Global Actions: Commitments to Reduce Harmful Drinking. June 12, 2013

Global Actions in Focus

icap translated materials

The Beer, Wine and Spirits Producers’ Commitments to Reduce Harmful Drinking are available for readers to view in six languages: English, Chinese, French, Spanish, Japanese, and Russian, at both www.global-actions.org and commitments.global-actions.org. In addition to the Commitments, several ICAP publications are available online and have been translated into numerous languages.

ICAP Issues Briefings are excellent tools that provide background information on specific topics relevant to alcohol policy and the Commitments. Alcohol Marketing and Young People, for example, is available to read in four languages: French, Portuguese, Russian, and Spanish. Alcohol-impaired Driving and Health Warning Labels are available in Spanish. Social Marketing and Alcohol has been translated in French, Portuguese, and Spanish.

ICAP recommends that the Issues Briefings be used in conjunction with ICAP's other Policy Tools, including the ICAP Blue Book and ICAP Policy Guides. ICAP Issues Briefings are updated on an ongoing basis. Visit the website regularly as more translated materials become available.

In addition to the ICAP Issues Briefings, the Toolkit for Working Together is available in French, German, and Spanish, and provides tools to facilitate cooperation between alcohol industry members and other stakeholders to reduce harmful drinking.

Key Recent Milestones

· Worldwide: The Global Actions Twitter gained 33 new followers in April and May, while the Global Actions Facebook page had 11,300 impressions and the ICAP Facebook page had 9,600 impressions during the same time frame.

What's Happening Next

· Nigeria: A Baseline Survey will be conducted by the Federal Road Safety Corps (FRSC) and researchers from the University of Lagos during the week of June 24, 2013. Questionnaires and breath alcohol tests will be administered to approximately 500 petroleum tanker drivers in Lagos.

Critique 113: Metabolic and biochemical mechanisms by which alcohol consumption affects health — 11 June 2013

Whitfield JB, Heath AC, Madden PAF, Pergadia ML, Montgomery GW, Martin NG. Metabolic and biochemical effects of low-to-moderate alcohol consumption. Alcohol Clin Exp Res 2013;37:575–586.
 
Forum Comments

The large majority of prospective epidemiologic studies have demonstrated a “J-shaped” or “U-shaped” relation between the consumption of alcohol and the risk of cardiovascular disease. While the average amount of alcohol consumed is generally related to such risk, studies providing data on the pattern of drinking generally show an even greater reduction in the risk of cardiovascular disease at be associated with light-to-moderate drinking, especially the regular consumption of alcohol without binge drinking.
Numerous mechanisms for the beneficial effects of light drinking have been identified. As well summarized by Brien et al (Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ 2011;342:doi:10.1136/bmj.d636), mechanisms have been shown for alcohol’s effects on lipids, coagulation, inflammation, endothelial function, and other metabolic parameters. Many studies have also shown that the polyphenols in wine have additional beneficial effects on risk of cardiovascular and other diseases.
The present paper describes the relation between reported alcohol consumption and a variety of metabolic and biochemical factors among a large number of subjects in a population-based study in Australia. That study focused on genetic factors among twins and their families. The main estimate of alcohol consumption was the reported total number of drinks in the preceding week from a retrospective alcohol diary collected at the time blood was drawn. For most subjects, intake was also assessed from a telephone interview seeking an estimate of the average alcohol intake over the past year; the latter gave a lower estimated average alcohol intake, but essentially the same relation with metabolic and biochemical parameters as the alcohol diary  > > > >  Read More

Safer Campuses and Communities: Tools for Implementing Evidence-based Interventions to Reduce Alcohol Problems

 

Higher Education Webinar Series:

June 26, 2013, 4:00 pm−5:30 pm ET
June 27, 2013, 11:00 am−12:30 pm ET

DESCRIPTION: High-risk alcohol consumption remains the greatest problem for most college campuses, associated with an estimated 1,825 alcohol-related student deaths, 599,000 student injuries, and 97,000 student sexual assaults or date rapes each year. As such, campuses and communities across the country have been working to reduce alcohol misuse and related consequences.
 
Based on a translational research project funded by the Centers for Disease Control and Prevention (CDC) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the Prevention Research Center developed a suite of Safer Campuses and Communities resources, including background materials, tools, and procedures to help campuses and communities develop and implement targeted interventions for alcohol problem prevention. The resources can help change the culture of dangerous drinking and related problems, and ultimately improve the quality of learning environment for students, protecting the health and safety of students and community members alike.

