IQ in adolescence and later risk of alcohol-related hospital admissions and deaths – 37 year follow-up of Swedish conscripts

To investigate the relationship between intelligence measured at age 18-19 and later alcohol-related hospital admission and mortality among men, while controlling for possible confounders.

Cohort study.

49 321Swedish men who were conscripted for military training in 1969-70 and followed until 2007.

IQ measured at conscription is the exposure, while alcohol-related hospital admission and death are the two outcomes. Adjustments for following variables were made: early life circumstances (childhood socioeconomic position, father's drinking), mental health, social adjustment and behavioural factors measured at age 18 (psychiatric diagnosis, contact with police and child care, low emotional control, daily smoking, risky use of alcohol) and adult social position (attained education, SEP and income at age 40).

IQ had an inverse and graded association with later alcohol-related problems. For alcohol-related hospital admissions the crude hazard ratio (HR) was 1.29 (95% CI = 1.26 – 1.31) and for alcohol-related mortality it was 1.21 (95% CI = 1.17-1.24) for every one point decrease on the nine point IQ scale. Adjustment for risk factors measured at age 18 attenuated the association somewhat for both outcomes. After adjustment for social position as adult, the HR was considerably lower resulting in a HR of 1.06 (95% CI=1.02-1.10) for alcohol-related hospital admissions and 1.01 (95% CI=0.95-1.08) for alcohol-related mortality.

In Swedish men there is an association between IQ in early adulthood and later alcohol-related hospital admission and death. Social position as adult could be an important contributory factor.



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Request Reprint E-Mail: sara.sjolund@ki.se

Working hours and alcohol problems in early adulthood

To examine the associations between working hours and alcohol-related problems during early adulthood.

Longitudinal study of a birth cohort born in Christchurch, New Zealand in 1977 and studied to age 30.

1019 participants with data available for working hours and alcohol-related problems at either age 25 or 30.

Weekly working hours in paid employment; frequent alcohol use; diagnosis of alcohol abuse/dependence; number of symptoms of alcohol abuse/dependence. Associations between working hours and alcohol-related problems were adjusted for covariates including measures of: parental and family background; personality and behaviour; IQ and educational achievement; recent negative life events; recent mental health problems; and current partner and family circumstances.

Longer work hours were significantly associated with more frequent alcohol use (p < .0001), higher rates of alcohol abuse/dependence (p = .0001), and a greater number of alcohol abuse/dependence symptoms (p = .01). These associations were adjusted for a wide range of confounding factors. After adjustment there remained significant (p < .05) associations between working hours and alcohol-related problems, with those working 50 or more hours per week having rates of alcohol-related problems 1.8 to 3.3 times higher than those who were not working. The associations between work hours and alcohol use were similar for males and females.

Longer work hours appear to be associated with higher rates of alcohol-related problems, including more frequent alcohol use, higher rates of alcohol abuse/dependence, and a greater number of alcohol abuse/dependence symptoms. These associations remain even after extensive adjustment for confounding.

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Request Reprint E-Mail: sheree.gibb@otago.ac.nz

News Release - MEAS urges government to address unregulated below-cost selling of alcohol

MEAS URGES GOVERNMENT

• TO ADDRESS UNREGULATED BELOW-COST SALE OF ALCOHOL and
• TO LEAD DEVELOPMENT OF INDUSTRY-WIDE CODE GOVERNING THE MERCHANDISING, SALE AND PROMOTION OF ALCOHOL.

MEAS CEO, Ms. Fionnuala Sheehan, has called on Government to address the unregulated, below-cost sale of alcohol within the off-trade sector and to lead the development of an industry-wide code of practice to regulate the merchandising, promotion and sale of alcohol. A comprehensive, co-regulatory code is required and MEAS would be very willing to assist in the development of such a code.
> > > > Read Full New Release

Intervention against Excessive Alcohol Consumption in Primary Health Care: A Survey of GPs' Attitudes and Practices in England 10 Years On

To ascertain the views of general practitioners (GPs) regarding the prevention and management of alcohol-related problems in practice, together with perceived barriers and incentives for this work; to compare our findings with a comparable survey conducted 10 years earlier. 

