To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.


Saturday, February 3, 2007

Short Report - Alcohol imagery on New Zealand television

Short Report
Alcohol imagery on New Zealand television

Substance Abuse Treatment, Prevention, and Policy 2007, 2:62007-02-01

McGee, Rob
Ketchel, Juanita
Reeder, Anthony I

1 February 2007Abstract (provisional)

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

To examine the extent and nature of alcohol imagery on New Zealand (NZ) television, a content analysis of 98 hours of prime-time television programs and advertising was carried out over 7 consecutive days viewing in June/July 2004. The main outcome measures were number of scenes in programs, trailers and advertisements depicting alcohol imagery; the extent of critical versus neutral and promotional imagery; and the mean number of scenes with alcohol per hour, and characteristics of scenes in which alcohol featured.

There were 648 separate depictions of alcohol imagery across the week, with an average of one scene every nine minutes. Scenes depicting uncritical imagery outnumbered scenes showing possible adverse health consequences of drinking by 12 to 1.

The evidence points to a large amount of alcohol imagery incidental to storylines in programming on NZ television. Alcohol is also used in many advertisements to market non-alcohol goods and services. More attention needs to be paid to the extent of alcohol imagery on television from the industry, the government and public health practitioners. Health education with young people could raise critical awareness of the way alcohol imagery is presented on television.

TAP 28: The National Rural Alcohol and Drug Abuse Network Awards for Excellence 2004

TAP 28: The National Rural Alcohol and Drug Abuse Network Awards for Excellence 2004

This TAP presents seven papers submitted to the 2004 National Rural Alcohol and Drug Abuse Network (NRADAN) Awards for Excellence. Each paper describes effective and innovative models of treatment and prevention services in rural populations. This publication seeks to promote and showcase research addressing the unique and special challenges of providing treatment services to individual in rural areas and their families.

The first place paper describes the effectiveness of a self-funded drug court.

The second place paper highlights effective strength- and home-based substance abuse treatment and recovery support programs.

The third place paper provides presents a substance abuse prevention program for lower income mothers.

The topics of the other four papers include treatment outcomes of people who use methamphetamine, a discussion of faith- and community-based reentry services, a comparison of people who use drugs in rural and very rural areas, and a description of an electronic version of the Addiction Severity Index.

View Materials in PDF Format

Contributor: Don Phillips



Addiction (207)102 (2), 189–190.
Full Article

We would like to thank Drs McGue [1], Sher [2] and Zucker [3] for their insightful commentaries on our paper and agree that there are still many unknowns in our understanding of transitions in alcohol use and the unfolding of risk across the life span. Risk factors that shape the pathway to alcohol dependence are dynamic in nature, fluctuating in potency throughout the multi-stage process during which the disorder develops [4]. As a result, identification of risk factors associated with a life time dependence diagnosis, although important in assessing overall liability to the disorder, is of limited utility in predicting changes in vulnerability to alcohol-related problems over time—an essential step toward distinguishing those junctures where alcohol outcomes may be most modifiable. As evidenced in the findings and noted in Dr Sher's commentary [2], variability in risk over the course of alcohol dependence development is a function of phase of the disorder in combination with stage of development, such that rate of progression and prominence of risk factors associated with transitions would be expected to differ, for example, between an individual initiating alcohol use at 12 versus 18 years of age. Investigation of the underlying mechanisms driving stage transitions in alcohol dependence course requires an approach that takes into account shifts in environmental sources of influence that occur as a consequence of increased severity of drinking behaviors, as well as those attributable to age-related maturation. Twin and other genetically-informative research, which has produced evidence of distinctions in risk profiles between initiation of alcohol use (14–40% heritable, with the majority of variance accounted for by shared environment) [5–7] and alcohol dependence (50–60% heritable) [8–10] is a critical tool for conducting such investigations.

The complex interplay of genetic and environmental risk factors that change over time as a function of both alcohol exposure and developmental stage presents the challenging task of disentangling sources of variance accounting for considerable heterogeneity in trajectories of alcohol dependence. Prospective assessment of psychiatric and psychosocial risk factors conducted in the context of a gene by environment (G × E) research design would create a framework for determining the role of specific environmental correlates of alcohol-related problems and their interactions with genetic liability to alcohol dependence in the manifestation of alcohol outcomes (and indicators of developmental course) at varying stages of the disorder. Beyond addressing continuity in risk for alcohol outcomes posed by a given risk factor, continuity in the degree to which genetic predisposition to alcohol dependence interacts with that factor to increase alcohol-related risk at various stages of the disorder can be assessed. For example, high genetic liability to alcohol dependence in combination with externalizing psychopathology may be associated with early age at alcohol use initiation, but rate of progression to first dependence symptom may not differ by genetic liability for individuals with externalizing disorders. In addition to characterizing fluctuations in G × E effects on alcohol outcomes, such a genetically-informative design would provide the opportunity to extend the small but growing literature on shared genetic influences on cross-stage alcohol outcomes [11] and heritability of transitions in the course of alcohol use [12] that informs etiological models of alcohol dependence development.



Addiction (2007) 102 (2), 188–189.
Full Article

EARLY DRINKING AND THE DEVELOPMENT OF ALCOHOLISM: A COMMENTARY ON SARTOR ET AL. (2007) [Friday, February 2, 2007 The role of childhood risk factors in initiation of alcohol use and progression to alcohol dependence ]

Researchers have increasingly adopted developmental approaches to the study of alcoholism. As a consequence, we know that individuals who develop alcoholism differ from those who do not in, for example, early manifestations of personality [1]; risk of experiencing abuse [2]; and the attainment of developmental milestones [3].
They also differ in the age at which they first tried alcohol, the focus of research reported by Sartor et al. [4] in this issue of Addiction. In a highly influential paper, Grant & Dawson [5] reported a strong association between age at first drink (AFD) and risk of alcoholism.
Individuals who reported an AFD of less than 15 years were four times more likely to have been alcoholic as an adult than those reporting an AFD of greater than 20 years.

