Concurrent drinking and smoking among college students: An event-level analysis.

Cigarette smoking and drinking commonly co-occur among college students, a population that is at high risk for developing alcohol and nicotine use disorders. Several studies have been conducted that have examined predictors of drinking or smoking to gain a better understanding of the antecedents of engaging in these behaviors. Yet, few studies have examined specific factors that influence concurrent smoking and drinking in this population.

The current study used data from a 21-day electronic diary-based study of college students (n = 86) who engaged in concurrent drinking and smoking to examine event-level associations between alcohol use and cigarette smoking in the student's natural environment.

We specifically focused on within-person analyses of contexts in which students reported smoking and drinking simultaneously in comparison to contexts in which students reporting drinking without smoking.

Situational contexts included environmental setting, whether s/he was alone or with others, and changes in stress and urges to smoke before initiating drinking.

Results indicated that students drank more while smoking and smoked three times as many cigarettes, on average, during drinking episodes. Being with others at a party or a bar was associated with increased odds of smoking while drinking. Likewise, increased stress since the prior assessment predicted a greater likelihood of smoking while drinking.

Based on the findings from the present study, it is important for future prevention and intervention efforts to consider social settings and heightened stress among students as potential risk factors for engaging in concurrent drinking and smoking.


Read Full Abstract

Request Reprint E-Mail: katie.witkiewitz@vancouver.wsu.edu

How reliable is depression screening in alcohol and drug users? A validation of brief and ultra-brief questionnaires

Depression is highly comorbid with alcohol and drug problems, resulting in greater impairment, reduced treatment adherence and poor outcomes. Little evidence exists to support the use of mental health screening tools in routine addiction treatment. This study tested the validity and reliability of PHQ-9 and PHQ-2 as depression case finding tools in an outpatient drug treatment sample in the United Kingdom.

A sample of 103 patients took part in diagnostic assessments using CIS-R and completed brief screening questionnaires. A subgroup of 60 patients completed retests after 4weeks. Diagnostic results were compared to brief measures using receiver operating characteristic (ROC) curves. Psychometric properties were also calculated to evaluate the validity and reliability of self-completed questionnaires.

A PHQ-9 score ≥12 had a sensitivity of 81% and specificity of 75% for major depression, also displaying good retest reliability (intra-class correlation, 0.78) and internal consistency (Cronbach's alpha, 0.84). PHQ-2 had 68% sensitivity and 70% specificity, with more modest retest reliability (0.66) and internal consistency (0.64).

Diagnostic interviews did not consider the temporal sequencing of the onset of drug use and mental health problems.

PHQ-9 is a valid and reliable depression screening tool for drug and alcohol users. The brevity and ease of administration of self-completed questionnaires make them useful clinical tools in addiction services commonly encountering a high prevalence of depression.

Read Full Abstract

Request Reprint E-Mail: jaime.delgadillo@nhs.net

Maryland estimates an extra $6M raised in July by alcohol tax increase

Maryland estimates the state raised roughly $6 million in added revenue in July from a 50 percent increase in the state’s sales tax on alcohol.

David Roose, director of the Maryland Bureau of Revenue Estimates, said Monday it’s hard to tell from the first month of a new tax how much will be raised on a yearly basis.

If July turns out to be the average, it would add up to about $72 million in extra state revenue a year. Initial estimates projected the tax would raise roughly $85 million a year. > > > > Read More

Exploring Treatment Options for Alcohol Use Disorders

Treatment techniques and tools to address alcohol use disorders (AUDs)* have multiplied over the last 30 years, moving beyond models based on Alcoholics Anonymous and its offshoot, the Minnesota Model. Care providers now can prescribe medications to aid people as they work to reduce their drinking. If a traditional mutual-help group model of care does not appeal to a patient, he or she has other behavioral therapy options. And Web-based approaches provide access to therapy 24 hours a day, 7 days a week.

Despite these developments, however, the majority of people with alcohol use disorders (AUDs) in the United States go untreated. According to data from NIAAA’s 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), only 14.6 percent of people with alcohol abuse or dependence receive treatment.^1,2 Another survey³ of people who experienced the onset of alcohol dependence a year before the study found that only 25 percent ever received treatment. Though some people with AUDs do actually recover on their own without formal treatment, some achieve partial remission, and some cycle in and out of alcohol problems throughout their lives, novel approaches and further access to treatment could play an important role in helping people to reduce their drinking.²

This picture of a largely untreated population of patients has prompted researchers to explore better ways of engaging people who might not have considered treatment as an option for addressing their problems with alcohol. Improving diagnosis is one area under exploration, including screening for alcohol abuse and alcoholism and providing brief interventions in a variety of settings, such as primary care clinics and emergency departments. Scientists are examining the effectiveness of medications for treating patients and preventing relapse to drinking. Research also suggests that a large proportion of people with co-occurring psychological or medical conditions remain underserved by existing treatment systems; greater coordination of care might improve responses to AUD treatment for this group.

This Alcohol Alert summarizes the state of alcoholism treatment research, explores its use in a variety of settings, and reviews new efforts for engaging people in treatment. Efforts to improve continuing care for those in treatment and to coordinate care for those with co-occurring disorders also are included. The Alert then examines how health services and financing vehicles, such as private and public insurance, influence people’s ability to access and pay for that treatment.

