The Co-occurrence of Alcohol Abuse in Alcohol Dependence Among a Treatment Sample of Asian/Pacific Islanders

Alcohol abuse is not always linked to alcohol dependence in the general population, especially among minorities and women. These studies have excluded Asian and Pacific Islanders from analyses.

We examine the prevalence of alcohol dependence with and without alcohol abuse among a treatment sample in Hawaii.

Two hundred twenty-five participants were recruited from 2 major residential treatment programs in Hawaii for an 89% response rate. Participants were interviewed as soon as possible after their admission, generally within the first week. Abuse and dependence criteria were assessed with the Diagnostic Interview Schedule.

One hundred and eighteen (52%) met criteria for alcohol dependence. Among respondents with current alcohol dependence, 17% did not additionally meet criteria for abuse among clients at facilities in Hawaii. Current dependence without abuse occurred more frequently among Native Hawaiian clients (20%) and less frequently among Asian clients (11%). Although the number of women in the study was small, current dependence without abuse occurred more frequently among women (25%) compared with men (14%).

This study contributes to the current state of knowledge with regards to co-occurrence of alcohol abuse and dependence among ethnic groups in Hawaii. It will help treatment facilities develop a better understanding of the individuals seeking treatment in an effort to develop a comprehensive treatment plan that will take into account ethnic considerations. In addition, the use of alcohol abuse as a screening method for alcohol dependence in epidemiologic studies may underestimate the prevalence of dependence among Pacific Islanders, further limiting access to services for this underserved group.

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Request Reprint E-Mail: goebertd@dop.hawaii.edu

Collegiate natural drinking groups: Characteristics, structure, and processes

College students typically consume alcohol in groups.

To examine group characteristics, structure, processes, and group drinking, we conducted semi-structured, in-depth interviews with 30 (50% female; 60% non-Latino White) college students (18–24 years old).

Participants described the last event they attended where alcohol was present.

The interviews were fully transcribed and coded using an inductive approach with the software ATLAS.ti 5.2.

The findings revealed that group formation often involved minimal planning and was facilitated by technologies such as phone, text messaging, and social networking Internet sites.

Multiple roles were identified that supported the groups and that pertained to the drinking event organization, to drinking activities, or group regulation.

As the groups reached drunkenness, decision negotiations were replaced by random actions that often exemplified the loss of judgment resulting from alcohol impairment, leading to risky situations.

Understanding group dynamics and social roles in drinking groups could inform prevention efforts by identifying new loci of interventions; promoting pro-social roles in the group could encourage peers to become effective agents of prevention within the group.


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Request Reprint E-Mail: jlange@mail.sdsu.edu

What do clients want from alcohol and other drug treatment services? A mixed methods examination

This article presents findings from a study that examined the assistance aspirations of clients attending an outpatient alcohol and other drug (AOD) treatment service.

Key research questions were as follows: What type(s) of assistance do clients want? Do assistance aspirations vary by age, gender or ethnicity? and Are assistance aspirations predictive of subsequent attendance duration?

The study was set in an outpatient AOD treatment service located in Auckland, New Zealand. Data were collected from two client groups via a questionnaire (n = 109) and a semi-structured interview (n = 12). Questionnaire data were collected following the completion of the first attended appointment. Interview data were completed, on average, after participants had attended two treatment appointments (range 1–3).

When asked to indicate the services they would most like to receive, from a list of 10 possible options, questionnaire participants most frequently selected the options ‘talk to a professional about an AOD-related problem’ (71%), ‘practical strategies for making/maintaining changes to AOD use’ (66%) and ‘ongoing support while making/maintaining changes to AOD use’ (61%).

These options were also the three most likely to be endorsed as the number one service type wanted. Binary regression analysis identified few between-group differences concerning the frequency with which each option was endorsed.

The interview data were consistent with the questionnaire findings suggesting that, irrespective of age, gender, ethnicity and subsequent attendance duration, outpatient AOD treatment clients may share a common set of assistance aspirations at the point of service entry.