Sartor et al. begin by replicating the Grant & Dawson association: in their sample, individuals who first drank alcohol prior to age 14 were more than two times more likely to be alcoholic than those trying alcohol after age 16.
Importantly, they go on to show that an early AFD does not occur in isolation, but rather is associated with numerous other markers of alcoholism risk.
Individuals with an early AFD were more likely to have a diagnosis of conduct disorder or attention deficit/hyperactivity disorder, a family history of alcoholism, and come from a divorced family. None the less, they report that an early AFD is not associated with a rapid progression from the initial stages of drinking to alcohol dependence.



Addiction (2007) 102 (2), 187–188.

Full Article

AN IMPORTANT NEW PHENOTYPE AND SOME NEXT-STEP QUESTIONS: COMMENTARY ON SARTOR ET AL. (2007) [Friday, February 2, 2007 The role of childhood risk factors in initiation of alcohol use and progression to alcohol dependence ]

The paper by Sartor et al. [1] is an important extension to the work by Wagner & Anthony [2], the Minnesota group [3] and others in the articulation of the early architecture of drug involvement as a multi-stage process.

It replicates a considerable amount of work demonstrating greater risk for eventual alcohol dependence (AD) among earlier first drinkers [4,5]. It also replicates findings that risk factors in the behavioral dysregulation/undercontrol domain [conduct disorder (CD), attention deficit hyperactivity disorder (ADHD)], [3,6,7], as well as family disorganization/conflict (parent divorce, maternal AD) known to sustain such undercontrolled behavior [8,9], predict earlier drinking onset.

What is new is the elaboration of a two-stage model of progression, involving (a) risk for onset of use and (b) rapidity of progression into dependence.

The Sartor et al. [1] data indicate that these are differentiated processes, with mostly different factors predicting speed of progression into disorder.

For the latter, it remains important to clarify order of precedence of the other drug comorbidity and generalized anxiety disorder (GAD) vis-à-vis the onset of AD. At least for cannabis comorbidity precedence is likely [2], but the issue needs to be addressed.

It also would be useful to know whether those factors which predict rapidity of progression into AD also predict whether or not dependence occurs. Although the issue is not highlighted in this report, the two are not the same phenotype. Their Table 2 data on differences in the probability of meeting AD criteria suggest that this may be related more to those factors which predict onset.

Friday, February 2, 2007



Addiction Volume 102 Issue 2 Page 185 - February 2007

[Friday, February 2, 2007 The role of childhood risk factors in initiation of alcohol use and progression to alcohol dependence ]

Sartor et al.'s [1] paper highlights several important considerations that are central to understanding the etiology of alcohol dependence in a developmental context. Two of these are central to an informed analysis of the relationship between risk factors and the unfolding of dependence: identifying informative milestones and distinguishing the development of disorder from the development of the person.
(continue reading)

Controlled study of brief personalized assessment-feedback for drinkers interested in self-help

Controlled study of brief personalized assessment-feedback for drinkers interested in self-help

Addiction (2007) 102 (2), 241–250.

T. Cameron Wild 1 School of Public Health, University of Alberta, Edmonton, Alberta, Canada, Cameron Wild, Addiction and Mental Health Research Laboratory, University of Alberta, 13–103 Clinical Sciences Building, Edmonton, Alberta T6G 2G3, Canada. E-mail: ,

John A. Cunningham 2 3Centre for Addiction and Mental Health, Toronto, Ontario, Canada, 3Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada and

& Amanda B. Roberts 4Public Health Agency of Canada, Alberta/NWT Branch, Edmonton, Alberta, Canada

1School of Public Health, University of Alberta, Edmonton, Alberta, Canada, 2Centre for Addiction and Mental Health, Toronto, Ontario, Canada, 3Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada and 4Public Health Agency of Canada, Alberta/NWT Branch, Edmonton, Alberta, Canada
Cameron Wild, Addiction and Mental Health Research Laboratory, University of Alberta, 13–103 Clinical Sciences Building, Edmonton, Alberta T6G 2G3, Canada. E-mail:

Brief alcohol interventions typically have been directed to heavy-drinking patients seeking primary health care and college students. This study examined the efficacy of mailing brief personalized assessment-feedback to interested drinkers recruited from the general public. We hypothesized that problem drinkers would benefit more from the intervention than individuals who were not problem drinkers.

A two-arm, double-blinded, community-based randomized controlled trial with 6-month follow-up.

Setting and participants
A screening interview was administered to a stratified random sample of 10 014 Canadians 18 years of age and older (5621 women and 4393 men; M age = 43.3 years, SD = 15.99; response rate = 65.4%).

Current drinkers interested in receiving alcohol self-help materials (n = 1727) were assigned randomly to receive brief personalized assessment-feedback on male and female population drinking norms by mail, or to a delayed-treatment control group, and were contacted 6 months later (76% retention rate).

Problem drinking status at baseline [using sex-specific Alcohol Use Disorders Identification Test (AUDIT) cut scores], and frequency and quantity of alcohol use at follow-up.

Analysis of covariance identified the hypothesized interaction of baseline problem drinking status and treatment condition (P < 0.01). Among problem drinkers identified at baseline the intervention caused a 10.1% reduction in per-occasion binge drinking compared to controls, whereas there was no difference in binge drinking across conditions for non-problem drinkers.

The continuum of care for alcohol problems can be broadened by providing brief interventions to interested drinkers in the general population.

The role of childhood risk factors in initiation of alcohol use and progression to alcohol dependence

The role of childhood risk factors in initiation of alcohol use and progression to alcohol dependence
Addiction Volume 102 Issue 2 Page 216 - February 2007

Carolyn E. Sartor ,
Michael T. Lynskey ,
Andrew C. Heath ,
Theodore Jacob &
William True

Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA

Corresponding author: Carolyn E. Sartor, Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St Louis, MO 63110, USA. E-mail:


To identify childhood risk factors that predict (a) age of first drink and (b) time from first use to alcohol dependence (AD) onset, using survival analysis.

The sample consisted of 1269 offspring (mean age = 20.1 years) of male twins from the Vietnam Era Twin Registry; 46.2% were offspring of alcohol-dependent fathers.

