Stress–response pathways are altered in the hippocampus of chronic alcoholics

 




The chronic high-level alcohol consumption seen in alcoholism leads to dramatic effects on the hippocampus, including decreased white matter, loss of oligodendrocytes and other glial cells, and inhibition of neurogenesis.

Examining gene expression in post mortem hippocampal tissue from 20 alcoholics and 19 controls allowed us to detect differentially expressed genes that may play a role in the risk for alcoholism or whose expression is modified by chronic consumption of alcohol.

We identified 639 named genes whose expression significantly differed between alcoholics and controls at a False Discovery Rate (FDR) ≤ 0.20; 52% of these genes differed by at least 1.2-fold. Differentially expressed genes included the glucocorticoid receptor and the related gene FK506 binding protein 5 (FKBP5), UDP glycosyltransferase 8 (UGT8), urea transporter (SLC14A1), zinc transporter (SLC39A10), Interleukin 1 receptor type 1 (IL1R1), thioredoxin interacting protein (TXNIP), and many metallothioneins.
Pathways related to inflammation, hypoxia, and stress showed activation, and pathways that play roles in neurogenesis and myelination showed decreases. The cortisol pathway dysregulation and increased inflammation identified here are seen in other stress-related conditions such as depression and post-traumatic stress disorder and most likely play a role in addiction. Many of the detrimental effects on the hippocampus appear to be mediated through NF-κB signaling.

Twenty-four of the differentially regulated genes were previously identified by genome-wide association studies of alcohol use disorders; this raises the potential interest of genes not normally associated with alcoholism, such as suppression of tumorigenicity 18 (ST18), BCL2-associated athanogene 3 (BAG3), and von Willebrand factor (VWF).


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Request Reprint E-Mail:   edenberg@iu.edu

Modulation of nicotinic acetylcholine receptors in native sympathetic neurons by

To determine whether actions on nicotine acetylcholine receptors (nAChRs) contribute to ethanol’s depressant effects on the autonomic nervous system.

The acute effects of ethanol on nAChRs were examined in primary cultured superior cervical ganglion (SCGs) by whole-cell patch clamp recordings. After the whole-cell configuration was formed, drugs diluted to various concentrations with extracellular solution were applied directly to single neurons.

Held at -70 mV, ethanol significantly and reversibly inhibited nicotine-evoked currents (INic) with a maximum inhibition rate of ~80% and an IC50 of 232.88±40.66 mM. At 50 mM, ethanol accelerated the slow decay, but did not affect the quick decay and rising time of INic. There was neither use-dependence nor voltage-dependence of ethanol on suppressing INic in SCGs.

Ethanol inhibited the whole-cell INic significantly, probably through noncompetitive inhibition at the binding sites outside of the cell membrane.



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Global Actions: Commitments to Reduce Harmful Drinking. Sep 19, 2013

Global Actions in Focus

Drink driving initiative in nigeria

Post-intervention survey

From August 26 to September 2, 2013, researchers from the University of Lagos in Lagos, Nigeria and Federal Road Safety Corps (FRSC) officials conducted a post-intervention survey for the Lagos Apapa Drink Driving Intervention Initiative. The researchers surveyed 509 petroleum tanker drivers from various oil companies in the Apapa region with the questionnaires

administered verbally by research interviewers. Petroleum tanker drivers were targeted in both the baseline and post-intervention surveys in Apapa because of the particular danger drink driving poses when they transport highly inflammable products. Researchers asked drivers about their driving experience, drinking patterns, and attitudes toward drink driving, as well as tested each driver’s blood alcohol concentration (BAC) level.

The results from the breath tests found that 98.6% of drivers tested possessed a zero BAC. Approximately 0.8% of the drivers possessed a BAC over 0.050 mg, a 50% reduction from the baseline survey conducted in July 2013.

