Alcohol News - 44/2010

The Copenhagen Post (Denmark) - Boozy Copenhagen
Approximately 800 inflatable bottles were floated out on to Peblinge Lake on Monday to represent the consumption of alcohol by Copenhagen residents.
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Jp.dk (Denmark) - City council: widespread sale of alcohol to underaged
MPs say upholding alcohol purchase laws is seller’s responsibility Although sales of beer, wine and spirits to anyone under 16 is illegal, 84 percent of the city's 15-year-olds have purchased alcohol at least once within the past month.
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Mmegi Online (Norway/Botswana) - Blue Cross calls for more tax on alcohol
An alcohol policy training manager for Blue Cross Norway has called on the government of Botswana to increase taxation in such a way that the alcohol industry covers all the expenditure created by alcohol consumption.
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New York Daily News - Alcohol is more harmful than heroin or crack: study
Alcohol is even worse than heroin and crack on the list of "most harmful" drugs, according to a new study published in the British medical journal, The Lancet.
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Adelaidenow (Australia) – Flawed stats veil alcohol usage
An article published yesterday by the Medical Journal of Australia argues that the Australian Bureau of Statistics has significantly underestimated alcohol consumption for years, a mistake that undermines alcohol policies.
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White Lake Beacon (USA) - ‘Super’ drunk law starts Sunday with enhanced penalties
Starting Sunday, Michigan's new high blood alcohol content (BAC) drunk driving law takes effect, with enhanced penalties for first-time drivers convicted of operating with a BAC of .17 or higher.
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TVNZ – Study shows link between buying and bingeing
A new study has found that people with off-licence liquor outlets near their home are more likely to be binge-drinkers.
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TheMedGuru - Boozers need help to reduce alcohol consumption over time—study
As per a new research study, heavy drinkers may cut down on their alcohol consumption over the period of time, but even then they cannot really bring it down to the level of an average adult drinker.
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Irish Examiner (Ireland) - Drinks industry calls for 20% cut in alcohol excise duty
A package of stimulus measures to stem the tide of shoppers buying alcohol across the border were unveiled today by alcohol manufacturers and sellers.
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BBC News (Wales) - Drinking banning orders to help tackle drink crime
Magistrates in parts of Wales have new powers to ban people convicted of alcohol-related offences from pubs for up to two years.
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Times LIVE (South Africa) - Minister draws the line on alcohol abuse
Health Minister Aaron Motsoaledi wants new laws to regulate South Africa's alcohol industry. Motsoaledi said the plan would be "extensive" and similar to the campaign launched against the tobacco industry which also led to a ban on cigarette advertising.
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Pediatric SuperSite - Drug and alcohol consumption linked to popularity in adolescents
Popular adolescents are more likely to consume larger amounts of alcohol and drugs than their less popular peers, according to study results announced in a press release.
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AllAfrica.com (Kenya) - Cut the Lectures - Alcohol is a Drug - a Ruinous One
Using drugs is dangerous - a social vice that must be stamped out. Experimenters are surveyors and probers, while users are slack-jawed, mouth breathing degenerates.
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The Local.se (Sweden) - Efforts to curb youth drinking 'ineffective'
A new report released on Monday has questioned the efficacy of the Swedish government's investment of about 900 million kronor ($135.81 million) over the last 10 years in reducing youth alcohol consumption.
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Hurriyet Daily News (Turkey) - Turkish tourism industry displeased with tax hike on alcohol
Turkish tourism industry representatives have strongly criticized a recent increase in the private consumption tax, or ÖTV, on alcoholic drinks.
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Independent (UK) - Government urged to tackle 'passive drinking'
The Government must tackle the damaging effects of "passive drinking" and give communities greater influence over licensing laws, campaigners said today.
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The Way (UK) - Alcohol puts a Brit in hospital every 7 minutes
A Briton is admitted to hospital with alcohol-related issues every seven minutes, according to official figures. Data from the NHS Information centre highlights that there has been a 54 per cent rise in the number of alcohol-related hospital visits in the past decade, as binge drinking takes its toll on the UK population.
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Herald Scotland (Scotland) - Scots council is first to call time on new liquor licences
New pubs, clubs or off-sales will be banned from opening across a Scottish local authority area in a highly controversial move designed to tackle the area’s chronic alcohol record.
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AOL Health - Alcohol, Flu May Trigger Strokes
Tossing back a few drinks during a night out with friends. Coming down with a cold or the flu. These might seem like harmless and seemingly unrelated events. But they all have something in common: They could raise your risk of having a stroke -- at least temporarily, a new study examining stroke triggers finds.
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Role for mammalian target of rapamycin complex 1 signaling in neuroadaptations underlying alcohol-related disorders

Alcohol addiction is a chronically relapsing disorder that includes certain maladaptive learning and memory. The serine and threonine kinase complex, mammalian target of rapamycin complex 1 (mTORC1), has been implicated in synaptic plasticity, learning, and memory by controlling protein translation.

