Opinion - College Drinking

Published: September 20, 2007

To the Editor:

Re “Calling the Folks About Campus Drinking” (On Education column, Sept. 12):

Samuel G. Freedman notes that since the start of the University of Wisconsin’s parent notification program, student detox admissions have increased by 65 percent. Why? Because more than half of our 28,000 undergraduates engage in dangerous drinking at least once every two weeks, and they constitute a reservoir that continues to feed the pipeline to detox.
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Gordon Brown's war on teen binge drinking


By Patrick Hennessy, Political Editor

23/09/2007

Gordon Brown will unveil a crackdown on teenage alcohol abuse this week in an attempt to end the "excessive drinking culture" among young people.

The campaign, clearly designed to appeal to Middle Britain's voters, attempts to tackle overconsumption by under-18s both on the streets and in the home.

Mr Brown has vowed action on teenage drinking as he puts Labour on alert for a snap general election, which may be held at the end of October.

He will use Labour's annual conference, which begins in Bournemouth today, to unveil policies he believes will capture support from Conservative and Liberal Democrat voters.

Key among them is the scheme to fight the growing menace of teenage alcoholism, The Sunday Telegraph can disclose, only a year after Labour changed the law to allow pubs and clubs to open later. Mr Brown has told Ed Balls, his closest Cabinet confidant: "This is one of my top priorities."

Mr Balls, the Children, Schools and Families Secretary, and Jacqui Smith, the Home Secretary, will lead the drive to tackle teenagers drinking to excess at home.

The plans include the first ever set of guidelines on safe drinking for under-18s to be published — aimed at parents of teenagers.

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Contributor: Tom Colhurst

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Lost Weekends: Alcoholism in the Movies

7:00-9:30 PM (Except as noted)
Ceremonial Hall - 4th floor

Host and discussion leader: Kurt Brokaw, MS, teaches at The New School and the 92nd Street Y

A 10-week fall film series featuring screenings/discussions of the rarest and classic feature films on drinking and drinkers.

The Films

Date	Title
Oct. 2	Introduction. The Struggle D.W. Griffth's final and only talking film (1931, 77 min.). The first feature about an alcoholic. Script by Anita Loos. Plus key scenes from Nightmare Alley; Bottom of the Bottle; Come Back Little Sheba; 8 Million Ways To Die; Leaving Las Vegas, and My Name Is Bill W.
Oct. 9	The Lost Weekend From Charles Jackson's novel, the most harrowing portrait of a drunk in 20th century fiction, with Ray Milland and Jane Wyman, directed by Billy Wilder. 1945 Oscars: Best Picture, Actor, Director, Screenplay.
Oct. 16	Smash-up, The Story Of A Woman Susan Hayward, a powerhouse actress, stars as a nightclub singer and failing parent in 1945 Manhattan who descends into alcoholism. Eddie Albert is a supportive songwriter.
Oct. 23	Something To Live For (1954) Ray Milland returns as a recovering alcoholic who 12th-steps Joan Fontaine, losing his sobriety. With Teresa Wright, directed by George Stevens. Plus scenes from Milland's drunken "Night Into Morning" (1954).
Oct. 30	I'll Cry Tomorrow Susan Hayward returns in 1955 as Follies beauty and Hollywood star Lillian Roth in this stirring, biographical drama. Eddie Albert co-stars again, this time as a recovering alcoholic.
Nov. 6	Come Fill The Cup A great 1951 performance by James Cagney as a drunken Chicago news reporter. With Phyllis Thaxter, From Harlan Ware's boozy gangland novel. Cagney's one lost film, rarely seen.
Nov. 13	The Country Girl Bing Crosby's astonishing 1954 role as an alcoholic actor trying for a last comeback, based on Clifford Odets' play. William Holden is his director, Oscar-winning Grace Kelly is his wife.
Nov. 20	Days Of Wine and Roses PR exec and drunk (Jack Lemmon) plunges his wife (Lee Remick in her finest role) into alcoholism with him. Blake Edwards directs this 1962 classic from J.P. Miller's script with unflinching realism.
Nov. 27	Under The Volcano Albert Finney is the alcoholic counsel. In John Huston's stark 1984 drama set in Mexico, based on the autobiographical 1947 novel by Malcolm Lowry. With Jacqueline Bisset, Katy Jurado. Quite rare.
Dec. 4 7:00-10:00 p.m. double feature!	Barfly and Drunks First Charles Bukowski's 1987 LA bar scene with Faye Dunaway and Mickey Rourke. Then Peter Cohn's 1995 fictionalized Times Square AA meeting. Sharing are Faye Dunaway, Dianne Wiest, Richard Lewis, Amanda Plummer, Howard Rollins, Parker Posey and Spalding Gray.

