Effects of Naltrexone on Alcohol Sensitivity and Genetic Moderators of Medication Response

A Double-blind Placebo-Controlled Study

Clinical trials have suggested a modest effect of naltrexone as a pharmacotherapy for alcoholism, and a recent study has suggested that the effects may be moderated by variations in the µ-opioid receptor gene (OPRM1). However, the mechanism by which naltrexone may be differentially effective as a function of the OPRM1 genotype is unclear.

1) To replicate and expand on the association between the A118G single nucleotide polymorphism(SNP) of the OPRM1 gene and alcohol sensitivity, (2) to examine the effects of naltrexone on alcohol sensitivity, and (3) to test the A118G SNP of the OPRM1 gene as a moderator of the effects of naltrexone on alcohol sensitivity.

Individuals with at least 1 copy of the G allele reported lower alcohol craving and higher alcohol-induced "high" across rising breath alcohol concentrations. Naltrexone was found to blunt alcohol's effects on stimulation, positive mood, craving, and enjoyment. The effects of naltrexone on blunting alcohol-induced high were stronger among individuals with the G allele.

This study advances the knowledge of mechanisms of action of naltrexone and genetic moderators of response to this pharmacotherapy.

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Reprint Request E-Mail: Lara_Ray@brown.edu
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How do Quantities Drunk Per Drinking day and the Frequencies of Drinking those Quantities Contribute to Self-reported Harm and Positive Consequences?
Alcohol and Alcoholism Advance Access published online on August 31, 2007



This article examines how quantities drunk per drinking day (dose) and the frequency of drinking those quantities affect self-reported harm and positive consequences at the individual and population level.

Respondents who reported frequent drinking at very high doses (13 drinks and above for men, 8 and above for women) were in a league of their own with respect to the risk of harm. At the population level, the dose of 8–12 drinks accounted for most problems among men, and doses of 5–7 and 3–4 drinks among women. No gain in positive consequences was attached to drinking beyond the dose of 5–7 drinks among men and 3–4 drinks among women.

The dose level at which the population-level risk was the highest was lower than the level at which the individual-level risk was the highest, due to a greater prevalence of drinking the lesser quantities.

Future studies should pay more attention to the separate effects of dose as well as the frequency of drinking the particular doses per occasion at the individual level, and also, as to how the prevalence of these drinking patterns contributes to the population-level risk.

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In Search of the Neurobiology of Addiction Recovery: A Brief Commentary on Science and Stigma

William L. White, MA

August, 2007

In 1997, Dr Alan Leshner, then Director of the National Institute on Drug Abuse (NIDA) published a seminal article, “Addiction is a Brain Disease, and It Matters,” in one of the world’s leading scientific journals (Leshner, 1997). That event was the opening salvo in a decade-long research and public education campaign to re-educate the public about the nature of addiction. The focus of this campaign has been to move “addiction is a disease” from the status of an ideological proclamation by policy activists and an organizing metaphor for individuals seeking to resolve alcohol and other drug problems to a science-grounded conclusion. The involvement of scientists was, in part, a response to earlier and continuing anti-disease polemics, e.g., Heavy Drinking: The Myth of Alcoholism as a Disease (Fingarette, 1989), The Diseasing of America (Peele, 1989), The Myth of Addiction (Davies, 1992) and Addiction is a Choice (Schaler, 2000). In the 1990s, the prolonged debate over disease conceptualizations of alcoholism and drug dependency moved from the philosophy departments to the scientific laboratories with the greatest financial investment in history in genetic and neurobiological studies of addiction. The fruits of that research triggered a campaign to re-educate the public and policy makers about the nature of addiction.
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Source: Addiction and Recovery News

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Commentary - A Toast to the Family

By STANTON PEELE
August 31, 2007; Page A9

Florida, Michigan and New Hampshire are some of a growing number of states to enact laws holding parents accountable for underage drinking at their homes. These laws typically involve hosting parties where alcohol is served to minors.

The target is parents who blithely allow keg parties in their basements and then let the teenagers who attend them drive home drunk. One such couple in Deerfield, Ill., was recently convicted when two 18-year-olds died in a car accident after such a party. Earlier this month, Karen Dittmer was arrested for allowing her 18-year-old son and his friends to drink beer at her birthday barbecue in New York's Suffolk County.