DSM-IV psychiatric diagnoses and substance use behaviors were assessed by structured telephone interview.

First drink occurred on average at 15.7 years; AD onset at 19.1 years.
A Cox proportional hazard regression analysis revealed conduct disorder (CD) as the most potent predictor of early alcohol initiation (HR 2.48; CI 1.85–3.32).
Attention deficit hyperactivity disorder (ADHD), maternal AD, paternal AD, male gender and parental divorce were also associated with early first use (HR 1.20–1.52; CI 1.04–1.39–1.18–1.96).
A Cox proportional hazard regression analysis modeling first drink to AD identified nicotine dependence (HR 3.91; CI 2.48–6.17) and generalized anxiety disorder (GAD) (HR 3.45; CI 2.08–5.72) as robust predictors of progression to AD.
CD (HR 1.75; CI 1.10–2.77) and cannabis abuse (HR 1.88; CI 1.22–2.90) were also associated with rapid transition to AD.

Results highlight the role of psychiatric and substance use disorders in progression from first drink to AD, underscore the continuity of risk associated with CD and indicate that (with the exception of CD) different factors play a role in transition to AD than in initiation of alcohol use. Distinctions between stages are interpreted in a developmental framework.

Thursday, February 1, 2007

EPHA Newsletter - *UPDATED* The ’Alcohol Strategy’: a missed opportunity to protect health?

european public health alliance
putting citizens' health at the heart of europe

*UPDATED* The ’Alcohol Strategy’: a missed opportunity to protect health?

*UPDATED with the Conclusions of the Council of Health Ministers - 01 12 2006.*

On the 25 October 2006, the European Commission unveils the EU Strategy to support Member States in reducing alcohol related harm - a very disappointing text for health NGOs which hoped for a stronger commitment from EU officials.

The main themes
While the paper makes clear that the European Commission do not intend to develop EU legislation in the field of the prevention of alcohol related harm, the European (read more ...)


31 January 2007
Second shock survey highlights terrible toll
By Natalie Walker

BOOZE abuse kills one Scot every six hours, it was revealed yesterday.

The horrifying figures came just three days after another report showed deaths from liver disease had soared by 85 per cent in 10 years.

Hundreds more Scots are dying from the effects of drink than five years ago, according to the new figures.

There were 2372 deaths in Scotland in 2005 where alcohol was either the cause or a contributing factor - up 15 per cent since 2001.

More than two-thirds of the deaths were men.

The number of people who end up in hospital with an alcohol-related illness or injury is also on the rise - up 10 per cent since 2001.

Health chiefs yesterday said the new statistics highlighted the need for people to do more to protect their own health.

Deputy health minister Lewis Macdonald said: "We must all take personal responsibility for our drinking habits. The solution does not lie solely with government."

Booze-related injuries or illness accounted for four per cent of hospital cases last year.
During 2005-06, there were 1,036,853 general hospital discharges in Scotland.

Of those, 39,061 involved alcohol-related injuries or illnesses - a 10 per cent rise from 2001-02's total of 35,445.

Just over seven in 10 - 71 per cent - of them were men.

The most common diagnosis in alcohol-related discharges was "harmful use", a factor in 29 per cent of cases.

A further 18 per cent were for acute intoxication.

And 15 per cent were diagnosed with alcoholic liver disease.

Nine in 10 alcohol-related discharges followed emergency admissions to hospital.

Figures also showed that of the 139 people accused of murder or culpable homicide in 2005-06, 19 per cent were drunk and a further nine per cent had taken both drink and drugs.

Macdonald insisted the Executive were taking steps to cut the toll.

He said: "We have allocated an additional £10 million this year for alcohol services to ensure more people get access to appropriate help.

"We have a Licensing Act that includes tough action to deal with irresponsible drinks promotions and underage drinking."

But the Tories called for more education to tackle the problem and for the law on underage drinking to be strictly enforced at all times.

Tory health spokeswoman Dr Nanette Milne attacked Macdonald's statements.

She said: "These stark statistics are the most visible consequence of the damage excessive drinking can create - but, behind the figures, are real lives that have been destroyed and families devastated.

"When a minister who has been in his position for over 18 months announces he's just realised the scale of the problem, you can tell he's given up."

SNP health spokeswoman Shona Robison said: "It's time to tackle head-on the terrible toll that alcohol is taking on the physical health of thousands of Scots each year."

Source: Feb 1, 2007 Alcohol and Drug History Society Matthew McKean

Newsletter - eYe on the field January 2007

eYe on the field
January 2007
vol. 8 issue 1

Binge Drinking, Gender, & Clinical Depression
Ethnic Disparities in Alcohol Services: Financial & Logistical Barriers are Key
The G Allele of the Mu-Opioid Receptor Gene is linked to Craving for Alcohol
Reduced Frontal-Lobe Activity & Impulsivity may be linked to Alcoholism Risk

NIH: Impact of Adolescent Drinking on the Developing Brain
SAMHSA: Targeted Capacity Expansion Program for Substance Abuse Treatment & HIV/AIDS Services
NIH: Inhalant Abuse - Supporting Broad-Based Research Approaches

DASIS Report: Facilities Offering Special Programs or Groups for Women
NIDA - Serie de Reportes de Investigación - Alucinógenos y Drogas Disociativas

Gulf Coast ATTC Report: Trends in the Abuse of Prescription Drugs (PDF)
2006 Monitoring the Future (MTF) Survey Results
SAMHSA: New Science to Service Awards - Call for Applications

CADCA's National Leadership Forum XVII: Coalitions: The Road to Results - February 12th-15th
CASA Conference "Compound Fractures: Substance Abuse & Trauma" - March 8th
American Counseling Association 2007 Annual Convention - March 21st-25th

Online/Correspondence Course: Adolescent Chemical Dependency - Current Perspectives & Treatment Approaches
Online/Correspondence Course: Introduction to Ethics & Professional Issues

Faces & Voices of Recovery - December 21, 2006
NIATx eNews Update - December 2006
Northwest Frontier ATTC Addiction Messenger - Using & Building Motivational Interviewing Skills Part 1: Assessment - Vol. 9, Issue 10 (PDF)
SAMHSA News - Electronic Records: Healthcare in the 21st Century - Vol. 14, No. 6
National Daily News from Join Together

Imagine Who You Could Save - Recruitment Resources
NIDA for Teens

Know Your Limits: a critical review by peer support forum NERAF (UK)

North East Regional Alcohol Forum (NERAF) recently facilitated a service user consultation on the Department of Health/Home Office 'Know Your Limits' campaign.

