Conceptual and Design Essentials for Evaluating Mechanisms of Change
Alcoholism: Clinical and Experimental Research 31 (s3), 4s–12s.

Considerable progress has been made toward the development of evidence-based treatments for a wide range of psychological disorders; however, little is known about the mechanisms through which these treatments actually lead to clinical change. Although the use of traditional randomized controlled treatment designs and tests of statistical mediation have significantly advanced understanding of psychological treatments, they are insufficient to test mechanisms of change.

Conceptualizing and conducting studies that test mechanisms of change requires substantial modifications to traditional research designs, but doing so will significantly enhance scientific understanding as well as the efficiency and effectiveness of clinical interventions.

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Request Reprint E-Mail: nock@wjh.harvard.edu
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The Search for Mechanisms of Behavior Change in Evidence-Based Behavioral Treatments for Alcohol Use Disorders: Overview
Alcoholism: Clinical and Experimental Research 31 (s3), 1s–3s.

Over the past three decades, the main question of interest to alcohol treatment researchers has concerned the main effects of a particular behavioral intervention or what works. Increasingly, alcohol treatment researchers are turning their attention to the underlying psychological, social, and even neurophysiologic processes or "active ingredients" that are driving therapeutic change.

The articles contained in this supplement to Alcoholism: Clinical and Experimental Research grew out of invited presentations given at a one-day satellite session immediately preceding the 28th Annual Meeting of the Research Society on Alcoholism (RSA). The conference was a collaborative effort of the Center on Alcoholism, Substance Abuse, and Addiction at the University of New Mexico, the Center on Addiction and Substance Abuse at Columbia University, Brown University, and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health.

The conference featured a mix of full-length presentations on conceptual and methodological issues, reports of original research findings, and lively discussion among speakers and conference participants. Understanding mechanisms of behavior change will benefit the field by identifying the key aspects of therapy that must be present for maximum effect, irrespective of the specific technique being applied; provide a new way to approach patient–treatment interactions; and lay the groundwork for understanding how change is affected by social and other extratreatment factors.

Although not a new topic to the field, understanding mechanisms of behavior change has begun to capture the interest of an increasing number of alcohol treatment researchers. Understanding behavior change is an exceedingly complex enterprise and innovative thinking and creative research designs will be required to advance the field.

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Request Reprint E-Mail: bhuebner@niaaa.nih.gov

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Reducing Past Harm Appraisals During Treatment Predicts Worse Substance Use Outcome
Alcoholism: Clinical and Experimental Research 31 (s3), 67s–70s.

Appraisals of the past harm from substance use have been associated with increased motivation and treatment seeking behaviors. Harm appraisals are subjective evaluations of the harm caused by substance use and differ from traditional consequences measures which assess the occurrence of adverse events related to substance use.

Although influencing these appraisals is a central component to most treatments, no studies have examined how changes in these appraisals during treatment influence outcome. The present study examined how changes in appraisals of the past harm from substance use over the course of treatment influence short- and long-term substance use outcomes.

Reductions in appraisals of past harm from baseline to end of treatment predicted lower PDA and higher objective consequences at end of treatment and 9-month follow-up. There were no significant differences in outcome between those who increased versus maintained harm appraisals from baseline to end of treatment. Higher treatment intensity and 12-step affiliation were associated with fewer reductions in past harm appraisals.

Results of the present study suggest subjective appraisals of the past harm from substance use wane for some people during treatment and that helping clients maintain or increase their perceptions of the past harm from substance use over the course of treatment is associated with better short- and long-term outcomes.

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Reprint Request E-Mail: frodisam@hotmail.com

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Detection and management of alcohol use disorders in German primary care influenced by non-clinical factors
Alcohol and Alcoholism 2007 42(4):308-316





The primary objective was to assess the proportion of detected and correctly referred patients in German primary care. The secondary objective was to identify patient and practitioner characteristics that predict detection and correct referral.

