Descriptive Drinking Norms: For Whom Does Reference Group Matter

Perceived descriptive drinking norms often differ from actual norms and are positively related to personal consumption. However, it is not clear how normative perceptions vary with specificity of the reference group. Are drinking norms more accurate and more closely related to drinking behavior as reference group specificity increases? Do these relationships vary as a function of participant demographics? The present study examined the relationship between perceived descriptive norms and drinking behavior by ethnicity (Asian or White), sex, and fraternity/sorority status.

Participants were 2,699 (58% female) White (75%) or Asian (25%) undergraduates from two universities who reported their own alcohol use and perceived descriptive norms for eight reference groups: "typical student"; same sex, ethnicity, or fraternity/sorority status; and all combinations of these three factors.

Participants generally reported the highest perceived norms for the most distal reference group (typical student), with perceptions becoming more accurate as individuals' similarity to the reference group increased. Despite increased accuracy, participants perceived that all reference groups drank more than was actually the case. Across specific subgroups (fraternity/sorority members and men) different patterns emerged. Fraternity/sorority members reliably reported higher estimates of drinking for reference groups that included fraternity/sorority status, and, to a lesser extent, men reported higher estimates for reference groups that included men.

The results suggest that interventions targeting normative misperceptions may need to provide feedback based on participant demography or group membership. Although reference group–specific feedback may be important for some subgroups, typical student feedback provides the largest normative discrepancy for the majority of students.



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

They Drink How Much and Where? Normative Perceptions by Drinking Contexts and Their Association to College Students' Alcohol Consumption

Prior research has shown that normative perceptions of others' drinking behavior strongly relates to one's own drinking behavior. Most research examining the perceived drinking of others has generally focused on specificity of the normative referent (i.e., gender, ethnicity). The present study expands the research literature on social norms by examining normative perceptions by various drinking contexts. Specifically, this research aimed to determine if college students overestimate peer drinking by several drinking contexts (i.e., bar, fraternity/sorority party, non–fraternity/sorority party, sporting event) and to examine whether normative perceptions for drinking by contexts relate to one's own drinking behavior specific to these contexts.

Students (N = 1,468; 56.4% female) participated
in a web-based survey by completing measures assessing drinking behavior and perceived descriptive drinking norms for various contexts.

Findings demonstrated that students consistently overestimated the drinking behavior for the typical same-sex student in various drinking contexts, with the most prominent being fraternity/sorority parties. In addition, results indicated that same-sex normative perceptions for drinking by contexts were associated with personal drinking behavior within these contexts.

Results stress the importance of specificity of social norms beyond those related to the normative referent. Clinical implications are discussed in terms of preventions and intervention efforts as well as risks associated with drinking in a novel context.


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

Attachment Avoidance and Anxiety as Predictors of 12-Step Group Engagement

Twelve-step mutual help groups such as Alcoholics Anonymous (AA) rely heavily on social interactions and support to reduce drinking, but little is known about how individual differences in social behavior tendencies, such as adult attachment, affect 12-step group engagement and resulting benefits. This prospective study investigated relationships between the anxiety and avoidance dimensions of adult attachment and subsequent 12-step meeting attendance, program behaviors, sponsorship, and alcohol use.

Early 12-step group affiliates (N = 253) were recruited from community-based AA and from outpatient treatment. Participants completed baseline interviews that included the Relationship Questionnaire, measures of motivation and professional treatment, and measures of 12-step meeting attendance, practices, and sponsorship. Follow-up interviews were conducted at 3, 6, 9, 12, 18, and 24 months.

At baseline, participants reported elevated attachment anxiety relative to a college population. Lagged analyses demonstrated that, as predicted, high attachment avoidance was related to lower rates of 12-step meeting attendance, practice of behaviors prescribed by 12-step organizations, and lower probability of acquiring a sponsor. Attachment anxiety did not predict any of these aspects of subsequent 12-step group engagement. Contrary to predictions, baseline attachment avoidance did not moderate the relationship between early sponsorship and alcohol use.

Findings support the hypothesis that social demands of behaviors prescribed by 12-step groups may deter high-avoidance individuals from fully engaging in them. Perhaps because of instability in attachment avoidance in this population, however, baseline attachment avoidance did not predict drinking outcomes or moderate sponsor benefits.