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News Release -
Restrictions proposed on alcohol advertising and sales (Finland)

The government has announced plans to reinforce current alcohol legislation by putting restrictions on pricing and price advertising, regulate advertising on TV and in movie theatres and give more information to customers on alcohol risks.

There will be restrictions on special offers on packs of drinks and happy hour notices. Packs of drinks will be labelled with health warnings in Finnish and Swedish.

The changes to the law will take effect at the beginning of next year. The aim is to cut and prevent alcohol problems, which have risen among the population as a result of EU-compliant tax cuts.

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Policy on reintegration of women with histories of substance abuse: A mixed methods study of predictors of relapse and facilitators of recovery
Substance Abuse Treatment, Prevention, and Policy 2007, 2:28

The predominant U.S. policy approach toward individuals with substance abuse problems has relied on stigma and punishment by withholding access to education, cash assistance, housing, social support, and normal social roles.

In contrast to this approach, the theory of reintegrative shaming asserts that providing individuals with the opportunity to reconnect with society is more effective in reducing potential to relapse to crime and drug abuse. Strategies that promote such reconnection include expanding access to basic needs and supportive relationships along with increasing opportunities to fully participate in mainstream social roles.

Results suggest that lower levels of instrumental support, affective support, and participation in normal roles (such as parent, employee, student, and citizen) are significant predictors of relapse to drug use and criminal behaviors. Qualitative findings support the quantitative results, revealing that participating women perceived the variables of support and role participation as critical in facilitating their recovery. They also noted the importance of individual characteristics such as optimism and strength and emphasized the significance of their relationship with their children in motivating them to avoid relapse. Findings suggest that punitive policies toward women with substance abuse histories may be ineffective.

The author concludes that current policies designed to withhold access to basic needs such as housing, education, cash assistance, and positive relationships may deprive women with histories of substance abuse of the means to reconnect with society. Policies that promote access to basic needs and offer avenues for women to participate in normal societal roles should be more fully explored.

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Pearson Family Chair to Support Forward-Looking Alcohol and Addiction Research

By Mika Ono Benedyk

Endowed chairs bring with them prestige and security, so when Professor Barbara Mason learned she would hold The Pearson Family Chair, a newly endowed position in alcohol and addiction research at The Scripps Research Institute, she was thrilled.

"The chair provides assurance that the team I assembled at The Scripps Research Institute can carry on our exciting work, which has great potential to help people in recovery," says Mason. "As part of the Pearson Center, the chair also gives me the freedom to conduct early proof-of-concept studies and quickly build on preclinical and clinical findings, work that could be delayed for years if we had to wait for National Institutes of Health funding, or never done at all."

The Pearson Family Chair was established with a gift from philanthropist and entrepreneur Mark Pearson, who also established the Pearson Center for Alcoholism and Addiction Research at Scripps Research in 2003. The center, co-directed by Mason and Professor George Koob, combines the latest biomedical research with new clinical treatments to fight the devastating, costly, and deadly disease of alcohol and drug addiction.
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Smaller feedback ERN amplitudes during the BART are associated with a greater family history density of alcohol problems in treatment-naïve alcoholics
Drug and Alcohol Dependence
Article in Press, Corrected Proof 14 September 2007



Alcoholism is characterized by impaired decision-making (i.e., choosing intoxication in the face of mounting negative consequences). This impairment may involve a reduced brain response to the negative consequences of behavior, which supports an inclination to engage in risky behaviors.