What kind of parents would ever allow their children to drink at home? Doesn't this put youngsters at risk?

The answer to the first question is simple. Most of the state laws include a specific exemption for children drinking at home during family and religious ceremonies. Observant Jews, for example, traditionally serve children small glasses of wine during Friday night Sabbath ceremonies. Other cultures also begin socializing children into drinking at an early age -- including Mediterranean societies such as Italy, Greece and Turkey (and non-Mediterranean societies such as China).
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Press Release - Young continue to drink and potentially damage their livers

Friday, August 31, 200

Between 2001 and 2006 unit consumption for 11-13 year olds who drank alcohol had risen by nearly one hundred percent from 5.6 units to 10.1 units in a one week period.

A report published today by The Information Centre highlights the need for a change in behaviour from young people with one in five pupils aged 11-15 years admitting to being drunk in the last four weeks of the study and around a third of these pupils had deliberately tried to get drunk.
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Follow this link to the full report
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The children drinking five pints a week

Cheap alcohol blamed as study finds pre-teen bingers have doubled intake

Rebecca Smithers, consumer affairs correspondent
Saturday September 1, 2007
The Guardian

A persistent hardcore of pre-teen binge drinkers - almost one in 10 of all 11- to 13-year-olds - are consuming more alcohol than ever before, according to new government figures.

They have doubled their weekly intake over five years - to more than 10 units a week, the equivalent of a bottle and a half of wine or five pints of beer, according to an NHS report which surveyed more than 8,000 secondary school pupils.

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Pernod takes aim at binge-drinking, youth

By William Spain, MarketWatch

Aug 31, 2007

CHICAGO (MarketWatch) -- Pernod Ricard is rolling out a new "responsibility" ad campaign as part of an effort that will eventually see the French wine and liquor giant spending a hefty percentage of its annual marketing budget on messages against drunk-driving, underage tippling and other alcohol-related ills.

Starting Friday with a full-page ad in USA Today, the campaign will soon extend to other national print media and also features the launch of a Web site, acceptresponsibility.org. It differs to some degree both in its size -- an initial investment of some $5 million over the next 10 months -- and its message from some other industry funded responsible drinking efforts
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Really Underage Drinkers: The Epidemiology of Children’s Alcohol Use in the United States
Prevention Science Online First 14 July 2007

Little attention has been paid to alcohol use by children aged 12 and younger. The present article summarizes findings on the prevalence of alcohol use from US national and statewide surveys of children in grades 6 and younger based on reports located in searches of the literature and the Internet.

Prevalence rates decrease with the level of involvement assessed. Alcohol use increases with age, doubling between grades four and six, with the largest jump in prevalence between grades five and six. At each grade level, boys are more likely to have used alcohol than girls. African-American children are nearly as likely as white and Hispanic children to have used alcohol.

Over the past decade or so, the prevalence of both lifetime and current alcohol use has been declining in children. The failure to assess intensity of children’s use hampers evaluation of the level of risk experienced by children.

There is a need for ongoing nationwide surveillance of alcohol use in this population and for greater education of parents regarding the dangers of introducing children to alcohol use.


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Provisional - Summary Health Statistics for the U.S. Population: National Health Interview Survey, 2006

Selected Highlights

Alcohol Drinking Status (Tables 26-27)

• Overall, 48% of adults 18 years of age and over were current regular drinkers, 12% were current infrequent drinkers, 6% were former regular drinkers, 8% were former infrequent drinkers, and 25% were lifetime abstainers.

• Fifty-seven percent of men were current regular drinkers compared with 39% of women. Men were also more likely to be former regular drinkers than were women. Women were more likely to be current or former infrequent drinkers or lifetime abstainers than were men.

• As age increased, the percentage of adults who were current regular drinkers decreased.

• Asian adults were more likely to be lifetime abstainers compared with other single race groups.

• When results are considered by single race and ethnicity, 53% of non-Hispanic white adults were current regular drinkers compared with 39% of Hispanic adults and 35% of non-Hispanic black adults. Hispanic adults and non-Hispanic black adults were almost twice as likely as non-Hispanic white adults to be lifetime abstainers.

• Educational attainment and family income were positively associated with current regular drinking status and inversely associated with being a lifetime abstainer.

• Among adults less than 65 years of age, 55% of those who had private health insurance coverage were current regular drinkers compared with 47% of those who were uninsured and 31% of those who had Medicaid health care coverage.