In addition to the baseline and post-intervention surveys, the Strap and Safe Child Initiative partnered with the Global Actions Drink Driving Initiative in Apapa and successfully launched a health education intervention. Volunteers from the Lagos-based NGO distributed information, education, and communication (IEC) materials to petroleum tanker drivers and alcohol beverage retailers in the Lagos-Apapa area. The materials discussed the dangers of drink driving and were handed out during local carnivals and road shows.

Ms. Bola Edwards, the Strap and Safe Child Initiative Executive Director said, “We see the enthusiasm that greeted our intervention this year as a testimonial of how important our work is to this all important sector of our economy.”

Key Recent Milestones

· Thailand: ICAP Country Manager Panrasri Khonputsa and Khun Chavlit of Pernod Ricard met with Ministry of Public Health officials and the Deputy Director General of the Department of Disease Control on September 17, 2013 to discuss upcoming initiatives in Thailand.

What's Happening Next

· China: ICAP and the Chinese Center for Disease Control and Prevention (CCDC) will host a capacity building workshop on September 24, 2013.

Media Release - Beer hits a 66 year low, but wine is still going up

Our tastes may be swinging away from beer and towards wine, but we're drinking a little less alcohol overall, according to figures released today by the Australian Bureau of Statistics (ABS).
"Beer is now at its lowest point in 66 years," said Louise Gates from the Australian Bureau of Statistics; "even so, that means that there are still 4.1 litres of pure alcohol available from beer for every person in Australia aged 15 years and over." While Australians are consuming less beer per person - a downwards trend that started in the 1970's - there's been an increase in wine consumption.  "In terms of pure alcohol available for consumption, beer was down 2.3 percent in 2011-12 (compared with the previous year) while wine rose 1.9 percent. Ready-to-drink beverages have also seen a drop and were down by 2.5 percent, while spirits have seen the largest fall, down by a full four percent. "But the overall picture is that consumption of alcohol in Australia has fallen for a second year in a row; 2011-12 saw us drink 1.4 million litres less than we did in 2010 -11, and 2.7 million litres less than in 2009-10."   > > > >  Read More

Press Release - Drinkaware call for evidence on binge drinking

 

 

Drinkaware is launching a review in support of the Government’s Alcohol Strategy to develop a coherent, well evidenced strategy with regards to the role Drinkaware could play in reducing the harm from public drunkenness and its negative consequences

> > > >   Read More

Latino subgroup as a moderator of the relationship between language usage and alcohol use in a national sample of Latino emerging adults.

 

Emerging adulthood represents a period of increased risk for alcohol

use. For Latino emerging adults, less is known regarding the role cultural variables play in alcohol use behaviors. Research in this area has primarily been conducted using Latino college student samples and/or a single Latino subgroup.

This study investigates Latino subgroup as a moderator of the relationship between language usage and alcohol use variables, using a nationally representative sample of Latino emerging adults from the National Longitudinal Study of Adolescent Health (Add Health).

Participants (n = 2,477) identified as Mexican/Mexican American, Cuban/Cuban American, Puerto Rican, or Central/South American/Other Hispanic.

Results of regression analyses indicated that gender, education, and language usage have a differential impact on alcohol use and binge drinking behaviors among individuals from different Latino subgroups. Implications for future research and alcohol prevention are discussed.



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Request Reprint E-Mail:       elvaugha@indiana.edu

Interpersonal Climate of 12-step Groups Predicts Reductions in Alcohol Use.

 


Research has shown that increases in the size of abstinence-based social networks helps explain the association between 12-Step attendance and increased abstinence.

This study investigated whether the quality of social interaction in 12-Step groups also predicts reduced substance use. Participants reported their perceptions of engagedness, avoidance, and conflict in their 12-Step groups and their substance use in four assessments.

Results showed that perceptions of group engagedness, but not avoidance or conflict, decreased over time. Despite this, engagedness predicted increased 12-Step-related behavior and decreased alcohol use.

Findings suggest that positive group interaction plays an important role in 12-Step affiliates' recovery efforts.


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Request Reprint E-Mail:   jtonigan@unm.edu

Chronic Care Management for Dependence on Alcohol and Other DrugsThe AHEAD Randomized Trial

To determine whether CCM for alcohol and other drug dependence improves substance use outcomes compared with usual primary care.