The feedback error-related negativity (F-ERN) is hypothesized to reflect the valence attached to the negative consequences of behavior. Performance on the Balloon Analogue Risk Task (BART) measures risk-taking propensity. We recorded F-ERNs during the BART and during a BART simulation, where individuals observed the rewards and consequences of (someone else's) BART performance.

F-ERNs over fronto-central electrode sites were observed to balloon pops in the BART and BART simulation. F-ERNs during the BART were more than twice the amplitude of F-ERNs during the BART simulation. Smaller F-ERN amplitudes from the BART (but not the BART simulation) were associated with a greater family history density of alcohol problems.

The results suggest a possible link between the genetic vulnerability toward developing alcoholism and the brain's response to the negative consequences of behavior.

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Reprint Request E-Mail: george@nbresearch.com
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Drinking by parents, siblings, and friends as predictors of regular alcohol use in adolescents and young adults: a longitudinal twin-family study
Alcohol and Alcoholism 2007 42(4):362-369;




The aim of this study was to examine whether the drinking habits of parents, siblings, and friends were related to regular drinking in adolescents and young adults, cross-sectionally as well as longitudinally.

Results show that age, sex, and one's own previous drinking habits were important predictors of later-life regular drinking. Drinking habits of parents showed small but persistent positive associations. Alcohol use of the co-twin was strongly related to alcohol use of the participants, especially in the cross-sectional analyses, while alcohol use of additional siblings other than the co-twin was relatively unimportant. Cross-sectionally, friends' alcohol use showed a high association with regular drinking, but this association decreased over time.

Cross-sectional analyses showed that a substantial part (29%) of the variance in regular drinking habits of adolescents and young adults was explained by the drinking habits of family members and friends, in particular, by drinking of co-twins and friends.

But, over time, drinking by family members and friends could only explain a relatively small part (4–5%) of the variance in adolescents' and young adults' alcohol use.


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Reprint Request E-Mail:</sup> e.poelen@pwo.ru.nl
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Pharmacokinetic and pharmacodynamic basis for partial protection against alcoholism in Asians, heterozygous for the variant ALDH2*2 gene allele.
Pharmacogenetics and Genomics October 2007, 17:10

It has been well documented that although homozygosity of the variant aldehyde dehydrogenase-2 (ALDH2) gene allele, ALDH2*2, in Asians almost fully protects against alcoholism, the heterozygosity only affords a partial protection to varying degrees.

The full protection against alcoholism has been ascribed to the low-amount of alcohol hypersensitivity accompanied by a prolonged and large accumulation of acetaldehyde in blood (Peng et al. Pharmacogenetics 1999; 9:463-476). The physiological basis for the partial protection, however, remains unclear.

Heterozygotic ALDH2*1/*2 subjects were found to be strikingly responsive to the moderate amount of alcohol, as evidenced by the prominent cardiovascular effects as well as subjective perceptions of general discomfort for as long as 2 h following ingestion. The ADH1B polymorphisms did not appear to correlate with the pharmacokinetic and pharmacodynamic effects.

These results indicate that acetaldehyde, rather than ethanol or acetate, is primarily responsible for the observed alcohol sensitivity reactions and suggest that substantially lower accumulation of blood acetaldehyde in the heterozygotes significantly reduces the aversion reaction to low amounts of alcohol that permits other biological as well as environmental factors to facilitate drinking and the according risk for the disease.