• Among adults aged 65 and over, 37% of those who had private health insurance coverage were current regular drinkers compared with 28% of those who had only Medicare health care coverage and 19% of those who had Medicaid and Medicare health care coverage.

• Adults who were living with a partner were more likely to be current regular drinkers compared with other marital status categories.

• Regionally, 31% of adults living in the South were lifetime abstainers, in contrast to 27% in the West, 19% in the Midwest, and 19% in the Northeast.

• Twenty-four percent of non-Hispanic white women were lifetime abstainers compared with 49% of Hispanic women and 44% of non-Hispanic black women. Conversely, 46% of non-Hispanic white women were current regular drinkers compared with 25% of non-Hispanic black women and 24% of Hispanic women. Among men, 15% of non-Hispanic white men were lifetime abstainers compared with 23% of Hispanic men and 26% of non-Hispanic black men; 61% of non-Hispanic white men were current regular drinkers compared with 53% of Hispanic men and 48% of non-Hispanic black men.

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Recovery Voices Count Just in time for your Rally for Recovery! and other Recovery Month observances, we are pleased to bring you our new, 2007-2008 Non-partisan Civic Engagement Guide, Recovery Voices Count. Use the Guide to raise recovery issues and participate in our electoral process. There’s information on registering voters at your Rally for Recovery! event. We’ll have more information about ways to use the Guide to build civic participation and engagement in your organization and community over the coming months. Rally for Recovery! and Recovery Month 2007 Over 60 organizations are participating in this year’s Rally for Recovery! to speak out about the power and proof of long-term recovery and call for policies to support recovery. Advocates in New Jersey and New York are coming together on September 15th in a “hub event” to bring national attention to Rally for Recovery! In Maine, the Alliance for Addiction Recovery (MAAR) has arranged for three advocates to be featured on a radio 'public affairs' talk show on Citadel Broadcast stations that will run on Sunday mornings. Use our sample media advisory and press release to publicize your events and activities. Learn more… Profiles of Recovery Advocacy in Action The sixth in our series of interviews with recovery advocates from across the country by Bill White and Pat Taylor features Bev Haberle, Executive Director of the Bucks County Council on Alcoholism and Drug Dependence, Inc. (BCADD). PRO-ACT, a grassroots recovery support initiative in Southeastern Pennsylvania, is a project of BCADD. Learn more… Resources In Search of the Neurobiology of Addiction Recovery: A Brief Commentary on Science and Stigma by William White, calls for a comprehensive recovery research agenda with a focus on the neurobiology of addiction recovery. Gender-specific Recovery Support Services: Evolution of the Women’s Community Recovery Center to the Women’s Recovery Community Center by Beverly Haberle and William White, describes the attempt of the Pennsylvania Recovery Organization-Achieving Community Together (PRO-ACT) to operate a gender-specific recovery home and a recovery support center within the same facility in New Britain, Pennsylvania. Recovery Solutions magazine features interviews with two Faces & Voices board members – Joe Powell, Executive Director of the Association of Persons Affected by Addiction and William Moyers, Vice President of Hazelden Foundation and author of Broken. The Substance Abuse Policy Research Program has called for proposals due by November 7, 2007 for research projects that address issues related to substance use, one of the most pressing public health problems facing our nation. Become a Founding Member! Dear Recovery Advocate, Thanks to your commitment and support, Faces & Voices of Recovery and our recovery advocacy movement continue to grow and make a difference in the lives of our families, friends and neighbors. In September 2006, we launched our founding member campaign, which runs through September 2007, Recovery Month. If you haven’t done so already, I urge you to become a founding member of Faces & Voices of Recovery Learn more…

Substance Abuse & Vocational Rehabilitation -- the Elephant in the Room: Research, Policies, and Exemplary Practices

October 16 & 17, 2007
Key Bridge Marriott, Arlington, VA

No other condition associated with large numbers of VR consumers has such state-to-state variability in diagnosis rates, inconsistencies in policy, and “hidden” cases than substance use disorder. Research suggests that approximately one quarter of VR consumers may have an active substance use disorder when they apply for VR services. This power-packed event will explore these issues with a panel of VR experts, including the Council of State Administrators of Vocational Rehabilitation (CSAVR) and State VR Directors. A second panel of lawyers will disentangle the applicable and sometimes conflicting statutes. Breakout sessions will review the latest findings regarding policies, training approaches, federal agency perspectives, and practices regarding substance use disorder and VR. A free web-based training series on the topic will be introduced.