The AHEAD study, a randomized trial conducted among 563 people with alcohol and other drug dependence at a Boston, Massachusetts, hospital-based primary care practice. Participants were recruited from September 2006 to September 2008 from a freestanding residential detoxification unit and referrals from an urban teaching hospital and advertisements; 95% completed 12-month follow-up.

Participants were randomized to receive CCM (n=282) or no CCM (n=281). Chronic care management included longitudinal care coordinated with a primary care clinician; motivational enhancement therapy; relapse prevention counseling; and on-site medical, addiction, and psychiatric treatment, social work assistance, and referrals (including mutual help). The no CCM (control) group received a primary care appointment and a list of treatment resources including a telephone number to arrange counseling.

The primary outcome was self-reported abstinence from opioids, stimulants, or heavy drinking. Biomarkers were secondary outcomes.

There was no significant difference in abstinence from opioids, stimulants, or heavy drinking between the CCM (44%) and control (42%) groups (adjusted odds ratio, 0.84; 95% CI, 0.65-1.10; P=.21). No significant differences were found for secondary outcomes of addiction severity, health-related quality of life, or drug problems. No subgroup effects were found except among those with alcohol dependence, in whom CCM was associated with fewer alcohol problems (mean score, 10 vs 13; incidence rate ratio, 0.85; 95% CI, 0.72-1.00; P=.048).

Among persons with alcohol and other drug dependence, CCM compared with a primary care appointment but no CCM did not increase self-reported abstinence over 12 months. Whether more intensive or longer-duration CCM is effective requires further investigation.

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Press Release - Chronic Care Management Program Does Not Result in Increased Abstinence From Alcohol and Other Drug Dependence

Persons with alcohol and other drug dependence who received chronic care management including relapse prevention counseling and medical, addiction and psychiatric treatment were no more abstinent than those who received usual primary care, according to a study in the September 18 issue of JAMA.

Chronic care management (CCM) is a way of delivering care that has been shown to be effective for chronic medical and mental health conditions. “Chronic care management is multidisciplinary patient-centered proactive care, a way to organize services that provides coordination and expertise, and has been effective for depression, medical illnesses, and tobacco dependence (a substance use disorder),” the authors write. Trials of integrated medical and addiction care suggest that CCM may be effective for treating addiction, particularly since care elements long known to be effective for addiction overlap with CCM approaches.   > > > >  Read More

Research Access to Confidential Data through the Data Portal

The Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration (SAMHSA) is announcing a call for applications for access to Drug Abuse Warning Network (DAWN) and National Survey on Drug Use and Health (NSDUH) confidential data for research purposes.

Through receipt, review and approval of applications, researchers may access confidential DAWN and NSDUH data through CBHSQ's new Data Portal system. The Data Portal is a secure virtual computing environment. It is designed to provide authorized researchers access to confidential data for approved research projects. The goal of the Data Portal is to maximize the use of data collected by CBHSQ for important research and policy analyses, while conforming to Federal law and protecting identifiable data from disclosure.

Access to the Data Portal is provided through approved computer location(s) and IP address(es) at the researcher's organization. Users are required to maintain the confidentiality of the data used in the Data Portal. Information cannot be transferred into or out of the secure Data Portal by researchers until a disclosure review is conducted by CBHSQ. CBHSQ will conduct site inspections of each approved applicant.  > > > >  Read More

Alcohol News - 37/2013

 

 

 

 

 

NCD Alliance (Norway) - Norway first to launch a national NCD strategy

100 years ago communicable diseases were the main causes of premature death. Poverty was the major risk factor. Today 80 % of Norwegians die from NCDs, many prematurely. The majorrisk factors are tobacco, alcohol, sugar, fat and physical inactivity.

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Scanomark (Sweden) - Tax increases expected on alcohol in Sweden in line with the new budget

Sweden to increase taxes on alcohol - that is, taxes on wine and beer to go up by seven percent and the tax on spirits and very strong alcohol is to increased by a percentage point according to components of the governments upcoming autumn budge.