In this webinar, Dr. Bob Saltz, Senior Research Scientist at the Prevention Research Center, will review the latest research-based approaches to reducing alcohol-related problems among college students and consider how to apply the Safer Campuses and Communities resources recently developed. Then Karen Hughes, Coordinator of PartySafe@Cal at UC Berkeley, and Genie Cheng, Outreach and Education Coordinator at UC Santa Barbara, will share how their colleges have been implementing evidence-based interventions to reduce alcohol problems on their campuses and in their communities.  > > > >  Read More

TAP 33: Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Technical Assistance Publication (TAP) 33, Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment, describes core elements of screening, brief intervention, and referral to treatment (SBIRT) programs for people with or at risk for substance use disorders. The TAP also covers SBIRT services implementation. TAP 33 provides general administrative and managerial information for SBIRT services, including effectiveness, implementation models, challenges and barriers to implementation, and cost and sustainability.


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Alcohol Policy Changes and Trends in Adolescent Drinking in Finland from 1981 to 2011

To test if changes in national alcohol policy have had an impact on alcohol use among 12- to 18-year-old adolescents in Finland over a 30-year period.

Frequencies of drinking any amounts of alcohol and drinking alcohol until really drunk from bi-annual repeated cross-sectional surveys from 1981 to 2011 were examined against a national alcohol policy review using nationally representative samples of 12-, 14-, 16- and 18-year-old adolescents (n = 99,724) in Finland.

Twelve-year-olds' alcohol drinking remained rare throughout the period. Drinking among 18-year-olds generally increased throughout the period. Significant increases until the late 1990s and decreases thereafter were observed in 14- and 16-year-olds' drinking patterns. A sharp increase was predicted between 2003 and 2005 as a result of EU-related processes, but instead decrease was observed among 14–16-year-olds. The tests of hypothesized decrease from 2005 to 2011 due to tightening alcohol policy including several tax raises produced mixed results.

Alcohol policy changes between 1981 and 2011 seem not to have had noticeable influence on alcohol drinking or drunkenness among the under-aged in Finland. Conspicuous increases seen in population total consumption in association with EU-related developments have not materialized among adolescents.


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Request Reprint E-Mail:   tomi.lintonen@uta.fi

Time-Course of Neuroendocrine Changes and Its Correlation with Hypertension Induced by Ethanol Consumption

 

Ethanol (ETOH) consumption has been associated with endocrine and autonomic changes, including the development of hypertension. However, the sequence of pathophysiological events underlying the emergence of this effect is poorly understood.

This study aimed to establish a time-course correlation between neuroendocrine and cardiovascular changes contributing to the development of hypertension following ETOH consumption.

 Male adult Wistar rats were subjected to the intake of increasing ETOH concentrations in their drinking water (first week: 5%, second week: 10%, third and fourth weeks: 20% v/v).

 ETOH consumption decreased plasma and urinary volumes, as well as body weight and fluid intake. Furthermore, plasma osmolality, plasma sodium and urinary osmolality were elevated in the ETOH-treated rats. ETOH intake also induced a progressive increase in the mean arterial pressure (MAP), without affecting heart rate. Initially, this increase in MAP was correlated with increased plasma concentrations of adrenaline and noradrenaline. After the second week of ETOH treatment, plasma catecholamines returned to basal levels, and incremental increases were observed in plasma concentrations of vasopressin (AVP) and angiotensin II (ANG II). Conversely, plasma oxytocin, atrial natriuretic peptide, prolactin and the hypothalamus–pituitary–adrenal axis components were not significantly altered by ETOH.

Taken together, these results suggest that increased sympathetic activity may contribute to the early increase in MAP observed in ETOH-treated rats. However, the maintenance of this effect may be predominantly regulated by the long-term increase in the secretion of other circulating factors, such as AVP and ANG II, the secretion of both hormones being stimulated by the ETOH-induced dehydration.


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Request Reprint E-Mail:    jantunesr@gmail.com

Excessive alcohol consumption could hinder MDGs, says EAC Civil Society platform

 

The East African Community Civil Society against alcohol abuse has warned that if nothing is done, alcohol abuse could hinder the Millennium Development Goals (MDGs).

The warning was made during the recently concluded international conference on alcohol and drug use that took place in Kampala, Uganda.

 

According to the Regional Civil Society Body, seven out of the Eight Millennium Development Goals (MDG) are substantially hindered by heavy alcohol consumption that negatively affects them all.