The Forum considered the consultation process for development of the campaign; the campaign messages; campaign materials; and the communication channels for members of the public wanting more information.

The Forum found:

  • No evidence of a consulation process in developing the campaign

  • An over-emphasis on the criminal justice agenda - as if binge drinking is only a problem when it leads to anti-social behaviour

  • The advice on drinking during pregnancy is a concern; they would prefer to see pregnant women advised not to drink alcohol at all

  • The emphasis on daily limits means the two drink free days a week message is lost

  • Dispensers for the campaign cards are of poor quality and of little use

  • Receiving more information by text, as suggested in campaign materials, requires people to send personal information by text, which was felt to be inappropriate

Source: 30 January 2007 Alcohol Policy UK Libby Ranzetta

Wednesday, January 31, 2007

eNewsletter - January 31, 2007 Faces & Voices of Recovery

eNewsletter - January 31, 2007

Just two more days to sign up for our Recovery Advocacy Webinar
Editorial Boards – Media Outreach Nuts and Bolts. Listen and participate in our first exciting online, hour long recovery advocacy training featuring communications expert Jeff Valliere and Reclaiming Futures Project Director Charlotte McGuire on Saturday, February 3rd more…

Profiles of Recovery Advocacy in Action
Faces & Voices is pleased to launch a regular series of interviews with recovery advocates from across the country who will be interviewed by Bill White and Pat Taylor. The first is with Connecticut Community for Addiction Recovery (CCAR) Executive Director Phillip Valentine. More…

Addiction Recovery Insurance Discrimination Registry Launch
State and federal policymakers are shining light on the fact that far too many Americans are not getting the help they need to achieve long-term recovery from addiction, even if they have private health insurance. We are setting up the Addiction Recovery Insurance Discrimination Registry to collect the stories of individuals and families to document the discriminatory practices that are preventing people and their families from new lives in recovery. We need your help to document your experiences and your story.

Campaign to Insure Mental Health and Addiction Equity
Representatives Patrick Kennedy (D-RI) and Jim Ramstad’s (R-MN) nationwide informal field hearings in cities across the country, the Campaign to Insure Mental Health and Addiction Equity, are underway. They are joining with other members of Congress to collect testimony from people whose lives have been touched by addiction or mental illness. More…

Rally for Recovery!
Mark your calendar for the 2007 Rally for Recovery! on Saturday, September 15th. This year Faces & Voices has produced a Rally for Recovery! logo that you can you can use in your organizing more…

- “The Science of Addiction from Neurobiology to Treatment,” is a new book by Carlton K. Erickson who participated in the Alliance Project and the founding of Faces & Voices of Recovery. In the book, he presents a comprehensive overview of the roles that brain function and genetics play in addiction. It is intended to equip people who are working as counselors, social workers and psychologists with a thorough understanding of the latest neurobiological causes of addiction, thus ensuring a more knowledgeable and effective approach to overcoming the illness.

-New research maps the brain’s recovery from alcoholism. Researchers in Germany and Switzerland have found that the brain can recover most if not all of its capabilities when people stop drinking. The article, “Manifestations of Early Brain Recovery Associated with Abstinence from Alcoholism” in the January 2007 issue of the journal Brain reports that its results support the notion that brain regeneration can be attained rapidly by abstinence. MRI studies and cognitive tests were used to track the brain changes in a group of alcohol-dependent subjects as they embarked on the road to recovery.

- A New PATH (Parents for Addiction Treatment and Healing). In 2004 A New PATH created the first “Faces of Recovery” calendar that more….

Faces & Voices of Recovery launches our membership campaign! Join now!


Patients With Addiction and Personality Disorder: Treatment Outcomes and Clinical Implications

Patients With Addiction and Personality Disorder: Treatment Outcomes and Clinical Implications

Louisa MC Van den Bosch; Roel Verheul

Curr Opin Psychiatry. 2007;20(1):67-71. ©2007 Lippincott Williams &Wilkins

Posted 01/22/2007

Abstract and Introduction


Purpose of Review:

The present review examines the outcomes of treatmentsf ocusing on substance abuse, on personality disorders, and on both the foci simultaneously. Clinical guidelines for the treatment of dually diagnosed patients are described.Recent Findings: Recent studies continued the tradition of examining the importance of factors such as the chronicity of substance abuse and the impact of sex with regard to the prognosis of the treatment of substance abuse and the development of effective treatment programs. Overall, the multifaceted and risky nature of dual problems is stressed, and as a logical consequence, an early detection of dual problems is promoted.

Several studies show the risk of suicidal and harmful behavior associated with this population, even when the treatment for substance abuse has been successful. For the first time, the issue
of dropout is studied from the client's perspective.


Knowledge about the effectiveness of dually focused treatments is emerging.

Results show that the treatment of dually diagnosed patients with severe problems needs to include both the foci because it leads to enormous gains for the patients when personality disorders are also addressed. Yet, integrated treatment programs are lacking and research is still too limited.

NOTE: To view the complete article with Web enhancements, go to:

Contributor: Don Phillips

Article: A Review of Perspectives on Alcohol and Alcoholism in the History of American Health and Medicine

"A Review of Prespectives on Alcohol and Alcoholism in the History of American Health and Medicine" in
Journal of Ethnicity in Substance Abuse 5/4 (2006): 39-106.

Victor B. Stolberg MA, MS, MSE, MAH, MALS, EdM, MAT, CSW

This review of alcohol use and alcoholism in the history of American health and medicine reveals a range of ambiguous perspectives.

In early America, alcohol was attributed with an array of medicinal uses, while habitual drunkenness was not accepted and was identified as a sin. The reformers of the temperance movement expanded upon what they regarded as the social problems associated with alcohol.