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Request Reprint E-Mail: chrisoej@unm.edu

Twelve-Step Program Attendance and Polysubstance Use: Interplay of Alcohol and Illicit Drug Use

The primary aim of this study was to advance understanding of the efficacy of 12-step programs by determining the temporal relationships between alcohol and illicit drug use among 12-step program affiliates.

A total of 253 early 12-step affiliates without extensive histories of Alcoholics Anonymous (AA) attendance were recruited from substance use treatment and community-based AA. A majority of the sample met criteria for a diagnosis of alcohol dependence, reported lifetime use of illicit drugs, and reported illicit drug use in the 90-day period before recruitment. After informed consent, participants were interviewed at intake and in 3-month increments for 1 year.

Preliminary analyses indicated that 12-step attendance was predictive of reductions in substance use and that such reductions were not moderated by illicit substance use disorder diagnosis or alcohol problem severity. Lagged hierarchical linear models indicated that illicit drug use was a robust predictor of later use of alcohol, although the frequency and intensity of drinking were contingent on whether participants sustained 12-step program affiliation. Alcohol use did not predict later illicit drug use among participants who sustained 12-step program participation.

Findings suggest that 12-step participation may serve as a protective factor after substance use occurs. Although our results suggest that the initiation of illicit drug use may undermine efforts to achieve and sustain abstinence from alcohol, our findings do not suggest that alcohol use necessarily mobilizes relapse across different substances among 12-step program affiliates.



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Request Reprint E-Mail: jtonigan@unm.edu

Gender Differences in Outcome at 2-Year Follow-Up of Treated Bipolar and Depressed Alcoholics

Alcohol dependence and affective disorders are significant health problems, and their co-occurrence is mutually detrimental. There are few long-term studies on the impact of treatment on the prognosis of these comorbid disorders. We wished to study if the impact of effective inpatient integrated treatment for these co-occurring disorders was maintained 2 years after discharge from the hospital.

A total of 189 patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for alcohol dependence and either bipolar disorder or depression were recruited, assessed, and assigned to an inpatient treatment unit. Following intensive integrated treatment that was designed to integrate psychotherapy with pharmacotherapy, affective disorder with substance use disorder treatment, and inpatient with outpatient therapy, this population was followed for 2 years after discharge.

Treatment improvements above baseline that were achieved over the course of the 4-week intensive inpatient treatment were essentially maintained over a 2-year outpatient period. Depression, elation, anxiety, and craving scores all fell, as did all drinking outcome measures in both depressed and bipolar alcohol-dependent groups. Findings suggested that women with a diagnosis of bipolar disorder reported higher levels of depression and anxiety symptoms than male bipolar patients at 2-year follow-up. More women than men remained abstinent at 2 years after treatment, with this difference mainly in the depressed sample.

Comorbid bipolar alcoholics and depressed alcoholics can be treated successfully together on an integrated inpatient treatment program, and the benefits can last for up to 2 years. There also appeared to be significant gender differences in treatment outcomes.



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Request Reprint E-Mail: cfarren@stpatsmail.com

Fire Fatality and Alcohol Intake: Analysis of Key Risk Factors

After a brief review of the literature on the role of alcohol in residential fire deaths, a comparison of different risk factors for residential fire fatality was undertaken by closely analyzing the circumstances of fire victims as a function of alcohol intake.

Analyses were based on Australian coroners' fire fatality records for the state of Victoria (1998–2006) and considered demographic, behavioral, and environmental factors for the 95 adult fire victims who were tested for alcohol (64 male, 31 female).

Most (58%) had a positive blood alcohol concentration (BAC) test, with 31% of the total sample having a BAC of more than 0.20 gm per 100 ml. Odds ratio analyses showed that four variables were significantly more associated with victims who had consumed alcohol compared with sober victims. In descending odds ratio order, these variables were as follows: (a) being aged 18–60 years, (b) involving smoking materials (e.g. cigarettes, pipes), (c) having no conditions preventing escape, and (d) being male. An important new finding is that fire fatalities with positive BAC levels were more than three times less likely to have their clothing alight or exits blocked than sober fire victims.

The risk of dying in a fire for alcohol-affected people who are capable of being alerted and escaping may be reduced if they can be alerted more quickly and effectively. Suitable measures for improving smoke alarms via interlinking and the use of an alarm signal demonstrated to be more effective at waking sleepers, including those who are alcohol affected, are discussed.