Correctly identified problem drinkers were 38.6% in a per-protocol analysis and 33.6% using a worst-case scenario. Referral behaviour of physicians was in conformity with current practice guidelines in 64.6% of the documented cases and 27.0% in a worst-case scenario. Several patient (e.g. sex, age) and practitioner characteristics (e.g. age), which influence the diagnosis and referral of patients, could be identified.

There is a clear need to increase the special diagnostic and therapeutic skills of general practitioners so that they may be able to indicate and perform secondary prevention. Further research should focus on the likely effects of the implementation of these diagnostic and management tools.

<sup>Read Full Abstract

Request Reprint E-Mail: michael.berner@uniklinik-freiburg.de
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Biochemical markers of alcoholism
Clinical Chemistry and Laboratory Medicine

Volume: 45 | Issue: 8

August 2007

Page(s): 953-961

Alcohol and alcohol-related diseases have become a major cause of death in Western countries.

The most sensitive and specific of the commonly used biomarkers of alcohol intake are carbohydrate-deficient transferrin (CDT), and the combination of γ-glutamyltransferase (GGT) and CDT. Other widely used laboratory markers are GGT, mean corpuscular volume of erythrocytes and the ratio of aspartate aminotransferase to alanine aminotransferase. Blood ethanol levels reveal recent alcohol use.

However, more specific and sensitive biomarkers to improve the detection of excessive alcohol use at an early stage are needed. New biomarkers, not yet used in routine clinical work, include phosphatidylethanol, fatty acid ethyl esters, ethyl glucuronide, sialic acid, and acetaldehyde adducts.

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Reprint Request E-Mail: minna.hannuksela@oulu.fi
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Impact of Alcohol and Illicit Drug Use in Wisconsin







Alcohol and illicit drug use and abuse are serious problems in Wisconsin. Although Wisconsin has among the highest rates of alcohol use in the nation, the state falls at or below the national average in nearly all measures of illicit drug use.

This report attempts to account for the total impact of substance use and abuse in Wisconsin considering mortality, morbidity, and crimes related to the consumption of alcohol and illicit drugs.

The University of Wisconsin Population Health Institute has been collaborating with the Wisconsin State Epidemiological Outcomes Workgroup (SEOW) since 2006 to explore consequence and consumption patterns of alcohol and illicit drug use in Wisconsin. This report is one of the results of that collaboration.

In March 2007, the SEOW released Wisconsin’s 2006 Epidemiological Profile. This report is both an update and a summary of that profile. Readers of both reports may notice some inconsistencies, particularly in the areas of motor vehicle fatalities and drug-related mortality. Researchers at the UW have re-examined the earlier efforts and found them in need of revision.

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Wisconsin's Epidemiological Profile on Alcohol and Other Drug Use 2006


The Wisconsin Department of Health and Family Services is committed to moving toward need-based funding through improved data collection and analysis. One important aspect of prevention services is the ability to track the needs of communities through epidemiological factors. Based on the identified needs, resources can be allocated to address the problem using evidence-based programming.

Wisconsin’s 2006 “Epidemiological Profile Report”provides a foundation for further study of problems regarding use and abuse of substances and the resulting consequences.

Alcohol Consumption

In 2005, Wisconsin had the highest prevalence of alcohol use in the country. The percent of high school students who initiated alcohol use before the age of 13 was similar to the national average and has been decreasing over the past five years. However, current use of alcohol among both youth and adults was among the highest in the country. In 2005, Wisconsin high school students reported the highest rate of current alcohol use among all reporting states and the fifth highest rate of binge drinking. Among adults, Wisconsin had the highest prevalence of binge drinking, current alcohol use, and chronic heavy drinking in the country. The rate of per capita alcohol consumption was also among the highest in the nation.

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Britons' penchant for pints leads to health, safety issues

By Jeffrey Stinson, USA TODAY
18 September 2007

LONDON — Beer and pubs are as British as, well, the Union Jack.

However, Britons' fondness for alcohol is causing ever more serious health and safety problems, including a wave of liver disease and violent crime. In response, some doctors and politicians are calling for measures to reverse the trend, such as raising the drinking age to 21 from 18.