In nineteenth century America, medical sectarians developed conflicting and contradictory views on health and healing, including the place of alcohol and how to address alcoholism. As the American hospital system evolved, approaches for the care and treatment that alcoholics received in hospitals had to develop as well.

Progressive reforms in the early twentieth century impacted many areas of public health in the United States, but continued to embody moralism.

These historical trends profoundly influenced the social and institutional responses to alcoholism that continue today, including the evolution of the modern addiction treatment system and the formulation and promulgation of the disease concept.

Source: David Fahey Alcohol and Drug History Society 31 Jan 2007

Addiction Counseling Competencies: The Knowledge, Skills, Attitudes of Professional Practice

Addiction Counseling Competencies: The Knowledge, Skills, Attitudes of Professional Practice

SAMHSA Announces Availability of TAP 21, Addiction Counseling Competencies:The Knowledge, Skills, and Attitudes of Professional Practice
The Substance Abuse and Mental Health Services Administration (SAMHSA)announces the availability of the updated Technical Assistance Publication(TAP) 21, Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice.
This printing of TAP 21 contains updated competencies that are essential to the effective practice of counseling for substance use disorders. Under each competency, the TAP lists updated knowledge, skills, and attitudes that counselors need to become proficient in that competency.
It also includes expanded bibliographies and new sections on cultural competence and Internet resources.
TAP 21 was originally developed in 1998, in cooperation with the Addiction Technology Transfer Center Network.
This update used the same development process as that used for the original version.
Order your FREE copy of TAP 21 online or, contact SAMHSA’s National Clearinghouse for Alcohol and Drug Information (NCADI). Ask for publication order number BKD246.
View this publication online in PDF format.
Phone: 800-729-6686 or 240-221-4017
800-487-4889 (TDD hearing impaired)
877-767-8432 (toll free) Hablamos Español
The issue is also available online at
Contributor: Don Phillilps

The psychological science of addiction

The psychological science of addiction

Elizabeth Gifford & Keith Humphreys
Veterans Affairs and Stanford University Medical Centers, Palo Alto, CA, USA
Addiction (OnlineEarly Articles).

Elizabeth Gifford, Program Evaluation and Resource Center (152-MPD), 795 Willow Road, Menlo Park, CA 94025, USA. E-mail:


To discuss the contributions and future course of the psychological science of addiction.

The psychology of addiction includes a tremendous range of scientific activity, from the basic experimental laboratory through increasingly broad relational contexts, including patient–practitioner interactions, families, social networks, institutional settings, economics and culture.

Some of the contributions discussed here include applications of behavioral principles, cognitive and behavioral neuroscience and the development and evaluation of addiction treatment.

Psychology has at times been guilty of proliferating theories with relatively little pruning, and of overemphasizing intrapersonal explanations for human behavior. However, at its best, defined as the science of the individual in context, psychology is an integrated discipline using diverse methods well-suited to capture the multi-dimensional nature of addictive behavior.

Psychology has a unique ability to integrate basic experimental and applied clinical science and to apply the knowledge gained from multiple levels of analysis to the pragmatic goal of reducing the prevalence of addiction.

News Release: Grape juice good for the heart: study:

Grape juice good for the heart: study

Wed Jan 31, 2007 11:04am ET
By Patricia Reaney
LONDON (Reuters)
- Grape juice seems to have the same protective effect against heart disease as red wine, French scientists said on Wednesday.

Researchers at the Universite Louis Pasteur de Strasbourg were examining the effect on the heart of Concord grape juice.

"Grape juice can have a similar effect (against heart disease) as red wine but without the alcohol. That is a very important message," said Dr Valerie Schini-Kerth, lead author of the study published in the journal Cardiovascular Research.

Red wine and certain types of grape juice have high levels of polyphenols, which block the production of a protein linked to cardiovascular disease -- the number one killer in many Western countries.

Heart and vascular problems develop when endothelial cells that make up blood vessels do not work properly.

Schini-Kerth and her team found that polyphenols in Concord grape juice activate endothelial cells to produce nitric oxide which helps to protect against cardiovascular disease and to maintain healthy blood vessels and blood pressure.

Press Release: New leadership on the ICAP Board of Directors

New leadership on the ICAP Board of Directors

Press Release:

Contacts: Ms. Marjana Martinic
International Center for Alcohol Policies
Tel: +1 202 986 1159 / Email:

Mr. Helmut Wagner
TCN Communications


New leadership on the Board of Directors at
international alcohol policy think tank

WASHINGTON, D.C., [.. November 2006] – A new Chairman and Vice-Chairman
have been appointed to the Board Directors of the International Center for Alcohol
Policies (ICAP). Both will serve a two-year term.

The new Chairman of ICAP is Mr. Barton Alexander, Global Vice President, Alcohol
Policy and Corporate Responsibility at Molson Coors. He has served on the ICAP
Board of Directors since 1995 and his term succeeds that of outgoing ICAP
Chairman Mr. Mark Leverton of Diageo.

ICAP’s new Vice Chairman is Mr. Rick Connor, Vice President, International Public
Affairs at Pernod Ricard Holding. He is also Director, Public Affairs at Pernod
Ricard's UK subsidiary Chivas Brothers Limited.

ICAP is a not-for-profit organization based in Washington, DC (USA) and supported
by some of the major global producers of beverage alcohol. Established in 1995,
ICAP encourages dialogue among key stakeholders in the alcohol debate and
promotes public/private partnerships in the area of alcohol policy.

# # #
Contributor: Tinisha Carroll

Tuesday, January 30, 2007

News Release: U.S. to become world's biggest wine market: study

U.S. to become world's biggest wine market: study

Tue Jan 30, 2007 7:22am ET

PARIS (Reuters)

The United States is set to overtake France in the next five years as the world's largest wine market, according to an annual study published on Tuesday.

The study, commissioned by the organizers of the VinExpo trade fair in Bordeaux in June, forecast global wine consumption in that time would grow five percent but the market value would increase nine percent to $117 billion from $107 billion in 2005.