Read Full Alcohol Alert (PDF)

Alcohol and calories: Alcohol Concern briefing links rising obesity to alcohol

A joint BDA (British Dietetic Association) and Alcohol Concern Cymru briefing paper on Alcohol and Calories has been released.

Alcohol Concern say many of us are taking in more calories in the form of food and drink than our bodies can use - and a major part of this is increasing levels of alcohol consumption.

The briefing paper states 'Amongst adults who drink, alcohol accounts for nearly 10% of their calorie intake, yet many people have little idea how many calories they are consuming in the form of alcoholic drinks. A recent Alcohol Concern survey of 1,000 drinkers in Wales, found that 82% of people were unable to correctly identify the number of calories in a standard pint.' > > > > Read More

Tackling homelessness and exclusion: Understanding complex lives

This paper:

• summarises findings from four projects examining the interaction between homelessness and other support needs.

• looks at services for people with complex needs and suggests ways that policy and practice can more effectively tackle homelessness.

Key points

• There is a strong overlap between experiences of more extreme forms of homelessness and other support needs, with nearly half of service users reporting experience of institutional care, substance misuse, and street activities (such as begging), as well as homelessness

• ‘Visible’ forms of homelessness – including the use of services like hostels or applying to the council as homeless – commonly happen after contact with non-housing agencies, for example mental health services, drug agencies, the criminal justice system and social services. They also occur after periods of ‘invisible’ homelessness such as sofa-surfing.

• Traumatic childhood experiences such as abuse, neglect and homelessness are part of most street homeless people’s life histories. In adulthood, the incidence of self-harm and suicide attempts is notable.

• Most complex needs were experienced by homeless men aged between 20 and 49, and especially by those in their 30s.

• Where homelessness and housing support agencies take on primary responsibility for supporting people with multiple and complex needs, workers can often feel isolated and out of their depth. It has been suggested elsewhere that housing support workers are now filling the gap left by the retreat of social workers from direct work with adults

• People with complex needs are at serious risk of falling through the cracks in service provision. There needs to be an integrated response across health, housing and social care.


Read Summary (PDF)

Alcohol News - 37/2011

Euractiv (EU) - Combat alcohol abuse with mandatory labels, EU urged

Policymakers gathered in Brussels this week to discuss the risks posed by alcohol abuse to unborn children urged the EU to introduce mandatory warning labels on bottles and cans.
Read more

YLE News (Finland) - Study: Reduced-alcohol beer would save 350 lives a year

Diluting beer could mitigate problems associated with alcohol use in Finland. Fresh research argues that alcohol consumption would clearly fall if grocery stores sold drinks diluted to 3.5 percent, as in Sweden.
Read more

Netdoctor (Finland) - Alcohol 'an important cause of death' among people with type-1 diabetes

There has been a worrying rise in alcohol-related deaths among people with type-1 diabetes, new research shows. Researchers in Finland investigated deaths among 17,306 under-30s with type-1 diabetes between 1970 and 1999, all of whom were followed for around 21 years.
Read more

MarketWatch (EU) - Changing European Drinking Habits Force Alcohol Producers to Diversify

Although the World Health Organization reports that European alcohol consumption remains the region with the heaviest drinking in the World, recent studies suggest that drinking is on the downturn in Europe.
Read more

The Press Association (Scotland) - Back alcohol price plan, MSPs urged

A Conservative leadership contender who opposed the SNP's minimum alcohol pricing plan last year has said politicians should now respect the "clear view" of the public and back the policy.
Read more

BBC News (UK) - 'E-course' to help hospital staff assist alcohol users

An online alcohol awareness course has been developed to help medical staff assist patients to choose healthier drinking behaviour.
Read more

CanadianBusiness.com (Canada) - Big Island study on fetal alcohol, drug exposure

Nearly half of the children on the Big Island were exposed to intoxicating substances in the womb, according to a study of women over the past three years.
Read more

Times of India - Out: Why office parties often leave you red-faced

People often embarrass themselves and behave badly at office parties. Now, scientists have come up with an explanation - drinking in unfamiliar environments make people lose control of their inhibitions.
Read more

Stuff.co.nz (New Zealand) - Alcohol contributes to quarter of child deaths – report

Alcohol contributed to the deaths of one in four children and young people who died between 2005 and 2007, a new report has found.
Read more

EurekAlert - Role of alcohol intake and smoking on upper aerodigestive cancers

This paper provides an extensive analysis of the proportion of the risk of upper aero-digestive tract (UADT) cancers in the population (the population attributable risk) that may be due to alcohol consumption and/or smoking.
Read more

French Tribune (South Africa) - Test for Alcohol Syndrome in Fetuses Launched

The first ever Commercial test for fetal alcohol syndrome has been launched in South Africa by the Trimega Laboratories. This test is going to be traded under the partnership with Tripelo, in order to form double bilateral system.
Read more

Adelaide Now (Australia) - Service stations and convenience stores float alcohol sales proposal

OWNERS of service stations and 24-hour convenience stores have launched a bid to sell alcohol. The Australasian Association of Convenience Stores - which counts Smokemart, On the Run and BP franchise owner Peregrine Corp among its members - has asked the Productivity Commission to consider the proposal.
Read more

BBC News (Ecuador) - Ecuador tackles bootleg alcohol after wave of deaths

Since mid-July, 50 people have died in Ecuador after drinking contaminated alcohol, according to the government.
Read more