 

International Evidence shows that alcohol is a cross-cutting risk factor in many areas of public health, as well social vices, from child health, non-communicable and communicable diseases including Sexually Transmitted Infections (STIs) and HIV/AIDS, gender based violence and crimes, to economic and social development. These grossly hinder sustainable development of households, communities and societies.  > > > >  Read More

Protracted withdrawal from ethanol and enhanced responsiveness stress: Regulation via the dynorphin/kappa opioid receptor system

Although recent work suggests that the dynorphin/kappa opioid receptor (DYN/KOR) system may be a key mediator in the stress-related effects of alcohol, the regulation of long-term changes associated with protracted withdrawal from ethanol via the DYN/KOR system has yet to be explored.

The objective of the present study was to determine the role of the DYN/KOR system in the regulation of anxiety-related behaviors during an extended period of abstinence from ethanol in animals with a history of ethanol dependence.

Male Wistar rats (n = 94) were fed an ethanol or control liquid diet for 25–30 days. Six weeks after its removal, rats were exposed to 20 min of immobilization, and the ability of the KOR antagonist nor-binaltorphimine (nor-BNI) (0–20 mg/kg, intraperitoneal [i.p.]) to attenuate the enhanced responsiveness to stress observed in rats chronically exposed to ethanol was investigated using the elevated plus maze. In addition, the ability of U50,488 (0–10 mg/kg, i.p.) to prime anxiety-like behavior during protracted withdrawal was also examined.

Rats with a history of ethanol dependence showed a significant decrease in open-arm exploration after exposure to restraint, indicating an anxiety-like state, compared to similarly treated controls, an effect that was blocked by nor-BNI. nor-BNI also selectively decreased center time and open-arm approaches in ethanol-exposed rats.

The highest dose of U50,488 decreased open-arm exploration and the total number of arm entries in ethanol-exposed and control rats. Although lower doses of U50,488 did not affect open-arm exploration in either group, the 0.1 mg/kg dose selectively decreased motor activity in the ethanol-exposed rats when compared to similarly pretreated controls.

These findings further support the hypothesis that behaviors associated with withdrawal from ethanol are in part regulated by the DYN/KOR system, and suggest that these effects may be long lasting in nature.



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Request Reprint E-Mail:     valdezg@gvsu.edu

Nicotine enhances ethanol-induced fat accumulation and collagen deposition but not inflammation in mouse liver

Alcohol and tobacco are frequently co-abused. Tobacco smoke increases alcoholic steatosis in apoE(−/−) mice. Tobacco smoke contains more than 4000 chemicals, but it is unknown which compounds in tobacco smoke play a major role in increasing alcoholic steatosis.

C57BL/J6 mice were intraperitoneally injected with nicotine at 1 mg/kg every day or saline at the same volume as a control and the mice were fed dextrose-control or ethanol Lieber–DeCarli liquid diets. Three weeks later the mice were sacrificed after overnight fasting.

Neither nicotine injection nor ethanol feeding alone increased serum levels of triglyceride, but the combination of nicotine and ethanol increased serum levels of triglyceride. Both nicotine injection alone and ethanol feeding alone increased hepatic collagen type I deposition, and nicotine injection and ethanol feeding combined further increased hepatic collagen type I deposition. The combination of nicotine and ethanol also activated hepatic stellate cells, a principal liver fibrogenic cell. Hepatic fat accumulation was induced by ethanol feeding, which was further enhanced by nicotine injection. Ethanol feeding caused an increase in serum ALT, but nicotine did not further increase serum ALT levels. Lipid droplets and inflammatory foci were observed in liver sections from ethanol-fed mice; nicotine treatment increased the number and size of lipid droplets, but not the number and size of inflammatory foci. Nicotine did not further increase ethanol-induced hepatic neutrophil infiltation.

These results suggest that nicotine enhances ethanol-induced steatosis and collagen deposition, but nicotine has no effect on ethanol-induced inflammation.


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Request Reprint E-Mail:    yongke.lu@mssm.edu

Nuanced but significant: How ethanol perturbs avian cranial neural crest cell actin cytoskeleton, migration and proliferation

Children with fetal alcohol syndrome (FAS) display striking craniofacial abnormalities. These features are proposed to result from perturbations in the morphology and function of cranial neural crest cells (cNCCs), which contribute significantly to the craniofacial complex. While certain pathways by which this may occur have been suggested, precise teratogenic mechanisms remain intensely investigated, as does the question of the teratogenic dose.

The present study focused on examining how avian cNCC actin cytoskeleton, migratory distance, and proliferation are affected ex vivo by exposure to ethanol concentrations that simulate maternal intoxication.

Chick cNCCs were cultured in 0.2% and 0.4% v/v ethanol. Distances migrated by both ethanol-treated and control cells at 24 and 48 h were recorded. Following phalloidin immunocytochemistry, treated and control cNCCs were compared morphologically and quantitatively. Apoptosis and proliferation in control versus treated cNCCs were also studied.