In total, 282 (73%) of 419 GPs surveyed in East Midlands, UK, completed a postal questionnaire, measuring practices and attitudes, including the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ)

GPs reported lower levels of post-graduate education or training on alcohol-related issues (<4 h for the majority) than in 1999 but not significantly so (P = 0.031). In the last year, GPs had most commonly requested more than 12 blood tests and managed 1–6 patients for alcohol. Reports of these preventive practices were significantly increased from 1999 (P < 0.001). Most felt that problem or dependent drinkers' alcohol issues could be legitimately (88%, 87%) and adequately (78%, 69%) addressed by GPs. However, they had low levels of motivation (42%, 35%), task-related self-esteem (53%, 49%) and job satisfaction (15%, 12%) for this. Busyness (63%) and lack of training (57%) or contractual incentives (48%) were key barriers. Endorsement for government policies on alcohol was very low.

Among GPs, there still appears to be a gap between actual practice and potential for preventive work relating to alcohol problems; they report little specific training and a lack of support. Translational work on understanding the evidence-base supporting screening and brief intervention could incentivize intervention against excessive drinking and embedding it into everyday primary care practice.


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Request Reprint E-Mail:   g.b.wilson@ncl.ac.uk

Operation Dry Water

Operation Dry Water, June 24-26, 2011, is a national weekend of Boating Under the Influence (BUI) education and enforcement aimed at reducing alcohol and drug-related accidents and fatalities.

Held each year during the weekend before the 4th of July holiday, Operation Dry Water is coordinated by the National Association of State Boating Law Administrators (NASBLA) in partnership with the states, the U.S. Coast Guard and other partner organizations.
Boating Under the Influence (BUI) is dangerous and illegal. BUI is the leading contributing factor in fatal boating accidents. Learn more about the effects of BUI.

If you boat under the influence:

• Your voyage will be terminated
• Your boat may be impounded, and
• You may be arrested.

Penalties can include fine, imprisonment,Impoundment of your boat, loss of boating privileges and even loss of driving privileges.

Global Actions

Welcome to Global Actions, your briefing on our efforts around the world as part of Global Actions on Harmful Drinking (www.global-actions.org). This new feature of Global Actions will keep you updated on what’s going on in our countries of focus.
 
Key Milestones for Global Actions

In Tallinn, Estonia, The International Center for Alcohol Policies (ICAP; www.icap.org) hosted an inaugural seminar on self-regulation of alcohol advertising on June 9. This event, the first of its kind in Estonia, focused on increasing awareness of the role of self-regulation in responsible marketing of beverage alcohol products.

In Colombia, Global Actions participated in The Prevention of Drink Driving Forum on June 8. In the company of guest speakers that included Diageo’s Rafael Pedraza, Colombia Country Coordinator Mario Alberto Lleras presented worldwide drink driving statistics, country problems, and possible solutions.     

On May 18, Mexico hosted an international advertising summit “Responsible advertising; towards best practices.”  Leading advertising institutions such as the World Federation of Advertisers made expositions on best practices for advertising, and addressed concerns, implications, and shared success stories from experts. Groups were organized to discuss self-regulation mechanisms for Mexico.
 
What’s Happening Next

Global Actions’ first capacity-building workshop on drink driving in Nigeria is scheduled for July 18-20 in Abuja. A confirmed guest list includes the Corps Marshall of the Federal Road Safety Corps (FRSC) and the Registrar of the Advertising Practitioners Council of Nigeria (APCON). The capacity-building facilitators will include renowned road safety expert Professor Pieter Venter, ICAP’s Ken Williams, and Global Actions Nigeria Country Manager Lanre Onigbogi.

On June 22 in Colombia, there will be a workshop in Bogotá for the Zonas Seguras (Safe Zones) Project that is being spearheaded by Bavaria-SABMiller, Bogotá’s Mayors Office and Secretary of Government, Mobility, Health and Environment, Bogotá’s Police Force, and the Association of Bars (ASOBARES). On June 23, there will also be a preliminary evaluation on the situation in Medellin. Bavaria-SABMiller, Senior Research Associate of LTG Associates Alberto Bouroncle, and Mario Alberto Lleras will hold discussion with persons involved in organizing the first Zonas Seguras for Medellin. 