Financial Times (Russia) - Russia counts the cost of drinking

Employers in Russia are not known for compassion – unless they are dealing with drunkenness. A hangover is still seen in many offices and factories as an excuse for skipping work, turning up late or just being grumpy and unproductive. However, as the Kremlin steps up its campaign against alcoholism, experts are counting the economic cost of Russians’ excessive drinking habits.
Read more

Independent Online (South Africa) - ‘Alcohol abuse costs SA’

Alcohol abuse costs South Africa's economy R9 billion a year, Deputy Trade and Industry Minister Elizabeth Thabethe said on Monday.
Read more

GP online (Scotland) - BMA backs minimum pricing in Scotland to end 'scourge of alcohol abuse'

BMA Scotland has welcomed the Scottish government's pledge to reintroduce a Bill for minimum pricing of alcohol to help address the 'scourge of alcohol abuse' in the country.
Read more

Wiki Peers (Sri Lanka) - Smoking and Alcohol Ads to Issue a Warning

Carlo Fonseka, the chief of National Authority on Tobacco and Alcohol in Sri Lanka, has stated that alcohol and tobacco are two of the biggest killers of the society. This has prompted a warning notice to be issued whenever an advertisement concerning these two products goes on air.
Read more

The Guardian (UK) - The shocking facts about young people and alcohol abuse

We want to express our support for Dr Sarah Wollaston's private member's bill, calling for restrictions on alcohol advertising in cinemas, on television and online, as a means of reducing the number of children and young people harmed by alcohol.
Read more

Novinite.com (Bulgaria) - Crackdown on Bulgaria Booze-Fests

Seems "alcohol tourism" has gotten a little out of control in the country due to British, German and Scandinavian tour companies promoting heavy drinking vacation packages. Cheap alcohol prices and lax regulations have made Eastern Europe, and especially Bulgaria, the current hot spot for stag (bachelor) parties from Western Europe.
Read more

Novinite.com (Bulgaria) - Bulgarians Get Drunk Fast, Die Old – Study

Contrary to popular beliefs, the Bulgarians' alcohol tolerance is inferior to that of other nations, a study has apparently shown.
Read more

Herald Scotland (Scotland) - Glasgow A&Es see 1300 child drink and drug cases

MORE than 1300 children were taken to hospital in Scotland’s biggest city over a three-year period as emergency cases because of drugs and alcohol.

Read more


Read Full Newsletter

Distraction osteogenesis in TNF receptor 1 deficient mice is protected from chronic ethanol exposure

Distraction osteogenesis (DO) is an orthopedic protocol, which induces direct new bone formation as a result of the stimulating effects of mechanical distraction.

Chronic ethanol exposure has been demonstrated to inhibit bone formation in rodent models of DO. Further, it has been demonstrated that (1) tumor necrosis factor-α (TNF) blockers are protective against ethanol exposure and (2) recombinant mouse TNF (rmTNF) inhibits direct bone formation in ethanol naïve mice through TNF receptor 1 (TNFR1).

These results suggest that the inhibitory effects are significantly mediated by TNF signaling.

Therefore, we hypothesized that direct new bone formation in TNFR1 knockout (KO) mice would be protected from ethanol exposure.

We used a unique model of mouse DO combined with liquid/chow diets to compare the effects of ethanol on both a strain of TNFR1 knockout (TNFR1 KO) mice and on mice of their C57BL/6 (B6) control strain.

In the B6 study, and in concordance with previous work, both radiological and histological analyses of direct bone formation in the distraction gaps demonstrated significant osteoinhibition due to ethanol compared with chow- or pair-fed mice.

In the TNFR1 KO study and in support of the hypothesis, both radiological and histological analyses of distraction gap bone formation demonstrated no significant differences between the ethanol, chow fed, or pair fed.

We conclude that exogenous rmTNF and ethanol-induced endogenous TNF act to inhibit new bone formation during DO by signaling primarily through TNFR1.


Read Full Abstract

Request Reprint E-Mail: lumpkincharlesk@uams.edu

Association of alcohol, alcohol and tobacco with mortality: findings from a prospective cohort study in Mumbai (Bombay), India

The aim of the present study was to examine the association between alcohol, alcohol and tobacco, and mortality in a large adult population in the city of Mumbai.

A total of 35,102 men aged 45 years and older were surveyed about their alcohol drinking as part of a cohort study. These respondents were followed up over time, and all deaths were recorded.

Compared with those who never drank alcohol, alcohol drinkers had 1.22 times higher risk of mortality, with the highest risk observed for liver disease (hazard ratio [HR]=3.19).

Among ever drinkers, risk of mortality varied according to types (country/desi), frequency (four or less times a week, HR=1.39), and quantity of alcohol consumed (>100mL) per day. In addition, country/desi drinkers (HR=1.34) had the highest mortality risk compared with all other types of alcohol (HR=0.97).

Alcohol drinkers had increased risk of mortality for tuberculosis (HR=2.53), cerebrovascular disease (HR=1.83), and liver disease (HR=3.19).

Synergistic joint effect of tobacco and alcohol on mortality was also observed, with lowest risk in never tobacco user drinkers (HR=1.02) and highest in mixed tobacco user drinkers (HR=1.79). The results of this study show a direct association between greater consumption of alcohol and increased risk of mortality from alcohol-specific causes.

In addition to individual effect, this study demonstrates the synergistic interaction between alcohol and tobacco use in various forms on mortality.