Chick cNCCs cultured in ethanol lost their spindle-like shapes and their ordered cytoskeleton. There was a significant stage-dependent effect on cNCC migration at 24 h (p = 0.035), which was greatest at stage 10 (HH).

Ethanol treatment for 48 h revealed a significant main effect for ethanol, chiefly at the 0.4% level. There was also an interaction effect between ethanol dose and stage of development (stage 9 HH). Actin microfilament disruption was quantitatively increased by ethanol at the doses studied while cNCC proliferation was increased but not significantly. Ethanol had no effect on cNCC apoptosis.

At ethanol levels likely to induce human FAS, avian cNCCs exhibit various subtle, potentially significant changes in morphology, migration, and proliferation, with possible consequences for fated structures.



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Request Reprint E-Mail:      olusegun.oyedele@ubc.ca

Endogenous cannabinoids in amygdala and hippocampus in post-mortem brains of Cloninger type 1 and 2 alcoholics

Accumulating evidence continues to link certain aspects of the endogenous cannabinoid (EC) system with alcohol dependence, negative-reinforcement learning, and the modulation of stress responses. Specific alterations in brain regions that are related to stress and negative-reinforcement learning have been reported to exist in Cloninger type 1 and type 2 alcoholics.

To study possible differences in profiles of EC systems between Cloninger type 1 (n = 9) and type 2 (n = 8) alcoholics and non-alcoholic control subjects (n = 10), we analyzed post-mortem amygdala and hippocampus brain samples for several ECs by quantitative liquid chromatography with triple quadrupole mass-spectrometric detection.

A significant difference was found between these 3 groups in terms of EC profiles in the amygdala (p = 0.037). In particular, this difference was prominent for variations in docosahexaenoylethanolamide levels, which were significantly higher in type 1 alcoholics (p = 0.022) when compared to controls.

There was also a large negative correlation between anandamide concentration and mGlu1/5 receptor density in the hippocampi of Cloninger type 1 alcoholics (R = −0.88, p = 0.002), which was not seen in Cloninger type 2 alcoholics or in controls.

Although preliminary, and from relatively small diagnostic groups, these results suggest that the EC system profile may be altered in the hippocampus and amygdala of Cloninger type 1 alcoholics.


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Request Reprint E-Mail:    markus.storvik@uef.fi

Editorial - Big alcohol catches up with adolescent girls

 

Alcohol is not an equal-opportunity substance when it comes to its harmful effects on young women, argues Flegel. Physicians and parents should provide information and good role modeling about the healthy use of alcohol.

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Acute and Chronic Effects of Alcohol on Trail Making Test Performance Among Underage Drinkers in a Field Setting

Alcohol's effects on executive functioning are well documented. Research in this area has provided much information on both the acute and chronic effects of alcohol on processes such as working memory and mental flexibility. However, most research on the acute effects of alcohol is conducted with individuals older than 21 years of age. Using field recruitment methods can provide unique empirical data on the acute effects of alcohol on an underage population.

The current study examined the independent effects of acute alcohol intoxication (measured by breath alcohol content) and chronic alcohol use (measured by years drinking) on a test of visuomotor performance and mental flexibility (Trail Making Test) among 91 drinkers ages 18–20 years recruited from a field setting.

Results show that breath alcohol predicts performance on Trails B, but not on Trails A, and that years drinking, above and beyond acute intoxication, predicts poorer performance on both Trails A and B.

These data suggest that, independent of the acute effects of alcohol, chronic alcohol consumption has deleterious effects on executive functioning processes among underage drinkers. Our discussion focuses on the importance of these data in describing the effect of alcohol on adolescents and the potential for engaging in risky behavior while intoxicated.



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Request Reprint E-Mail:    anne_day@brown.edu.

Smokers Report Greater Demand for Alcohol on a Behavioral Economic Purchase Task

Cigarette smokers have higher levels of alcohol consumption than nonsmokers and poorer response to alcohol treatment. It is possible that the greater severity of alcohol problems observed in smokers reflects a greater susceptibility to alcohol-related reinforcement. The present study used a behavioral economic purchase task to investigate whether heavy drinking smokers would have greater demand for alcohol than heavy drinking nonsmokers.

Participants were 207 college students who reported at least one heavy drinking episode in the past month. Of the 207 participants, 33.2% (n = 67) reported smoking cigarettes at least 1 day in the past month. Participants completed the hypothetical alcohol purchase task, a simulation task that asked them to report how many drinks they would purchase at varying price increments.

After the participants' reported alcohol consumption, gender, alcohol problems, and depression were controlled for, analyses of covariance revealed that heavy drinking smokers had significantly greater reported maximum alcohol expenditures (Omax), greater maximum inelastic price (Pmax), and higher breakpoint values (first price suppressing consumption to zero).