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Contributor: Don Phillips

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Changes in some personality traits after recovery from alcohol dependence/abuse, anxiety and depression - Results of a 5-year follow-up in a general population sample of women
Nordic Journal of Psychiatry, Volume 61, Issue 4 2007 , pages 279 - 287





The aim of this study was to analyse stability of and change in personality traits in a general population sample of women over 5 years.

Specific questions were how personality traits changed after a first episode of alcohol dependence/abuse (ADA), anxiety or depression disorders and after remission of an episode.

Personality traits were assessed with the Karolinska Scales of Personality (KSP) and lifetime psychiatric diagnoses given according to the Diagnostic and Statistical Manual of Mental Disorders, 3rd revised edition (DSM-III-R).

Mean T-scores (KSP) for the general population sample were stable between initial assessment and follow-up 5 years later. Correlations between assessments were high for most KSP scores, indicating high individual stability.

For women with resolved ADA, KSP scores were normalized to five scales at the follow-up assessment: somatic anxiety, muscular tension, monotony avoidance, social desirability and irritability.

Women who recovered from anxiety disorders during the follow-up had decreased scores in somatic anxiety and muscular tension and increased scores in verbal aggression.

Women who developed ADA during follow-up had increased scores on the scales impulsiveness and verbal aggression.

Women who developed depression during follow-up had increased monotony avoidance.

Personality traits were generally stable in this adult female population but some personality traits changed in association with changes in psychiatric disorders. This knowledge could be useful in evaluation of treatment needs and treatment outcome.

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Reprint Request E-Mail: Anette.Ostlund@socmed.gu.se

Contributor: Don Phillips
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Externalizing symptoms among children of alcoholic parents: Entry points for an antisocial pathway to alcoholism.
Journal of Abnormal Psychology. 2007 Aug Vol 116(3) 529-542



The authors examined heterogeneity in risk for externalizing symptoms in children of alcoholic parents, as it may inform the search for entry points into an antisocial pathway to alcoholism.

Through integrative analyses of 2 independent, longitudinal studies, they showed that children with either an antisocial alcoholic parent or 2 alcoholic parents were at greatest risk for externalizing symptoms.

Moreover, children with a depressed alcoholic parent did not differ from those with an antisocial alcoholic parent in reported symptoms. These findings were generally consistent across mother, father, and adolescent reports of symptoms; child gender and child age (ages 2 through 17); and the 2 independent studies examined.

Multialcoholic and comorbid-alcoholic families may thus convey a genetic susceptibility to dysregulation along with environments that both exacerbate this susceptibility and provide few supports to offset it.

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Reprint request E-Mail: ahussong@email.unc.edu
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Gender differences and developmental change in externalizing disorders from late adolescence to early adulthood: A longitudinal twin study.
Journal of Abnormal Psychology. 2007 Aug Vol 116(3) 433-447




Using data from over 1,000 male and female twins participating in the Minnesota Twin Family Study, the authors examined developmental change, gender differences, and genetic and environmental contributions to the symptom levels of four externalizing disorders (adult antisocial behavior, alcohol dependence, nicotine dependence, and drug dependence) from ages 17 to 24.

Both men and women increased in symptoms for each externalizing disorder, with men increasing at a greater rate than women, such that a modest gender gap at age 17 widened to a large one at age 24. Additionally, a mean-level gender difference on a latent Externalizing factor could account for the mean-level gender differences for the individual disorders.

Biometric analyses revealed increasing genetic variation and heritability for men but a trend toward decreasing genetic variation and increasing environmental effects for women.

Results illustrate the importance of gender and developmental context for symptom expression and the utility of structural models to integrate general trends and disorder-specific characteristics.

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Reprint request E-mail: hicks013@umn.edu
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Licensed to drink: The reason Kenya is losing its deadly battle with alcohol

Story by SAMWEL KUMBA
Publication Date: 8/26/2007

After living in denial for a long time, Kenya is slowly waking up to its growing alcohol problem. In the latest of staggering steps meant to control overindulgence and related risks among Kenyans, industry players launched a campaign early in the week against underage drinking.