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Reprint Request E-Mail: penggs@ndmctsgh.edu.tw
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Moderate Level Fetal Alcohol Exposure and Serotonin Transporter Gene Promoter Polymorphism Affect Neonatal Temperament and Limbic-Hypothalamic-Pituitary-Adrenal Axis Regulation in Monkeys

Biological Psychiatry Article in Press, Corrected Proof Online 20 september 2007

A length polymorphism in the serotonin (5-HT) transporter gene promoter region in humans and rhesus monkeys affects functional characteristics of the brain 5-HT system. Prenatal alcohol exposure (FA-exposure) can have an impact on brain and psychosocial development that could interact with genetic endowment. This study determined whether moderate FA-exposure interacts with polymorphism in the 5-HT transporter gene to increase the incidence or severity of fetal alcohol effects in rhesus monkeys.

Prenatal alcohol exposed carriers of the s allele exhibited increased neonatal irritability and increased ACTH and CORT compared with FA-exposed monkeys homozygous for the l allele and monkeys that were not FA-exposed regardless of genotype.

The s allele of the 5-HT transporter increases the probability of neonatal irritability and increased stress responsiveness in FA-exposed monkeys, and this gene-environment interaction may affect psychosocial development. It is probable that FA-exposure contributes to 5-HT transporter gene-environment interactions in humans.

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Reprint Request E-Mail: schneider@education.wisc.edu

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Asian Americans in community-based substance abuse treatment: Service needs, utilization, and outcomes
Journal of Substance Abuse Treatment
Volume 33, Issue 3, October 2007, Pages 313-319




The objectives of this study were to examine differences in substance abuse treatment needs, treatment utilization, and outcomes between Asian Americans/Pacific Islanders (AAPI) and others.

AAPI presented to treatment with lower alcohol and drug severity lower than the comparison group and similar problem severity in other domains. There were no group differences in treatment retention, but AAPI received a greater number of legal services and fewer medical and psychiatric services than the comparison group. AAPI also received fewer total services within their treatment program.

Treatment outcomes were similar between the two groups, with one exception: AAPI demonstrated better alcohol outcomes than those in the comparison group.

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Reprint Request E-Mail: noosha23@yahoo.com
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Religiosity and participation in mutual-aid support groups for addiction
Journal of Substance Abuse Treatment
Volume 33, Issue 3, October 2007, Pages 321-331




Mutual-aid support groups play a vital role in substance abuse treatment in the United States.

A national survey of mutual-aid support groups for addiction was conducted to identify key differences between participants in recovery groups.

Survey data indicate that active involvement in support groups significantly improves one's chances of remaining clean and sober, regardless of the group in which one participates. Respondents whose individual beliefs better matched those of their primary support groups showed greater levels of group participation, resulting in better outcomes as measured by increased number of days clean and sober.

Religious respondents were more likely to participate in 12-step groups and Women for Sobriety. Nonreligious respondents were significantly less likely to participate in 12-step groups. Religiosity had little impact on SMART Recovery participation but actually decreased participation in Secular Organizations for Sobriety.

These results have important implications for treatment planning and matching individuals to appropriate support groups.


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Reprint Request E-Mail: randy.atkins@walshgroup.org
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Spirituality and recovery in 12-step programs: An empirical model
Journal of Substance Abuse Treatment
Volume 33, Issue 3, October 2007, Pages 265-272


Alcoholics Anonymous (AA) and other 12-step programs are widely employed in the addiction rehabilitation community. It is therefore important for researchers and clinicians to have a better understanding of how recovery from addiction takes place, in terms of psychological mechanisms associated with spiritual renewal.

A program like AA is described here as a spiritual recovery movement, that is, one that effects compliance with its behavioral norms by engaging recruits in a social system that promotes new and transcendent meaning in their lives.

The mechanisms underlying the attribution of new meaning in AA are considered by recourse to the models of positive psychology and social network support; both models have been found to be associated with constructive health outcomes in a variety of contexts.

By drawing on available empirical research, it is possible to define the diagnosis of addiction and the criteria for recovery in spiritually oriented terms.