In Vietnam, National Traffic Safety Committee (NTSC) and Global Actions are meeting with Global Actions Drink Driving Vietnam Da Nang Project Management Unit and Working Group on June 15-16 to clarify project management mechanism, budget, and proposal. Following this visit, Global Actions in Da Nang will complete the project proposals and submit to the Project Steering Committee for approval.

Cognitive and neurobiological mechanisms of alcohol-related aggression

Add caption

Alcohol-related violence is a serious and common social problem. Moreover, violent behaviour is much more common in alcohol-dependent individuals. 

Animal experiments and human studies have provided insights into the acute effect of alcohol on aggressive behaviour and into common factors underlying acute and chronic alcohol intake and aggression. These studies have shown that environmental factors, such as early-life stress, interact with genetic variations in serotonin-related genes that affect serotonergic and GABAergic neurotransmission. This leads to increased amygdala activity and impaired prefrontal function that, together, predispose to both increased alcohol intake and impulsive aggression. 

In addition, acute and chronic alcohol intake can further impair executive control and thereby facilitate aggressive behaviour.

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Request Reprint E-Mail:   aheinz3@uic.edu 

Alcohol News - 25/2011

YLE News (Finland) - TS: More demand for addiction services among expectant mothers

Expectant mothers using drugs or alcohol are increasingly common in Finland. According to the Turku newspaper Turun Sanomat, hospitals are reporting a rise in the number of expectant mothers in need of specialist treatment to deal with drug or alcohol problems.

Read more

MyHealthNewsDaily (Sweden) - Sobering Study: Most Don't Know What 'Sensible Drinking' Is

A recent study from Sweden showed that between 94 and 97 percent of respondents did not know the line between sensible drinking and heavy drinking that can damage health.

Read more

Views and News from Norway (Norway) - Police: ‘No more beers on the fjord’

Norwegian police are cracking down on pleasure boat skippers who join their passengers in enjoying a beer or a glass of wine on the water. If they’re caught with blood alcohol levels above the legal limit, they’ll lose their boating license for up to two years.

Read more

The Baltic Course (Latvia) - Traffic safety campaign "Steer Sober!" launched in Latvia

Today, the Road Traffic Safety Directorate of Latvia (CSDD), in cooperation with Transport and Interior ministries and the State Police, launched a traffic safety campaign "Steer Sober!", Nozare.lv was informed by CSDD representative Alise Kleinberga.

Read more

Los Angeles Times (USA) - Guns and alcohol: Gun owners drink more and take more risks, study says

Gun owners: Don't shoot me, I'm just the messenger. I must warn you, though, that the findings on gun ownership and risky alcohol behaviors published this week in the British Medical Journal do not paint an altogether flattering picture.

Read more

Herald Sun (Australia) - Clinic to target baby alcohol disorders

AUSTRALIA's first screening and diagnostic service for children with alcohol-related birth defects could be up and running by the end of the year.

Read more

Medical News Today - UK Mass Drinking Child Report Released; US Parents Supervising More

While friends play a critical role in peer drinking habits, family has a strong direct and indirect influence. The parent or guardian has a particularly strong influence on their child's behavior.

Read more

RedOrbit - How Alcohol Damages the Brain

Although alcohol affects many areas in the body, the brain is the primary target. Previously, not much was known about the molecular mechanisms by which alcohol alters brain activity, but now researchers have discovered interaction between alcohol and brain proteins thought to underlie alcohol actions in the brain.

Read more

Sky News (Australia) - Battle To Curb Aborigines' Drink Problem

Australia’s Prime Minister has been urged to raise the minimum price of alcohol to curb addiction among aborigines.

Read more

Vancouver Sun (Canada) - Daily drinking, cannabis use, mental distress up in Ontario: Study

People in Canada's most populous province are drinking alcohol more often and smoking dope in larger proportions — and psychological distress is more widespread there, according to the latest data from a long-running study of Ontario residents.

