others are detailed in an oversight report released Tuesday that highlights the department's struggles with employees who drink on the job or whose drunkenness results in problems off the job.

Alcohol-related incidents involving department employees have increased this year, according to findings released by the Office of Independent Review. There were 33 incidents since January, more than all of last year, including several cases in which deputies were found drunk on duty.

Sheriff Lee Baca acknowledged Tuesday that the report shows the ineffectiveness of recent department efforts to crack down on drinking. In 2008, Baca announced plans to bar deputies from carrying firearms while intoxicated. . . . .

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Puberty-Dependent Sleep Regulation and Alcohol Use in Early Adolescents

Research has shown a bi-directional relation between alcohol use and sleep regulation in adults. Much less is known about this association in early adolescents, while profound puberty-dependent transitions regarding sleep patterns take place in early adolescence. Moreover, puberty has been associated with an increase in alcohol use of adolescents.

In this study, we investigated the associations between pubertal development, sleep preference, sleep problems, and alcohol use in 431 early adolescents (mean age: 13.66). Second, it was studied whether the associations changed when controlling for adolescent internalizing and externalizing problems. Furthermore, we included gender as a moderator on all the associations.

Results showed that pubertal development was positively associated with sleep problems and more evening-type tendencies (e.g., favoring later bedtimes), which in turn were positively related to alcohol use. Underlying psychopathology, gender and educational level did not change these relationships.

From this study, it can be concluded that both puberty and sleep regulation are important factors in explaining alcohol use in early adolescence.

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Request Reprint E-Mail: S.Pieters@pwo.ru.nl

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The Moderating Effect of Religiosity on the Genetic Variance of Problem Alcohol Use

Previous studies have demonstrated that the heritability of alcohol-related phenotypes depends upon the social background in which it is measured (e.g., urbanicity, marital status, and religiosity). The aim of the current study was to identify whether religiosity moderated the genetic variance of problem alcohol use in men and women at two time points: adolescence and early adulthood.

Participants were 312 male MZ pairs, 379 female MZ pairs, 231 male DZ pairs, 235 female DZ pairs, and 275 opposite sex DZ pairs participating in the University of Colorado Center on Antisocial Drug Dependence. Religiosity was measured using the Value on Religion Scale (Jessor and Jessor, 1977), and problem alcohol use was measured using the Composite International Diagnostic Interview–Substance Abuse Module (Cottler et al., 1989). Data were analyzed using a model-fitting approach to the twin data.

In adolescence, genetic variance of problem alcohol use decreased significantly with increasing levels of religiosity in both men and women, whereas in early adulthood, religiosity did not moderate the genetic variance of problem alcohol use in either men or women.

Religiosity appears to moderate the genetic effects on problem alcohol use during adolescence, but not during early adulthood. The reduced genetic variance for problem alcohol use in adolescence may be the consequence of greater social control in adolescence than in young adulthood.

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Request Reprint E-Mail tanya.button@colorado.edu

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Toward a Neurobehavioral Profile of Fetal Alcohol Spectrum Disorders

A primary goal of recent research is the development of neurobehavioral profiles that specifically define fetal alcohol spectrum disorders (FASD), which may assist differential diagnosis or improve treatment. In the current study, we define a preliminary profile using neuropsychological data from a multisite study.

Data were collected using a broad neurobehavioral protocol from 2 sites of a multisite study of FASD. Subjects were children with heavy prenatal alcohol exposure and unexposed controls. The alcohol-exposed group included children with and without fetal alcohol syndrome (FAS). From 547 neuropsychological variables, 22 variables were selected for analysis based on their ability to distinguish children with heavy prenatal alcohol exposure from nonexposed controls. These data were analyzed using latent profile analysis (LPA).

The results indicated that a 2-class model best fit the data. The resulting profile was successful at distinguishing subjects with FAS from nonexposed controls without FAS with 92% overall accuracy; 87.8% of FAS cases and 95.7% of controls were correctly classified. The same analysis was repeated with children with heavy prenatal alcohol exposure but without FAS and nonexposed controls with similar results. The overall accuracy was 84.7%; 68.4% of alcohol-exposed cases and 95% of controls were correctly classified. In both analyses, the profile based on neuropsychological variables was more successful at distinguishing the groups than was IQ alone.

We used data from 2 sites of a multisite study and a broad neuropsychological test battery to determine a profile that could be used to accurately identify children affected by prenatal alcohol exposure. Results indicated that measures of executive function and spatial processing are especially sensitive to prenatal alcohol exposure.