College student heavy drinkers who also smoke cigarettes exhibit increased demand for alcohol. Smokers in this high-risk developmental stage may thus be less sensitive to price and other contingencies that would otherwise serve to modulate drinking and may require more intensive intervention approaches.



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Request Reprint E-Mail:      myurasek@memphis.edu

Exome-Wide Association Study of Replicable Nonsynonymous Variants Conferring Risk for Alcohol Dependence

In the present study, we scanned the whole exome in three independent samples to search for replicable risk nonsynonymous (ns) variants (ns single-nucleotide polymorphisms [nsSNPs]) for alcohol dependence.

A total of 10,554 subjects in three independent samples were analyzed for association with alcohol dependence, including one European American sample (1,409 cases with alcohol dependence and 1,518 controls), one African American sample (681 cases and 508 controls), and one European Australian sample (a total of 6,438 family subjects with 1,645 alcohol-dependent probands). RNA expression of the risk genes in human, mouse, and rat brains was also explored.

We identified a total of 70 nsSNPs at 65 genes with nominally replicable associations; 22 nsSNPs at 21 genes among them survived corrections for multiple testing in meta-analysis (α = .0007). By incorporating the information from bioinformatics and RNA expression analyses, we identified at least two of the most promising risk genes for alcohol dependence: APOER2 and UBAP2.

The gene coding for apolipoprotein E receptor 2 (APOER2) and the gene coding for ubiquitin-associated protein-2 (UBAP2) are among the most appropriate for follow-up in human and nonhuman species as contributors to risk for alcohol dependence.



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Request Reprint E-Mail:    Lingjun.Zuo@yale.edu.

Integration and Sustainability of Alcohol Screening, Brief Intervention, and Pharmacotherapy in Primary Care Settings

At-risk drinking and alcohol use disorders are common in primary care and may adversely affect the treatment of patients with diabetes and/or hypertension. The purpose of this article is to report the impact of dissemination of a practice-based quality improvement approach (Practice Partner Research Network-Translating Research into Practice [PPRNet-TRIP]) on alcohol screening, brief intervention for at-risk drinking and alcohol use disorders, and medications for alcohol use disorders in primary care practices.

Nineteen primary care practices from 15 states representing 26,005 patients with diabetes and/or hypertension participated in a group-randomized trial (early intervention vs. delayed intervention). The 12-month intervention consisted of practice site visits for academic detailing and participatory planning and network meetings for "best practice" dissemination.

At the end of Phase 1, eligible patients in early-intervention practices were significantly more likely than patients in delayed-intervention practices to have been screened (odds ratio [OR] = 3.30, 95% CI [1.15, 9.50]) and more likely to have been provided a brief intervention (OR = 6.58, 95% CI [1.69, 25.7]. At the end of Phase 2, patients in delayed-intervention practices were more likely than at the end of Phase 1 to have been screened (OR = 5.18, 95% CI [4.65, 5.76]) and provided a brief intervention (OR = 1.80, 95% CI [1.31, 2.47]). Early-intervention practices maintained their screening and brief intervention performance during Phase 2. Medication for alcohol use disorders was prescribed infrequently.

PPRNet-TRIP is effective in improving and maintaining improvement in alcohol screening and brief intervention for patients with diabetes and/or hypertension in primary care settings.


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Request Reprint E-Mail:    nemethl@musc.edu

 

Drinking to Dampen Affect Variability: Findings From a College Student Sample

We hypothesized that individuals who are unable to effectively regulate emotional reactivity, which we operationalized as variability in self-reported affect throughout the day, would use alcohol more frequently and would report higher levels of drinking to cope. Further, we hypothesized that affect variation would be a stronger predictor of alcohol use or drinking to cope than level of negative affect.

A total of 86 college-age students (53% female, 77% White) participated in an intensive longitudinal study for 28 days. Participants reported positive and negative affect thrice daily and reported alcohol use once daily. Participant coping motives were assessed at study initiation.

Affect variability predicted increased drinking frequency and higher levels of self-reported drinking to cope. Mean level of negative affect was not related to an increased probability of drinking, nor was it related to self-reported drinking to cope. Both individual differences in affect variation and intra-individual daily fluctuations in affect were associated with an increased likelihood of drinking.

Our results imply that individuals with higher-than-average levels of affect variation are at risk for high levels of alcohol involvement and that people are more likely to drink on days characterized by higher-than-normal levels of fluctuation in affect. Future studies on self-medication should consider negative affect variability in addition to—or instead of—level of negative affect.