"The world is drinking more and better, more expensive wines," VinExpo Secretary General Robert Beynat told a news conference.

The study predicted U.S. still wine consumption would rise to 27.3 million hectoliters in 2010 from 23.0 million in 2005, exceeding French consumption, which is set to fall to 24.9 million hl from 27.4 million hl.

In value terms, the U.S. still wine market is set to be worth $22.8 billion by 2010, up from $19.2 billion in 2005, with fastest growth rates expected for bottles costing more than $5 each -- a trend also expected in other industrialized countries.

Italy would remain the second largest market in terms of volume with consumption in 2010 of around 27.2 million hl, the study by London-based consultants International Wine and Spirit Record found.

In total, the global market for still wines with an alcohol content of less than 15 percent by volume was seen growing to 224.8 million hl in 2010 from 211.9 million hl in 2005.

For the first time in the survey's 10 year history, Russia and China appeared in the top-10 markets in terms of consumption, and were forecast to continue growing strongly in the next five years.

The study also looked at trends in the spirits industry, forecasting the global spirits market would be worth $180.7 billion in 2010 compared with $170 billion in 2005.

Tequila, cognac and rum are set to replace vodka as the fastest growing spirits, the study found.

© Reuters 2007. All Rights Reserved.

News Release: West Australian Women: Drinking Before, And During, Pregnancy

West Australian Women: Drinking Before, And During, Pregnancy

Article Date: 30 Jan 2007 - 1:00 PST

In a survey of non-indigenous West Australian women, 79.8 percent reported drinking alcohol in the three months before becoming pregnant.

* Nearly half of the women (46.7%) surveyed reported that their pregnancy was unplanned.

* More than half (58.7%) drank alcohol during pregnancy despite recommendations of abstinence.

Complications due to drinking during pregnancy can range from the very serious Fetal Alcohol Syndrome to the less severe and possibly greater-occurring Fetal Alcohol Spectrum Disorders. The timing of alcohol consumption, its frequency, the beverage size and type, all appear to be crucial elements of identifying risk.

A new survey has found that nearly 80 percent of non-Indigenous West Australian women consumed alcohol during the three months before pregnancy; nearly half had not planned their pregnancies; and more than half drank alcohol during pregnancy despite recommendations of abstinence.

Results are published in the February issue of Alcoholism: Clinical & Experimental Research.

"There is a lack of information as it relates to the measurement of alcohol consumption during the periconceptional period of pregnancy," said Lyn Colvin, a researcher at the Telethon Institute for Child Health Research at The University of Western Australia and corresponding author for the study.

"In particular, information on specific alcoholic beverage consumed, frequency, timing during pregnancy, and volume in standard drinks are rare.

" Colleen O'Leary, a research associate at the Telethon Institute for Child Health Research, concurs.

"The most vulnerable period for the fetus is during the first trimester," she said, "although there is potential risk to the baby from drinking throughout pregnancy. It is important to know how much alcohol women are drinking both during the periconceptional period and throughout pregnancy, as well as more about the relationship between alcohol consumption during the periconceptional period and unplanned pregnancy. This information is important for women and men, policy makers and researchers."

Researchers analyzed data from a survey of 4,839 women 12 weeks after delivery. The women had agreed to participate in the 1995 - 1997 West Australian Pregnancy and Infancy Survey, created from a 10-percent random sample of all non-Indigenous women giving birth in Western Australia. Each participant was asked questions about alcohol consumption during four time periods: the periconceptional period, and each trimester of pregnancy. Questions were designed to measure the volume and type of alcoholic beverage consumed, as well as frequency of consumption.

* Nearly 80 percent reported drinking alcohol in the three months before becoming pregnant.

"Of those 3,860 women consuming alcohol in the three months before pregnancy," said Colvin, "the majority (55.6%) drank more than one type of alcoholic beverage. Once pregnant, the majority (65.5%) drank only one type of alcoholic beverage."

* Nearly half of the women (46.7%) surveyed had not planned their pregnancy.

"These data are in agreement with other Australian studies, and studies from the United States and Britain," said O'Leary. "It is concerning, however, that with the range of contraceptive options available to women that such a high proportion of pregnancies are unplanned."

Furthermore, she added, the women who had planned their pregnancies were significantly less likely to drink alcohol during the first trimester than women who did not plan their pregnancy. "This would indicate that many pregnancies may be exposed to high levels of alcohol during the periconceptional period, prior to pregnancy awareness."

* More than half of the women (58.7%) drank alcohol during pregnancy despite the recommendation at the time of the study (1995-1997) of abstinence.

"It is interesting to note that the number of women who consumed alcohol during the 2nd trimester (42.4%) was similar to the number during the 1st trimester (42.1%)," said Colvin.

"This probably indicates that the pregnant women were unaware of the recommendation of abstinence."

"Until 2001," added O'Leary, "the Australian guideline for alcohol consumption during pregnancy was abstinence. However, to my knowledge, there was no health promotion campaign in WA to educate women of this policy during or prior to the period these data were collected. Furthermore, a survey of health professionals conducted in WA during 2002 - 2003 found that fewer than half of health professionals surveyed routinely provided information to pregnant women about alcohol consumption during pregnancy."

'Despite what initially appears alarming, said Colvin, "it is actually encouraging that many women who drank alcohol reduced their consumption in the first trimester of pregnancy. With appropriate information, they and others may be able to further reduce or abstain from consuming alcohol when they are pregnant or might soon become pregnant.

The challenge is to develop effective health promotion messages to reach women of child-bearing age before they consider pregnancy so they can make informed decisions."

She added that involving health-promotion practitioners, medical practitioners and obstetricians would be key.

Both Colvin and O'Leary were concerned about "binge" drinking among women of childbearing age.

"The findings that 14.2 percent of women surveyed consumed five or more standard drinks per occasion during the three months prior to pregnancy, and that almost half of the pregnancies were unplanned pregnancies, indicate that many women may have exposed their babies to high levels of alcohol before they were aware of their pregnancy," said O'Leary.