Read more

Medscape (Sweden) - Fetal Alcohol Syndrome: Prevalence High in Child Care Systems

Russia and Sweden had the highest prevalence of FAS (42.7% - 68.0%) in orphanages for children with special needs. The highest reported prevalences for FASD were 39.7% for Russian orphanages and 52.1% for adoptees from Eastern Europe in Sweden.

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Time (Finland) - Smarter Kids Are Smart Enough to Avoid Alcohol and Drugs, Right?

The researchers followed 3000 healthy identical or fraternal twins in Finland, focusing on the group who had significant differences in verbal development as children and who also turned out to have varied drinking behavior as adults.

Read more

ABC Online (Australia) - Police Commissioner likens parents who give alcohol to kids 'drug dealers'

Western Australia's Police Commissioner has likened parents who supply alcohol to their children as drug dealers.

Read more

BBC News (Pakistan) - Pakistan battles growing alcohol addiction

Alcoholism is a growing problem in Pakistan despite it being illegal for the Muslim majority to drink. The BBC's Charles Haviland finds lives ruined and clinics and therapy groups trying to overcome a taboo subject.

Read more

Daily Mail - Why Red Bull and vodka is a recipe for trouble: Mixing alcohol and energy drinks could be even more harmful than previously thought

Mixing alcohol with energy drinks to get a bigger hit could be more harmful than research currently suggests, claims a leading psychologist.

Read more

Irish Independent (Ireland) - Not all is gloomy in alcohol's 'dark markets'

WE are in the midst of a very interesting debate in this country about the wisdom of allowing sports sponsorship by the makers of alcoholic beverages. As usual we tend to think that the issue is entirely a domestic one, but of course it is not.

Read more

The Guardian (UK) - Alcohol marketing in TV football should be restricted, say scientists

Researchers have called for much tighter government restrictions or even a ban on the marketing of alcohol during televised football matches, arguing that the messages are seen by and affect millions of children.

Read more

Myanmar Times (Myanmar) - Experts report sharp rise in alcohol-related mental disorders

Alcohol-related mental health disorders are on the rise, experts warn. The number of patients admitted to Yangon Mental Health Hospital has risen more than 60 percent – from 1600 to 2600 a year – since 2008, says the hospital’s medical superintendent Dr Kyaw Soe.

Read more

Tax-news.com (Bulgaria) - 2014 Bulgarian Excise Rate For Cigarettes And Alcohol Confirmed

Bulgaria's Deputy Finance Minister Lyudmila Petkova has confirmed that there will be no excise tax increases on cigarettes and alcohol in 2014, despite a European Union directive that cigarette excise rates must reach a minimum of EUR90 per 1,000 by the start of 2018.

Read more

Hurriyet Daily News (Turkey) - Turkish PM refutes charge of intervention in lifestyles through alcohol restrictions

Prime Minister Recep Tayyip Erdoğan today refuted claims that the government was interfering in people’s lifestyles with the restrictions on the sale of alcohol that came into effect on Sept. 9.

Read more

Newcastle Herald (Australia) - EDITORIAL: Children drinking alcohol

MAKING parents and guardians more accountable for alcohol consumption by minors under their care seems a reasonable enough idea. There is plenty of anecdotal evidence that some adults aren't as careful or responsible as they should be when it comes to alcohol and young people.

Read more

Irish Independent (Ireland) - Move to tackle cheap alcohol sales 'on way'

NEW government policy is being drawn up to tackle the type of alcohol that is "too freely available at too low a cost", said Minister for Agriculture Simon Coveney.

Read more

Examiner.com (USA) - Chicago bans guns in bars and restaurants serving alcohol

According to an NBC News report on Wednesday, Chicago’s City Council took a swipe at the new Illinois gun laws and approved the ban of guns in all city restaurants that serve alcohol and all bars and nightclubs. The notion that a lawsuit will arise from the new City Council ruling hasn’t stopped the lawmakers who obviously have a mind of their own when it comes to guns in the city that has been pegged the murder capital for over a year now.