Nine out of 10 Britons older than 14 drink alcohol, the government estimates. And they're drinking more. In 2005, they drank 1.7 billion gallons of alcohol, with average consumption per person doubling since 1960.

Particularly problematic is a rise in binge drinking, defined as having five or more drinks in one sitting. Britain has a greater percentage of regular binge drinkers, 24%, than other European Union nations except the Republic of Ireland and Finland, among 25 countries surveyed by the European Commission earlier this year.
. . . . . .

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Motor Functioning and Alcohol Dependence
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles).
17 Septemeber 2007



Autopsy and neuroimaging research in stably abstinent alcoholics illuminated structural and functional abnormalities in brain areas that organize and coordinate motor functioning.

Researchers that used behavioural tasks to measure motor functioning found that abstinent alcoholics perform worse than healthy controls. These researchers however did not analyze timed responses into their cognitive and motor components. They thus were unable to decide which aspects of information processing are impaired.

We here used a Fitts’ task to examine differences in cognitive and motor components between abstinent alcoholics and healthy controls.

Abstinent alcoholics needed more time to perform timed responses than healthy controls. As both reaction and movement times were higher in abstinent alcoholics, both cognitive and motor processes seem to be impaired. When the task became more difficult (small targets instead of large targets) abstinent alcoholics needed proportionally more time to give the correct response than healthy controls. This phenomenon solely applied to movement times.

These research data indicate that abstinent alcoholics are somewhat impaired on a behavioral level. The execution of timed responses indeed was lengthier in abstinent alcoholics than in healthy controls. As both cognitive and motor processes were impaired, we here assume that both central and peripheral processes are affected by progressive alcohol intake. Abstinent alcoholics also have more difficulties to adapt their motor responses to changing task conditions.

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Reprint Request E-Mail: biekedewilde@hotmail.com
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Cognitive Performance in Long-Term Abstinent Elderly Alcoholics
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles).
17 September 2007


To date, there is a wealth of literature describing the deleterious effects of active alcoholism on cognitive function. There is also a growing body of literature on the extent of cognitive recovery that can occur with abstinence. However, there is still a dearth of published findings on cognitive functioning in very long-term abstinence alcoholics, especially in the elderly population.

Overall, the EAA groups performed comparably to controls on the assessments of cognitive function. Only the abstinent in group before 50 years of age performed worse than controls, and this was only in the domain of auditory working memory. EAAs had larger craniums than their controls. This effect was strongest for those who drank the longest and had the shortest abstinence. Such individuals also performed better cognitively.

Our data showed that elderly alcoholics that drank late into life, but with at least 6 months abstinence can exhibit normal cognitive functioning. Selective survivorship and selection bias probably play a part in these findings.

Cognitively healthier alcoholics, with more brain reserve capacity, may be more likely to live into their 60s, 70s, or 80s of age with relatively intact cognition, and to volunteer for studies such as this.

Our results do not imply that all elderly alcoholics with long-term abstinence will attain normal cognition.

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Request Reprint E-Mail: george@nbresearch.com

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Population-Level Relationships Between Alcohol Consumption Measures and Ischemic Heart Disease Mortality in U.S. Time-Series
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles).
17 September 2007


Individual-level studies indicate the possibility of both protective and harmful effects of alcohol consumption on Ischemic Heart Disease (IHD) mortality depending on the pattern of consumption. Population-level relationships could be in either direction and previous studies have found mixed results.

In multivariate ARIMA models controlling for accumulated heavy drinking as represented by cirrhosis mortality, a protective effect of 4%/l was found for total alcohol consumption while cirrhosis mortality rates had significant positive effects on IHD rates. Beverage-specific models found no effect for wine, positive risks for spirits, and significant protective effects for beer. The protective effects for both total alcohol and beer were also found in vector error correction models. Significant positive effects of cigarette sales on IHD rates were also found in both types of models.

The complexity of alcohol’s relationship with IHD is highlighted. Aspects of pattern represented by beverage-specific consumption and cirrhosis mortality indicate potential protective effects from moderate drinking and harmful effects from heavy drinking in accord with individual-level findings.