Read more

Belfast Telegraph (Ireland) - New drivers may face alcohol ban

Newly qualified drivers may be banned from drinking any alcohol before getting behind the wheel in Northern Ireland, the environment minister has said.

Read more

UPI.com - Energy drinks linked to alcohol

Researchers, in a study involving musicians in Buffalo, N.Y., found the music-makers used energy drinks with binge drinking and prescription drug misuse.

Read more

BBC News (Australia) - Call to raise alcohol prices in Australia to tackle addiction

Australia's Prime Minister, Julia Gillard, has been urged to raise the minimum price of alcohol to curb addiction. Cheap alcohol is being blamed for fuelling a crime wave in the Northern Territory town of Alice Springs.

Read more

New Zealand Herald (New Zealand) - Tapu Misa: We need to ask right questions about alcohol

It's a good argument: If our kids are old enough at 18 to vote and be sent to fight wars for us, why shouldn't they be allowed to have a drink at the pub if they want to?

Read more

Moneycontrol.com (India) - Alcohol major cause of liver diseases in young adults

Bollywood actor Imran Khan may be making age an issue of discretion when it comes to drinking but according to medical experts, maximum number of liver damage cases have been found in young adults resulting from excessive liquor consumption.

Read more

Irish Health (Ireland) - 71,000 kids are carers due to alcohol

An estimated 71,000 children in Ireland are taking care of a parent or siblings as a result of parental alcohol problems, Alcohol Action Ireland (AAI) has said.

Read more

Mission Network News (Moldova) - Moldova leads globe for alcohol consumption; churches respond

In February of 2011, the World Health Organization dubbed Moldova the world's leading nation in per-person alcohol consumption.

Read more

Daily Mail (EU) - Men twice as likely as women to die before 65 because of smoking and alcohol abuse

Smoking and drinking too much means men are twice as likely as women to die before the age of 65, a European Union study has revealed.

Read more

HealthCanal.com - Health data can help address alcohol-related harm in youth

Using ambulance, hospital and other routinely collected health data can provide a more comprehensive, dynamic picture of trends in alcohol use among young people, according to a new report involving CAMH collaboration.

Read more

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Do Women Differ from Men on Alcoholics Anonymous Participation and Abstinence? A Multi-Wave Analysis of Treatment Seekers

Given the widespread use of Alcoholics Anonymous (AA) and other similar groups in the United States and the increasing membership of women, this study compares women with men on their meeting attendance and AA-prescribed behaviors, factors associated with that AA participation, and tests how these relate to women’s and men’s abstinence across time.

All consecutive new admissions (age ≥ 18) from county-wide public and private treatment programs representing the larger population of treatment seekers were approached to be in the study at treatment entry. Those consenting at baseline (n = 926) were sought for follow-up interviews 1, 3, 5, and 7 years later. Generalized linear models were used to test whether various help-seeking factors were associated with AA participation differentially by gender and, controlling for AA and other confounders, whether women differ from men on abstinence.

At each follow-up interview, women and men attended AA at similar rates and similarly practiced specific AA behaviors, and they were alike on most factors associated with AA participation and abstention across time including abstinence goal, drink volume, negative consequences, prior treatment, and encouragement to reduce drinking. Relative to men, women with higher drug severity were less likely to participate in AA. Although higher AA participation was a predictor of abstinence for both genders, men were less likely to be abstinent across time. Men were also more likely to reduce their AA participation across time.

These findings add to an emerging literature on how women compare with men on factors related to AA participation and subsequent drinking outcomes across time. Findings have clinical implications for service providers referring clients to such groups.




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Request Reprint E-Mail:  jwitbrodt@arg.org 

Monitoring Alcohol Marketing in Africa

Monitoring Alcohol Marketing in Africa - MAMPA Project is a new report released by the Africa Regional Office of the World Health Organization (WHO). The study on alcohol marketing was commissioned by the WHO Regional Office for Africa in 2010. The background was an intention to support governments decide on what measures to take regarding alcohol advertising. In order to inform such decissions insight into the impact of advertising, specifically in terms of volume, frequency, and content of alcohol advertising and promotion is essential.