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Request Reprint E-Mail: smattson@sunstroke.sdsu.edu

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Environmental Modulation of Alcohol Intake in Hamsters: Effects of Wheel Running and Constant Light Exposure

Alcohol abuse leads to marked disruptions of circadian rhythms, and these disturbances in themselves can increase the drive to drink. Circadian clock timing is regulated by light, as well as by nonphotic influences such as food, social interactions, and wheel running. We previously reported that alcohol markedly disrupts photic and nonphotic modes of circadian rhythm regulation in Syrian hamsters. As an extension of this work, we characterize the hedonic interrelationship between wheel running and ethanol (EtOH) intake and the effects of environmental circadian disruption (long-term exposure to constant light [LL]) on the drive to drink.

First, we tested the effect of wheel running on chronic free-choice consumption of a 20% (v/v) EtOH solution and water. Second, the effect of this alcohol drinking on wheel running in alcohol-naive animals was investigated. Third, we assessed the influence of LL, known to suppress locomotor activity and cause circadian rhythm disruption, on EtOH consumption and wheel-running behavior.

Inhibitory effects of wheel running on EtOH intake and vice versa were observed. Exposure to LL, while not affecting EtOH intake, induced rhythm splitting in 75% of the animals. Notably, the splitting phenotype was associated with lower levels of EtOH consumption and preference prior to, and throughout, the period of LL exposure.

These results are evidence that exercise may offer an efficacious clinical approach to reducing EtOH intake. Also, predisposition for light-induced (or other) forms of circadian disruption may modulate the drive to drink.

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Request Reprint E-Mail: jglass@kent.edu


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Addictions 2010 The New Frontier in Addiction Treatment: Evidence-Based Policy and Practice

October 28-31, 2010, Sheraton National, Arlington, VA, USA

Experts agree that the current systems for the treatment of addictions are inadequate in terms of policy, structure, methodology, and treatment efficacy. Only a small minority of addicted individuals receive the evidence-based treatment they need. This conference brings together policy makers, administrators, clinicians and researchers who will outline a new frontier in addiction services and discuss ways to adopt and implement a more expeditious, user-friendly, cost effective and evidence-based system. Speakers will be urged to brainstorm new ideas and think outside the box.

Themes and Topics

• Overcoming practical barriers to changing current treatment systems
• Pathways to innovations in addiction practice
• Translating addiction research into the real world
• Bridging the gap between research and policy
• Encouraging treatment entry
• Making treatments more appealing
• Marketing treatment services
• Redefining treatment outcomes
• Promoting the adoption of evidence-based treatments
• Novel treatment approaches
• Novel treatment venues
• Improving treatment retention
• Treatment accountability
• Facilitating the use of medications in substance abuse treatment

Additional Conference Information


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Gender differences in the relationship of internalizing and externalizing psychopathology to alcohol dependence: Likelihood, expression and course

To determine whether internalizing and externalizing psychopathology were differentially associated with alcohol dependence in men and women.

Four categories of lifetime psychopathology were examined: neither internalizing nor externalizing (NINE), internalizing only (IO), externalizing only (EO) and both internalizing and externalizing (BIE). Multivariate models assessed gender differences in the adjusted associations of these categories with the odds of lifetime alcohol dependence in a representative sample of 43,093 U.S. adults 18 and older and with clinical course and expression in a subsample of 4781 lifetime alcoholics.

The excess odds of lifetime alcohol dependence associated with IO, EO and BIE were significantly greater for women than men, OR = 2.6, 8.8 and 10.7 versus 1.9, 4.0 and 6.5, respectively. Regardless of gender, the ORs were significantly higher for EO than IO and for BIE than EO. Gender differences in the expression and course of alcoholism were most pronounced for the categories of NINE and IO, with men having greater consumption, dependence severity and treatment but less familial alcoholism. Gender variation in the association of psychopathology with the expression and course of alcoholism was most evident in the BIE category, where the associations were stronger for women. Lifetime externalizing psychopathology was associated with an increased likelihood of treatment utilization, especially among women.

Findings highlight the need to increase alcoholism screening, prevention and intervention among women with psychopathology, especially externalizing. The greater numbers of internalizing than externalizing alcoholics emphasize the need to treat symptoms of depression and anxiety in alcohol treatment settings.

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Clinical effectiveness of KSS formula, a traditional folk remedy for alcohol hangover symptoms

A formula (KSS formula) containing the pith of Citrus tangerine Hort. et Tanaka (Kitsuraku), the rhizome of Zingiber officinale (Shokyo), and brown sugar has been traditionally used in China for the treatment of discomfort and cold sensation in the abdomen after ingestion of large amounts of alcohol.