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Request Reprint E-Mail: wkerr@arg.org.
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Alcohol: Effects on Neurobehavioral Functions and the Brain
Neuropsychology Review Published on-line 15 September 2007





Alcoholism results from an interplay between genetic and environmental factors, and is linked to brain defects and associated cognitive, emotional, and behavioral impairments.

A confluence of findings from neuroimaging, physiological, neuropathological, and neuropsychological studies of alcoholics indicate that the frontal lobes, limbic system, and cerebellum are particularly vulnerable to damage and dysfunction.

An integrative approach employing a variety of neuroscientific technologies is essential for recognizing the interconnectivity of the different functional systems affected by alcoholism. In that way, relevant experimental techniques can be applied to assist in determining the degree to which abstinence and treatment contribute to the reversal of atrophy and dysfunction.

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Request Reprint E-Mail: oscar@bu.edu
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Remission of alcohol dependency following deep brain stimulation of the nucleus accumbens: valuable therapeutic implications?



Chronic consumption of alcohol represents one of the greatest health and socioeconomic problems worldwide. We report on a 54-year-old patient with a severe anxiety disorder and secondary depressive disorder in whom bilateral deep brain stimulation (DBS) of the nucleus accumbens was carried out.

Despite the absence of desired improvement in his primary disorder, we observed a remarkable although not primarily intended alleviation of the patient’s comorbid alcohol dependency.

Our case report demonstrates the extremely effective treatment of alcohol dependency by means of DBS of the nucleus accumbens and may reveal new prospects in overcoming therapy resistance in dependencies in general.


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Request Reprint E-Mail: Jens.Kuhn@uk-koeln.de
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Hazards: Heavy Drinking May Raise Risk of Endometrial Cancer

By NICHOLAS BAKALAR

Published: September 18, 2007

Women who have more than two alcoholic drinks a day double their risk of endometrial cancer compared with those who drink less, a new study finds.

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Competencies for Substance Abuse Treatment Clinical Supervisors











This research and consensus-based publication provides practical, clear lists of the competencies necessary for effective supervision in substance abuse treatment programs. It also provides administrators with step-by-step guidelines to implement structured supervision components in both State and private treatment systems.

Download Full Document (PDF)
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News Release - Yale Receives $7 Million to Develop Treatment for Alcoholism

New Haven, Conn. — The National Institutes of Health (NIH) has renewed a $7 million grant to Yale School of Medicine to speed research discoveries from the laboratory to the clinic for individuals at risk for becoming alcoholic, or for patients who already suffer from alcoholism.

“The gap between basic research advances and new clinical insights and treatments remains a critical obstacle to progress in the field of alcoholism research,” said the principal investigator, John Krystal, M.D., professor and deputy chair for research for the Department of Psychiatry and the VA Connecticut Healthcare System. “This mission is the enduring focus of the Center for Translational Neuroscience of Alcoholism (CTNA) at Yale.”
. . . . . .

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Interactive Effects of Sex and 5-HTTLPR on Mood and Impulsivity During Tryptophan Depletion in Healthy PeopleBiological Psychiatry
Volume 62, Issue 6, 15 September 2007, Pages 593-599

Serotonin (5-HT) plays a central role in mood regulation and impulsivity. We studied whether healthy men and women react differently on mood and impulsivity measures during acute tryptophan depletion (ATD). We also studied the relative contribution of a functional length triallelic polymorphism in the promoter region of the serotonin transporter, designated 5-HTTLPR, to the behavioral responses to ATD.

During ATD, women reported mood reduction and showed a cautious response style, which is commonly associated with depression. Men showed an impulsive response style and did not report mood reduction. The 5-HTTLPR influenced the mood response to ATD in women.

Healthy men became more impulsive, whereas healthy women showed mood reduction in response to ATD. This suggests that 5-HT could be one mechanism contributing to the sex differences in the prevalence of mood and impulsivity disorders. The influence of 5-HTTLPR on mood responses in women further substantiates the relevance of this variant in the pathophysiology of at least a subgroup of patients with major depressive disorder.