The MAMPA project generated data on alcohol advertising and promotion in Uganda, Nigeria, Ghana and Gambia. It concludes that the content of advertisements and marketing styles appeal to young people. The results underline the need for countries to strengthen policy and legislation to restrict alcohol marketing.

Among the reccommendations of the report is for governments to recognize that a comprehensive ban on advertising, promotion and sponsorship would reduce alcohol-related harm, and that selfregulation is an ineffective mechanism to reduce alcohol related harm, effective legislation is necessary to strictly regulate alcohol marketing activities.

> > > >   Read More

Buzz kills

In the United States, the blood-alcohol limit may be 0.08 percent, but no amount of alcohol seems to be safe for driving, according to a University of California, San Diego sociologist. A study led by David Phillips and published in the journal Addiction finds that blood-alcohol levels well below the U.S. legal limit are associated with incapacitating injury and death.

Phillips, with coauthor Kimberly M. Brewer, also of UC San Diego, examined official data from the Fatality Analysis Reporting System (FARS). This dataset includes information on all persons in the U.S. who were involved in fatal car accidents – 1,495,667 people in the years 1994 to 2008. The researchers used FARS because it is nationally comprehensive, covering all U.S. counties, all days of the week and all times of day, and, perhaps most important, reports on blood-alcohol content in increments of 0.01.

All the accidents included in FARS are, by definition, severe. But the authors looked at different levels of accident severity by examining the ratio of severe injuries to minor ones.

"Accidents are 36.6 percent more severe even when alcohol was barely detectable in a driver's blood," Phillips said. Even with a BAC of 0.01, Phillips and Brewer write, there are 4.33 serious injuries for every non-serious injury versus 3.17 for sober drivers. 

There are at least three mechanisms that help to explain this finding, Phillips said: "Compared with sober drivers, buzzed drivers are more likely to speed, more likely to be improperly seat-belted and more likely to drive the striking vehicle, all of which are associated with greater severity.

> > > >    Read More

The relationship between serious injury and blood alcohol concentration (BAC) in fatal motor vehicle accidents: BAC = 0.01% is associated with significantly more dangerous accidents than BAC = 0.00%

To analyze the severity of automotive injuries associated with blood alcohol concentration (BAC) in increments of 0.01%.

Epidemiological study using the Fatality Analysis Reporting System.

All people in US fatal automotive accidents, 1994–2008 (n = 1 495 667).

The ratio of serious: non-serious injuries for drivers, by BAC.

Accident severity increases significantly even when the driver is merely ‘buzzed’, a finding that persists after standardization for various confounding factors. 

Three mechanisms mediate between buzzed driving and high accident severity: compared to sober drivers, buzzed drivers are significantly more likely to speed, to be improperly seatbelted and to drive the striking vehicle. In addition, there is a strong ‘dose–response’ relationship for all three factors in relation to accident severity (e.g. the greater the BAC, the greater the average speed of the driver and the greater the severity of the accident).

The severity of life-threatening motor vehicle accidents increases significantly at blood alcohol concentrations (BACs) far lower 
than the current US limit of 0.08%. 

Lowering the legal limit could save lives, prevent serious injuries and reduce financial and social costs associated with motor vehicle accidents.


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Request Reprint E-Mail:   dphillips@ucsd.edu 

Functional Adaptation of the NMDA receptor to acute ethanol inhibition is modulated by striatal-enriched protein tyrosine phosphatase and p38 mitogenactivated protein kinase

The hippocampal N-methyl-D-aspartate receptor (NMDAR) activity plays important roles in cognition and is a major substrate for ethanol-induced memory dysfunction. This receptor is a glutamate-gated ion channel, which composes of NR1 and NR2 subunits in various brain areas. While homomeric NR1 subunits form an active ion channel that conducts Na⁺ and Ca²⁺ currents, the incorporation of NR2 subunits allows this channel to be modulated by the Src family of kinases, phosphatases, and by simple molecules such as ethanol. Recently, we found that acute ethanol inhibits the NMDAR activity via STriatal Enriched protein tyrosine Phosphatase (STEP)-regulated mechanisms. The genetic deletion of the active form of STEP, STEP61, leads to marked attenuation of acute ethanol inhibition of NMDAR currents. Also, STEP61 negatively regulates Fyn and p38 mitogen-activated protein kinase (p38 MAPK), and these proteins are members of the NMDAR super molecular complex. 