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Press Release - Social contacts, self-confidence crucial to successful recovery through Alcoholics Anonymous

Among the many ways that participation in Alcoholics Anonymous (AA) helps its members stay sober, two appear to be most important – spending more time with individuals who support efforts towards sobriety and increased confidence in the ability to maintain abstinence in social situations. In a paper that will appear in the journal Addiction and has been released online, researchers report the first study to examine the relative importance to successful recovery of the behavior changes associated with participation in AA. > > > > Read More

2ND International SAFFrance Colloquium, 15- 16 December 2011, Strasbourg

The second international conference of SAFFrance to be organised on the 15th and 16th of December in Strasbourg is linked to the first conference organised in the Senate in September 2009 to which the higher head of state participated.

Its aim will be to facilitate the professionals’ awareness on the link between prenatal alcohol, brain damage, difficulties to learn and social maladjustment and hence, on the way to prevent these issues. > > > > Read More

Drinkaware's 'why let good times go bad' returns for 2011

The industry funded body Drinkaware has re-launched its why let good times go bad? campaign to 'tackle binge drinking amongst young adults'.

Messages were placed on billboards, poster sites and in stations, supporting campaign activity taking place in pubs, clubs, bars and supermarkets 'ensuring that young adult drinkers are targeted at every stage of their night out'. The campaign includes 3 main tips:

• 'It’s not a race, remember to pace'
• 'Have something to eat to stay on your feet'
• 'Try to make every third drink a soft one' > > > > Read More
  

Reinforcement of Smoking and Drinking: Tobacco Marketing Strategies Linked With Alcohol in the United States

We investigated tobacco companies’ knowledge about concurrent use of tobacco and alcohol, their marketing strategies linking cigarettes with alcohol, and the benefits tobacco companies sought from these marketing activities.

We performed systematic searches on previously secret tobacco industry documents, and we summarized the themes and contexts of relevant search results.

Tobacco company research confirmed the association between tobacco use and alcohol use. Tobacco companies explored promotional strategies linking cigarettes and alcohol, such as jointly sponsoring special events with alcohol companies to lower the cost of sponsorships, increase consumer appeal, reinforce brand identity, and generate increased cigarette sales. They also pursued promotions that tied cigarette sales to alcohol purchases, and cigarette promotional events frequently featured alcohol discounts or encouraged alcohol use.

Tobacco companies’ numerous marketing strategies linking cigarettes with alcohol may have reinforced the use of both substances. Because using tobacco and alcohol together makes it harder to quit smoking, policies prohibiting tobacco sales and promotion in establishments where alcohol is served and sold might mitigate this effect. Smoking cessation programs should address the effect that alcohol consumption has on tobacco use.

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Request Reprint E-Mail: pling@medicine.ucsf.edu

Alcohol Advertising at Boston Subway Stations: An Assessment of Exposure by Race and Socioeconomic Status

We investigated the frequency of alcohol ads at all 113 subway and streetcar stations in Boston and the patterns of community exposure stratified by

race, socioeconomic status, and age.

We assessed the extent of alcohol advertising at each station in May 2009. We measured gross impressions and gross rating points (GRPs) for the entire Greater Boston population and for Boston public school student commuters. We compared the frequency of alcohol advertising between neighborhoods with differing demographics.

For the Greater Boston population, alcohol advertising at subway stations generated 109 GRPs on a typical day. For Boston public school students in grades 5 to 12, alcohol advertising at stations generated 134 GRPs. Advertising at stations in low-poverty neighborhoods generated 14.1 GRPs and at stations in high-poverty areas, 63.6 GRPs.

Alcohol ads reach the equivalent of every adult in the Greater Boston region and the equivalent of every 5th- to 12th-grade public school student each day. More alcohol ads were displayed in stations in neighborhoods with high poverty rates than in stations in neighborhoods with low poverty rates.

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Request Reprint E-Mail: gentry.lisa@gmail.com

Low-Risk Lifestyle Behaviors and All-Cause Mortality: Findings From the National Health and Nutrition Examination Survey III Mortality Study

We examined the relationship between 4 low-risk behaviors—never smoked, healthy diet, adequate physical activity, and moderate alcohol consumption—and mortality in a representative sample of people in the United States.