Here we show that administration of alcohol and excessive voluntary consumption of alcohol induce the activation of the mTORC1-mediated signaling pathway in the nucleus accumbens (NAc) of rodents.

We further show that the protein expression levels of GluR1 and Homer, two synaptic proteins whose translation has been shown to be modulated by mTORC1, are up-regulated in the NAc of rodents with a history of excessive alcohol consumption. 

In addition, our results document that the Food and Drug Administration-approved inhibitor of mTORC1, rapamycin, decreases expression of alcohol-induced locomotor sensitization and place preference, as well as excessive alcohol intake and seeking in preclinical rodent models of alcohol abuse. 

Together, our results suggest that mTORC1 within the NAc is a contributor to molecular mechanisms underlying alcohol-drinking behaviors.

Furthermore, despite its massive health and socioeconomic impact worldwide, pharmacotherapies for alcohol abuse and addiction remain limited.

Our data therefore put forward the possibility that targeting the mTORC1 signaling cascade is an innovative and valuable strategy for the treatment of alcohol use and abuse disorders. 

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Request Reprint E-Mail:  dron@gallo.ucsf.edu.   

Long-Lasting Adaptations of the NR2B-Containing NMDA Receptors in the Dorsomedial Striatum Play a Crucial Role in Alcohol Consumption and Relapse

A growing number of studies suggest that the development of compulsive drug seeking and taking depends on dorsostriatal mechanisms.

We previously observed that ex vivo acute exposure of the dorsal striatum to, and withdrawal from, alcohol induces long-term facilitation (LTF) of the activity of NR2B-containing NMDA receptors (NR2B-NMDARs) in a mechanism that requires the Src family protein tyrosine kinase (PTK), Fyn (Wang et al., 2007).

In the present study, we first compared alcohol's actions in rat dorsomedial (DMS) and the dorsolateral (DLS) subregions of the striatum, which differ in their anatomical connectivity and function.

We found that alcohol-mediated induction of LTF of NR2B-NMDAR activity is centered in the DMS. 

Next, we tested whether in vivo exposure of rats to alcohol leads to long-term adaptations of the NMDAR system in the DMS. 

We observed that repeated daily administration of alcohol results in a long-lasting increase in the activity of the NR2B-NMDARs in the DMS. The same procedure leads to a prolonged activation of Fyn, increased NR2B phosphorylation, and membrane localization of the subunit. Importantly, similar electrophysiological and biochemical modifications were observed in the DMS of rats that consumed large quantities of alcohol.
 
Finally, we show that inhibition of NR2B-NMDARs or Src family PTKs in the DMS, but not in the DLS, significantly decreases operant self-administration of alcohol and reduces alcohol-priming-induced reinstatement of alcohol seeking. Our results suggest that the upregulation of NR2B-NMDAR activity within the DMS by alcohol contributes to the maladaptive synaptic changes that lead to excessive alcohol intake and relapse.



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Request Reprint E-Mail:  dron@gallo.ucsf.edu  

Per capita alcohol consumption in Australia: will the real trend please step forward?

To estimate the national trend in per capita consumption (PCC) of alcohol for Australians aged 15 years and older for the financial years 1990–91 to 2008–09. 

 

With the use of data obtained from Australian Bureau of Statistics’ catalogues and World Advertising Research Centre reports, three alternative series of annual totals of PCC of alcohol for the past 20 years (1990–91 to 2008–09) were estimated based on different assumptions about the alcohol content of wine. For the “old” series, the alcohol content of wine was assumed to have been stable over time. For the “new” series, the alcohol content of wine was assumed to have increased once in 2004–05 and then to have remained stable to 2008–09. For the “adjusted” series, the alcohol content of wine was assumed to have gradually increased over time, beginning in 1998–99. Linear trend analysis was applied to identify significant trends.

National trend in annual PCC of alcohol 1990–91 to 2008–09.

The new and adjusted series of annual totals of PCC of alcohol showed increasing trends; the old series was stable.

Until recently, official national annual totals of PCC of alcohol were underestimated and led to the mistaken impression that levels of alcohol consumption had been stable since the early 1990s. In fact, Australia’s total PCC has been increasing significantly over time because of a gradual increase in the alcohol content and market share of wine and is now at one of its highest points since 1991–92. 

This new information is consistent with evidence of increasing alcohol-related harm and highlights the need for timely and accurate data on alcohol sales and harms across Australia.

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Drug harms in the UK: a multicriteria decision analysisprint

Proper assessment of the harms caused by the misuse of drugs can inform policy makers in health, policing, and social care. We aimed to apply multicriteria decision analysis (MCDA) modelling to a range of drug harms in the UK.