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Reprint Request E-Mail: marcgalanter@nyu.edu
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Assessment of spirituality and its relevance to addiction treatment
Journal of Substance Abuse Treatment
Volume 33, Issue 3, October 2007, Pages 257-264




The prominence of Twelve-Step programs has led to increased attention on the putative role of spirituality in recovery from addictive disorders.

We developed a 6-item Spirituality Self-Rating Scale designed to reflect a global measure of spiritual orientation to life, and we demonstrated here its internal consistency reliability in substance abusers on treatment and in nonsubstance abusers.

This scale and the measures related to recovery from addiction and treatment response were applied in three diverse treatment settings: a general hospital inpatient psychiatry service, a residential therapeutic community, and methadone maintenance programs.

Findings on these patient groups were compared to responses given by undergraduate college students, medical students, addiction faculty, and chaplaincy trainees. These suggest that, for certain patients, spiritual orientation is an important aspect of their recovery.

Furthermore, the relevance of this issue may be underestimated in the way treatment is framed in a range of clinical facilities.

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Reprint Request E-Mail: marcgalanter@nyu.edu
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What does recovery mean to you? Lessons from the recovery experience for research and practice
Journal of Substance Abuse Treatment
Volume 33, Issue 3, October 2007, Pages 243-256



Recovery is a ubiquitous concept but remains poorly understood and ill defined, hindering the development of assessment tools necessary to evaluate treatment effectiveness.

This study examines recovery definitions and experiences among persons who self-identify as “in recovery.” Two questions are addressed: (a) Does recovery require total abstinence from all drugs and alcohol? (b) Is recovery defined solely in terms of substance use or does it extend to other areas of functioning as well? Inner-city residents with resolved dependence to crack or heroin were interviewed yearly three times (N = 289).

Most defined recovery as total abstinence. However, recovery goes well beyond abstinence; it is experienced as a bountiful “new life,” an ongoing process of growth, self-change, and reclaiming the self.

Implications for clinical and assessment practice are discussed, including the need to effect paradigmatic shifts from pathology to wellness and from acute to continuing models.

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Reprint Request E-Mail: laudet@ndri.org
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Addiction recovery: Its definition and conceptual boundaries
Journal of Substance Abuse Treatment
Volume 33, Issue 3, October 2007, Pages 229-241


The addiction field's failure to achieve consensus on a definition of “recovery” from severe and persistent alcohol and other drug problems undermines clinical research, compromises clinical practice, and muddles the field's communications to service constituents, allied service professionals, the public, and policymakers.

This essay discusses 10 questions critical to the achievement of such a definition and offers a working definition of recovery that attempts to meet the criteria of precision, inclusiveness, exclusiveness, measurability, acceptability, and simplicity.

The key questions explore who has professional and cultural authority to define recovery, the defining ingredients of recovery, the boundaries (scope and depth) of recovery, and temporal benchmarks of recovery (when recovery begins and ends).

The process of defining recovery touches on some of the most controversial issues within the addictions field.

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Reprint Request E-Mail: bwhite@chestnut.org
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Trends in alcohol consumption in Singapore 1992–2004
Alcohol and Alcoholism 2007 42(4):354-361




To present trends in alcohol consumption between 1992 and 2004 in Singapore.

Prevalence of frequent, regular and binge drinking increased between 1992 and 2004. Prevalence increase in binge drinking was highest (from 5.1 to 10.0%), followed by frequent drinking (from 4.5 to 7.5%) and regular drinking (from 2.9 to 3.1%). Uptake in binge drinking increased in both genders and across all age groups but was most evident among adults aged 18–29.

Frequent drinking increase was observed for both genders but was most pronounced among women aged 18–29. The level of regular drinking declined in men but increased in women, especially those aged 18–29 and 30–49.

Being younger, male, separated, divorced or widowed, a current smoker, or having a monthly household income of S$6000 and above were attributes positively associated with binge drinking.