Read Full Abstract

Request Reprint E-Mail: pednekarmangesh@rediffmail.com

The decrease of serum MMP-2 activity corresponds to alcoholic cirrhosis stage

Because of numerous limitations for liver biopsy, a noninvasive marker of liver cirrhosis is sought. Promising indicators seem to be matrix metalloproteinases (MMPs) that are responsible for degradation of extracellular matrix.

The aim of the study was to evaluate the gelatinase activities (MMP-2 and MMP-9) in patients with different stages of alcoholic cirrhosis.

Sixty-seven outpatients who presented various stages of alcoholic cirrhosis according to Child–Turcotte–Pugh criteria and 26 healthy control subjects were enrolled. Blood samples were collected for MMP-2 and MMP-9 activities.

A significant decrease of serum MMP-2 activity was noted in stages B and C of cirrhosis in comparison with control. Serum MMP-9 activity did not depend on the stage of cirrhosis.

The MMP-2 levels, but not those of MMP-9, may be of value in understanding the pathogenesis and progression of alcoholic cirrhosis.



Read Full Abstract

Request Reprint E-Mail: agnieszka.madro@wp.pl

Alcohol Dependence is Related to Overall Internalizing Psychopathology Load Rather than to Particular Internalizing Disorders: Evidence from a Nationa

Alcohol dependence is more prevalent among those with any one of several anxiety or depressive (“internalizing”) disorders than among those in the general population. However, because internalizing disorders are highly intercorrelated, it is ambiguous whether alcohol dependence is related to internalizing psychopathology components that are: (i) unique to a particular internalizing disorder (“specific”); versus (ii) shared across a number of internalizing disorders (“general”). To clarify this ambiguity, we employed structural equation and logistic models to decompose the specific versus general components of internalizing psychopathology and then related these components separately to alcohol dependence.

The data were based on face-to-face interviews of U.S. community residents collected in the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093).

Both analytic approaches demonstrated that increases in the general internalizing psychopathology load are accompanied by increases in the prevalence of alcohol dependence. Once the general internalizing psychopathology load is accounted for, knowing whether a particular internalizing disorder is present or absent provides little additional information regarding the prevalence of alcohol dependence.

The components of internalizing psychopathology that are associated with alcohol dependence are shared and cumulative among common anxiety and depressive disorders. These findings have the potential to influence clinical and scientific conceptualizations of the association between alcohol dependence and internalizing psychopathology.

Read Full Abstract

Request Reprint E-Mail: kushn001@umn.edu

Comparison of Alcoholism Subtypes as Moderators of the Response to Sertraline Treatment

A variety of typologies have been used to categorize alcoholism’s diverse manifestations. Although the most widely studied typologies are dichotomous ones based on genetic epidemiologic findings or using cluster analytic methods, recent efforts have utilized a single item or the onset of a diagnosis of alcohol dependence to subtype individuals based on the age of alcoholism onset. We compared 3 different methods to subtype alcoholics.

This secondary analysis used data from 134 alcohol-dependent participants in a placebo-controlled trial of sertraline (Kranzler et al., 2011). We compared cluster analysis to distinguish 2 risk/severity subtypes (Babor et al., 1992) with 2 age-of-onset subtypes (i.e., based on the age of onset of problem drinking or the age at which alcohol dependence criteria were first met).

Each method yielded subgroups that differed significantly from one another on demographic and clinical measures. Although concordance was high between the 2 age-of-onset methods, it was poor between the age-of-onset methods and the cluster analysis–derived approach. All 3 subtyping approaches significantly moderated the effects of sertraline or placebo, but only in the L’L’ genotype group, as originally reported (Kranzler et al., 2011). In all cases, sertraline treatment was superior to placebo in later-onset individuals and inferior to placebo in the earlier-onset groups.

Because age-of-onset subtypes can be defined retrospectively on an individual basis, they may be more clinically useful than cluster-derived subtypes, which require group data. Because the 2 age-of-onset measures we examined appear to have comparable validity, a single item is easier to use as a measure of the age of onset of problem drinking.

Read Full Abstract

Request Reprint E-Mail: kranzler_h@mail.trc.upenn.edu

Reward and Relapse: Complete Gene-Induced Dissociation in an Animal Model of Alcohol Dependence

In animal models of continuous alcohol self-administration, in which physical dependence does not constitute the major factor of ethanol intake, 2 factors likely contribute to the perpetuation of alcohol self-administration: (i) the rewarding effects of ethanol and (ii) the contextual conditioning cues that exist along with the process of self-administration. Present studies are aimed at understanding the relative contribution of these factors on the perpetuation of heavy alcohol self-administration, as an indication of relapse.

Wistar-derived UChB high ethanol drinker rats were allowed access to 10% ethanol and water on a 24-hour basis. In initial studies, an anticatalase shRNA gene-coding lentiviral vector aimed at inhibiting acetaldehyde generation was administered into the ventral tegmental area (VTA) of the animals prior to ethanol access. In subsequent studies, the lentiviral vector was administered to animals, which had consumed ethanol on a 24-hour basis, or a 1-hour basis, after the animals had reached high levels of ethanol intake for 60 to 80 days. In final studies, quinine (0.01%) was added to the ethanol solution to alter the conditioning taste/smell cues of alcohol that animals had chronically ingested.