Members of the Independent Scientific Committee on Drugs, including two invited specialists, met in a 1-day interactive workshop to score 20 drugs on 16 criteria: nine related to the harms that a drug produces in the individual and seven to the harms to others. Drugs were scored out of 100 points, and the criteria were weighted to indicate their relative importance.

MCDA modelling showed that heroin, crack cocaine, and metamfetamine were the most harmful drugs to individuals (part scores 34, 37, and 32, respectively), whereas alcohol, heroin, and crack cocaine were the most harmful to others (46, 21, and 17, respectively). Overall, alcohol was the most harmful drug (overall harm score 72), with heroin (55) and crack cocaine (54) in second and third places.

These findings lend support to previous work assessing drug harms, and show how the improved scoring and weighting approach of MCDA increases the differentiation between the most and least harmful drugs. However, the findings correlate poorly with present UK drug classification, which is not based simply on considerations of harm.

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Request Reprint E-Mail:  d.nutt@imperial.ac.uk  

Alcohol screening and brief intervention in primary care: Absence of evidence for efficacy in people with dependence or very heavy drinking

Although screening and brief intervention (BI) in the primary-care setting reduces unhealthy alcohol use, its efficacy among patients with dependence has not been established. 

This systematic review sought to determine whether evidence exists for BI efficacy among patients with alcohol dependence identified by screening in primary-care settings.

We included randomised controlled trials (RCTs) extracted from eight systematic reviews and electronic database searches published through September 2009. These RCTs compared outcomes among adults with unhealthy alcohol use identified by screening who received BI in a primary-care setting with those who received no intervention.

Sixteen RCTs, including 6839 patients, met the inclusion criteria. Of these, 14 excluded some or all persons with very heavy alcohol use or dependence; one in which 35% of 175 patients had dependence found no difference in an alcohol severity score between groups; and one in which 58% of 24 female patients had dependence showed no efficacy.

Alcohol screening and BI has efficacy in primary care for patients with unhealthy alcohol use, but there is no evidence for efficacy among those with very heavy use or dependence. As alcohol screening identifies both dependent and non-dependent unhealthy use, the absence of evidence for the efficacy of BI among primary-care patients with screening-identified alcohol dependence raises questions regarding the efficiency of screening and BI, particularly in settings where dependence is common. 

The finding also highlights the need to develop new approaches to help such patients, particularly if  screening and BI are to be disseminated widely.


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Request Reprint E-Mail:  rsaitz@bu.edu 

Conducting economic evaluations of screening and brief intervention for hazardous drinking: Methods and evidence to date for informing policy

Many policy review articles have concluded that alcohol screening and brief intervention (SBI) is both cost-effective and cost-beneficial. Yet a recent cost-effectiveness review for the United Kingdom's National Institute for Health and Clinical Excellence suggests that these conclusions may be premature.

This article offers a brief synopsis of the various types of economic analyses that may be applied to SBI, including cost analysis, cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis and other types of economic evaluation. 

A brief overview of methodological issues is provided, and examples from the SBI evaluation literature are provided.

The current evidence base is insufficient to draw firm conclusions about the cost, cost-effectiveness or cost-benefit of SBI and about the impact of SBI on health-care utilisation.

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Request Reprint E-Mail:    cowell@rti.org

Internet-based interventions for problem drinkers: From efficacy trials to implementation

Internet-based interventions (IBIs) for problem drinkers have been in existence for over a decade. In that time, IBIs have increased in sophistication and there is the beginning of a solid research base suggesting their efficacy. A growing number of problem drinkers are using IBIs and attempts have been made to explore how IBIs can be integrated within primary care and other health-care settings. 

This symposium provided an overview of IBIs for problem drinkers and highlighted some of the important issues in their development and implementation.

IBIs appear to be at a ‘cusp’ as technology and intervention practices are merged together in an attempt to provide better health care for problem drinkers. 

The timing of the 2009 International Network on Brief Interventions for Alcohol Problems Conference was ideal for a presentation and discussion of the role that IBIs play now that IBIs have started to shift into the mainstream of services for problem drinkers.

The presentations in this symposium covered the ‘bench to bedside’ aspects of the development and evaluation of IBIs. They included a systematic review of the research to-date in this field, a report on the results from a just completed randomised controlled trial, a report on an effectiveness trial of implementing IBIs in multiple university settings and a consideration of the cost-effectiveness of IBIs.


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Request Reprint E-Mail:    john_cunningham@camh.net 

What process research tells us about brief intervention efficacy

This article explores mechanisms of the efficacy of brief intervention (BI).

We conducted a BI trial at the emergency department of the Lausanne University Hospital, of whom 987 at-risk drinkers were randomised into BI and control groups.