Here, we demonstrate, using whole-cell electrophysiological recording, Western blot analysis and pharmacological manipulations, that neurons exposed to a 3-hour, 45 mM ethanol treatment develop an adaptive attenuation of acute ethanol inhibition on NMDAR currents in brain slices. 

Our results suggest that this adaptation of NMDAR responses is associated with 1) a partial inactivation of STEP61, 2) an activation of p38 MAPK, and 3) a requirement for NR2B activity. 

Together, these data indicate that altered STEP61 and p38 MAPK signaling contribute to the modulation of ethanol inhibition of NMDARs in brain neurons. 

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Alcohol Medical Scholars Program—A Mentorship Program for Improving Medical Education Regarding Substance Use Disorders

The Alcohol Medical Scholars Program (AMSP) is designed to improve medical education related to substance use disorders (SUDs) through mentorship of junior, full-time academic faculty from medical schools across the United States. 

Scholarship focuses on literature review and synthesis, lecture development and delivery, increasing SUD education in their medical schools, professional development, and networking. 

Results are reported from an anonymous survey of self-reported changes in educational involvement by 28 of 33 AMSP graduates. 

Participation was associated with a 4-fold increase in yearly SUD lecture time and topics, increased numbers of medical disciplines taught and trained in clinical rotations, design of new SUD-related electives and journal clubs, and membership on medical education committees. Sixty percent of scholars reported promotion since involvement in AMSP, with the majority endorsing the organization's contribution to professional development. 

AMSP is a useful mentorship model for junior faculty and is associated with increasing SUD-related medical education.

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Request Reprint E-Mail:  kneufel2@jhmi.edu  

Substance Use Prevalence and Screening Instrument Comparisons in Urban Primary Care

Substance use screening in a primary care setting compared the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST version 3.0), Two-Item Conjoint Screen (TICS), National Institute on Alcohol Abuse and Alcoholism (NIAAA) daily limit single item, and electronic medical record (EMR). 

Among 236 consecutive adults, ASSIST moderate- to high-risk substance use prevalence was tobacco, 15.3%; alcohol, 8.5%; cannabis, 5.1%; cocaine, 2.5%; and opioids, 2.5%. 

Compared to ASSIST, a positive TICS was 45% (95% confidence interval [CI], 27-64%) sensitive, 99% (95-100%) specific; the NIAAA single-item screen was 80% (56-94%) sensitive, 87% (82-91%) specific. 

The NIAAA single item correlated closely with alcohol ASSIST. TICS and EMR were less sensitive for any nontobacco substance use.

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Request Reprint E-Mail:    joshua.lee@med.nyu.edu 

ALDH2 in alcoholic heart diseases: Molecular mechanism and clinical implications

Alcoholic cardiomyopathy is manifested as cardiac hypertrophy, disrupted contractile function and myofibrillary architecture. An ample amount of clinical and experimental evidence has depicted a pivotal role for alcohol metabolism especially the main alcohol metabolic product acetaldehyde, in the pathogenesis of this myopathic state. 

Findings from our group and others have revealed that the mitochondrial isoform of aldehyde dehydrogenase (ALDH2), which metabolizes acetaldehyde, governs the detoxification of acetaldehyde formed following alcohol consumption and the ultimate elimination of alcohol from the body. The ALDH2 enzymatic cascade may evolve as a unique detoxification mechanism for environmental alcohols and aldehydes to alleviate the undesired cardiac anomalies in ischemia–reperfusion and alcoholism. 