Read more

RedOrbit - Sober Drinking Knowledge Often Fails ‘In The Moment’ Of Intoxication

Approximately one-third of all fatal crashes each year in the U.S. involve an alcohol-impaired driver. Prior research has shown that alcohol alters perceptions of risky behaviors such as drinking and driving.

Read more

BBC News - Bradford study finds binge drinkers increased 'small baby' risk

Women who binge drink in the second three months of pregnancy are 68% more likely to have a small baby, research has shown.

Read more

 

 

 

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Problem solving styles among people who use alcohol and other drugs in South Africa

The present study examines the relationship between problem-solving styles, socio-demographic variables and risk of alcohol and other drug (AOD)-related problems among a South African population.

The Social Problem-Solving Inventory–Revised, Center for Epidemiologic Studies Depression Scale (CES-D) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were administered to a convenience sample of 1000 respondents.

According to the ASSIST, 32% and 49% of respondents met criteria for moderate to high risk of alcohol use and illicit drug use respectively. After adjusting for the effects of other variables in the model, respondents who were of “Coloured” ancestry (PR = 1.20, 95% CI 1.0-1.4), male (PR = 1.19, 95% CI 1.04-1.37), older (PR = 1.01, 95% CI 1.00-1.02), who adopted an avoidance style of coping with problems (PR = 1.03, 95% CI 1.01-1.05) and who met criteria for depression (PR = 1.42, 95% CI 1.12-1.79) were more likely to be classified as having risky AOD use. This suggests that interventions to improve problem solving and provide people with cognitive strategies to cope better with their problems may hold promise for reducing risky AOD use.

This suggests that interventions to improve problem solving and provide people with cognitive strategies to cope better with their problems may hold promise for reducing risky AOD use.



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Request Reprint E-Mail:    Katherine.sorsdahl@uct.ac.za

Acute alcohol-related dysfunction as a predictor of employment status in a longitudinal study of working-age men in Izhevsk, Russia

To investigate longitudinally the effect of alcohol consumption and related acute alcohol-related dysfunction on employment status.

 

A total of 1143 men aged 25–55 years in regular paid employment and resident in the city of Izhevsk, Russia were interviewed between 2003–06 and then re-interviewed (2008–09) and their employment status ascertained.

 

Exposures of interest were baseline alcohol intake (yearly total volume of ethanol consumed and non-beverage alcohols) and alcohol-related dysfunction, measured by a latent variable defined in terms of frequency of alcohol-related dysfunctional behaviours and by one or more episodes of zapoi (a period of continuous drunkenness lasting 2 or more days). The outcome of interest was whether or not men were still in regular paid employment at follow-up. The inter-relationship between these variables was investigated using structural equation modelling.

 

Total volume of ethanol consumed had no substantive effect on future employment status; however, taking into account education and other socio-demographic factors, there was strong evidence that loss of regular paid employment at follow-up was influenced by non-beverage alcohol consumption [odds ratio = 2.30 for non-beverage drinkers compared with beverage-only drinkers, 95% confidence interval (CI) = 1.21, 4.40)], latent acute alcohol-related dysfunction (odds ratio = 1.50 per standard deviation increase in dysfunction score, 95% CI = 1.20, 1.88) and zapoi (odds ratio = 3.08, 95% CI = 1.71, 5.55). Acute alcohol-related dysfunction was an important mediator of the relationship between non-beverage alcohol use and employment status.

 

Acute alcohol-related dysfunction is an important factor in determining whether men remain in employment and an important mediator of the effects of alcohol intake.



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Trend analysis and modelling of gender-specific age, period and birth cohort effects on alcohol abstention and consumption level for drinkers in Great Britain using the General Lifestyle Survey 1984–2009

 

British alcohol consumption and abstinence rates have increased substantially in the last 3 decades. This study aims to disentangle age, period and birth cohort effects to improve our understanding of these trends and suggest groups for targeted interventions to reduce resultant harms.