Data indicate that the administration of an anticatalase vector into the VTA of naïve animals blocked reward and alcohol self-administration, while it was, nevertheless, inactive in inhibiting alcohol self-administration in rats that had been conditioned to ingest ethanol for over 2 months. The lack of inhibitory effect of the anticatalase vector on ethanol intake in animals that had chronically self-administered ethanol was fully reversed when the contextual conditioning cues of the alcohol solution were changed.

Data highlight the importance of conditioning factors in relapse and suggest that only abolishing or blunting it, along with long-lasting pharmacological treatment to reduce ethanol reward, may have protracted effects in reducing alcohol self-administration.

Read Full Abstract

Request Reprint E-Mail: yisrael@uchile.cl

Corticotropin-Releasing Factor Acting on Corticotropin-Releasing Factor Receptor Type 1 is Critical for Binge Alcohol Drinking in Mice

The corticotropin-releasing factor (CRF) system has been implicated in the regulation of alcohol consumption. However, previous mouse knockout (KO) studies using continuous ethanol access have failed to conclusively confirm this. Recent studies have shown that CRF receptor type 1 (CRFR1) antagonists attenuate alcohol intake in the limited access “drinking in the dark” (DID) model of binge drinking. To avoid the potential nonspecific effects of antagonists, in this study, we tested alcohol drinking in CRFR1, CRFR2, CRF, and urocortin 1 (Ucn1) KO and corresponding wild-type (WT) littermates using the DID paradigm.

On days 1 to 3, the CRFR1, CRFR2, Ucn1, and CRF KO mice and their respective WT littermates were provided with 20% ethanol or 10% sucrose for 2 hours with water available at all other times. On day 4, access to ethanol or sucrose was increased to 4 hours. At the end of each drinking session, the volume of ethanol consumed was recorded, and at the conclusion of the last session, blood was also collected for blood ethanol concentration (BEC) analysis.

CRFR1 KO mice had lower alcohol intakes and BECs and higher intakes of sucrose compared with WTs. In contrast, CRFR2 KO mice, while having reduced intakes initially, had similar alcohol intakes on days 2 to 4 and similar BECs as the WTs. To determine the ligand responsible, Ucn1 and CRF KO and WT mice were tested next. While Ucn1 KOs had similar alcohol intakes and BECs to their WTs, CRF KO mice showed reduced alcohol consumption and lower BECs compared with WTs.

Our results confirm that CRFR1 plays a key role in binge drinking and identify CRF as the ligand critically involved in excessive alcohol consumption.

Read Full Abstract

Request Reprint E-Mail:

ryabinin@ohsu.edu

Opioidergic Modulation of Ethanol Self-Administration in the Ventral Pallidum

Striatopallidal medium spiny neurons have been viewed as a final common path for drug reward and the ventral pallidum as an essential convergent point for hedonic and motivational signaling in the brain. The medium spiny neurons are GABAergic, but they colocalize enkephalin. Purpose of this study was to investigate the role of the opioidergic mechanisms of the ventral pallidum in ethanol self-administration behavior.

Effects of bilateral microinjections of μ-, δ-, and κ-opioid receptor agonists and antagonists into the ventral pallidum on voluntary ethanol consumption were monitored in alcohol-preferring Alko Alcohol (AA) rats using the 90-minute limited access paradigm.

Stimulation of μ-opioid receptors with DAMGO (0.01 to 0.1 μg) or morphine (1 to 10 μg) in the ventral pallidum decreased ethanol intake dose-dependently. Conversely, blocking μ-receptors with CTOP (0.3 to 3 μg) increased ethanol intake significantly. Unlike CTOP, DAMGO also increased locomotor activity. Consumption of ethanol was not modified significantly by a broad-spectrum opioid receptor antagonist naltrexone, by δ-opioid receptor agonist DPDPE or antagonist naltrindole, or by a κ-opioid receptor agonist U50,488H or antagonist nor-BNI.

The study provides evidence for μ- but not δ- or κ-opioid receptors in the ventral pallidum playing a role in the regulation of voluntary ethanol consumption. Furthermore, present findings give support to earlier work, suggesting an essential role of pallidal opioidergic transmission in drug reward.

Read Full Abstract

Request Reprint E-Mail: kalervo.kiianmaa@thl.fi

No Half Measures: Revitalising Alcohol Harm Reduction Strategies in Europe

18th October 2011
Silken Berlaymont Hotel, Brussels

Alcohol consumption is a growing public health and social concern in the EU. Europe has the highest proportion of drinkers in the world, the highest levels of alcohol consumption per capita and a high level of alcohol-related harm. Indeed, latest statistics show that 7.4% of all ill-health and early death in the EU is caused by harmful and hazardous alcohol consumption.

Whilst it must be acknowledged that alcohol is a significant economic commodity and also represents a cultural value in many regions, it is clear that there are many serious health issues attached. Furthermore, harmful and hazardous consumption has a broader social impact such as violence, family problems, crime, social exclusion and low productivity at work.

In order to confront these issues, it is vital to implement effective alcohol related policies at all levels. Five years have passed since the European Commission adopted a milestone for reducing alcohol related harm with a key Communication setting out a strategy to support Member States and establishing an Alcohol and Health Forum. The dissemination of good practices has helped to demonstrate the positive steps that have been made but it is clear, however, that there is still much to be done. > > > > Read More

An Optimized Method for the Measurement of Acetaldehyde by High-Performance Liquid Chromatography

Acetaldehyde is produced during ethanol metabolism predominantly in the liver by alcohol dehydrogenase and rapidly eliminated by oxidation to acetate via aldehyde dehydrogenase. Assessment of circulating acetaldehyde levels in biological matrices is performed by headspace gas chromatography and reverse phase high-performance liquid chromatography (RP-HPLC).