Polymorphic variants of the ALDH2 gene encode enzymes with altered pharmacokinetic properties and a significantly higher prevalence of cardiovascular diseases associated with alcoholism. 

The pathophysiological effects of ALDH2 polymorphism may be mediated by accumulation of acetaldehyde and other reactive aldehydes. 

Inheritance of the inactive ALDH2*2 gene product is associated with a decreased risk of alcoholism but an increased risk of alcoholic complications. This association is influenced by gene–environment interactions such as those associated with religion and national origin. 

The purpose of this review is to recapitulate the pathogenesis of alcoholic cardiomyopathy with a special focus on ALDH2 enzymatic metabolism. It will be important to dissect the links between ALDH2 polymorphism and prevalence of alcoholic cardiomyopathy, in order to determine the mechanisms underlying such associations. The therapeutic value of ALDH2 as both target and tool in the management of alcoholic tissue damage will be discussed.


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Request Reprint E-Mail:   jren@uwyo.edu  

Universal Screening for Alcohol and Drug Use and Racial Disparities in Child Protective Services Reporting

This study examines racial disparities in Child Protective Services (CPS) reporting at delivery in a county with universal screening for alcohol/drug use in prenatal care. 

It also explores two mechanisms through which universal screening could reduce reporting disparities: Equitable Surveillance and Effective Treatment. 

Equitable Surveillance is premised on the assumptions that identification of drug use through screening in prenatal care leads to CPS reporting at delivery and that Black women are screened more than White women, which leads to disproportionate reporting of Black newborns. 

Universal screening would correct this by ensuring that prenatal providers screen and therefore also report White women to CPS, thereby reducing disparities. 

Effective Treatment is premised on the idea that identification of drug use through screening in prenatal care leads women to receive treatment during pregnancy, which thereby reduces CPS reporting at delivery. Universal screening would lead to prenatal providers screening more Black women and thereby to more Black women receiving treatment prenatally. 

The increase in treatment receipt during pregnancy would then decrease the number of Black newborns reported to CPS at delivery, thereby reducing disparities. 

County data were used to compare the racial/ethnic distribution of women and newborns in three points in the system (identification in prenatal care, treatment entry during pregnancy, and reporting to CPS at delivery related to maternal alcohol/drug use) and explore pathways to treatment. 

Despite Black women having alcohol/drug use identified by prenatal care providers at similar rates to White women and entering treatment more than expected, Black newborns were four times more likely than White newborns to be reported to CPS at delivery. 

This contradicts the premise of Effective Treatment. By default, findings were more consistent with Equitable Surveillance than Effective Treatment. Providers and policy makers should not assume that universal screening in prenatal care reduces CPS reporting disparities. 

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Request Reprint E-Mail:   sroberts@arg.org . 

New Fact Sheet: Alcohol marketing regulations in Europe: How effective are they?

De Bruijn and Van den Broeck (2011) have developed a framework to evaluate the effectiveness of existing alcohol marketing regulations and have used this to analyse which European countries have the best and worst regulations.   > > > >    Read Morehttp://www.eucam.info/eucam/home/marketing-products-and-reports.html?bericht2248=1243#p2248

Industry declares war on proposed alcohol advertising ban in Lithuania

In 2008 the Lithuanian Parliament accepted an amendment to the Alcohol Control Law that would install a comprehensive ban on alcohol advertising in the year 2012. Now with only 6 months left the pressure to withdraw the ban is steadily rising. The alcohol industry has stepped up its lobbying activities and politicians are backing out.
> > > >   Read More

Taxing sin and saving lives: Can alcohol taxation reduce female homicides?

With costs exceeding $5.8 billion per year, violence against women has significant ramifications for victims, their families, the health care systems that treat them, and the employers who depend on their labor. 

Prior research has found that alcohol abuse contributes to violence against both men and women, and that stringent alcohol control policies can reduce alcohol consumption and in turn some forms of violence. 

In this paper, we estimate the direct relationship between an important alcohol control measure, excise taxes, and the most extreme form of violence, homicide. 

We use female homicide rates as our measure of severe violence, as this measure is consistently and accurately reported across multiple years. 