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Request Reprint E-Mail: justin.pulford@pngimr.org.pg

Interventions delivered during antenatal care to reduce alcohol consumption during pregnancy: A systematic review

Despite the importance of reducing prenatal exposure to alcohol, a recent Cochrane review found limited evidence from randomised controlled trials (RCTs) regarding effectiveness of interventions to reduce drinking during pregnancy.

The aim of this systematic review was to consider additional evidence by including RCTs and non-RCTs to determine whether pregnant women reduced alcohol consumption during pregnancy following interventions delivered during antenatal care.

Five electronic databases were searched using keywords: e.g. pregnancy, maternal, alcohol, consumption, drinking, cognitive-behavioural therapy, motivational interviewing (MI), brief intervention, health education, social support and self-efficacy.

Papers were excluded through a consecutive method using the title, abstract and full text paper. Two authors assessed the full text papers, including quality assessment.

Eight trials were included in the review, including six RCTs and two non-RCTs. Interventions included brief interventions, MI, a self-help manual, supportive counselling, high feedback ultrasound and basic educational interventions.

In general, methodological quality in all but two studies was poor, limiting the conclusions that could be drawn from this review.

However, there was some evidence from a small number of studies that single-session face-to-face brief interventions resulted in positive effects on the maintenance of alcohol abstinence during pregnancy.

Women choosing abstinence as their drinking goals and heavier drinking women who participated with a partner were more likely to be abstinent at follow-up.

However, more intensive interventions may be required to encourage women who continue to drink during pregnancy to reduce their consumption.

Implications for practice and future research directions are discussed.


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Request Reprint E-Mail: a.s.gilinsky@stir.ac.uk

Do Psychological Variables Mediate Sex Differences in Young Adults’ Alcohol Use?

This study applied an extended theory of planned behavior to test whether psychological variables mediate sex differences in alcohol consumption in social contexts.

Questionnaires of 300 young adults (urban, mean age 25 years, 49% female) were collected in 2007 prior to a sociable drinking occasion; consumption data were obtained through telephone interviews thereafter. The multiple-path mediation model was analyzed using structural equation modeling.

Sex differences in alcohol consumption, which were considerable, were partly mediated by the significant specific indirect effects of subjective norms through intention and of self-efficacy through both intention and willingness. Body weight was not a significant mediator.

Limitations are noted and implications for future research are discussed.


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Request Reprint E-Mail: friederike.zimmermann@psychologie.uni-heidelberg.de

Alcohol News 36/2010

BBC News (Scotland) - Alcohol price pilot claims 'damage' Scottish Borders
An MSP has criticised a south of Scotland colleague who suggested the Borders should pilot plans for a minimum price per unit of alcohol.
http://www.bbc.co.uk/news/uk-scotland-south-scotland-11199418

Telegraph.co.uk (UK) - Academic stress 'pushing young girls to alcohol and cigarettes'
Academic stress and the pressure to look attractive are driving young girls to alcohol and cigarettes, according to a study by the Girl Guides.
http://www.telegraph.co.uk/news/uknews/7982648/Academic-stress-pushing-young-girls-to-alcohol-and-cigarettes.html

Herald Scotland (Scotland) - Minimum pricing will help reduce the human cost of alcohol abuse
The opposition parties are acting irresponsibly over the Scottish Government’s proposals to introduce a minimum alcohol price of 45p per unit (“Sturgeon sets the minimum price of alcohol at 45p a unit”, The Herald, September 3).
http://www.heraldscotland.com/comment/herald-letters/letters-monday-6-september-2010-1.1053036

USA Today - 3 to 4 drinks per week may raise risk of breast cancer's return
Drinking even moderate amounts of alcohol may raise the risk for breast cancer recurrence in some women, new research indicates.
http://www.usatoday.com/yourlife/health/medical/breastcancer/2010-09-06-alcohol-drinking_N.htm

Sunday Business Post (Ireland) - Government advised to ban alcohol firms from sponsoring sporting events
Proposals to ban sponsorship of sports and other events by drinks companies are expected to be included in a report to government to be finalised next month, writes Pat Leahy.
http://www.sbpost.ie/news/government-advised-to-ban-alcohol-firms-from-sponsoring-sporting-events-51509.html