We evaluated the clinical effectiveness of this formula on signs and symptoms of alcohol hangover (AH).

Of the twenty-two symptoms listed, significant decreases in severity scores were shown in nausea, vomiting, and diarrhea when the formula was administered in scheduled prophylactic doses. The score in overall well-being, ranging from 0 to 100 (worst possible condition), was 68.9 ± 16.5 (mean ± SD) in the control group and it decreased to 46.9 ± 27.3 and to 44.4 ± 26.4 in the two groups that included a dosing point prior to alcohol ingestion.

Regardless of dosing schedules, KSS formula did not alter the time required for complete recovery from AH symptoms.

These findings suggest the possibility that KSS formula may become a candidate for AH remedy when administered prophylactica.



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School, college and community-based personal, social, health and economic education focusing on sex and relationships and alcohol education -

NICE public health guidance

The Department of Health (DH) asked the National Institute for Health and Clinical Excellence (NICE) to produce public health guidance on school, college and community-based personal, social, health and economic education, including health literacy, with particular reference to sexual health behaviour and alcohol.


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Preventing Alcohol Use Among Late Adolescent Urban Youth: 6-Year Results From a Computer-Based Intervention

This study was undertaken to evaluate the efficacy of a skills-based CD-ROM intervention, with and without a parent component, to reduce alcohol use among urban youth at 6-year follow-up.

At recruitment, 513 youths with a mean age of 10.8 years were randomly assigned to one of three study arms: youth CD-ROM intervention plus parent component, youth CD-ROM intervention only, or control. All youths completed pretest, posttest, and annual follow-up measures. Youths and parents in their respective arms received the initial intervention program between pretest and posttest measures and received booster interventions between each follow-up measure.

With 80% sample retention at 6-year follow-up, youths in both intervention arms reported less past-month alcohol and cigarette use and fewer instances of heavy drinking and negative alcohol-related consequences. Despite having similar numbers of drinking peers as youths in the control arm, youths in both intervention arms reported greater alcohol-refusal skills. Only past-month cigarette use differed between the two intervention arms, with youths in the intervention-plus-parent-component arm smoking less than youths in the CD-ROM intervention-only arm.

Six years after initial intervention, youths who received a culturally tailored, skills-based prevention program had reduced alcohol use and lower rates of related risky behaviors than youths in the control arm.

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Workplace Substance-Use Norms as Predictors of Employee Substance Use and Impairment: A Survey of U.S. Workers

Although much research has explored the relation of substance-use norms to substance use among college students, much less research has focused on employed adults and the workplace as a social context for social norms regarding substance use.

This study explored the relation of descriptive and injunctive workplace substance-use norms regarding alcohol and illicit drug use to employee substance use. Both alcohol use and illicit drug use were explored, as well as overall and context-specific use and impairment.

Data were collected from a national probability sample of 2,430 employed adults (55% female) using a random-digit-dial telephone survey. Overall employee alcohol and illicit drug use were assessed, as well as use before work, use and impairment during the workday, and use after work.

After controlling for a number of potential covariates, injunctive norms regarding workplace alcohol and illicit drug use predicted substance use and impairment overall and across all contexts of use. Descriptive norms predicted alcohol and illicit drug use before and during work, as well as workplace impairment.

This study shows that both workplace injunctive and descriptive norms are important predictors of substance use in the U.S. workforce. There were two general patterns, however, that were consistent across both alcohol and illicit drug use. Social norms marketing campaigns, therefore, may be a useful way for employers to target employee substance use. The present results also helped to integrate the results of several prior studies that employed narrower samples and measures.


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Spouses of Older Adults With Late-Life Drinking Problems: Health, Family, and Social Functioning

This study focuses on the health, family, and social functioning of spouses of late-life remitted and continuing problem drinkers, and on predictors of spouses' alcohol-related functioning and depressive symptoms.

Three groups of spouses were compared at baseline and a 10-year follow-up: (a) spouses (n = 73) of older adults who had no drinking problems at baseline or follow-up, (b) spouses (n = 25) of older adults who had drinking problems at baseline but not follow-up, and (c) spouses (n = 69) of older adults who had drinking problems at both baseline and follow-up. At each contact point, spouses completed an inventory that assessed their alcohol-related, health, family, and social functioning.