Our results provide evidence that increased alcohol taxes reduce alcohol consumption and that reductions in alcohol consumption can reduce femicide. 

Unfortunately, a direct test of the relationship does not have the power to determine whether alcohol taxes effectively reduce female homicide rates. 

We conclude that while alcohol taxes have been shown to effectively reduce other forms of violence against women, policy makers may need alternative policy levers to reduce the most severe form of violence against women.


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Request Reprint E-Mail:  
christine.durrance@unc.edu 

Does religion belong at AA? Fight over 'God' splits Toronto AA groups

It uses “fellowship” to help chronic drinkers quit the bottle. But there is little fellowship in a schism that splintered the Alcoholics Anonymous umbrella group in the GTA this week.

At issue is this question: Do alcoholics need God?

On Tuesday, Toronto’s two secular AA groups, known as Beyond Belief and We Agnostics, were removed or “delisted” from the roster of local meetings. They’ve disappeared from the Toronto AA website and will not be in the next printed edition of the Toronto directory. 

The dispute started when Beyond Belief posted an adapted version of AA’s hallowed “Twelve Steps” on the Toronto website. They removed the word “God” from the steps, which are used as a kind of road map to help drinkers achieve sobriety.  > > > >   Read More

Modeling the Rutgers Alcohol Problem Index (RAPI): A comparison of statistical methods

The Rutgers Alcohol Problem Index (RAPI) is a scale designed to identify alcohol-related problems experienced by adolescents and young adults. RAPI scores tend to be skewed due in part to a substantial proportion of zero scores.
 

In this study, we compared different statistical models for analyzing the RAPI as an outcome measure using data collected as part of an alcohol intervention program for college freshmen. Predictors included intervention group indicators. Model fit, predictive ability and practicality of implementation were compared among competing models and recommendations are made.

Of 558 students who completed the baseline survey (68% response rate), 76% completed a 3-month follow-up survey. Mean RAPI scores were 4.7 (SD = 6.0) at baseline and 4.6 (SD = 5.5) at 3 months. Significance of intervention group differences at 3 months adjusting for baseline RAPI were heavily dependent upon the type of statistical model employed. A zero-inflated (ZI) negative binomial model provided the best model fit.

This study demonstrated that inferences and conclusions about intervention efficacy were method-dependent in analysis of RAPI scores. There was empirical evidence of improved inference when methods accounting for zero-inflation and skewness were employed.

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Request Reprint E-Mail:  llight@wfubmc.edu

Polydrug abuse and personality disorders in a sample of substance-abusing inpatients

In the last two decades, polydrug abuse has gained increasing attention and many studies have reported high prevalence rates of this phenomenon. 

The psychological and demographic correlates and negative associated outcomes of polydrug abuse have also been investigated. 

These findings support the need of an exploration of the relationship between polydrug abuse and comorbid personality pathology. In fact, although the issue of comorbidity between personality disorders (PDs) and substance use has become an established field of study, the association between dual diagnosis and polydrug abuse has received little attention in the literature.

The present study aims to investigate the prevalence of polydrug abuse and personality pathology in a sample of substance-abusing inpatients and to compare polydrug abusers and monodrug abusers in terms of sociodemographic characteristics, medical and case history data, outcome variables, and PDs. 

The files of 117 consecutively admitted inpatients were reviewed, and information on medical history, case history, and personality disorder diagnosis was collected. 

The majority of patients were polydrug abusers (53.8%) and the prevalence rate of PDs was 47.0%. No sociodemographic differences emerged between polydrug and monodrug abusers, whereas polydrug abusers were more likely to have a history of treatment dropout and reported first contact with substances at a lower age. Polydrug abusers were also more prone tohave at least one Axis II diagnosis and had a higher number of personality disorder diagnoses compared with monodrug abusers. 

The high prevalence of polydrug abuse found in this study is in agreement with the literature. 

Polydrug abusers show a more severe profile compared with monodrug abusers, indicating that further studies should be performed in both clinical and research fields.

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Request Reprint E-Mail:   e.preti2@campus.unimib.it