We have developed an optimized method for the measurement of acetaldehyde by RP-HPLC in hepatoma cell culture medium, blood, and plasma. After sample deproteinization, acetaldehyde was derivatized with 2,4-dinitrophenylhydrazine (DNPH). The reaction was optimized for pH, amount of derivatization reagent, time, and temperature. Extraction methods of the acetaldehyde-hydrazone (AcH-DNP) stable derivative and product stability studies were carried out. Acetaldehyde was identified by its retention time in comparison with AcH-DNP standard, using a new chromatography gradient program, and quantitated based on external reference standards and standard addition calibration curves in the presence and absence of ethanol.

Derivatization of acetaldehyde was performed at pH 4.0 with an 80-fold molar excess of DNPH. The reaction was completed in 40 minutes at ambient temperature, and the product was stable for 2 days. A clear separation of AcH-DNP from DNPH was obtained with a new 11-minute chromatography program. Acetaldehyde detection was linear up to 80 μM. The recovery of acetaldehyde was >88% in culture media and >78% in plasma. We quantitatively determined the ethanol-derived acetaldehyde in hepatoma cells, rat blood and plasma with a detection limit around 3 μM. The accuracy of the method was <9% for intraday and <15% for interday measurements, in small volume (70 μl) plasma sampling.

An optimized method for the quantitative determination of acetaldehyde in biological systems was developed using derivatization with DNPH, followed by a short RP-HPLC separation of AcH-DNP. The method has an extended linear range, is reproducible and applicable to small-volume sampling of culture media and biological fluids.

Read Full Abstract

Request Reprint E-Mail: eleni.anni@jefferson.edu

Ethanol-Induced Loss-of-Righting Response During Ethanol Withdrawal in Male and Female Rats: Associations with Alterations in Arc Labeling

There is increasing evidence for relevant sex differences in responses to ethanol. Several investigations have found differences in expression and recovery from ethanol withdrawal (EW) in people and across various animal models. We have found that female rats recover more quickly than male rats and show differential responses to various behavioral assessments and pharmacological challenges during withdrawal. The purpose of this study was to determine whether sex differences in EW behaviors extend to the hypnotic effects of acute ethanol administration.

We used a repeated measures design to assess duration and latency for loss-of-righting reflex following an acute injection of ethanol (4.2 g/kg; 20% w/v) to pair-fed control or ethanol-withdrawn animals at 1 and 3 days EW in male, female, and ovariectomized female (OVX) rats. We determined protein levels of the activity-regulated cytoskeletal protein (Arc), used as a marker for synaptic activity in glutamatergic synapses, in the motor cortex and prefrontal cortex across these same treatment conditions.

Ethanol-withdrawn animals had a reduced ethanol-induced sleep time compared to controls at 1 day EW. Sleep time remained shortened at 3 days EW for males and OVX, but not females. Arc protein levels in motor cortex and preoptic nuclei significantly increased at 1 day EW across all sex conditions, suggestive of an association with the reduced ethanol-induced sleep times during EW. Arc levels increased further for males and OVX, but not females, at the 3 days EW time point.

These findings add further support to sex differences in effects of and responses to ethanol. They suggest that the more rapid recovery from EW for females than males also includes expression of tolerance to the hypnotic effects of ethanol. These sex differences may involve some differential neuroadaptations in glutamatergic signaling.

Read Full Abstract

Request Reprint E-Mail: devaudl@husson.edu

Acamprosate for Alcohol Dependence: A Sex-Specific Meta-Analysis Based on Individual Patient Data

It is unknown whether women derive comparable benefits and have a similar safety and tolerability profile as men from acamprosate, a widely prescribed drug for the maintenance of abstinence in alcohol dependence. The objective of this study was to assess sex-specific differences in the efficacy, safety, and tolerability of acamprosate in the treatment of women and men with alcohol dependence.

A sex-specific meta-analysis was conducted based on individual patient data (IPD). Data were obtained from double-blind, randomized controlled trials with quantitative drinking measures in patients with alcohol dependence receiving oral acamprosate or placebo. Sources included PubMed, PsychInfo, and Cochrane electronic databases; reference lists from retrieved articles and presentations at professional meetings; and direct access to authors and companies who provided IPD.

Individual records were obtained from 1,317 women and 4,794 men who participated in 22 eligible studies conducted in 18 countries. IPD meta-analyses found a significant beneficial effect of acamprosate relative to placebo across all 4 efficacy end points: an incremental gain of 10.4% (95% CI 7.1 to 13.7, p < 0.001) in percentage of abstinent days, an incremental gain of 11.0% (7.4 to 14.6, p < 0.001) in percentage of no heavy drinking days, an odds ratio of 1.9 (1.6 to 2.2, p < 0.001) for rate of complete abstinence, and an odds ratio of 1.9 (1.6 to 2.3, p < 0.001) for rate of no heavy drinking, over the study duration. Acamprosate was also associated with significantly higher rates of treatment completion (p = 0.004) and medication compliance (p < 0.001) than placebo. Men and women did not differ on any measure of acamprosate efficacy, safety, or tolerability.