At baseline, compared with spouses of problem-free individuals, spouses of older adults whose drinking problems later remitted reported more alcohol consumption, poorer health, more depressive symptoms, and less involvement in domestic tasks and social and religious activities. At the 10-year follow-up, spouses of remitted problem drinkers were comparable to spouses of problem-free individuals, but spouses of continuing problem drinkers consumed more alcohol, incurred more alcohol-related consequences, and had friends who approved more of drinking.

Overall, spouses whose friends approved more of drinking and whose partners consumed more alcohol and had drinking problems were likely to consume more alcohol and to have drinking problems themselves.

Spouses of older adults whose late-life drinking problems remit can attain normal functioning; however, spouses of older adults with continuing late-life drinking problems experience some ongoing deficits.


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Incidence of Alcoholism in the Revisited Lundby Population, 1947-1997

The Lundby Study is a prospective longitudinal study of an unselected population consisting of 3,563 subjects. The Lundby Study started in 1947, and follow-ups were carried out in 1957, 1972, and in 1997.

In all four surveys, semistructured interviews were performed by psychiatrists. Registers, key informants, and case notes from hospitals and outpatient clinics supplemented the interview data. Best-estimate consensus diagnoses of mental disorders were applied after gathering all available data. In the present study, age- and sex-specific incidences of any alcoholism (alcohol problems and alcohol dependence) were studied for the entire 50-year period. Alcohol dependence was studied for the periods 1947-1972 and 1972-1997. Incidences and cumulative probabilities by age were calculated and compared. Age-standardized incidence rates were also calculated for five 10-year periods for subjects 40 years of age and older.

Incidence rates of alcohol-use disorders show large differences across the life span. The cumulative probability for any alcoholism over the 50-year period was 24.4% for men and 4.0% for women. The incidence of any alcoholism was similar for men in both periods, whereas for women it increased in the period 1972-1997; however, this increase was not significantly on the 5% level.

At least one in four men was found to be at risk of developing alcohol problems or becoming dependent on alcohol during his lifetime in the present study, which is in accordance with other studies. The gender differences in alcohol-use disorders in Sweden may have decreased in later decades


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School-Level Substance Use: Effects on Early Adolescents' Alcohol, Tobacco, and Marijuana Use

School-level use of tobacco and alcohol are related to individual students' use in high school, but few studies have examined the effects of school-level substance use in early adolescence. In addition, little is known about factors modifying individuals' vulnerability to school-level influences.

This study examined school-wide levels of alcohol, cigarette, and marijuana use in relation to early adolescents' substance use and the role of peer deviance and parenting practices as modifiers of school-level effects.

This cross-sectional study included 542 students attending 49 public middle schools in a single metropolitan area. Students reported on their use of alcohol, cigarettes, and marijuana, and friends' deviant behavior in the last 12 months. Parents provided information about parental nurturance and harsh and inconsistent discipline. School-wide levels of substance use were obtained from the Pride Surveys completed by all students in Grades 6-8 at each school. Multilevel logistic regressions modeled individual use as a function of school-level use for each substance. Interactions of friends' deviance and poor parenting with school-level substance use evaluated differential susceptibility.

Among the three substances, only school-level rates of cigarette smoking were associated with individual smoking. The relationships of school-level smoking and alcohol use with individual use were stronger for students whose parents reported poorer parenting practices.

Antismoking programs may need to preferentially target middle schools with high rates of cigarette smoking. Students who receive suboptimal parenting may benefit from increased support to deter them from early initiation of smoking and alcohol use, especially in high-risk schools.


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Reproductive health: Findings from the Australian Longitudinal Study on Women’s Health

This report focuses on the reproductive health of women from the Australian Longitudinal Study of Women’s Health (ALSWH). The report was developed on the basis of discussions between the ALSWH research team and the staff of the Australian Government Department of Health and Ageing and has the broad aim of examining reproductive health among Australian women of child bearing ages.

6.5. Use of tobacco and alcohol during pregnancy

6.5.1. Summary

This section examined the prevalence of tobacco and alcohol consumption among non-pregnant women and before, during and after pregnancy. Of women who were smokers and not pregnant at any survey 30% quit smoking over the ten years from 1996 to 2006. At least half the women who were smokers before pregnancy quit smoking during pregnancy, but 30% or more did not. Of women who were drinking at risky levels (for pregnant women) but were not pregnant at any survey, 40% stopped risky drinking over the ten years from 1996 to 2006. More than half the women who were drinking at risky levels (for pregnant women) before pregnancy stopped drinking at those levels during pregnancy, but 35% or more did not. Women who were younger were more likely to smoke or to consume alcohol at risky levels during pregnancy.

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