We used data from 16958 participants aged 17 years and older in the National Health and Nutrition Examination Survey III Mortality Study from 1988 to 2006.

The number of low-risk behaviors was inversely related to the risk for mortality. Compared with participants who had no low-risk behaviors, those who had all 4 experienced reduced all-cause mortality (adjusted hazard ratio [AHR]=0.37; 95% confidence interval [CI]=0.28, 0.49), mortality from malignant neoplasms (AHR=0.34; 95% CI=0.20, 0.56), major cardiovascular disease (AHR=0.35; 95% CI=0.24, 0.50), and other causes (AHR=0.43; 95% CI=0.25, 0.74). The rate advancement periods, representing the equivalent risk from a certain number of years of chronological age, for participants who had all 4 high-risk behaviors compared with those who had none were 11.1 years for all-cause mortality, 14.4 years for malignant neoplasms, 9.9 years for major cardiovascular disease, and 10.6 years for other causes.

Low-risk lifestyle factors exert a powerful and beneficial effect on mortality.

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Request Reprint E-Mail: eford@cdc.gov

The Alcohol Identification and Brief Advice e-learning project (Alcohol IBA)

The Alcohol Identification and Brief Advice e-learning project (Alcohol IBA) helps professionals with identifying those individuals whose drinking might be impacting on their health and delivering simple, structured advice. It has been developed in partnership with the Department of Health's Alcohol Policy Team and e-Learning for Healthcare .

This e-learning course has been developed by NHS Portsmouth and e-Learning for Healthcare to provide the learning for hospital staff to identify and provide brief advice to those whose alcohol use may be impacting on their health. The course was conceived and designed by Iain Armstrong and builds on the successful courses for IBA in Primary Care and Community Pharmacy developed by the Department of Health. IBA e-learning in hospital settings is currently available on the Alcohol Learning Centre and will soon be available through National Learning Management System (NLMS) which is linked to the NHS Electronic Staff Record (ESR).

Alcohol IBA has been designed to provide the skills and understanding to deliver IBA in line with the National Occupational Standard AH10 - 'employ techniques to help individuals adopt sensible drinking behaviour'. > > > > Read More

Global Actions: September 14, 2011

Key Recent Milestones: Self-Regulation in India

The Advertising Standards Council of India (ASCI) has introduced a new process for companies wishing to file complaints regarding competitors’ advertisements. The Fast Track Complaints Redress Process was designed by the self-regulatory organization to provide speedier solutions to intra-industry complaints.

Along with other leading industry associations, the World Federation of Advertisers (WFA) and the Indian Society of Advertisers (ISA) are working to strengthen India’s long-standing self-regulatory system.

The new system enhances the efficiency and speed of handling of consumer complaints, now ensuring that all complaints are resolved within seven days, with a final decision from the Fast Track Complaints Council (FTCC). Four to six months from introduction, the ASCI board will review the Redress Process.

Global Actions in Focus: China

Drink drive training workshops for local staff and traffic police will be held September 16 through 25 in Xi’an and Nanjing, both prominent cities in Chinese history and culture, with populations of eight million and five million, respectively.

Global Actions’ partners/stakeholders in China include the China Center for Health Education (CCHE), Xi’an Center for Health Education, Jiangsu Center for Health Education, local government agencies, and beverage alcohol producers that include Diageo and Pernod Ricard. International road safety expert Ray Shuey will lead training of the enhanced enforcement program.

“Thanks to CCHE, local facilitators, and the alcohol industry, the projects are progressing,” said Global Actions China Country Coordinator James Yu. “We hope these workshops will encourage participants to implement interventions to reduce the rate of alcohol-related road traffic crashes in these major cities.”

“For the workshops, held separately in Xi’an and Nanjing, one program manager and one practitioner involved in local action of drink driving intervention will attend,” said CCHE’s Qian Ling. “ICAP and the CCHE team have invited health educators from more than 30 provincial institutes for health education to attend the workshops and learn skills about program design and evaluation.”

What’s Happening Next

· Advertising News: The Consolidated ICC Code website will launch globally on September 15. Visit www.codescentre.com for information on global best practice and self-regulation of advertising and marketing communications.