The overall results demonstrated a general decrease in alcohol use with no differences across groups. The intention to change was explored among 367 patients who completed BI. Analyses of 97 consecutive tape-recorded sessions explored patient and counsellor talks during BI, and their relationship to alcohol use outcome.

Evaluation of the articulation between counsellor behaviours and patient language revealed a robust relationship between counsellor motivational interviewing (MI) skills and patient change talk during the intervention.

Further exploration suggested that communication characteristics of patients during BI predicted changes in alcohol consumption 12 months later.
Moreover, despite systematic training, important differences in counsellor performance were highlighted. Counsellors who had superior MI skills achieved better outcomes overall, and maintained efficacy across all levels of patient ability to change, whereas counsellors with inferior MI skills were effective mostly with patients who had higher levels of ability to change.
Finally, the descriptions of change talk trajectories within BI and their association with drinking 12 months later showed that final states differed from initial states, suggesting an impact resulting from the progression of change talk during the course of the intervention.

These findings suggest that BI should focus on the general MI attitude of counsellors who are capable of eliciting beneficial change talk from patients.
 

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Request Reprint E-Mail:    mailto:jean%E2%80%90bernard.daeppen@chuv.ch

Alcohol identification and brief advice in England: A major plank in alcohol harm reduction policy

Screening and brief interventions form a vital plank in England's plans to reduce alcohol-related harm. 

This article clarifies the use of terminology in England to describe various drinking categories and screening and brief interventions. It details efforts to implement these interventions, including recent incentive packages that have been put in place to encourage primary care to implement these interventions.

It describes the Screening and Intervention Programme for Sensible Drinking research program that is underway to clarify tools and methods to introduce and support these interventions.

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Request Reprint E-Mail:    don.lavoie@dh.gsi.gov.uk

Community pharmacy service users' views and perceptions of alcohol screening and brief intervention

Community pharmacists have the potential to deliver alcohol screening and brief interventions (SBI) to pharmacy users. However, little is known if SBI would be utilised and views of people who might use the service. Therefore, the aim was to investigate potential barriers and enablers of pharmacy SBI.

Purposive sampling was used to select four pharmacies within the London borough of Westminster, UK. Semistructured interview schedule recorded participants' views of pharmacy SBI. The Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) was incorporated to record views of high and low-risk drinkers. Categorical data were analysed and content analysis undertaken.

Of the 237 participants (149 female) approached 102 (43%) agreed to be interviewed (63 female). Of these 98 completed AUDIT-C, with 51 (52%) identified as risky drinkers. Risky drinkers were significantly identified among the younger age group (χ² = 11.03, P = 0.004), professional occupations (χ² = 10.41, P = 0.015), with higher qualifications (χ² = 10.46, P = 0.033), were least frequent visitors to a pharmacy (χ² = 11.58, P = 0.021) and more frequently identified in multiple pharmacy establishments than independents (χ² = 8.52, 0.004). Most were willing to discuss drinking (97, 96%) and accept written information (99, 98%). Accessibility and anonymity were reported as positive aspects and concerns were expressed about lack of privacy and time (pharmacist and user).

This study reports the first results of pharmacy users' views on SBI. Regardless of drinking status, most were willing to utilise the service and positive about pharmacists' involvement.

 
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Request Reprint E-Mail:  ranjita.dhital@kcl.ac.uk 

Psychological interventions with families of alcohol misusers: A systematic review

To review the literature on psychological interventions for families affected by alcohol misuse, with a focus on outcomes for family members.

A comprehensive and systematic literature review. A detailed search strategy was developed and implemented with no date, language or time restrictions. Two reviewers screened all identified titles and abstracts, and then independently assessed the eligibility and quality of all potential studies. The studies were analysed according to whether or not the alcohol misuser was involved in the primary intervention under investigation and analysed thematically.

Forty-three publications (34 studies) were included in the review. All were in English, covered the period 1979–2009, were mainly published articles in peer review journals and included 2500–3000 family members. Research with female family members (particularly spouses or partners), and ‘white’ family members dominated. The included studies show how the field has moved from primarily focussing on how family members can engage and support the user through treatment to adopting a wider holistic focus which considers the needs of family members in their own right. Studies in both categories demonstrated positive outcomes for family members across a range of domains.

Adopting a broader review methodology has brought a fuller understanding of a field where few such reviews have been conducted, and offers direction for future research. Further work is needed in terms of broadening the reach of such interventions and embedding them more firmly into routine therapeutic practice.

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LTempleton72@googlemail.com

  

Alcohol Focus Scotland: newsletter feature on minimum price ahead of final Alcohol Bill stage

Alcohol Focus Scotland's latest In Focus Newsletter [pdf] is now available. The edition features an exploration of minimum pricing and surrounding issues as the Alcohol Bill approaches its final stage. The Scottish National Party's attempt to introduce a 45 pence per unit minimum price was blocked by opposition parties at the second stage, despite the offer of a 'sunset clause'   > > > >

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News Release - Study explores genetic influence in depression and addiction

Christchurch researchers are examining the role of genes in two of New Zealand’s most common mental illnesses – depression and alcohol addiction.