Alcohol consumption, especially binge drinking, has increased among Singaporeans between 1992 and 2004. There is gender convergence in alcohol consumption.

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Request Reprint E-Mail: Lim_Wei_Yen@moh.gov.sg

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Translational methods in biostatistics: linear mixed effect regression models of alcohol consumption and HIV disease progression over time
Epidemiologic Perspectives & Innovations 2007, 4:8

Longitudinal studies are helpful in understanding how subtle associations between factors of interest change over time. Our goal is to apply statistical methods which are appropriate for analyzing longitudinal data to a repeated measures epidemiological study as a tutorial in the appropriate use and interpretation of random effects models.

To motivate their use, we study the association of alcohol consumption on markers of HIV disease progression in an observational cohort. To make valid inferences, the association among measurements correlated within a subject must be taken into account. We describe a linear mixed effects regression framework that accounts for the clustering of longitudinal data and that can be fit using standard statistical software. We apply the linear mixed effects model to a previously published dataset of HIV infected individuals with a history of alcohol problems who are receiving HAART (n=197).

The researchers were interested in determining the effect of alcohol use on HIV disease progression over time. Fitting a linear mixed effects multiple regression model with a random intercept and random slope for each subject accounts for the association of observations within subjects and yields parameters interpretable as in ordinary multiple regression.

A significant interaction between alcohol use and adherence to HAART is found: subjects who use alcohol and are not fully adherent to their HIV medications had higher log RNA (ribonucleic acid) viral load levels than fully adherent non-drinkers, fully adherent alcohol users, and non-drinkers who were not fully adherent.

Longitudinal studies are increasingly common in epidemiological research. Software routines that account for correlation between repeated measures using linear mixed effects methods are now generally available and straightforward to utilize. These models allow the relaxation of assumptions needed for approaches such as repeated measures ANOVA, and should be routinely incorporated into the analysis of cohort studies.


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A comparison of brief intervention versus simple advice for alcohol use disorders in a North India community-based sample followed for 3 months
Alcohol and Alcoholism 2007 42(4):328-332;

To examine the change in alcohol use parameters following a brief intervention (BI) based on the FRAMES protocol, compared to simple advice (SA), in a community setting in North India.

Of the 90 subjects, 87 (96.7%) were available for follow up in the first month and 86 (95.6%) in the third month. There was significant improvement across many drinking and QOL parameters in both the BI and SA groups, Significant differences were noticed across interventions, with a decrease in severity of dependence as measured by alcohol use in the last 30 days, composite ASI scores & improvement in physical and psychological quality of life, in those who received BI compared to those who received SA.

Changes in motivation toward action were documented at first follow up, but were not sustained in either of the interventions.

BI had a slight advantage over SA in excessive users of alcohol in this community setting in India. It is probable that booster sessions would be needed to achieve sustained effect.

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Reprint Request E-Mail: hemraj_pal@yahoo.co.uk , hemrajpal@gmail.com

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The acute effects of alcohol on auditory thresholds
BMC Ear, Nose and Throat Disorders 2007, 7:4

There is very little knowledge about alcohol-induced hearing loss. Alcohol consumption and tolerance to loud noise is a well observed phenomenon as seen in the Western world where parties get noisier by the hour as the evening matures. This leads to increase in the referrals to the "hearing aid clinic" and the diagnosis of "cocktail party deafness" which may not necessarily be only due to presbyacusis or noise-induced hearing loss.

Our results showed that there was a positive association between increasing breath alcohol concentration and the magnitude of the increase in hearing threshold for most hearing frequencies. This was calculated by using the Pearson Regression Coefficient Ratio which was up to 0.6 for hearing at 1000Hz. Over 90% of subjects had raised auditory thresholds in three or more frequencies; this was more marked in the lower frequencies.

Alcohol specifically blunts lower frequencies affecting the mostly 1000 Hz, which is the most crucial frequency for speech discrimination.

In conclusion alcohol does appear to affect auditory thresholds with some frequencies being more affected than others.

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