· Nigeria: September 20-21, Capacity-building program for the Lagos-Apapa intervention.

· Mexico: September 28-29, Drink drive summit in Mexico City.

· Ukraine: September 30, World Federations of Advertisers (WFA) will be participating in a self-regulation conference in Kiev.

Press Release - European Region has heaviest drinking in the world

The 53 countries in the WHO European Region meeting in Baku, Azerbaijan from 12 to 15 September 2011 are endorsing a plan to reduce the harmful use of alcohol. In this Region, alcohol is the second largest risk factor for the death and disease burden, just after tobacco use.

“The harmful use of alcohol is a priority public health concern. The evidence supporting this action plan is large, diverse and persuasive,” said Zsuzsanna Jakab, WHO Regional Director for Europe. “Countries are well aware of the expensive and devastating damage it causes and our action plan is intended to provide them with technical guidance and support on what can and should be done to reduce this harm.”

The WHO European Region is the heaviest drinking region in the world, with a prevalence of heavy episodic drinking in over 20% of adults. Alcohol consumption reportedly decreased during the 1990s, then increased and stabilized at a higher level between 2004 and 2006. Consumption varies greatly among countries, with a European average of 9.24 litres of pure alcohol equivalent consumed per person per year. The overall tendency is that consumption has decreased in western Europe and increased in eastern Europe during the last 15 years, although there are huge differences among countries – see the European status report on alcohol and health 2010. > > > > Read More

Predicting university undergraduates’ binge-drinking behavior: A comparative test of the one- and two-component theories of planned behavior

This study provides a comparative test of the one- and two-component theories of planned behavior (TPB) in the context of university undergraduates’ binge-drinking.

Participants (N = 120) self-completed questionnaire measures of all TPB constructs at time 1 and subsequent binge-drinking at time 2 (two-weeks later). The data were analyzed using a combination of path analyses and bootstrapping procedures.

Both models accounted for a substantial proportion of the variation in behavior.

However, the two-component TPB provided a significantly better fit to the data, with the total direct and indirect effects accounting for 90% of the variance.

Intention was the only direct predictor of behavior. Instrumental attitude, affective attitude and self-efficacy had indirect effects.

Although health interventions could usefully target these cognitive antecedents, simulation analyses, modelling the effects of cognition change on behavior, showed that only large- (0.8 SD) sized changes to affective attitude, or moderate-sized changes to all of these cognitions in combination were sufficient to reduce binge-drinking.

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Request Reprint E-Mail: mark.a.elliott@strath.ac.uk

Memory associations between negative emotions and alcohol on the lexical decision task predict alcohol use in women

Implicit alcohol expectancies, or beliefs about alcohol which exist in the form of automatic memory associations, are thought to uniquely affect drinking behavior. Research also has indicated that there may be a distinctive relationship between negative reinforcement and alcohol use in women. However, the most common measures used to examine implicit alcohol cognitions may be insufficient to examine associations involving negative reinforcement.

The current study utilized the Lexical Decision Task (LDT) to examine the relationship between implicit alcohol cognitions and reported drinking in a sample of college women. Seventy-eight female participants completed a LDT including alcohol- and emotion-words, questionnaire measures of explicit alcohol expectancies, and a measure of drinking behavior at baseline and after two months.

Strong associations between negative emotion-words and alcohol-words (as measured by the LDT) were found to predict drinking at follow up, and to account for unique variance in drinking beyond the contribution of explicit measures.

In addition, women who reported heavier drinking in response to social conflict on an explicit measure showed stronger priming of alcohol words by negative emotion words, thus implying that the LDT may tap into implicit cognitions related to alcohol use as a method of coping.

These findings suggest that the LDT is sensitive to negative-reinforcement associations in a way that other measures are not.

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Request Reprint E-Mail: mailto:janellen@unm.edu

Personality and alcohol use: The role of impulsivity

Research has shown that personality traits associated with impulsivity influence alcohol use during emerging adulthood, yet relatively few studies have examined how distinct facets of impulsivity are associated with alcohol use and abuse.

We examine the influence of impulsivity traits on four patterns of alcohol use including frequency of alcohol use, alcohol-related problems, binge drinking, and alcohol use disorders (AUDs) in a community sample of young individuals (N = 190).