The University of Otago,  Christchurch, researchers are running the country’s largest study to date on treating the combination of these two mental illnesses.

They found 58 per cent of participants have immediate relatives (e.g. mother, father, sibling or adult child) with depression and alcohol addiction – pointing to a likely genetic connection.

The two conditions are often treated in isolation, despite tens of thousands of New Zealanders suffering from both illnesses.

This is the first time in New Zealand extensive data on demographics, genetics and reaction to medication is being gathered on people with both these common illnesses.         > > > > 

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Alcohol 'more harmful than heroin or crack'

Alcohol is the most dangerous drug in the UK by a considerable margin, beating heroin and crack cocaine into second and third place, according to an authoritative study published today which will reopen calls for the drugs

classification system to be scrapped and a concerted campaign launched against drink.

Led by the sacked government drugs adviser David Nutt with colleagues from the breakaway Independent Scientific Committee on Drugs, the study says that if drugs were classified on the basis of the harm they do, alcohol would be class A, alongside heroin and crack cocaine.   > > > >


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Two Drinks Max: Lobby power

When alcohol industry reps unleash their charm offensives on the corridors of power there is one office they dodge, that of Progressive leader Jim Anderton. 

"They don't come and see me any more because it's not a pleasant experience for them," says the MP for Wigram, who is outspoken on toughening up controls on the alcohol industry. 

And as the multi-billion-dollar alcohol and hospitality industry - historically renowned for lobbying Parliament and donating cash to political parties - defends its patch in the face of pressure to lower the drink-drive limit, those left to mop up the mess after road accidents involving alcohol wonder just how much weight that lobby carries.       > > > >

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Following Problem Drinkers Over Eleven Years: Understanding Changes in Alcohol Consumption

Much of what we know about the course of alcohol consumption in problem and dependent drinkers comes from studies of in-treatment populations. Less is known about the natural course of alcohol consumption among such drinkers in the general population and what predicts how much they drink. 

This study examined alcohol consumption over the course of 11 years in a randomly selected sample of 672 problem and dependent drinkers from a single, heterogeneous U.S. county.

 Alcohol consumption declined and leveled off over time but did not decrease to the average general U.S. population level. Several indicators of ongoing problems with drinking are associated with high levels of drinking over time: having a heavy-drinking network, receiving suggestions to do something about one's drinking, and going to treatment. 

Factors associated with less drinking include having contact with community agencies and going to Alcoholics Anonymous (AA).

Results suggest that problem and dependent drinkers continue to drink at an elevated level over the course of years. Gatekeepers, family members, and policymakers should encourage and facilitate contact with social service agencies and with AA for problem drinkers.

Suggestions from others to do something about one's drinking and seeking specialty care occur more often in those with more severe problems and do not appear to be linked to less drinking over time.

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Grasping the thistle: The role of alcohol brief interventions in Scottish alcohol policy

Scotland has experienced a substantial rise in alcohol-related harm, which is now one of the biggest public health challenges it faces.
 

Alcohol problems in Scotland are described along with national alcohol policy response in addressing them. The role of a program of Alcohol Brief Interventions is discussed therein.

In Scotland, considerable proportions of the population are drinking hazardously or harmfully, common across different age and socioeconomic groups. Rising consumption has been set in wider environmental changes with alcohol becoming more available and affordable. Scotland has had one of the fastest growing chronic liver disease mortality rates in the world at a time when rates in most of Western Europe are falling. Scotland's alcohol policy has an explicit aim to reduce population consumption and includes legislative measures to tackle price and availability. A national program to deliver Alcohol Brief Interventions for hazardous drinkers is a key plank of this wider strategy. A portfolio of studies will monitor and evaluate national policy and, through contribution analysis, describe the role Alcohol Brief Interventions play in reducing alcohol misuse.
 

Effective alcohol policy recognises that determinants of health not only lie at individual level, but include wider social, environmental and economic factors. Scotland's policy is addressing these determinants with both population-based and population-targeted interventions.

Scotland has a serious problem with alcohol. A comprehensive, evidence-based, resourced alcohol policy is being implemented, which will need continual review to ensure it remains anchored in evidence while maintaining its ambition.


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Request Reprint E-Mail:  lesley.graham@nhs.net 

Breaking new ground in the study and practice of alcohol brief interventions

This article amplifies the decision to subtitle the INEBRIA2009 Conference ‘Breaking New Ground’. 

The effectiveness of screening and brief intervention (SBI) for hazardous and harmful drinking is now well-established for primary health care and is promising for other medical settings. In addition, significant advances in the implementation of SBI are being made in various parts of the world. 