TestCountry.com - Fetal Brain Size Affected by Alcohol Consumption
Mothers who continue to drink even at an early stage of pregnancy do not only endanger themselves but their babies as well.
http://hometestingblog.testcountry.com/?p=9581

FLEXNEWS (Kenya) - Kenyan Market Frets Over Impact of New Alcohol Law
A new Kenyan alcohol law could open up East African Breweries to competition, with micro-brewers springing up to capitalise on the legalisation of traditional liquors, analysts said.
http://www.flex-news-food.com/console/PageViewer.aspx?page=32024

Helsinki Times (Finland) - Doctors to order alcohol locks for risk patients
A law enabling Finnish doctors to recommend alcohol locks on the cars of patients who consume a lot of alcohol is to come into use soon, according to regional daily Aamulehti on Monday.
http://www.helsinkitimes.fi/htimes/domestic-news/general/12374-doctors-to-order-alcohol-locks-for-risk-patients-aamulehti-.html

AFP (Russia) - Russians urged to smoke, drink more
Smoke and drink more, Russia's finance minister Alexei Kudrin urged citizens on Wednesday, explaining that higher consumption would help lift tax revenues for spending on social services.
http://www.google.com/hostednews/afp/article/ALeqM5jGzvnPQDSDAZ-_szkxN65OwffAKA

DailyFinance (USA) - Alcohol and College: How Much Money Are Students Really Drinking?
The average college student spends $500 per year on alcohol, according to Rachel Barrington of the University of Wisconsin.
http://www.dailyfinance.com/story/alcohol-college-money-cost-students-drinking/19620570/

NewsOK.com (USA) - Millions drive drunk, government study finds
An estimated 17 million people have driven while drunk at least once on U.S. streets and highways in the course of a year, according to a government study released last week.
http://newsok.com/millions-drive-drunk-government-study-finds/article/3491952

NDTV.com - Judging when alcohol's effects wear off not easy
The way that alcohol impairs reasoning and problem-solving abilities may explain why some people feel they are fit to drive even though they are drunk.
http://doctor.ndtv.com/storypage/ndtv/id/4711/Judging_when_alcohols_effects_wear_off_not_easy.html

MedIndia (Sweden) - Privatizing Retail Alcohol Sales in Sweden Will Escalate Alcohol-Related Violence
Privatizing Sweden's government monopoly on the sale of alcohol, a study published today in the scientific journal Addiction argues, will significantly increase alcohol-related violence and other harms.
http://www.medindia.net/news/Privatizing-Retail-Alcohol-Sales-in-Sweden-Will-Escalate-Alcohol-Related-Violence-73538-1.htm

YLE News (Finland) - Psychiatrists Propose Forcing Sobriety on Violent Criminals
Finland's leading forensic psychiatrists are calling for violent convicts to prove their sobriety as a condition for freedom. According to the proposal, prisoners who are considered dangerous should not be released unless they have committed to sobriety.
http://www.yle.fi/uutiset/news/2010/09/psychiatrists_propose_forcing_sobriety_on_violent_criminals_1951377.html

WHO (Africa) - WHO proposes strategy to reduce harmful use of alcohol
The World Health Organization has proposed a strategy to prevent or at least reduce the harmful use of alcohol and related problems in the African Region.
http://www.afro.who.int/en/media-centre/pressreleases/2402-who-proposes-strategy-to-reduce-harmful-use-of-alcohol.html


Alcohol News

Accumbens Homer2-mediated signaling: A factor contributing to mouse strain differences in alcohol drinking?

Alcohol-induced increases in nucleus accumbens glutamate actively regulate alcohol consumption and the alcohol responsiveness of corticoaccumbens glutamate systems relates to genetic variance in alcohol reward.