In multivariate regression analyses that controlled for peer and parental alcohol use, psychological distress, and developmental correlates (i.e., college, marriage, employment) in emerging adulthood, we found that urgency and sensation seeking were consistently related to all four constructs of alcohol use.

The present study suggests that distinct impulsivity traits may play different roles in escalation of alcohol use and development of AUDs during emerging adulthood.



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Request Reprint E-Mail: hshin@bu.edu

Joint Meeting of the NIDA and NIAAA Councils - September 2011

Monday, September 12, 2011
NIDA and NIAAA
Total Running Time: 03:10:27


View Video

NIAAA Spectrum Volume 3, Issue 3, September 2011

In This Issue

Features
1 NIAAA Advances Research on Fetal Alcohol Spectrum Disorders
2 Imaging Helps Researchers See Into Alcohol-Exposed Brains


Photo Essay
2 Brain scans Reveal the Damage of Fetal Alcohol Exposure


Charticle
4 One in Eight Pregnant Women Drinks


News From The Field
5 Receptor May Help Explain Susceptibility to Addiction
5 Heavily Advertised Alcohol Brands May Attract MoreUnderage Drinkers
6 Research Shows the Value of a Minimum Legal Drinking Age of 21
6 Evidence Mounts That Binge Drinking Harms Adolescent Brain Development

Questions With...
7 Kenneth Warren, Ph.D.


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Alcohol Awareness Week 2011: 14 - 20 November

Alcohol Awareness Week (AWW) will run from 14^th November to 20^th November 2011, during which Alcohol Concern will launch an 'Alcohol Charter' for a world free from alcohol harm.

The ‘alcohol charter’ campaign has the following goals:

1. 100,000 people signing up to the charter
2. All MPs and Peers signing up to the charter
3. Charter adopted in forthcoming alcohol strategy
4. Charter paves way for political discussion on precise goals and policies needed > > > > Read More
   

Determining the Relative Importance of the Mechanisms of Behavior Change within Alcoholics Anonymous: A Multiple Mediator Analysis

Evidence indicates AA participation reduces relapse risk but less is known about the mechanisms through which AA confers this benefit. Initial studies indicate self-efficacy, negative affect, adaptive social networks, and spiritual practices are mediators of this effect, but because these have been tested in isolation, their relative importance remains elusive.

This study tested multiple mediators simultaneously to help determine the most influential pathways.

Prospective, statistically controlled, naturalistic investigation examined the extent to which purported mechanisms (i.e., self-efficacy, negative affect, social networks, and spirituality/religiosity) mediated the effect of AA attendance on alcohol outcomes controlling for baseline outcome values, mediators, treatment, and other confounders.

Nine clinical sites within the United States.

Adults (N = 1,726) suffering from alcohol use disorder (AUD) with varying levels of severity initially enrolled in a randomized study with two arms: Aftercare (n = 774); and Outpatient (n-952) comparing three outpatient treatments (Project MATCH)

AA attendance during treatment; mediators at 9 months; and, outcomes (Percent Days Abstinent [PDA] and Drinks per Drinking Day [DDD]) at 15 months.

Among outpatients the effect of AA attendance on alcohol outcomes was explained primarily by adaptive social network changes and increases in social abstinence self-efficacy. Among more impaired aftercare patients, in addition to mediation through adaptive network changes and increases in social self-efficacy, AA lead to better outcomes through increasing spirituality/religiosity and by reducing negative affect .

The degree to which mediators explained the relationship between AA and outcomes ranged from 43%-67%.

AA facilitates recovery by mobilizing several processes simultaneously, including influential social change and spirituality/religiosity.


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Request Reprint E-Mail: jkelly11@partners.org

News Release - Public-Private Partnership Helps Teens Escape Drugs, Alcohol and Crime

Governor Bev Perdue today announced a partnership between state agencies and two North Carolina foundations that will expand the successful Reclaiming Futures program from a model to a statewide initiative that helps youths in the juvenile justice system beat problems with drugs and alcohol. This tested and proven program will help put teenagers on a path toward finishing high school ready, for a career, college or technical training. > > > > Read More

Live footage from Ireland's First Alcohol Free Comedy Club

'Ireland's First Alternative Alcohol Free Comedy Club was full to the rafters and a roaring success!' tweeted Dil Wickremasinghe, founder of Dublin's new club. We had 'great acts, great audience & a great venue, plus a full house'. Hosting Ireland's first alternative alcohol-free comedy club, Accents Lounge Dublin offered 'the most fun you can have with your clothes on' at the opening night, Monday 5th September. > > > > Read More

"Other teens drink and use marijuana but my kids don't," parents say in new poll

The latest C.S. Mott Children's Hospital National Poll on Children's Health finds that few parents (10 percent) believe their own teens, ages 13 to 17 years old, have used alcohol in the last year and even fewer (5 percent) believe their own teens have used marijuana in the last year.