But, because of the need to establish efficacy and effectiveness, and perhaps too because of a preoccupation with meta-analysis of existing research findings, progress in other aspects of the theory and practice of SBI has been slower than ideal. There may also be a risk of complacency in the SBI field of study. 

For these reasons and others, the Conference Organizing Committee decided to focus the conference and invite presentations on a number of specific topics in the field of alcohol SBI and these are listed here followed by a discussion of other areas in which new ground needs to be broken.

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Request Reprint E-Mail:   : nick.heather@unn.ac.uk     

NICE work if you can get it: Development of national guidance incorporating screening and brief intervention to prevent hazardous and harmful drinking in England

This paper describes the development of the first set of national guidance focused on the prevention of alcohol problems in England. 

These guidelines were produced by the National Institute for Health and Clinical Excellence (NICE) working with a multidisciplinary program development group of scientists, practitioners and lay members. In this work, screening and brief alcohol interventions represent a key element of a comprehensive public health strategy to prevent alcohol-related risk and harm across the population.

The first controlled trials of brief alcohol intervention were published in the mid to late 1980's and there are now around 60 published trials in this field. After 25 years of accumulated evidence in this field, brief alcohol interventions have yet to make a significant impact on routine clinical practice. While it is imperative to have good science to make the case for brief intervention delivery, this work is in vain if practitioners are unwilling or unable to use these interventions with their patients. Evidence from the alcohol field and other clinical areas indicates that national prioritisation of brief alcohol intervention activity, by a body, such as NICE, is likely to be a key driver of implementation by practitioners. 

This paper summarises a suite of complementary system-level and practice recommendations, which were published by NICE in June 2010, and considers their likely impact on screening and brief alcohol in England.



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e.f.s.kaner@newcastle.ac.uk

Exploring the emergence of alcohol use disorder symptoms in the two years after onset of drinking: Findings from the National Surveys on Drug Use and Health

This study investigates the occurrence of clinical features of alcohol dependence and socially-maladaptive drinking during the first 24 months after the onset of alcohol use.  

Data for this study are from the nationally representative 2004-2007 National Surveys on Drug Use and Health (NSDUH). 

General population of the US, aged 12 years and older. Participants: Newly-onset alcohol users (NOAUs) were drinkers who started to drink alcohol within 24 months of the NSDUH assessment and consumed alcohol during the last 12 months.  

The NSDUH assessed for clinical features of alcohol dependence and socially-maladaptive drinking, 

consistent with the DSM-IV. 

NOAUs frequently experienced problems relating to self-reported tolerance, spending a lot of time getting over the effects of alcohol, and unsuccessful attempts at cutting down on drinking. The likelihood of experiencing the clinical features steadily increased in the first nine months after use, but appeared to plateau or only gradually increase thereafter. 

Strong evidence emerged that the clinical features measured a single latent dimensional of ‘alcohol use disorder’ (AUD) in this sample. 

The majority of the clinical features were good indicators of the underlying AUD continuum in the two years after first drinking onset. 

There may be a period of time during the second year of alcohol use when level of alcohol use disorder fluctuates rather than increases. Public health and safety efforts designed to target problematic alcohol use in the earliest stages of alcohol involvement could be useful in preventing the escalation of alcohol problems in this group of drinkers.

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Request Reprint E-Mail: o.mcbride@ulster.ac.uk 

Folic Acid and Selenite during Reproduction, Gestation and Lactation Protect against Ethanol Changed Se Bioavailability

Levels of antioxidants such as folic acid and selenium decrease in dams exposed to ethanol during gestation and lactation, affecting their antioxidant status, their reproductive function and consequently the health of their progeny.

We will study whether a Se (0.5 p.p.m.) plus folic acid (8 p.p.m.) supplemented diet administered to ethanol-exposed dams and male rats prevents the effects provoked by ethanol in Se bioavailability and in their glutathione peroxidase (GPx) activity, thus improving the health of their offspring.  

Se levels in tissue were measured by graphite-furnace atomic absorption spectrometry and serum GPx activity by spectrophotometry. 

 

Results show that ethanol decreases Se retention in dams, affecting their tissues’ Se deposits, decreasing serum GPx activity, gestational parameters and the weight of their progeny. 

Se plus folic acid balance Se bioavailability, something that is especially important during gestation and lactation, and as a direct result, the health of their progeny is improved. 

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Request Reprint E-Mail:  olimpia@us.es

Altered fronto-cerebellar connectivity in alcohol-naïve youth with a family history of alcoholism

Fronto-cerebellar connections are thought to be involved in higher-order cognitive functioning. It is suspected that damage to this network may contribute to cognitive deficits in chronic alcoholics. However, it remains to be elucidated if fronto-cerebellar circuitry is altered in high-risk individuals even prior to alcohol use onset. 