This sex-specific IPD meta-analysis provides evidence that acamprosate has a significant effect compared with placebo in improving rates of abstinence and no heavy drinking in both women and men with alcohol dependence. Further, acamprosate was associated with significantly higher rates of treatment completion and medication compliance than placebo among both women and men and had a comparable safety and tolerability profile.

Read Full Abstract

Request Reprint E-Mail: mason@scripps.edu

To Approach or Avoid Alcohol? Automatic and Self-Reported Motivational Tendencies in Alcohol Dependence

Motivational conflict is central to alcohol dependence, with patients reporting motivation to limit their drinking at the same time as urges to drink alcohol. In addition, dual process models of addiction emphasise the power of automatic cognitive processes, particularly automatic approach responses elicited by alcohol-related cues, as determinants of drinking behavior. We aimed to examine the strength of automatic and self-reported alcohol approach and avoidance tendencies among alcohol-dependent inpatients relative to matched controls.

A total of 63 alcohol-dependent patients undergoing detoxification and 64 light-drinking controls completed a stimulus-response compatibility (SRC) task, which assesses the speed of categorization of alcohol-related pictures by making symbolic approach and avoidance movements. We also included modified versions of the SRC task to assess automatic motivational conflict, that is, strong approach and avoidance tendencies elicited simultaneously by alcohol-related cues.

There were no differences between alcohol-dependent patients and controls on the SRC task, although individual differences in the quantity of alcohol consumed before entering treatment were significantly positively correlated with the strength of approach (but not avoidance) tendencies elicited by alcohol-related cues. Automatic approach tendencies were also positively correlated with self-reported “approach” inclinations and negatively correlated with self-reported “avoidance” inclinations.

Although alcohol-dependent patients and matched controls did not differ on automatic approach and avoidance tendencies elicited by alcohol-related cues, individual differences in the quantity of alcohol consumed before entering treatment were associated with the strength of automatic approach tendencies elicited by alcohol cues.

Read Full Abstract

Request Reprint E-Mail: mfield@liverpool.ac.uk

Alcohol Dehydrogenase-1B Arg47His Polymorphism and Upper Aerodigestive Tract Cancer Risk: A Meta-Analysis Including 24,252 Subjects

Cancers of the upper aerodigestive tract (UADT) include malignant tumors of the oral cavity, pharynx, larynx, and esophagus, account for approximately 4% of all new cancers in world. Alcohol drinking is an established risk factor for UADT cancers, and the rate of alcohol metabolism could significantly been influenced by genetic polymorphisms of alcohol dehydrogenase-1B (ADH1B) His47Arg (rs1229984). To evaluate whether combined evidence shows ADH1B His47Arg as a common genetic variant that influenced the risk of UADT cancers, we considered all available studies in a meta-analysis.

Eighteen studies were combined representing data of 8,539 cases and 15,713 controls for meta-analysis. Stratified analyses were carried out to determine the gene–environment interaction between ADH1B His47Arg and alcohol drinking and gene–gene interaction between ADH1B His47Arg and aldehyde dehydrogenase-2 (ALDH2) Glu/Lys related to UADT cancer risk. Potential sources of heterogeneity between studies were explored; sensitivity analysis and publication bias was also evaluated.

The ADH1B 47Arg allele was found to be associated with increased risk of UADT cancers, the pooled odds ratios (ORs) being 1.66 (95% CI: 1.54 to 1.79) and 3.47 (95% CI: 2.76 to 4.36) for the His/Arg and Arg/Arg genotypes compared with the His/His genotype, respectively. An 18.48-fold increase in OR (95% CI: 12.95 to 26.40) for UADT cancers among alcohol drinkers with Arg/Arg genotype was found, when compared among nondrinkers with the His/His genotype. Significant interaction between carriers with ADH1B 47Arg and ALDH2 487Lys allele related to risk for UADT cancers was more evident, compared with noncarriers (OR = 10.31, 95% CI: 5.45 to 18.85).

ADH1B 47Arg allele is a common genetic variant that increased the risk of UADT cancers; furthermore, it modulates the susceptibility to UADT cancers coupled with alcohol drinking and interaction with the ALDH2 487Lys allele.

Read Full Abstract

Request Reprint E-Mail: g_ghzhang@yahoo.com.cn

GABAA Receptor Modulation During Adolescence Alters Adult Ethanol Intake and Preference in Rats

To address the hypothesis that GABA_A receptor modulation during adolescence may alter the abuse liability of ethanol during adulthood, the effects of adolescent administration of both a positive and negative GABA_A receptor modulator on adult alcohol intake and preference were assessed.

Three groups of adolescent male rats received 12 injections of lorazepam (3.2 mg/kg), dehydroepiandrosterone (DHEA, 56 mg/kg), or vehicle on alternate days starting on postnatal day (PD) 35. After this time, the doses were increased to 5.6 and 100 mg/kg, respectively, for 3 more injections on alternate days. Subjects had access to 25 to 30 g of food daily, during the period of the first 6 injections, and 18 to 20 g thereafter. Food intake of each group was measured 60 minutes after food presentation, which occurred immediately after drug administration on injection days or at the same time of day on noninjection days. When subjects reached adulthood (PD 88), ethanol preference was determined on 2 separate occasions, an initial 3-day period and a 12-day period, in which increasing concentrations of ethanol were presented. During each preference test, intake of water, saccharin, and an ethanol/saccharin solution was measured after each 23-hour access period.