In addition, she observed, "the percentage of Australian teenagers who binge drink has increased over the past decade since these data were collected. We need to find ways to reduce the very culture of binge drinking which is particularly concerning in young people as this is when drinking patterns are established."

O'Leary spoke of the need to educate both men and women. "We need to be careful how we frame our health-promotion messages since many women may have consumed alcohol prior to pregnancy awareness and unintentionally exposed their baby to alcohol," she said. "It is important not to generate undue fear and/or guilt.

In addition, it is important not to place all the responsibility onto women alone: both women and men need to know about the risks to the baby from the consumption of alcohol during pregnancy; and many women and men need to take better precautions to prevent unplanned pregnancies."


Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism.

Co-authors of the ACER paper, "Alcohol Consumption During Pregnancy in Non-Indigenous West Australian Women," were: Jan Payne, Deborah E. Parsons, and Carol Bower of the Telethon Institute for Child Health Research at The University of Western Australia; and Jennifer J. Kurinczuk of the National Perinatal Epidemiology Unit at the University of Oxford.

The study was funded by the Health Promotion Foundation of Western Australia.

Lyn Colvin, M.P.H. Colleen O'Leary, M.P.H. Telethon Institute for Child Health Research

Alcoholism: Clinical & Experimental Research

News Release: A Form Of The Alcohol Dehydrogenase Gene May Protect Afro-Trinidadians From Developing

A Form Of The Alcohol Dehydrogenase Gene May Protect Afro-Trinidadians From Developing Alcoholism

Article Date: 30 Jan 2007 - 3:00 PST

The ADH1B*3 allele may also increase the risk for liver disease if individuals choose to drink

* Alcohol dehydrogenase (ADH) is one of the major enzymes involved in alcohol metabolism.

* New findings indicate that the ADH1B*3 allele may protect against the development of alcoholism.

* At the same time, the ADH1B*3 allele may be a risk factor for liver disease most likely because it increases levels of acetaldehyde if an individual with the allele does drink.

Alcohol dehydrogenase (ADH) is one of the major enzymes involved in alcohol metabolism. The genes for ADH are polymorphic at two loci, ADH1B and ADH1C. While the three alleles at the ADH1B locus have previously been linked with protection from alcohol dependence, a new study is the first to examine the relationship between the ADH1B*3 allele and alcohol-related disorders among Afro-Trinidadians.

Findings indicate that while the ADH1B*3 allele appears to protect against alcoholism, it can also increase the risk for liver disease among those individuals who drink heavily.

Results are published in the February issue of Alcoholism: Clinical & Experimental Research.

"Alcohol is primarily metabolized or broken down in the liver by two enzymes," explained Cindy L. Ehlers, associate professor of molecular and integrative neuroscience at The Scripps Research Institute.

"The first is ADH, which converts alcohol to acetaldehyde. Acetaldehyde is a toxic compound that can be damaging to the liver and other body organ systems. The second enzyme is aldehyde dehydrogenase (ALDH), which breaks down acetaldehyde to acetate, a relatively nontoxic compound."

Ehlers said that most people do not realize that people of different racial origins metabolize alcohol differently and that this influences their risk for alcoholism. "Approximately 40 percent of Asians have a mutation in ALDH that may cause them to have an aversive reaction when they drink so they are much less likely to develop alcohol dependence." And recently, she said, researchers have discovered that individuals of African ancestry have a form of ADH that is more active.

"These same authors have shown that young African Americans with the ADH1B*3 allele tend to have a more intense response to alcohol, and are less likely to have a positive family history of alcoholism - both of which are associated with a reduced vulnerability for the development of alcohol-use disorders," said Mary-Anne Enoch, a staff scientist in the Laboratory of Neurogenetics at the National Institute on Alcohol Abuse and Alcoholism.

"This current study builds on those earlier studies." "Although ADH1B*3 was identified in Indianapolis 10 years ago, there had been few studies that investigated its role in drinking or the development of alcoholism," said Ehlers.

"Trinidad and Tobago is an island nation in the Caribbean comprised mainly of individuals of two separate ethnic groups of African and East Indian ancestry. Island populations often provide a unique opportunity to evaluate genetic factors as populations on these islands are often genetically 'isolated' for a number of generations and can have a more homogenous environment when compared to large heterogeneous cultures such as the United States."

Study participants were recruited from the two major ethnic groups of Trinidad: 138 alcohol-dependent individuals, as well as 98 "controls" or non-alcohol-dependent individuals matched on age, gender, education, and ethnicity.

Researchers assessed all participants using the Semi-Structured Assessment for the Genetics of Alcoholism in order to gather information on demographics, psychiatric diagnoses, personal drinking, and drug-use history. Each participant was genotyped at the ADH1B locus through a blood sample, and also provided a number of other health measures.

"As predicted, we found a relatively high prevalence of the ADH1B*3 allele - a full 41 percent - in Afro-Trinidadians," said Ehlers. "Individuals with at least one ADH1B*3 allele were found to have lower alcohol consumption levels and were less likely to be alcohol dependent. Thus, we have found that this allele is protective against the development of alcoholism." However, the ADH1B*3 allele may also be a risk factor for liver disease.

"Elevated serum alanine aminotransferease levels are a measure of liver dysfunction," said Ehlers. "Since having the ADH1B*3 allele presumably causes increases in acetadehyde when an individual drinks, especially at higher levels of consumption, individuals who have this allele and who nonetheless drink heavily could be at higher risk for alcohol/acetaldehyde-induced organ damage."

"These findings are likely to be most significant for African-descent individuals," said Enoch, "around a third to one-half of whom may carry this allele, as this study has shown that they have a reduced risk of developing alcoholism. However, it is important that they should not develop a false sense of security.

This study shows that this particular ADH variant may be both protective for addiction and a risk factor for liver disease in African-descent individuals in the same way that another ADH variant, ADH1B*2, is both a protective and risk allele in East Asians."

"We still do not know what causes alcoholism," said Ehlers. "It appears that 50 percent of the disorder is genetic and 50 percent is environmental. Having the ADH1B*3 allele provides some genetic protection from developing alcoholism but it is not complete. Individuals can choose to drink at high levels in spite of having some protection against alcoholism just like individuals at high genetic risk for alcoholism can choose not to drink.