The current study used functional connectivity MRI (fcMRI) to examine fronto-cerebellar circuitry in 13 alcohol-naïve, at-risk youth with a family history of alcoholism (FH+) and 14 age-matched controls. 

In addition, we examined how white matter microstructure, as evidenced by fractional anisotropy (FA) related to fcMRI. FH + youth showed significantly reduced functional connectivity between bilateral anterior prefrontal cortices and contralateral cerebellar seed regions compared to controls. 

We found that this reduction in connectivity significantly correlated with reduced FA in the anterior limb of the internal capsule and the superior longitudinal fasciculus. 

Taken together, our findings reflect associated aberrant functional and structural connectivity in substance-naïve FH + adolescents, perhaps suggesting an identifiable neurophenotypic precursor to substance use. 

Given the role of frontal and cerebellar brain regions in subserving executive functioning, the presence of premorbid abnormalities in fronto-cerebellar circuitry may heighten the risk for developing an alcohol use disorder in FH + youth through atypical control processing.


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Request Reprint E-Mail:  nagelb@ohsu.edu 

TYPES OF DRINKERS AND DRINKING SETTINGS: AN APPLICATION OF A MATHEMATICAL MODEL

U.S. college drinking data and a simple population model of alcohol consumption are used to explore the impact of social and contextual parameters on the distribution of light, moderate, and heavy drinkers. Light drinkers become moderate under social influence, moderate drinkers may change environments and become heavy drinkers. 

We estimate the drinking reproduction number, Rd, the average number of individual transitions from light to moderate drinking that result from the introduction of a moderate drinker in a population of light drinkers.  

Ways of assessing and ranking progression of drinking risks and data-driven definitions of high- and low-risk drinking environments are introduced. Uncertainty and sensitivity analyses, via a novel statistical approach, are conducted to assess Rd variability and to analyze the role of context on drinking dynamics.

 Our estimates show Rd well above the critical value of 1. Rd estimates correlate positively with the proportion of time spent by moderate drinkers in high-risk drinking environments. Rd is most sensitive to variations in local social mixing contact rates within low-risk environments. The parameterized model with college data, suggests that high residence times of moderate drinkers in low-risk environments maintain heavy drinking.  

With regard to alcohol consumption in US college students, drinking places, the connectivity (traffic) between drinking venues, and the strength of socialization in local environments are important determinants in transitions between light, moderate and heavy drinking as well as in long-term prediction of the drinking dynamics.


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Request Reprint E-Mail: anujmubayi@yahoo.com 

Alcohol News - 43/2010

 

The Wall Street Journal Blog (EU) - EU Mulls Booze Warning Labels
Brussels is a battlefield of rule-making; there are always a thousand small skirmishes taking place off-camera, many with an impact on your future and the bottom lines of big companies.
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The Forigner (Norway) - Norway’s ‘no-no’ to alcohol ads could be corked
TV channels transmitting from abroad with content aimed at Norwegian viewers are not permitted to advertise alcohol under current Norwegian legislation, but this could contravene European law.
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Helsinkin Sanomat (Finland) - Working group proposes new alcohol restrictions for Helsinki
A working group of the City of Helsinki is proposing radical measures to curtail what it sees as an “alcohol-friendly culture” that permeates in the city. The task force wants to ban alcohol advertising in advertising space that is owned by the city. It also proposes that the city stop serving alcoholic beverages at city events, and take stronger action against drinking among young people.
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New York Times (Iraq) - Drug and Alcohol Abuse Growing in Iraqi Forces
A growing number of Iraqi security force members are becoming dependent on drugs or alcohol, which has led to concerns about a significant addiction problem among the country’s armed services as the insurgency remains a potent force and American troops prepare to depart at the end of next year.
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Morning Advertiser (UK) - Underage drinking costs NHS £19m a year
Underage drinking, fuelled by the "ludicrously cheap price of alcohol" in supermarkets, is costing the National Health Service £19m a year.
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New Zealand Herald (New Zealand) - Cut drink-drive limit: doctor
The Government believes New Zealand drivers aren't ready to moderate their drinking. We know they are. So take responsibility for keeping our roads safe by signing up: Two Drinks Max.
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MSN India - Smart people drink more alcohol, says new study
In the National Child Development Study in the UK and the National Longitudinal Study of Adolescent Health in the US, childhood intelligence was measured before the age of 16.
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ABC Online (Australia) - NSW wants to ban energy drinks on tap
The New South Wales Government says it plans to ban the sale of energy drinks on tap at clubs and pubs.
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Ivanhoe - Heavy Alcohol Use May Cause Change In Teen Cognitive Development
Alcohol, to an adolescent, is usually seen as a rite of passage. Many teenagers view drinking as a gateway into adulthood, or independence.
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Businessweek - Study Confirms It: Booze Impairs Decision-Making
A new study confirms what many people may know first- or secondhand: Too much alcohol slows reaction time and increases errors during decision-making.
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USA Today - Alcohol and caffeine drinks: The next student health problem?
Three beers, a can of Red Bull and a large espresso: no big deal, many college students might say. Three beers, a can of Red Bull and a large espresso times three or four, and they still might tell you they're not intoxicated.
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Medscape - Variants in Region of Ethanol Metabolism Gene Predict Alcoholism Risk
A search for genetic factors that influence individuals' early experience with ethanol has found variants in or near CYP2E1 associated with stronger responses and inebriation after relatively low alcohol intake.
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Arka News Agency (Armenia) - Minister: Armenia conducts serious negotiations with WTO on taxation of alcohol drinks and tobacco
Armenia conducts serious negotiations with WTO on taxation of alcohol drinks and cigarettes, said Armenian Minister of Economy Nerses Yeritzyan during the parliamentary discussions of state budget 2011.
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Crikey (Australia) - Universities: a marketing arm of the alcohol industry?
Public health efforts to reduce the harm caused by risky alcohol consumption should be paying much more attention to university campuses, says public health policy consultant Margo Saunders.
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The Guardian (UK) - Charity calls for ban on alcohol ads on pre-watershed TV and online
Alcohol Concern has called for a ban on TV and internet alcohol ads after conducting research claiming that well over a million under-16-year-olds saw multiple drinks commercials while watching England games during the World Cup.
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FairWarning (USA) - Looser About Drinking and Driving, U.S. Suffers More Alcohol-Related Deaths
Compared to most other countries, the U.S. has a lax standard for determining whether someone behind the wheel is driving drunk. The U.S. is one of only 16 nations with a limit for blood alcohol content of .08.
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The microstructural integrity of the corpus callosum and associated impulsivity in alcohol dependence: A tractography-based segmentation study using diffusion spectrum imaging