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Request Reprint E-Mail: espen.walderhaug@psykologi.uio.no

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Screening and Assessment of Co-occurring Substance Use and Mental Health Disorders


Evidence shows that people with mental health or substance use disorders are at increased risk of also developing the other disorder. Early recognition of co-occurring disorders leads to the development of the most effective possible treatment. Yet even very experienced mental health clinicians often fail to recognise a co-occurring substance use disorder. Similarly, many substance use disorder treatment clinicians struggle to recognise – let alone assess and respond to – the presence of co-occurring mental health disorders in their clientele.

This guide aims to equip treating mental health (MH) and alcohol and other drug (AOD) treatment clinicians and agencies to recognise co-occurring disorders and provide effective responses.

Download Full Guide (PDF)

Contributor: Don Phillips
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E-UPDATE	9/14/2007
SUCCESS STORY NEW FUTURES NEWS LEGISLATIVE UPDATE RESOURCES IN THE NEWS UPCOMING EVENTS
SUCCESS STORY Congratulations to the NH State Liquor Commission The NH State Liquor Commission's Bureau of Enforcement has received the "Liquor Law Enforcement Agency of the Year Award" from the National Liquor Law Enforcement Association (NLLEA). Presented at the 9th Annual Leadership Conference for Enforcing Underage Drinking Laws in Orlando Florida on August 3, the award was given in recognition of the Bureau of Enforcement's "multifaceted approach to preventing underage access to alcohol, impaired driving, hazardous drinking, illegal gambling and drug use, through state wide compliance check operations, specialized, gambling, and fictitious ID investigations, the Ripple Effect program, and specialized trainings for servers and sellers of alcohol." As reported here last month, the Dover, NH Police Department was also recognized with the Office of Juvenile Justice and Delinquency Prevention's "Law Enforcement Partner of the Year" award for their efforts to reduce youth access to alcohol at this conference. Back to Top ^ NEW FUTURES NEWS a. RESCHEDULED: 9th Annual Leadership Recognition and Awards Celebration Acting U.S. Surgeon General Moritsugu has cancelled his visit to New Hampshire in October. Due to this schedule change, the 9th Annual Leadership Recognition and Awards Celebration will be rescheduled for early next year. The Tom Fox Award for Excellence, the Tom Fox Scholarship for Prevention, and Tom Fox Scholarship for Treatment will be awarded at this time. More details will be forthcoming. Thank you for your understanding as we reschedule this celebratory event. Back to Top ^ LEGISLATIVE UPDATE a. Legislative Session Wrap Up http://www.new-futures.org/issues-action/current-issues/legislative-updates.asp b. Update on Legislative Study Committees New Futures has continued to follow a number of legislative study committees including: · SB 233 (Relative to flavored malt beverages) - This committee has scheduled its organizational meeting for September 18. New Futures is following this to advocate against any legislation that would expand the availability or increase the alcohol content of flavored malt beverages (also knows as "Alcopops"). · HB 323 (Relative to Liquor Commission Enforcement, procedures and training) - New Futures is following this study both to advocate for improved training for those who sell or serve alcohol and to support enforcement of existing statues related to underage alcohol. c. Preview of 2008 Legislative Session House and Senate members will soon begin filing legislation for the 2008 session. We will monitor these bills and proposed titles as they become available and continue to keep you updated throughout the legislative session. Back to Top ^ RESOURCES a. Get the Truth About the 21 Law As the nation's current debate on the 21 Minimum Drinking Age Law rages on, it's easy to mistake opinions as facts. MADD's new website, http://why21.org, presents facts on why the law is important - and how it saves lives. Use this information and other information from valid sources to refute the rumors. To view New Futures fact sheet on the MLDA and a recent action alert, visit http://www.new-futures.org/pdf/publications/NF_Why_21.pdf and http://www.new-futures.org/issues-action/current-issues/action-alerts.asp respectively. b. Teacher's Aid to Prevent Drinking in Middle School Teacher's Corner is a new feature on TheCool Spot.gov, NIAAA's alcohol prevention web resource for ages 11 to 13. This feature