Here, we extend earlier data for inbred mouse strain differences in accumbens glutamate by examining for differences in basal and alcohol-induced changes in the striatal expression of glutamate-related signaling molecules between inbred C57BL/6J and DBA2/J mice.
Repeated alcohol treatment (8 X 2 g/kg) increased the expression of Group1 metabotropic glutamate receptors, the NR2a/b subunits of the N-methyl-D-aspartate receptor, Homer2a/b, as well as the activated forms of protein kinase C epsilon and phosphoinositol-3-kinase within ventral, but not dorsal, striatum.

Regardless of prior alcohol experience, C57BL/6J mice exhibited higher accumbens levels of mGluR1/5, Homer2a/b, NR2a and activated kinases versus DBA2/J mice, while an alcohol-induced rise in dorsal striatum mGluR1/5 expression was observed only in C57BL/6J mice.

We next employed virus-mediated gene transfer approaches to ascertain the functional relevance of the observed strain difference in accumbens Homer2 expression for B6/D2 differences in alcohol-induced glutamate sensitization, as well as alcohol preference/intake.

Manipulating NAC shell Homer2b expression actively regulated these measures in C57BL/6J mice, while DBA2/J mice were relatively insensitive to the neurochemical and behavioral effects of virus-mediated changes in Homer2 expression.

These data support the over-arching hypothesis that augmented accumbens Homer2-mediated glutamate signaling may be an endophenotype related to genetic variance in alcohol consumption.

If relevant to humans, such data pose polymorphisms affecting glutamate receptor/Homer2 signaling in the etiology of alcoholism.

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Request Reprint E-Mail: szumlinski@psych.ucsb.edu

A Review of Synaptic Plasticity at Purkinje Neurons with a Focus on Ethanol-Induced Cerebellar Dysfunction

The cerebellum controls balance, posture, motor coordination, and cognition, and studies suggest that ethanol impairs these cerebellar functions. However, the mechanisms through which ethanol produces these effects are not fully understood.

Here, we review evidence suggesting that ethanol acts, in part, by impairing synaptic plasticity mechanisms at cerebellar Purkinje neurons.

We will primarily focus on recent experiments indicating that long-term depression at both parallel fiber– and climbing fiber–Purkinje cell synapses is inhibited by acute ethanol exposure.

We will also discuss experimental evidence showing that chronic prenatal ethanol exposure converts long-term depression into long-term potentiation at parallel fiber–Purkinje cell synapses.


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Request Reprint E-Mail: fvalenzuela@salud.unm.edu

Bk Channel and Alcohol, a Complicated Affair

Alcohol is a fast acting molecule that alters behavior within a few minutes of absorption. Its rapid behavioral impact suggests early action on ion channels.

Of all voltage-gated potassium ion channels, BK channels, a subcategory of potassium channels characterized by their large unitary conductance, and by their capacity of being activated synergistically by membrane potential and intracellular free calcium, are unique due to their high sensitivity to alcohol.

In this review, we discuss BK channels structure and function, and how they help us understand the various ways BK channel mediates alcohol's effects on neuronal function and on behavior in the striatum.

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Request Reprint E-Mail: gilles.martin@umassmed.edu

Alcohol and the Prefrontal Cortex

The prefrontal cortex occupies the anterior portion of the frontal lobes and is thought to be one of the most complex anatomical and functional structures of the mammalian brain. Its major role is to integrate and interpret inputs from cortical and sub-cortical structures and use this information to develop purposeful responses that reflect both present and future circumstances. This includes both action-oriented sequences involved in obtaining rewards and inhibition of behaviors that pose undue risk or harm to the individual. Given the central role in initiating and regulating these often complex cognitive and behavioral responses, it is no surprise that alcohol has profound effects on the function of the prefrontal cortex.

In this chapter, we review the basic anatomy and physiology of the prefrontal cortex and discuss what is known about the actions of alcohol on the function of this brain region.

This includes a review of both the human and animal literature including information on the electrophysiological and behavioral effects that follow acute and chronic exposure to alcohol.

The chapter concludes with a discussion of unanswered questions and areas needing further investigation.