During adolescence, lorazepam increased 60-minute food intake, and this effect was enhanced under the more restrictive feeding schedule. DHEA had the opposite effect on injection days, decreasing food intake compared with noninjection days. In adulthood, the lorazepam-treated group preferred the 2 lowest concentrations of ethanol/saccharin more than saccharin alone compared with vehicle-treated subjects, which showed no preference for any concentration of ethanol/saccharin over saccharin. DHEA-treated subjects showed no preference among the 3 solutions.

These data demonstrate that GABA_A receptor modulation during adolescence can alter intake and preference for ethanol in adulthood and highlights the importance of drug history as an important variable in the liability for alcohol abuse.

Read Full Abstract

Request Reprint E-Mail: pwinsa@lsuhsc.edu

Ethanol-Induced Oxidative Stress via the CYP2E1 Pathway Disrupts Adiponectin Secretion from Adipocytes

Adipose tissue is an important target for ethanol action. One important effect of ethanol is to reduce the secretion of adiponectin from adipocytes; this decrease is associated with lowered circulating adiponectin in rodent models of chronic ethanol feeding. Adiponectin is an insulin-sensitizing, anti-inflammatory adipokine; decreased adiponectin activity may contribute to tissue injury in response to chronic ethanol. Here, we investigated the role of cytochrome P450 2E1 (CYP2E1) and oxidative stress in the mechanism for impaired adiponectin secretion from adipocytes in response to ethanol.

Male Wistar rats were fed a liquid diet containing ethanol as 36% of calories or pair-fed a control diet for 4 weeks. 3T3-L1 adipocyte cultures, expressing CYP2E1 or not, were exposed to ethanol or 4-hydroxynonenal (4-HNE).

Chronic ethanol feeding to rats suppressed the secretion of adiponectin from isolated epididymal adipocytes. Ethanol feeding induced the expression of CYP2E1 in adipocytes and increased markers of oxidative stress, including 4-HNE and protein carbonyls. Because adiponectin is posttranslationally processed in the endoplasmic reticulum and Golgi, we investigated the impact of ethanol on the redox status of high-density microsomes. Chronic ethanol decreased the ratio of reduced glutathione to oxidized glutathione (4.6:1, pair-fed; 2.9:1, ethanol-fed) in high-density microsomes isolated from rat epididymal adipose tissue. We next utilized the 3T3-L1 adipocyte-like cell model to interrogate the mechanisms for impaired adiponectin secretion. Culture of 3T3-L1 adipocytes overexpressing exogenous CYP2E1, but not those overexpressing antisense CYP2E1, with ethanol increased oxidative stress and impaired adiponectin secretion from intracellular pools. Consistent with a role of oxidative stress in impaired adiponectin secretion, challenge of 3T3-L1 adipocytes with 4-HNE also reduced adiponectin mRNA expression and secretion, without affecting intracellular adiponectin concentration.

These data demonstrate that CYP2E1-dependent reactive oxygen species production in response to ethanol disrupts adiponectin secretion from adipocytes.

Read Full Abstract

Request Reprint E-Mail: nagyL3@ccf.org

Alcohol adverts face being canned

Severe restrictions on alcohol advertising will be tabled before the cabinet within two months, Social Development Minister Bathabile Dlamini confirmed on Tuesday.

Dlamini’s special adviser, Zane Dangor, said the restrictions would not necessarily take the form of an outright ban, but would focus on location, time and space.

“The restrictions would be quite significant… It could mean a complete ban on alcohol advertising on television, but you could have space (elsewhere),” he said.

Alcohol product sponsorships would be banned, he added, as the government was concerned about the “inaccurate link of sporting prowess and alcohol use”.

Earlier this year, Health Minister Aaron Motsoaledi seemed to throw down the gauntlet to the alcohol industry, saying an advertising ban similar to the one on tobacco products was in the pipeline. > > > > Read More

Prevalence and correlates of alcohol use among a sample of general MSM and money boys in Shanghai, China

The use and misuse of alcohol and their relation to risky sex have received modest scholarly attention in China. This type of research in high HIV/STI groups such as men who have sex with men (general MSM) and men who sell sex to other men (“money boys”) (MB) in China is essentially absent.

Therefore, the primary purpose of this exploratory study was to describe the types of alcohol consumed and levels of daily alcohol consumption among Chinese general MSM and MB in Shanghai, China. A secondary purpose was to explore demographic, lifetime sexual behavior, and psychosocial correlates of daily consumption levels.

The sample consisted of 404 MSM (200 MB) who live in Shanghai, China. Participants were recruited using respondent-driven sampling and filled out a cross-sectional behavioral survey. Where appropriate, comparisons were made between MB and general MSM.

Over 73% of participants reported drinking at least moderately every day. MB reported drinking Western red wine and other Western hard liquors (e.g., vodka) more frequently than general MSM. Conversely, general MSM consumed Chinese white wine more frequently than MB.

Results from the regression analyses showed that MSM having higher lifetime sexual risks were more likely to drink in excess; though MB with greater social provisions were less likely to drink in excess.

These results begin to highlight high levels of drinking and drinking-sexual risk relationships among groups of general MSM and MB and are useful for guiding intervention efforts among high-risk groups in China.



Read Full Abstract

Request Reprint E-Mail: enehl@emory.edu