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Request Reprint E-Mail:   gottfredson@unc.edu

Hazardous Drinking, Depression, and Anxiety Among Sexual-Minority Women: Self-Medication or Impaired Functioning?

Sexual-minority women are at heightened risk for a number of mental health problems, including hazardous alcohol consumption, depression, and anxiety. We examined self-medication and impaired-functioning models of the associations among these variables and interpreted results within a life course framework that considered the unique social stressors experienced by sexual-minority women.

Data were from a sample of 384 women interviewed during the first two waves of the Chicago Health and Life Experiences of Women (CHLEW) study.

Covariance structure modeling revealed that (a) consistent with a self-medication process, anxiety was prospectively associated with hazardous drinking and (b) consistent with an impaired-functioning process, hazardous drinking was prospectively associated with depression.

Our findings support a life course perspective that interprets the mental health of adult sexual-minority women as influenced by adverse childhood experiences, age at drinking onset, first heterosexual intercourse, and first sexual identity disclosure, as well as by processes associated with self-medication and impaired functioning during adulthood.


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Request Reprint E-Mail:        timj@uic.edu

Hazelden and Chestnut Health Systems’ Digital Archive of the Journal of Inebriety (1876-1914)

Hazelden figures prominently in the past six decades of addiction treatment in America, and now the pioneering organization is helping to preserve an important period of the industry’s earlier history.

Working with prominent historian William White, Hazelden recently finished locating and digitizing all 141 issues of the Journal of Inebriety, which, from 1876 to 1914, documented the earliest stages of addiction medicine in the United States.
> > > >   Read More 


Read Vol. 1 - 35

Association Between Childhood Adversities and Suicide Attempts Among Alcoholic Inpatients in Taiwan

 
Alcohol dependence is frequently associated with suicide attempts. A history of adverse childhood experiences (ACEs) increases the risk of emotional and behavioral problems in adulthood. Child abuse is reported to increase suicide risk among alcohol-dependent patients. However, other types of ACEs, including ACEs related to family dysfunction that may have exceptional impact among the Chinese, are rarely explored.

The contribution of a broad spectrum of ACEs to lifetime risk of suicide attempts among alcoholic inpatients in Taiwan was examined. Family Health History Questionnaires were used to assess ACEs among 194 male alcohol-dependent inpatients admitted for alcohol detoxification. Logistic regression analysis was applied to examine the prediction of ACEs for lifetime risk of suicide attempts.

The rate of attempted suicide in this cohort was 27.4%. The prevalence of ACEs was high, with around 90% of participants reporting at least one type of ACE. In the regression analysis, after adjusting for lifetime depression, illicit drug use, and severity of alcohol dependence, having had a battered mother (odds ratio [OR] = 3.99, 95% CI [1.40, 11.34]) and having parents who were separated/divorced (OR = 7.35, 95% CI [1.56, 34.72]) were associated with the risk of suicide attempts, but having experienced physical and sexual abuse were not. A 1-unit increase in childhood adversity raised the likelihood of a suicide attempt by 61% (OR = 1.61, 95% CI [1.16, 2.25]).

There is a direct and graded relationship between childhood adversities and lifetime risk of suicide attempts among male alcoholic patients. In Chinese societies, adversities related to parental separation, divorce, and interparental violence may have a specific effect in aggravating suicide risk.


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Request Reperint E-Mail:    ychen@tpech.gov.tw

Alcohol as an Acute Risk Factor for Recent Suicide Attempts: A Case-Crossover Analysis

The extent to which acute alcohol use is a unique risk factor for suicide attempts is unknown. The aims of the current study were to quantify the unique effect of acute alcohol use on suicide attempts when adjusting for other acute exposures (other drug use and negative life events).

The current study used a case-crossover design and participants included 192 (62% female) recent suicide attempters presenting to a Level 1 trauma hospital. A timeline followback methodology was used to assess acute exposures within the 48 hours before the suicide attempt.

Results indicated that individuals were at increased odds of attempting suicide soon after drinking (odds ratio [OR] = 6.34), adjusting for acute drug use and negative life events. Furthermore, higher levels of drinking uniquely posed greater risk for a suicide attempt than lower levels of drinking (OR = 6.13) and no drinking (OR = 16.19) before the attempt.

Findings suggest the importance of considering acute alcohol use when evaluating short-term risk for suicide attempts.



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Request Reprint  E-Mail:     klgratz@aol.com

Are Certain College Students Prone to Experiencing Excessive Alcohol-Related Consequences? Predicting Membership in a High-Risk Subgroup Using Pre-College Profiles

Previous research identified a high-risk subgroup of students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). Although they consist of 20% of the population and account for nearly 50% of the consequences, the MRC group has not been the focus of etiological or prevention research. The present study identified pre-college profiles of psychosocial and behavioral characteristics and examined the association between these profiles and membership in the MRC group.