provides educators and volunteers working in middle schools and after school programs with materials, including lesson plans, role-playing activities and science-based information about alcohol. www.thecoolspot.gov/teachercorner.asp. c. Funds Available for Youth Led Community Events By hosting a Take It Back Community Briefing youth can influence adults to support, assist and get out of the way of policies that will keep youth safer. Support to conduct a community briefing, fill out an application form as soon as possible. All applications will be reviewed on a first-come, first-served basis. Deadline for consideration is November 2, 2007. Details at: www.utakeitback.org. d. Funding Available for Screening and Brief Alcohol Interventions The National Institute on Alcohol Abuse and Alcoholism (NIAAA) invites nonprofits, schools, and others to apply for funding under the agency's Screening and Brief Alcohol Interventions in Underage and Young Adult Populations grants program. The program is aimed at generating research on screening and brief interventions to prevent and/or reduce alcohol use and its consequences. Grants will be awarded under the R01, R03, and R21 mechanisms. e. Reclaiming Futures' Recommendations for Addressing Adolescent Problems Improved Care for Teens in Trouble with Drugs, Alcohol and Crime suggests 10 recommendations such as creating a service team made up of treatment providers, judges, probation officers, family and community members to design a care plan for the youth. That report and several supporting documents can be found at: www.reclaimingfutures.org. f. How to Use Local Regulatory and Land Use Powers to Prevent Underage Drinking Local governments have the responsibility and authority to protect the public's general health, safety, and welfare. They fulfill this responsibility in part through their land use powers. Both commercial and noncommercial activities associated with alcohol fall within these broad powers. Get some ideas here: www.udetc.org/documents/LocalRegulLandUse.pdf. g. A Call to Action: Changing the Culture of Drinking at US Colleges This new report from NIAAA issues a call to action for college campuses around the consequences of excessive drinking by students. For more information, visit: http://www.collegedrinkingprevention.gov/media/TaskForceReport.pdf. h. MMWR Podcasts on Youth Exposure to Alcohol Advertising in Magazines If you haven't had a chance to read CAMY's latest report, you can hear about it on-line. Listen to A Minute of Health with CDC (Length: 0:59) at or view a PDF transcript. If you have a little more time, listen to or read the longer version (Length: 6:30), A Cup of Health with CDC. Think about linking to them in your next newsletter or on your website. Back to Top ^ IN THE NEWS a. Gender Differences in Alcohol Use Based on combined data from SAMHSA's 2004-2005 National Surveys on Drug Use & Health, males had higher rates than females for all measures of drinking in the past month: any alcohol use (57.5% vs. 45%), binge drinking (30.8% vs. 15.1%), and heavy alcohol use (10.5% vs. 3.3%). Males were twice as likely as females to have met the criteria for alcohol dependence or abuse in the past year (10.5% vs. 5.1%). http://oas.samhsa.gov/2k7/AlcGender/AlcGender.cfm. b. Can schools help reduce youth risk-taking behavior? A report out of UCLA's Center for Mental Health in Schools suggests that by creating a positive learning environment - rather than through teaching prevention programs - youths' negative behaviors will decrease both on and off school grounds. Read the report at: http://smhp.psych.ucla.edu/pdfdocs/policyissues/risktaking.pdf. c. Brief Interventions Found Effective in Curbing Student Drinking Researchers at Rutgers University studied two different administrative responses to violations of the campus alcohol policy. After 15 months, students who received brief motivational interview reported less alcohol use and fewer related problems than those who received written feedback. The study is in the August Alcoholism: Clinical and Experimental Research (Vol. 31, pp. 1380-1391). Read the abstract at: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1530-0277.2007.00435.x. d. Alcoholic Beverages May Get New Labels The U.S. Alcohol and Tobacco Tax and Trade Bureau (TTB) of the U.S. Department of Treasury is formally considering a new rule to require alcohol labels to contain information on alcohol content, serving size, servings per container, calories, and other nutritional facts. Comments on the proposed rule are due by October 29. Learn more at: http://a257.g.akamaitech.net/7/257/2422/01jan20071800/edocket.access.gpo.gov/2007/pdf/E7-14774.pdf. e. Most