The latest C.S. Mott Children's Hospital National Poll on Children's Health finds that few parents (10 percent) believe their own teens, ages 13 to 17 years old, have used alcohol in the last year and even fewer (5 percent) believe their own teens have used marijuana in the last year.
Those levels are substantially below what teens themselves reported in the latest Monitoring the Future study, where 52 percent of 10th graders reported drinking alcohol in the last year and 28 percent of 10th graders reported using marijuana in the last year.
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In alcoholism, excessive glutamatergic neurotransmission has long been implicated in the acute withdrawal syndrome and as a key signal for dependence-related neuroplasticity. Our understanding of this pathophysiological mechanism originates largely from animal studies, but human data are needed for translation into successful medication development.
We measured brain glutamate levels during detoxification in alcohol-dependent patients (n = 47) and in healthy control subjects (n = 57) as well as in a rat model of alcoholism by state-of-the-art 1H-magnetic magnetic resonance spectroscopy at 3 and 9.4 T, respectively.
We found significantly increased glutamate levels during acute alcohol withdrawal in corresponding prefrontocortical regions of treatment-seeking alcoholic patients and alcohol-dependent rats versus respective control subjects. The augmented spectroscopic glutamate signal is likely related to increased glutamatergic neurotransmission because, enabled by the high field strength of the animal scanner, we detected a profoundly elevated glutamate/glutamine ratio in alcohol-dependent rats during acute withdrawal. All dependence-induced metabolic alterations normalize within a few weeks of abstinence in both humans and rats.
Our data provide first-time direct support from humans for the glutamate hypothesis of alcoholism, demonstrate the comparability of human and animal magnetic resonance spectroscopy responses, and identify the glutamate/glutamine ratio as potential biomarker for monitoring disease progression.
Quantification of gene expression using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) requires normalization to an endogenous reference gene termed housekeeping gene (HKG). Many of the commonly used HKGs are regulated and vary under experimental conditions and disease stages. Alcoholic liver disease (ALD) is associated with several different liver histological lesions that may modulate HKG expression. We investigated the variability of commonly used HGKs (18S, β-actin, glyceraldehyde-3-phosphate [GAPDH], and arginine/serine-rich splicing factor [SFRS4]) in the liver of patients with ALD.
Fifty consecutive patients at different stages of ALD underwent liver biopsy. The stability of HKG was assessed according to liver histological lesions.
β-actin had the highest coefficient of dispersion (COD) (23.9). β-actin tended to decrease with steatosis and to increase with alcoholic hepatitis; β-actin also increased in patients with both alcoholic hepatitis and cirrhosis. GAPDH and SFRS4 COD were 2.8 and 2.1, respectively. GAPDH was decreased with steatosis and increased with alcoholic hepatitis and fibrosis. 18S had the lowest COD (1.4). Both 18S and SFRS4 levels were not significantly modified with respect to all alcohol-induced liver histological lesions.
In patients with ALD, the most constantly expressed HKGs are 18S and SFRS4. These genes are appropriate reference genes for normalization of RT-qPCR in the liver of patients with ALD. The use of other HKGs such as β-actin or GAPDH would lead to misinterpretation of the results.
The vast majority of individuals with alcohol problems in the United States and elsewhere do not seek help. One policy response has been to encourage institutions such as criminal justice and social welfare systems to mandate treatment for individuals with alcohol problems (Addiction, 1997;92:1133). However, informal pressures to drink less from family and friends are far more common than institutional pressures mandating treatment (Addiction, 1996;91:643). The prevalence and correlates of these informal pressures have been minimally studied.
This analysis used data from 5 Alcohol Research Group National Alcohol Surveys (NAS) collected at approximately 5-year intervals over a 21-year period (1984 to 2005, pooled N = 16,241) to describe the patterns of pressure that drinkers received during the past year from spouse, family, friends, physicians, police, and the workplace.