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Request Reprint E-Mail: woodward@musc.edu

Ethanol Action on Dopaminergic Neurons in the Ventral Tegmental Area: Interaction with Intrinsic Ion Channels and Neurotransmitter Inputs

The dopaminergic system originating in the midbrain ventral tegmental area (VTA) has been extensively studied over the past decades as a critical neural substrate involved in the development of alcoholism and addiction to other drugs of abuse.

Accumulating evidence indicates that ethanol modulates the functional output of this system by directly affecting the firing activity of VTA dopamine neurons, whereas withdrawal from chronic ethanol exposure leads to a reduction in the functional output of these neurons.

This chapter will provide an update on the mechanistic investigations of the acute ethanol action on dopamine neuron activity and the neuroadaptations/plasticities in the VTA produced by previous ethanol experience.

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Request Reprint E-Mail: morikawa@mail.utexas.edu

Glutamate Plasticity in the Drunken Amygdala: The Making of an Anxious Synapse

Plasticity at glutamatergic synapses is believed to be the cellular correlate of learning and memory. Classic fear conditioning, for example, is dependent upon NMDA-type glutamate receptor activation in the lateral/basolateral amygdala followed by increased synaptic expression of AMPA-type glutamate receptors.

This review provides an extensive comparison between the initiation and expression of glutamatergic plasticity during learning/memory and glutamatergic alterations associated with chronic ethanol exposure and withdrawal.

The parallels between these neuro-adaptive processes suggest that long-term ethanol exposure might “chemically condition” amygdala-dependent fear/anxiety via the increased function of pre- and post-synaptic glutamate signaling.

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Request Reprint E-Mail: bmccool@wfubmc.edu

Identifying Quantitative Trait Loci (QTLs) and Genes (QTGs) for Alcohol-Related Phenotypes in Mice

Alcoholism is a complex clinical disorder with genetic and environmental contributions. Although no animal model duplicates alcoholism, models for specific factors, such as the withdrawal syndrome, are useful to identify potential genetic determinants of liability in humans.

Murine models have been invaluable to identify quantitative trait loci (QTLs) that influence a variety of alcohol responses. However, the QTL regions are typically large, at least initially, and contain numerous genes, making identification of the causal quantitative trait gene(s) (QTGs) challenging.

Here, we present QTG identification strategies currently used in the field of alcohol genetics and discuss relevance to alcoholic human populations.

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Request Reprint E-Mail: milnerl@ohsu.edu

Genetic Variation and Brain Gene Expression in Rodent Models of Alcoholism: Implications for medication development

Much research on experimental animals that is aimed to decipher genetic factors involved in alcoholism has been devoted to either models of innate alcohol-related phenotypes or responses after acute alcohol challenge.

Such focus has, however, limitations when it comes to the pathogenetic mechanism underlying alcohol addiction, because the progression into the disorder takes years and genetic as well as environmental factors may exert different influences along this trajectory.

Animal models of the neuroadaptations involved in the development of dependence exist, but have been difficult to implement for genetic and genomics analysis. Consequently, currently available data have been difficult to reconcile with the human condition and could be misleading in predicting targets for medication development.

This review will illustrate strengths and pitfalls of genomic approaches in rodent models of alcoholism and emphasize the need for convergent lines of evidence to improve the predictive value of such studies.

Examples of a convergent research approach include validation studies for Agt, Arrb2, Crhr1, Grin3a, and Npy.

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Request Reprint E-Mail: karl.bjork@ki.se

Using Expression Genetics to Study the Neurobiology of Ethanol and Alcoholism

Recent simultaneous progress in human and animal model genetics and the advent of microarray whole genome expression profiling have produced prodigious data sets on genetic loci, potential candidate genes, and differential gene expression related to alcoholism and ethanol behaviors. Validated target genes or gene networks functioning in alcoholism are still of meager proportions.

Genetical genomics, which combines genetic analysis of both traditional phenotypes and whole genome expression data, offers a potential methodology for characterizing brain gene networks functioning in alcoholism.

This chapter will describe concepts, approaches, and recent findings in the field of genetical genomics as it applies to alcohol research.