Those levels are substantially below what teens themselves reported in the latest Monitoring the Future study, where 52 percent of 10th graders reported drinking alcohol in the last year and 28 percent of 10th graders reported using marijuana in the last year.

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Translational Magnetic Resonance Spectroscopy Reveals Excessive Central Glutamate Levels During Alcohol Withdrawal in Humans and Rats

In alcoholism, excessive glutamatergic neurotransmission has long been implicated in the acute withdrawal syndrome and as a key signal for dependence-related neuroplasticity. Our understanding of this pathophysiological mechanism originates largely from animal studies, but human data are needed for translation into successful medication development.

We measured brain glutamate levels during detoxification in alcohol-dependent patients (n = 47) and in healthy control subjects (n = 57) as well as in a rat model of alcoholism by state-of-the-art ¹H-magnetic magnetic resonance spectroscopy at 3 and 9.4 T, respectively.

We found significantly increased glutamate levels during acute alcohol withdrawal in corresponding prefrontocortical regions of treatment-seeking alcoholic patients and alcohol-dependent rats versus respective control subjects. The augmented spectroscopic glutamate signal is likely related to increased glutamatergic neurotransmission because, enabled by the high field strength of the animal scanner, we detected a profoundly elevated glutamate/glutamine ratio in alcohol-dependent rats during acute withdrawal. All dependence-induced metabolic alterations normalize within a few weeks of abstinence in both humans and rats.

Our data provide first-time direct support from humans for the glutamate hypothesis of alcoholism, demonstrate the comparability of human and animal magnetic resonance spectroscopy responses, and identify the glutamate/glutamine ratio as potential biomarker for monitoring disease progression.

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Request Reprint E-Mail: wolfgang.sommer@zi-mannheim.de

Housekeeping Gene Variability in the Liver of Alcoholic Patients

Quantification of gene expression using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) requires normalization to an endogenous reference gene termed housekeeping gene (HKG). Many of the commonly used HKGs are regulated and vary under experimental conditions and disease stages. Alcoholic liver disease (ALD) is associated with several different liver histological lesions that may modulate HKG expression. We investigated the variability of commonly used HGKs (18S, β-actin, glyceraldehyde-3-phosphate [GAPDH], and arginine/serine-rich splicing factor [SFRS4]) in the liver of patients with ALD.

Fifty consecutive patients at different stages of ALD underwent liver biopsy. The stability of HKG was assessed according to liver histological lesions.

β-actin had the highest coefficient of dispersion (COD) (23.9). β-actin tended to decrease with steatosis and to increase with alcoholic hepatitis; β-actin also increased in patients with both alcoholic hepatitis and cirrhosis. GAPDH and SFRS4 COD were 2.8 and 2.1, respectively. GAPDH was decreased with steatosis and increased with alcoholic hepatitis and fibrosis. 18S had the lowest COD (1.4). Both 18S and SFRS4 levels were not significantly modified with respect to all alcohol-induced liver histological lesions.

In patients with ALD, the most constantly expressed HKGs are 18S and SFRS4. These genes are appropriate reference genes for normalization of RT-qPCR in the liver of patients with ALD. The use of other HKGs such as β-actin or GAPDH would lead to misinterpretation of the results.

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Request Reprint E-Mail: gabriel.perlemuter@abc.aphp.fr

Twenty-One-Year Trends and Correlates of Pressure to Change Drinking

The vast majority of individuals with alcohol problems in the United States and elsewhere do not seek help. One policy response has been to encourage institutions such as criminal justice and social welfare systems to mandate treatment for individuals with alcohol problems (Addiction, 1997;92:1133). However, informal pressures to drink less from family and friends are far more common than institutional pressures mandating treatment (Addiction, 1996;91:643). The prevalence and correlates of these informal pressures have been minimally studied.