Drug Users and Alcohol Abusers are in the Work Force Most of the nation's approximately 16.4 million current illicit drug users and approximately 15 million heavy alcohol users hold full-time jobs, according to a new study by the Substance Abuse and Mental Health Services Administration. The report found that illicit drug use and heavy alcohol use are associated with higher levels of absenteeism and frequent job changes. Read more at: www.samhsa.gov/newsroom/advisories/070713survey0610.aspx. f. Non-smoking Spouses, Smoke-free Workplaces Help Quitters A recent study suggests that environmental factors are important to tobacco cessation. Researchers at Indiana University found that the strongest predictors of a successful quit attempt were a non-smoking spouse and a smoke-free workplace. FMI: http://www.newswise.com/articles/view/531089/?sc=rsmn. g. Students Report Drinking Hard Liquor To examine types of alcoholic beverages usually consumed by students in 9th--12th grades, CDC analyzed 2005 Youth Risk Behavior Survey (YRBS) data from the four state surveys that included a question on the type of alcohol consumed (Arkansas, Nebraska, New Mexico, and Wyoming). In all four grades, in all four states, liquor was the most prevalent type of alcohol usually consumed among students who reported current alcohol use. For more detail, go to: www.cdc.gov/mmwr/preview/mmwrhtml/mm5629a3.htm. h. SAMHSA Parent Education Campaign Reports Positive Results In a recent tracking study, 42% of parents who saw or heard "Start Talking Before They Start Drinking" campaign advertising have spoken to other parents or friends about the issue compared to 22% of those who haven't. Furthermore, visitors are spending more time on the campaign Web site (10 to 13 minutes) than the average of 3 minutes. For more information, visit the campaign Web site, www.stopalcoholabuse.gov. i. New Data from the National Survey of American Attitudes on Substance Abuse XII: Teens and parents This new data report issued by the National Center on Addiction and Substance Abuse (CASA) at Columbia University found that 80 percent of high schoolers and 44 percent of middle schoolers see drugs used, kept, sold, classmates drunk and/or classmates high on school grounds. At least once a week, more than four million high schoolers and more than one million middle schoolers see illegal drugs used, sold, students high and/or students drunk on school grounds. For more information, and to read the entire report, visit: http://www.casacolumbia.org/absolutenm/articlefiles/380-2007%20Teen%20Survey%20XII.pdf. j. Join Together: Heavy Drinking Increases Relocation to Poor Neighborhoods It's not the neighborhood that creates the behavior, but the other way around. Tracking 400 men for 12 years, and controlling for factors like poverty level and antisocial behavior, researchers found that the men with the greatest alcohol problems were more likely to live in or move into a poor neighborhood. On the other hand, recovering alcoholics were no more likely to live in poor neighborhoods than non-alcoholics. www.jointogether.org/news/research/summaries/2007/heavy-drinking-forces-move-to.html. Back to Top ^ UPCOMING EVENTS See all this and more at: www.new-futures.org/calendar a. Art and Recovery September 17th- October 12th at Franklin Pierce University, Portsmouth NH In celebration of National Recovery Month, The Partnership for Healthy Youth will be having an art show featuring work by artists in recovery and those inspired by recovery. We are reaching out to artists of all ages, and will accept work in any medium. The deadline for submissions is September 10th. Contact Megan McDonald at 373-9251 or megan@makinithappen.org for details. b. Addiction: The New England Drug Court Perspective - When Communities Respond, People Recover September 20-21 at UMASS Boston The New England Association of Drug Courts' Annual Meeting will feature HBO Addiction Series' Executive Producers John Hoffman and Susan Froemke, as well as featured experts Dr. Kathleen Brady, Dr. Douglas Marlowe, and many other field professionals, as they discuss the latest advancements in addiction treatment and research. For more information, please contact Kerin Raymond at (978) 772-1846 or kraymon@advocatesinc.org. c. Getting a Handle on Substance Abuse in the Elderly September 24, 2007 10:30 to 3 PM Fireside Inn, West Lebanon, NH 10:30 - noon is networking and announcements. The afternoon will include presentations on Polypharmacy and Alcohol Use in the Older Patient; Taking Action to Aid Elders at Risk from Substance Abuse and Medication Misuse: and "What Services Are Currently Available for Elders