The overall trend of pressure combining all 6 sources across all 5 NAS data sets indicated a decline. Frequent heavy drinking and alcohol-related harms also declined, and both were strong predictors of receiving pressure. Trends among different sources varied. In multivariate regression models, pressure from friends showed an increase. Pressure from spouse and family showed a relatively flat trajectory, with the exception of a spike in pressure from family in 1990.
The trajectory of decreasing of pressure over time is most likely the result of decreases in heavy drinking and alcohol-related harm. Pressure was generally targeted toward higher risk drinkers, such as heavy drinkers and those reporting alcohol-related harm. However, demographic findings suggest that the social context of drinking might also be a determinant of receiving pressure. Additional studies should identify when pressure is associated with decreased drinking and increased help seeking.
Prior efforts to examine the course of drinking from onset to midlife have been limited to analyses of year-to-year changes in alcohol dependence (AD). The current investigation sought to examine the course of drinking over this time frame using consumption-based measures of drinking and evaluate the degree of comparability in trajectories estimated from diagnostic and quantity-frequency data.
Participants included 420 men with a lifetime history of AD who were drawn from the Vietnam Era Twin Registry and administered the Lifetime Drinking History, which provided person-year (retrospective) data on patterns of consumption and diagnostic symptoms from drinking onset to participants’ current age. Consumption-based data were aggregated into age categories that ranged from “up to age 20” to “ages 54 to 56” and analyzed separately as a dichotomous measure of “heavy drinking (HD)” and continuous quantity-frequency index (QFI)
scores.
Using latent growth mixture modeling, trajectories based on the HD measure were moderately concordant with those based on changes in AD that were previously identified in this sample, whereas trajectories based on QFI scores were only weakly related to those based on AD diagnoses. Moreover, examination of the degree of concordance between AD- and QFI-derived trajectories revealed that measures of consumption (and potentially other continuous indices of drinking) may qualify past interpretations of various developmental trajectories that have been discussed in the alcoholism typology literature (particularly “Late Onset” alcoholism).
Collectively, the findings highlight the importance of integrating repeated measures of alcohol consumption in future efforts to describe the course of drinking across the life span.
Depression is highly comorbid with alcohol and drug problems, resulting in greater impairment, reduced treatment adherence and poor outcomes. Little evidence exists to support the use of mental health screening tools in routine addiction treatment. This study tested the validity and reliability of PHQ-9 and PHQ-2 as depression case finding tools in an outpatient drug treatment sample in the United Kingdom.
A sample of 103 patients took part in diagnostic assessments using CIS-R and completed brief screening questionnaires. A subgroup of 60 patients completed retests after 4
weeks. Diagnostic results were compared to brief measures using receiver operating characteristic (ROC) curves. Psychometric properties were also calculated to evaluate the validity and reliability of self-completed questionnaires.
A PHQ-9 score ≥12 had a sensitivity of 81% and specificity of 75% for major depression, also displaying good retest reliability (intra-class correlation, 0.78) and internal consistency (Cronbach's alpha, 0.84). PHQ-2 had 68% sensitivity and 70% specificity, with more modest retest reliability (0.66) and internal consistency (0.64).
Diagnostic interviews did not consider the temporal sequencing of the onset of drug use and mental health problems.
PHQ-9 is a valid and reliable depression screening tool for drug and alcohol users. The brevity and ease of administration of self-completed questionnaires make them useful clinical tools in addiction services commonly encountering a high prevalence of depression.
Maryland estimates the state raised roughly $6 million in added revenue in July from a 50 percent increase in the state’s sales tax on alcohol.
David Roose, director of the Maryland Bureau of Revenue Estimates, said Monday it’s hard to tell from the first month of a new tax how much will be raised on a yearly basis.