Previous post-mortem and structural magnetic resonance imaging (MRI) studies in patients with alcohol dependence have demonstrated abnormalities of brain white matter. 

The present study investigated the microstructural integrity in the corpus callosum and the associations of this integrity with neurobehavioral assessments. 

Twenty-five male cases fulfilling the DSM-IV diagnosis of alcohol dependence and 15 male control subjects were scanned using a 3T MRI system. Callosal fiber tracts were reconstructed by diffusion spectrum imaging tractography and were subdivided into seven functionally distinct segments. The microstructural integrity was quantified in terms of generalized fractional anisotropy (GFA). 

Compared with normal subjects, men with alcohol dependence showed lower GFA values on all segments of the corpus callosum. The segment interconnecting the bilateral orbitofrontal cortices was the most affected. The score on the Barratt Impulsivity Scale showed an inverse relationship with GFA on the callosal fiber tracts connecting the bilateral orbitofrontal cortices. Furthermore, the duration of regular use was negatively associated with GFA on the callosal fiber tracts connecting the bilateral temporal and parietal cortices. 

Our findings suggest that a high self-rated impulsivity level was associated with low anisotropy in white matter of corpus callosum sectors extending to the orbitofrontal cortex.

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Signs of Preclinical Wernicke's Encephalopathy and Thiamine Levels as Predictors of Neuropsychological Deficits in Alcoholism without Korsakoff's Syndrome

The purpose of this study was to determine whether meeting historical criteria for unsuspected Wernicke's encephalopathy (WE), largely under-diagnosed in vivo, explains why some alcoholics have severe neuropsychological deficits, whereas others, with a similar drinking history, exhibit preserved performance.

Demographic, clinical, alcohol related, and neuropsychological measures were collected in 56 abstinent alcoholics and 38 non-alcohol-dependent volunteers. Alcoholics were classified using the clinical criteria established by Caine et al (1997) and validated in their neuropathological study of alcoholic cases.

Our alcoholics who met a single criterion were considered ‘at risk for WE’ and those with two or more criteria with ‘signs of WE’. Whole blood thiamine was also measured in 22 of the comparison group and 28 alcoholics.

Of the alcoholics examined, 27% met no criteria, 57% were at risk for WE, and 16% had signs of WE. Neuropsychological performance of the alcoholic subgroups was graded, with those meeting zero criteria not differing from controls, those meeting one criterion presenting mild-to-moderate deficits on some of the functional domains, and those meeting two or more criteria having the most severe deficits on each of the domains examined. Thiamine levels were selectively related to memory performance in the alcoholics. 

Preclinical signs of WE can be diagnosed in vivo, enabling the identification of ostensibly ‘uncomplicated’ alcoholics who are at risk for neuropsychological complications. 

The graded effects in neuropsychological performance suggest that the presence of signs of WE explains, at least partially, the heterogeneity of alcoholism-related cognitive and motor deficits.

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edie@stanford.edu