The campaign by the National Alcohol Beverages Association of Kenya (Nabak) called “We ID”, among other things, requires bar operators to ask their patrons to produce national identity cards as proof of age. This, the association hopes, will ensure that young people below the legal drinking age of 18 years keep off the bottle.

The Nabak initiative follows the introduction of the Alcoblow — the breath testing gadget — by the traffic police to curb drunk driving last year. The gadget was, however, withdrawn from the roads after a motorist successfully challenged its use in court.

But even before the alcohol sellers and makers begin to take stock of their successes or failures, anti-alcohol and drug abuse campaigners are warning that a liberal liquor licensing system, which allows business people to operate bars and restaurants everywhere, is making such efforts count for little.
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Study: Alcohol can speed up Aids progression

Written by Albert Muriuki

30-August-2007: Kenya may lose the gains it has made against HIV due to rampant alcoholism among the infected, a new research on the impact of alcohol on management of the pandemic indicates.

The study by the University of Boston found that heavy consumption of alcohol speeds up the onset of Aids in those infected by HIV.

“The impact is most pronounced in HIV patients who are not on anti-retroviral therapy (ART),” said Jeffrey Samet of Boston University.
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The PhenoGen Informatics website: tools for analyses of complex traits
BMC Genetics 2007, 8:59 30 August 2007

With the advent of "omics" (e.g. genomics, transcriptomics, proteomics and phenomics), studies can produce enormous amounts of data. Managing this diverse data and integrating with other biological data are major challenges for the bioinformatics community. Comprehensive new tools are needed to store, integrate and analyze the data efficiently.

Description: The PhenoGen Informatics website (http://phenogen.uchsc.edu) is a comprehensive toolbox for storing, analyzing and integrating microarray data and related genotype and phenotype data. The site is particularly suited for combining QTL and microarray data to search for "candidate" genes contributing to complex traits. In addition, the site allows, if desired by the investigators, sharing of the data. Investigators can conduct "in-silico" microarray experiments using their own and/or "shared" data.

The PhenoGen website provides access to tools that can be used for high-throughput data storage, analyses and interpretation of the results. Some of the advantages of the architecture of the website are that, in the future, the present set of tools can be adapted for the analyses of any type of high-throughput "omics" data, and that access to new tools, available in the public domain or developed at PhenoGen, can be easily provided.

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Substance Abuse Treatment Advisory: Naltrexone

The Center for Substance Abuse Treatment’s (CSAT’s) latest Substance Abuse Treatment Advisory, Naltrexone for Extended-Release Injectable Suspension for Treatment of Alcohol Dependence (Spring 2007, Volume 6, Issue 1) is available now!

Naltrexone for Extended-Release Injectable Suspension for Treatment of Alcohol Dependence (SMA07-4267)

In April 2006, the U.S. Food and Drug Administration approved a new extended-release injectable formulation of naltrexone (Vivitrol®) for the treatment of alcohol dependence. This issue answers questions treatment providers, particularly counselors and program administrators, may have about injectable naltrexone.

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Televised alcohol advertising: charity calls for ban before watershed

29 Aug 2007

Alcohol Concern, a UK charity, has stated that children are being exposed to alcoholic beverages because of inappropriate advertising times. As a result, the charity is calling for an advertising ban on alcohol before the watershed. For beer and flavored alcoholic beverage (FABs) manufacturers, it is a further indication of the increased pressure they face to change their marketing practices.

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Prevalence and Correlates of Substance Use Among High School Students in South Africa and the United States
AJPH First Look, published online ahead of print Aug 29, 2007

We compared prevalence rates and correlates of substance use among high school students in South Africa and the United States.

Rates of past-month alcohol and marijuana use were lower among South African students than among US students, but rates of illicit hard drug use were higher. Correlates of use in the 2 countries differed. For example, female gender was protective against tobacco, alcohol, and marijuana use in South Africa, whereas in the United States it was protective only against marijuana use. Black race/ethnicity was associated with lower rates of past-month cigarette and alcohol use in both countries, but the protective effect for alcohol use was stronger in South Africa.

Crosscultural studies can elucidate common and culturally unique pathways to drug use. Our results can inform future research, policies, and behavioral interventions in South Africa.

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Reprint Request E-Mail: nilen@archac.com

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