The sample consisted of 370 first-year college students (57% female) recruited in the summer before college. Participants reported on typical drinking, alcohol-related risky and protective drinking behaviors, alcohol beliefs, descriptive and injunctive norms, and alcohol-related consequences at three time points over 15 months.

Latent profile analysis identified four baseline student profiles: extreme-consequence drinkers, high-risk drinkers, protective drinkers, and nondrinkers. Logistic regression revealed that, when the high-risk drinkers were used as the reference group, both the protective drinkers and the nondrinkers were significantly less likely to be members of the MRC group, whereas the extreme-consequence drinkers were at increased odds of being in the MRC group, even after first-year drinking was controlled for. Student profiles and previously identified parental profiles both had unique main effects on MRC group membership, but there was no significant interaction between parental and student profiles.

Findings suggest ways that brief interventions can be tailored for students and parents in relation to the MRC group.



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Request Reprint E-Mail:     lvweld@psu.edu.

Who's At Risk? Ethnic Drinking Cultures, Foreign Nativity, and Problem Drinking Among Asian American Young Adults

Despite the low overall prevalence of alcohol use among Asian Americans, rates of alcohol use disorder are high among Asian American young adults. The influence of ethnic drinking cultures on immigrants and their descendants has been overlooked in past research. We took an integrative approach to examine the influence of ethnic drinking culture, acculturation, and socioeconomic disparities on problem drinking among Asian American young adults.

This study was a nationally representative sample of 854 Asian American young adults extracted from the Wave 4 National Longitudinal Study of Adolescent Health data. About 48% of the sample was female and 52% male. Several multiple logistic regression models were fitted.

Controlling for other covariates, two dimensions of ethnic drinking culture were associated with alcohol outcomes only for the foreign born: (a) detrimental drinking pattern with frequent drunkenness and alcohol-abuse symptoms and (b) drinking prevalence with alcohol-dependence symptoms. Financial hardship was a significant predictor of symptoms of alcohol abuse and dependence only for the U.S. born. Asian language use was protective against alcohol-abuse symptoms and alcohol-dependence symptoms for the foreign born.

Cultural and socioeconomic factors of problem drinking may be different for U.S.- and foreign-born Asian American young adults. Ethnic drinking cultures may significantly influence problem drinking of foreign-born Asian American young adults, independent of their acculturation into U.S. cultures. To inform effective interventions targeted at immigrants and their descendants, future research might further investigate the cultural and socioeconomic processes in immigrant communities that might significantly influence drinking.



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Request Reprint E-Mail:     wcook@arg.org

Associations Between Alcohol Use and Alcohol-Related Negative Consequences Among Black and White College Men and Women

The gender gap in alcohol use has been narrowing among young adults, while race differences in alcohol problems change throughout the life course, with Whites experiencing more problems before middle adulthood and Blacks experiencing more after. Yet, there is a paucity of research on the intricate relationship among gender, race, alcohol use, and alcohol problems in emerging adults. The present study addressed this gap in the literature.

The sample included White (n = 14,772) and Black (n = 458) college students from multiple colleges across the United States (59% female; 51% freshmen; mean age = 20 years).

With alcohol use levels adjusted for, women were more likely to report consequences related to damage to self and dependence-like symptoms than men. There were no significant race differences in either the type or the number of alcohol problems. Further, there was no Race × Alcohol Use interaction in relation to alcohol problems. We found a statistically significant interaction between gender and alcohol use in predicting alcohol problems, suggesting that, at higher levels of drinking, the risk for women to experience alcohol problems was significantly greater than that for men.

The reverse race gap in alcohol use and problems may not surface until young adulthood or may not be relevant for those who attend college. College interventions should help both Black and White students reduce problems associated with drinking and focus on limiting harm among female students.



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Request Repreint E-Mail:    eymun@rci.rutgers.edu

Longitudinal Study of Urban American Indian 12-Step Attendance, Attrition, and Outcome

Strong opinions have been voiced about the "fit" between 12-step treatment, community-based 12-step practices, and American Indian beliefs and values. Little is known, however, about the relative benefit of 12-step programs for urban American Indians, although they are the most widely accessed type of treatment by American Indians. This study investigated rates of 12-step attendance, attrition, and substance use outcomes for American Indians for 9 months relative to non-Hispanic White participants.