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Request Reprint E-Mail: farrissp2@vcu.edu

Neural Plasticity, Human Genetics, and Risk for Alcohol Dependence

Opportunities for advances in the neurobiology of alcohol dependence have been facilitated by the development of sophisticated neurophysiological and neuroimaging techniques that allow us to have a window on developmental changes in brain structure and function.

The search for genes that may increase susceptibility to alcohol dependence has been greatly facilitated by the recognition that intermediate phenotypes, sometimes referred to as endophenotypes, may be closer to the genetic variation than is the more complex alcohol dependence phenotype.

This chapter will review the evidence that the brain is highly plastic, exhibiting major postnatal changes, especially during adolescence, in neural circuits that appear to influence addiction susceptibility.

This chapter will suggest that heritable aspects of brain structure and function that are seen developmentally may be an important endophenotypic characteristic associated with familial risk for developing alcohol dependence.

Finally, a review of studies showing associations between brain structural and functional characteristics and specific genes will be offered.


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Request Reprint E-Mail: syh50@imap.pitt.edu

The Genetics of Behavioral Alcohol Responses in Drosophila

Drosophila melanogaster is commonly found near rotting or fermenting fruit, reflected in its name pomace, or vinegar fly. In such environments, flies often encounter significant levels of ethanol.

Three observations have made Drosophila a very promising model organism to understand the genetic contributions to the behavioral responses to alcohol.

First, similar to higher vertebrates, flies show hyperactivation upon exposure to a low to medium dose of alcohol, while high doses can lead to sedation. In addition, when given a choice, flies will actually prefer alcohol-containing food over regular food.

Second, the genes and biochemical pathways implicated in controlling these behavioral responses in flies are also participating in determining alcohol responses, and drinking behavior in mammals.

Third, the fact that flies have been studied genetically for over one hundred years means that an exceptional repertoire of genetic tools are at our disposal.

Here, we will review some of these tools and experimental approaches, survey the methods for, and measures after Drosophila ethanol exposure, and discuss the different molecular components and functional pathways involved in these behavioral responses to alcohol.

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Request Reprint E-Mail: aylin.rodan@utsouthwestern.edu

The Role of microRNAs in Drug Addiction: A Big Lesson from Tiny Molecules

Alcoholism is a multifactorial disease of unclear molecular underpinnings.

Currently, we are witnessing a major shift in our understanding of the functional elements of the genome, which could help us to discover novel insights into the nature of alcoholism.

In humans, the vast majority of the genome encodes non-protein-coding DNA with unclear function.

Recent research has started to unveil this mystery by describing the functional relevance of microRNAs, and examining which genes are regulated by non-protein-coding DNA.

Here, I describe alcohol regulation of microRNAs and provide examples of microRNAs that control the expression of alcohol-relevant genes.

Emphasis is put on the potential of microRNAs in explaining the polygenic nature of alcoholism and prospects of microRNA research and future directions of this burgeoning field.

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Request Reprint E-Mail: andrepi@aesop.rutgers.edu

Does Drinking Impair College Performance? Evidence from a Regression Discontinuity Approach

This paper examines the effect of alcohol consumption on student achievement.

To do so, we exploit the discontinuity in drinking at age 21 at a college in which the minimum legal drinking age is strictly enforced.

We find that drinking causes significant reductions in academic performance, particularly for the highest-performing students.

This suggests that the negative consequences of alcohol consumption extend beyond the narrow segment of the population at risk of more severe, low-frequency, outcomes.
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Press Release - WHO proposes strategy to reduce harmful use of alcohol

The World Health Organization has proposed a strategy to prevent or at least reduce the harmful use of alcohol and related problems in the African Region.

The strategy, based on five key principles to guide policy development at country level, is predicated on: the use of the best available evidence and sensitivity to national contexts in policy formulation; protection of people at risk, particularly harm from other people’s act of drinking, and from pressures to drink; strong political commitment, leader-ship and appropriate funding; equitable and non-stigmatized access to effective prevention and care services, and undertaking of joint actions with key agencies, partners and stakeholders in a coordinated, strategic and integrated manner. > > > >

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