There are no genes for alcohol dependence like there are genes for Huntington's chorea or other single-gene disorders. There are only genes that influence risk and protection for the disorder. While there have been a number of studies demonstrating that, overall, African Americans have lower rates of alcohol dependence when compared to EuroAmericans and Native Americans … we have simply isolated one reason why that might be so."


Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism.

Co-authors of the ACER paper, "Association of the ADH1B*3 Allele with Alcohol Related Phenotypes in Trinidad," were: Karelia Montane-Jaime, Shelly Moore, and Samuel Shafe of the University of the West Indies; Roma Joseph of the San Fernando Hospital in Trinidad; and Lucinda G. Carr of Indiana University.

The study was funded by the National Institute on Alcohol Abuse and Alcoholism, the Stein Endowment Fund, and the University of the West Indies.

Cindy L. Ehlers, Ph.D.The Scripps Research Institute
Mary-Anne Enoch, M.D.National Institute on Alcohol Abuse and Alcoholism

Alcoholism: Clinical & Experimental Research

News Release: Excessive Drinking, Not Alcoholism, May Lead To Most Alcohol-RelatedProblems

Excessive Drinking, Not Alcoholism, May Lead To Most Alcohol-RelatedProblems

Science Daily — Most people realize that too much alcohol can lead to multiple health problems, injuries and violence. Numerous statistics support the accuracy of this perception. Many people also assume that a substantial proportion of people who drink to excess are probably alcoholics.
This may not be accurate.

A recent study of the general population in New Mexico reveals that, in fact, most alcohol-related problems may be due to excessive drinking -- especially binge drinking -- among persons who are not alcoholics.

Results are published in the February issue of Alcoholism: Clinical &Experimental Research."In the period following prohibition, most researchers, policy makers, and the general public tended to define excessive drinking in terms of alcohol dependence or alcoholism," explained Jim Roeber, an alcohol epidemiologist with the New Mexico Department of Health and corresponding author for the study.

This was likely related to cultural norms that sanctioned all but the most obviously problematic drinking such as alcoholism. More recently,researchers and policy makers have ... extended the definition of excessive drinking to encompass other behaviors such as binge drinking (consuming five or more drinks at one time) and impaired driving, and to address other problems such as alcohol-related injuries and social harm.

""The reality," added Tim Naimi, a physician with the Alcohol Team at the Centers for Disease Control & Prevention, "is that drinking to the point of intoxication or drinking above national guidelines with respect to average consumption also carries significant risks, and is unfortunately quite common. Although there are many effective policy and clinical interventions to address excessive drinking, many of them have not been implemented or are underutilized."

For this study, researchers examined data from the 2002 Behavioral Risk Factor Surveillance System in New Mexico, an annual telephone survey that provides state-level estimates of the prevalence of various health-related risk behaviors and outcomes. Study authors assessed the prevalence of"excessive drinking," defined to include: binge drinking, heavy drinking,alcohol-impaired driving, and alcohol dependence.

"We found that in New Mexico, most excessive drinkers are not alcohol dependent," said Roeber, "and that binge drinking is the most prevalent form of excessive drinking." More specifically, 16.5 percent of 4,761 New Mexico adults were considered "excessive drinkers," but only 1.8 percent of them met criteria for alcohol dependence.

"The downside of the assumption that alcohol dependence is the predominant form of excessive drinking is that prevention resources have tended to be directed toward treatment of alcohol dependence," said Roeber, "rather than prevention of more prevalent forms that are responsible for a large proportion of alcohol-related problems." He added that, at least in New Mexico, "alcohol-related prevention efforts should be broadened to focus on other forms of excessive drinking in addition to alcohol dependence,especially binge drinking.

"Naimi wholeheartedly concurs. "In order to prevent most alcohol-related problems, including alcoholism itself, we need to focus on excessive drinking, not just alcoholism," he said. "Focusing exclusively on alcoholism will identify only a small percentage of those at risk of causing or incurring alcohol-related harms, precludes the possibility of prevention,and is very costly, at least on a per-person basis."

Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism.

Co-authors of the ACER paper, "The Prevalence of Alcohol Dependence among Excessive Drinkers in New Mexico,"were Sandra Woerle of the National Institute of Justice; and Michael G.Landen of the New Mexico Department of Health.Source: Alcoholism: Clinical & Experimental Research

Contributor: Don Phillips

Monday, January 29, 2007

A Life Course Perspective on Exiting Addiction: The Relevance of RecoveryCapital in Treatment

A Life Course Perspective on Exiting Addiction: The Relevance of Recovery Capital in Treatment

William Cloud & Robert Granfield
pg 185-202 in NAD Publications no. 44 Addiction and life course Eds. Pia Rosenqvist, Jan Blomqvist, Anja Koski-Jännes & Leif Öjesjö, 2004

Over the past several years, research on the life course has examined the pathways associated with social deviance, status mobility, and educational attainment. The life course perspective seeks to uncover the dynamics of life span trajectories as well as the transitions that occur within any given trajectory.An important dimension of this perspective has been the recognition that continuity and change are mediated by a “dynamic process whereby the interlocking nature of trajectories and transitions generates turning points in the life course” (Laub & Sampson 1993). For some, turning points can be abrupt, radical turnarounds that separate the past from the future (Elder1985). For others, and perhaps most, turning points are part of a process occurring over time.(Clausen 1990; McAdam 1989).The life course perspective suggests that trajectories and transitions are bounded by broader social environments and social relationships. For instance, a good deal of research has found that trajectories into and out of criminal behavior are affected by the degree of social capital available to an individual. As Laub and Sampson (1993) assert, adults will be inhibited from committing crime to the extent that, over time, they accumulate social capital in their work and family lives, regardless of delinquent background. These researchers recognize that the accumulation of social capital can lead to normative systems as well as assorted resources that serve as pathways to change. This paper adopts a life course perspective, and particularly the focus on social capital, to examine the process of natural recovery and explores the implications that natural recovery has for treatment providers.

full text (PDF)

Contributor: Don Philips