with Addiction and What is Needed?" Please reserve a space for this MAZE program by sending an email to Marcia.Masland@Hitchcock.org or calling her at 603-653-1975. Certificates of attendance available by request when you register. d. What are the Implications of Adolescent Brain Development for Juvenile Justice? October 16, 2007, Concord Marriott, Grappone Center This conference will focus on better understanding of the adolescent brain and how it differs from the adult brain and positive youth development. The speakers include Dr Patricia MacNamee, Dr Jeffrey Butts from the University of Chicago, and Michael Nurney. Please e-mail psullivan@dhhs.state.nh.us by September 20, to request a registration form. e. What are They Thinking? October 16, 7:00pm - 9:00pm. Manchester Central High School's McAllister Hall A community forum with Michael Nerney, an expert on adolescent brain development and a consultant in substance abuse prevention and education. This event is specially designed to help parents, coaches, and others in the community understand what motivates adolescents to become involved in drug use and other risky behaviors. The forum is free and refreshments will be provided. For further information, visit www.makinithappen.org. f. Adolescent Brain: Substance Abuse & Other Risky Behaviors October 17, 9:00am - 3:00pm, at the Manchester Health Department Child and Family Services and the Makin' it Happen Coalition present a conference for industry professionals, including therapists, educators, healthcare providers and other professionals who work with adolescents. The presentation by Michael Nerney features the latest research on the structure and neuro-chemistry of the adolescent brain, explores the psychological and social motivations for drug use, reveals the signs and symptoms of at-risk youth, explores elements of treatment and examines prevention and intervention strategies. For further information and to register, visit www.makinithappen.org. g. State of the Art in Addiction Medicine October 25-27, Hyatt Regency Capitol Hill, Washington, DC This course is designed to meet the needs of: (1) addiction specialists who seek an update on recent developments in addiction research and practice; (2) individuals who conduct or wish to obtain funding for addiction research; (3) educators who are concerned with translating scientific knowledge to clinical services, and (4) physicians, nurses, counselors and other professionals who seek a succinct review of the latest knowledge about the causes, identification, and management of addictive disorders. Learn more at www.asam.org. h. How to Talk so Families Will Listen and Listen so Families Will Talk November 13, 2007, 8:30 - 12:15, Highlander Inn and Conference Center, Manchester This workshop is designed to provide home visitors, therapists, counselors, social workers, teachers, child-care providers, and early supports and services specialists with information and techniques to better address alcohol and drug related concerns with families. Contact the NH Task Force on Women and Recovery at 603-647-4629 or nmiller@nhtwr.org to find out more. _____________________________________________________________________

Rural, Suburban, and Urban Variations in Alcohol Consumption in the United States: Findings From the National Epidemiologic Survey on Alcohol and Related Conditions
The Journal of Rural Health 23 (4), 314–321.

Alcohol consumption is a major public health problem nationally, but little research has investigated drinking patterns by rurality of residence.

To describe the prevalence of abstinence, alcohol use disorders, and risky drinking in rural, suburban, and urban areas of the United States.

Nationally, the odds of abstinence and, among drinkers, the odds of a current alcohol disorder and exceeding daily limits were higher in rural than suburban areas. Stratified analyses revealed differences in the associations between rurality of residence and drinking across Census Regions. Rural residents of the Northeast, Midwest, and South and urban residents of the Northeast had higher odds of abstinence than their suburban peers. Among drinkers, rural and urban residents of the Midwest had higher odds of a current alcohol disorder and exceeding daily limits; urban residents of the Midwest had higher odds of exceeding weekly limits.

Abstinence is particularly common in the rural South, whereas alcohol disorders and excessive drinking are more problematic in the urban and rural Midwest. Health policies and interventions should be further targeted toward those places with higher risks of problem drinking.

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