 

Age, period, cohort analysis of repeated cross-sectional surveys using separate logistic and negative binomial models for each gender.

 

Great Britain 1984–2009.

 

Annual nationally representative samples of approximately 20 000 adults (16+) within 13 000 households.

 

Age (eight groups: 16–17 to 75+ years), period (six groups: 1980–84 to 2005–09) and birth cohorts (19 groups: 1900–04 to 1990–94). Outcome measures were abstinence and average weekly alcohol consumption. Controls were income, education, ethnicity and country.

 

After accounting for period and cohort trends, 18–24-year-olds have the highest consumption levels (incident rate ratio = 1.18–1.15) and lower abstention rates (odds ratio = 0.67–0.87). Consumption generally decreases and abstention rates increase in later life. Until recently, successive birth cohorts' consumption levels were also increasing. However, for those born post-1985, abstention rates are increasing and male consumption is falling relative to preceding cohorts. In contrast, female drinking behaviours have polarized over the study period, with increasing abstention rates accompanying increases in drinkers' consumption levels.

 

Rising female consumption of alcohol and progression of higher-consuming birth cohorts through the life course are key drivers of increased per capita alcohol consumption in the United Kingdom. Recent declines in alcohol consumption appear to be attributable to reduced consumption and increased abstinence rates among the most recent birth cohorts, especially males, and general increased rates of abstention across the study period.



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Childhood Verbal Development and Drinking Behaviors from Adolescence to Young Adulthood: A Discordant Twin-Pair Analysis

Studies suggest that better cognitive and verbal abilities in childhood predict earlier experimentation with alcohol and higher levels of drinking in adolescence, whereas poorer ability is related to a higher likelihood of remaining abstinent. Whether individual differences in language development in childhood predict differences in adolescent drinking behaviors has not been studied.

 

To address that question, we compared co-twins from twin pairs discordant for their childhood language development and studied associations of parental reports of within-pair differences in age at speaking words, age at learning to read, and expressive language skills during school age with self-reported within-pair differences in drinking, intoxication, and alcohol-related problems across adolescence and young adulthood. Data from 2 longitudinal population-based samples of twin families were used, with verbal developmental differences in childhood reported by the parents when the twins were 12 and 16 years of age, respectively.

 

Conditional logistic regression analyses and within-pair correlation analyses suggested positive associations between verbal development and drinking behaviors in both data sets. In analyses adjusted for birth order and birth weight, the co-twin reported to be verbally more advanced in childhood tended to report more frequent drinking and intoxication in adolescence in both samples. Better verbal development also was associated with the likelihood of having friends who drink in adolescence.

 

These findings suggest that, adjusting for familial and other factors shared by co-twins, better verbal development in childhood predicts more frequent drinking and intoxication in adolescence and young adulthood, possibly due, in part, to peer associations.


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Request Reprint E-Mail:    antti.latvala@helsinki.fi

Perceived Danger While Intoxicated Uniquely Contributes to Driving After Drinking

Previous findings suggest that alcohol alters perceptions of risky behaviors such as drinking and driving. However, studies testing these perceptions as a predictor of drinking and driving typically measure these perceptions while participants are sober. This study tested whether the perceived danger of driving after drinking assessed while intoxicated was associated with increased willingness to drive and self-reported drinking-and-driving behavior over and above perceptions assessed while sober. Additionally, we tested the effect of acute tolerance on the perceived danger of driving after drinking assessed on the ascending and descending limbs of the breath alcohol concentration (BrAC) curve.

 

Eighty-two young adults attended 2 counterbalanced laboratory sessions. In one session, participants consumed a moderate dose of alcohol (men: 0.72 g/kg, women: 0.65 g/kg) and reported their perceived danger of driving and willingness to drive at multiple points across the BrAC curve. On a separate occasion, participants remained sober and appraised the dangerousness of driving at a hypothetical, illegal BrAC.