This study compared urban American Indian (n = 63) and non-Hispanic White (n = 133) 12-step attendance, attrition, and substance use over 9 months. The sample was formed by merging data from two prospective single-group longitudinal studies investigating behavior change in community-based 12-step programs. Participants were interviewed at baseline and at 3-, 6-, and 9-month follow-ups. No intervention was provided. Participants were recruited from Alcoholics Anonymous meetings in the community and as they presented for outpatient substance use disorder treatment. Substance use and patterns of 12-step attendance were measured using the Form 90 calendar-based interview, and the General Alcoholics Anonymous Tools of Recovery was administered to assess the adoption of prescribed 12-step practices and beliefs.

Trajectories in 12-step meeting attendance over 9 months did not differ between American Indian and non-Hispanic White participants. However, American Indian participants discontinued 12-step attendance significantly less often than non-Hispanic White participants. Higher rates of 12-step attendance predicted increased alcohol abstinence and decreased drinking intensity for both American Indian and non-Hispanic White participants. Twelve-step attendance was unrelated to later illicit drug use for both American Indian and non-Hispanic White participants.

Community-based 12-step program attendance is associated with drinking reductions among urban American Indians.


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Breath Alcohol Concentrations of Designated Drivers

This study established breath alcohol concentrations (BrACs) and alcohol-related behaviors of designated drivers (DDs) to determine (a) whether DDs are abstaining from drinking, (b) whether alcohol-related behaviors of non-DDs and DDs were different, and (c) whether the alcohol consumption of DDs resulted in BrAC levels that affected driving performance or caused psychomotor impairment.

We conducted six anonymous field studies during a 3-month period in a southeastern college community restaurant and bar district. Intercept interviews were conducted with 1,071 bar patrons. Alcohol-related behaviors, BrAC, and whether one was serving as a DD were measured. The sample was primarily White (72.7%), male (62.4%) college students (64.7%). Descriptive statistics and an independent sample t test compared the BrACs of DDs versus non-DDs. A one-way analysis of variance examined the differences in the alcohol-related behaviors (Alcohol Use Disorders Identification Test–consumption [AUDIT-C] score) across DDs abstaining from drinking (BrAC = .00 g/210 L), drinking DDs (BrACs ≥ .02 and < .05 g/210 L), and impaired DDs (BrACs ≥ .05 g/210 L). A logistic regression assessed the impact of alcohol-related behaviors (AUDIT-C) on whether one was serving as a DD.

Of the 165 DDs, approximately 40% did not abstain from drinking. Approximately 17% of DDs had BrACs between .02 g/210 L and .049 g/210 L, whereas 18% recorded BrACs at .05 g/210 L or greater. The mean AUDIT-C score for impaired DDs significantly differed from both abstaining DDs and drinking DDs. Participants with greater AUDIT-C scores were more likely to serve as a DD and have a BrAC that significantly inhibited driving ability and psychomotor function.

These findings identify the need for consensus across researcher, layperson, and communication campaigns that a DD must be someone who has abstained from drinking entirely.


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Association Between Neurotensin Receptor 1 Gene Polymorphisms and Alcohol Dependence in a Male Han Chinese Population

Neurotensin (NT) is a 13-amino acid multifunctional neuropeptide. Previous studies have demonstrated the roles of NT and its high-affinity receptor 1 (NTR1) in genetically mediated differential sensitivities to alcohol. However, no studies have investigated the association between NTR1 gene single-nucleotide polymorphisms (SNPs) and alcohol dependence (AD).

We therefore examined this link. We genotyped three SNPs (rs6090453C/G, rs6011914C/G, and rs2427422A/G) of NTR1 gene in 127 AD patients and 131 healthy controls drawn from Han Chinese males. Allele and genotype frequencies were compared, and linkage disequilibrium and haplotype analysis were performed.

For rs6011914C/G, the frequencies of GG genotypes in AD patients showed an increased trend compared with controls (p = 0.057), and the ratio of GG/(CG + CC) for dominant model in AD patients was significantly higher (p = 0.024). For rs2427422A/G, both the frequencies of G alleles and GG genotypes and the ratio of GG/(AG + AA) for dominant model in AD patients were significantly higher compared with controls (p = 0.003, 0.006, 0.002, respectively).

There was no significant difference in the frequencies of alleles, genotypes, and dominant or recessive model for rs6090453C/G (all p > 0.05).

There were three pairs of SNP linkage disequilibriums, and the haplotype frequencies differed significantly between patients and controls for the CCA (p = 0.005, less frequent in the patients) and CCG (p = 0.002, more frequent in the patients) haplotypes.

The current study supported an association between NTR1 gene variants and AD in the Han Chinese population.


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Request Reprint E-Mail:    gzhu@mail.cmu.edu.cn