If July turns out to be the average, it would add up to about $72 million in extra state revenue a year. Initial estimates projected the tax would raise roughly $85 million a year. > > > > Read More
Treatment techniques and tools to address alcohol use disorders (AUDs)* have multiplied over the last 30 years, moving beyond models based on Alcoholics Anonymous and its offshoot, the Minnesota Model. Care providers now can prescribe medications to aid people as they work to reduce their drinking. If a traditional mutual-help group model of care does not appeal to a patient, he or she has other behavioral therapy options. And Web-based approaches provide access to therapy 24 hours a day, 7 days a week.
Despite these developments, however, the majority of people with alcohol use disorders (AUDs) in the United States go untreated. According to data from NIAAA’s 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), only 14.6 percent of people with alcohol abuse or dependence receive treatment.1,2 Another survey3 of people who experienced the onset of alcohol dependence a year before the study found that only 25 percent ever received treatment. Though some people with AUDs do actually recover on their own without formal treatment, some achieve partial remission, and some cycle in and out of alcohol problems throughout their lives, novel approaches and further access to treatment could play an important role in helping people to reduce their drinking.2
This picture of a largely untreated population of patients has prompted researchers to explore better ways of engaging people who might not have considered treatment as an option for addressing their problems with alcohol. Improving diagnosis is one area under exploration, including screening for alcohol abuse and alcoholism and providing brief interventions in a variety of settings, such as primary care clinics and emergency departments. Scientists are examining the effectiveness of medications for treating patients and preventing relapse to drinking. Research also suggests that a large proportion of people with co-occurring psychological or medical conditions remain underserved by existing treatment systems; greater coordination of care might improve responses to AUD treatment for this group.
This Alcohol Alert summarizes the state of alcoholism treatment research, explores its use in a variety of settings, and reviews new efforts for engaging people in treatment. Efforts to improve continuing care for those in treatment and to coordinate care for those with co-occurring disorders also are included. The Alert then examines how health services and financing vehicles, such as private and public insurance, influence people’s ability to access and pay for that treatment.
A joint BDA (British Dietetic Association) and Alcohol Concern Cymru briefing paper on Alcohol and Calories has been released.
Alcohol Concern say many of us are taking in more calories in the form of food and drink than our bodies can use - and a major part of this is increasing levels of alcohol consumption.
The briefing paper states 'Amongst adults who drink, alcohol accounts for nearly 10% of their calorie intake, yet many people have little idea how many calories they are consuming in the form of alcoholic drinks. A recent Alcohol Concern survey of 1,000 drinkers in Wales, found that 82% of people were unable to correctly identify the number of calories in a standard pint.' > > > > Read More
=3.19).=1.39), and quantity of alcohol consumed (>100mL) per day. In addition, country/desi drinkers (HR=1.34) had the highest mortality risk compared with all other types of alcohol (HR=0.97).=2.53), cerebrovascular disease (HR=1.83), and liver disease (HR=3.19).=1.02) and highest in mixed tobacco user drinkers (HR=1.79). The results of this study show a direct association between greater consumption of alcohol and increased risk of mortality from alcohol-specific causes.
Alcohol dependence is more prevalent among those with any one of several anxiety or depressive (“internalizing”) disorders than among those in the general population. However, because internalizing disorders are highly intercorrelated, it is ambiguous whether alcohol dependence is related to internalizing psychopathology components that are: (i) unique to a particular internalizing disorder (“specific”); versus (ii) shared across a number of internalizing disorders (“general”). To clarify this ambiguity, we employed structural equation and logistic models to decompose the specific versus general components of internalizing psychopathology and then related these components separately to alcohol dependence.
The data were based on face-to-face interviews of U.S. community residents collected in the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093).
Both analytic approaches demonstrated that increases in the general internalizing psychopathology load are accompanied by increases in the prevalence of alcohol dependence. Once the general internalizing psychopathology load is accounted for, knowing whether a particular internalizing disorder is present or absent provides little additional information regarding the prevalence of alcohol dependence.
The components of internalizing psychopathology that are associated with alcohol dependence are shared and cumulative among common anxiety and depressive disorders. These findings have the potential to influence clinical and scientific conceptualizations of the association between alcohol dependence and internalizing psychopathology.