 

Perceptions of the dangerousness of driving following alcohol administration were associated with increased willingness to drive and higher rates of self-reported drinking-and-driving behavior over and above perceptions reported when sober. Furthermore, perceived danger was reduced on the descending limb of the BrAC curve, compared with the ascending limb, suggesting the occurrence of acute tolerance.
 

Results from this study suggest that intoxicated perceptions are uniquely associated with drinking-and-driving decisions and that the perceived danger of drinking and driving is lower on the descending limb of the BrAC curve. Efforts to prevent alcohol-impaired driving have focused on increasing awareness of the danger of driving after drinking. Prevention efforts may be enhanced by educating drivers about how intoxication can alter perceived danger, and interventions may benefit from targeting perceptions of dangerousness while individuals are intoxicated in addition to when they are sober.
 


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Request Reprint E-Mail:      mccarthydm@missouri.edu

Psychiatric Comorbidity and 12-Step Participation: A Longitudinal Investigation of Treated Young Adults

Evidence indicates that 12-step mutual-help organizations (MHOs), such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), can play an important role in extending and potentiating the recovery benefits of professionally delivered addiction treatment among young adults with substance use disorders (SUD). However, concerns have lingered regarding the suitability of 12-step organizations for certain clinical subgroups, such as those with dual diagnosis (DD). This study examined the influence of diagnostic status (DD vs. SUD-only) on both attendance and active involvement (e.g., having a sponsor, verbal participation during meetings) in, and derived benefits from, 12-step MHOs following residential treatment. 

Young adults (N = 296; 18 to 24 years old; 26% female; 95% Caucasian; 47% DD [based on structured diagnostic interview]), enrolled in a prospective naturalistic study of SUD treatment effectiveness, were assessed at intake and 3, 6, and 12 months posttreatment on 12-step attendance/active involvement and percent days abstinent (PDA). t-Tests and lagged, hierarchical linear models (HLM) examined the extent to which diagnostic status influenced 12-step participation and any derived benefits, respectively.

 

For DD and SUD-only patients, posttreatment attendance and active involvement in 12-step

organizations were similarly high. Overall, DD patients had significantly lower PDA relative to SUD-only patients. All patients appeared to benefit significantly from attendance and active involvement on a combined 8-item index. Regarding the primary effects of interest, significant differences did not emerge in derived benefit between DD and SUD-only patients for either attendance (p = 0.436) or active involvement (p = 0.062). Subsidiary analyses showed, however, that DD patients experienced significantly greater abstinence-related benefit from having a 12-step sponsor.

 

Despite concerns regarding the clinical utility of 12-step MHOs for DD patients, findings indicate that DD young adults participate and benefit as much as SUD-only patients, and may benefit more from high levels of active involvement, particularly having a 12-step sponsor. Future work is needed to clarify how active 12-step involvement might offset the additional recovery burden of a comorbid mental illness on substance use outcomes.


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Request Reprint E-Mail:    bgbergman@partners.org

 

Does the Severity of Hangovers Decline with Age? Survey of the Incidence of Hangover in Different Age Groups

Alcohol hangover is a growing research area, but differences across the life span have not been assessed. Here, we test the hypothesis that the severity of hangovers depends on age.

 

A cross-sectional study of 51,645 men and women aged 18 to 94 years old, who participated in the population-based Danish Health Examination Study (DANHES) in Denmark between 2007 and 2008, formed the database for our study.

 

The incidence of severe hangover was lower among older than younger participants. Odds ratios for experiencing severe hangover following an episode of binge drinking were 6.8, 4.8, 3.0, and 2.0 among the 18 to 29, 30 to 39, 40 to 49, and 50 to 59-year-old men, compared with those aged 60+ years. For women, similar results were obtained. This finding could not be explained by the usual amount of alcohol consumption, frequency of binge drinking, or the proportion of alcohol consumed with meals.

 

We found that hangover following engagement in binge drinking is much more common in the young than in the older age groups.

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Request Reprint E-Mail:    jst@niph.dk