This analysis used data from 5 Alcohol Research Group National Alcohol Surveys (NAS) collected at approximately 5-year intervals over a 21-year period (1984 to 2005, pooled N = 16,241) to describe the patterns of pressure that drinkers received during the past year from spouse, family, friends, physicians, police, and the workplace.

The overall trend of pressure combining all 6 sources across all 5 NAS data sets indicated a decline. Frequent heavy drinking and alcohol-related harms also declined, and both were strong predictors of receiving pressure. Trends among different sources varied. In multivariate regression models, pressure from friends showed an increase. Pressure from spouse and family showed a relatively flat trajectory, with the exception of a spike in pressure from family in 1990.

The trajectory of decreasing of pressure over time is most likely the result of decreases in heavy drinking and alcohol-related harm. Pressure was generally targeted toward higher risk drinkers, such as heavy drinkers and those reporting alcohol-related harm. However, demographic findings suggest that the social context of drinking might also be a determinant of receiving pressure. Additional studies should identify when pressure is associated with decreased drinking and increased help seeking.

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Request Reprint E-Mail: dpolcin@arg.org

Drinking Course Through Midlife Based on Diagnostic Versus Quantity-Frequency Indices

Prior efforts to examine the course of drinking from onset to midlife have been limited to analyses of year-to-year changes in alcohol dependence (AD). The current investigation sought to examine the course of drinking over this time frame using consumption-based measures of drinking and evaluate the degree of comparability in trajectories estimated from diagnostic and quantity-frequency data.

Participants included 420 men with a lifetime history of AD who were drawn from the Vietnam Era Twin Registry and administered the Lifetime Drinking History, which provided person-year (retrospective) data on patterns of consumption and diagnostic symptoms from drinking onset to participants’ current age. Consumption-based data were aggregated into age categories that ranged from “up to age 20” to “ages 54 to 56” and analyzed separately as a dichotomous measure of “heavy drinking (HD)” and continuous quantity-frequency index (QFI)

scores.

Using latent growth mixture modeling, trajectories based on the HD measure were moderately concordant with those based on changes in AD that were previously identified in this sample, whereas trajectories based on QFI scores were only weakly related to those based on AD diagnoses. Moreover, examination of the degree of concordance between AD- and QFI-derived trajectories revealed that measures of consumption (and potentially other continuous indices of drinking) may qualify past interpretations of various developmental trajectories that have been discussed in the alcoholism typology literature (particularly “Late Onset” alcoholism).

Collectively, the findings highlight the importance of integrating repeated measures of alcohol consumption in future efforts to describe the course of drinking across the life span.

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Request Reprint E-Mail: ttjbocaj@aol.com

Developing the Climate Schools: Alcohol and Cannabis Module: A Harm-Minimization, Universal Drug Prevention Program Facilitated by the Internet

The Climate Schools: Alcohol and Cannabis Module is a universal harm-minimization school-based prevention program for adolescents aged 13–15 years. The core content of the program is delivered over the Internet using cartoon storylines to engage students, and teacher-driven activities reinforce the core information. The program is embedded within the school health curriculum and is easy to implement with minimal teacher training required.

The program was developed in 2007 through extensive collaboration with teachers, students, and health professionals (N = 24) in Sydney, Australia and has since been evaluated (N = 764).

This article describes the formative research and process of planning that formed the development of the program and the evidence base underpinning the approach. The study's limitations are noted.

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Request Reprint E-Mail: nickien@unsw.edu.au

Substance Use/Abuse and Suicidal Behavior in Young Adult Women: A Population-Based Study

Associations between substance use variables and suicidal behavior were analyzed in an urban population sample from (“the Women and Alcohol in Gothenburg” study).

In Phase I, 20-year-old women (n = 2,069) completed a screening questionnaire. Interviews were carried out with a stratified sample (n = 560). Data, collected in 1995 and 2000, were analyzed using logistic regression to generate odds ratios.

Drug use, but not risky alcohol consumption, was associated with suicidal thoughts after adjusting for current depression. Study limitations and implications for suicide prevention are discussed.

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Request Reprint E-Mail: margda.waern@neuro.gu.se

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.


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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.

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