A behavioral economic measure of demand for alcohol predicts brief intervention outcomes
Drug and Alcohol Dependence
Article in Press, Corrected Proof
7 February 2007

James MacKillop^a, E-mail: james_mackillop@brown.edu , and

James G. Murphy<sup>a, b

a</sup>Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
^bAuburn University, Auburn, AL, USA

Abstract

Considerable basic and clinical research supports a behavioral economic conceptualization of alcohol and drug dependence. One behavioral economic approach to assess motivation for a drug is the use of demand curves, or quantitative representations of drug consumption and drug-reinforced responding across a range of prices.

This study used a hypothetical alcohol purchase task to generate demand curves, and examined whether the resulting demand curve parameters predicted drinking outcomes following a brief intervention.

Participants were 51 college student drinkers (67% female; 94% Caucasian; drinks/week: M = 24.57, S.D. = 8.77) who completed a brief alcohol intervention.

Consistent with predictions, a number of demand curve indices significantly predicted post-intervention alcohol use and frequency of heavy drinking episodes, even after controlling for baseline drinking and other pertinent covariates.

Most prominently, O_max (i.e., maximum alcohol expenditure) and breakpoint (i.e., sensitivity of consumption to increasing price) predicted greater drinking at 6-month post-intervention follow-up.

These results indicate that a behavioral economic measure of alcohol demand may have utility in characterizing the malleability of alcohol consumption. Moreover, these results support the utility of translating experimental assays of reinforcement into clinical research.

Corresponding author at: Center for Alcohol and Addiction Studies, Brown University, Box G-BH, Providence, RI 02906, USA. Tel.: +1 401 444 1822; fax: +1 401 444 1850.

Role of social support and self-efficacy in treatment outcomes among clients with co-occurring disorders

Drug and Alcohol Dependence
Article in Press, Corrected Proof
27 February 2007

Jazmin I. Warren^a,

Judith A. Stein^a, E -mail:jastein@ucla.edu, and

Christine E. Grella<sup>b

a</sup>University of California, Los Angeles, United States
^bIntegrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States

Abstract

Individuals with co-occurring substance use and psychiatric disorders have a more severe clinical course and poorer outcomes than do individuals with one disorder.

In an attempt to find intervening variables that may contribute to improvement in treatment outcomes among individuals with co-occurring disorders, we investigated the roles of social support and self-efficacy in a sample of 351 clients with co-occurring disorders in residential drug abuse treatment programs (53% male; 35% African American, 13% Hispanic).

Given their demographic variability, we also explored how ethnicity and age influence self-efficacy and access to social support, as well as their relationships to the outcomes.

Structural equation modeling was used to examine the impact of the demographics and baseline psychological status, substance use, social support, and self-efficacy on mental health and substance use outcomes 6 months after treatment entry. Time in treatment was included as a control.

Greater social support at baseline predicted better mental health status and less heroin and cocaine use; greater self-efficacy predicted less alcohol and cocaine use.

Older clients reported less social support. African-American ethnicity was associated with more cocaine use at baseline and follow-up; however, African Americans reported more self-efficacy, which moderated their cocaine use.

The current study highlights the potential therapeutic importance of clients’ personal resources, even among a sample of severely impaired individuals.

Stress-Induced and Alcohol Cue-Induced Craving in Recently Abstinent Alcohol-Dependent Individuals

Volume 31 Issue 3 Page 395 - March 2007

• Helen C. Fox¹
• ¹Department of Psychiatry, Yale University School of Medicine, Substance Abuse Center, Connecticut Mental Health Center, New Haven, Connecticut.,
• Keri L. Bergquist¹
• ¹Department of Psychiatry, Yale University School of Medicine, Substance Abuse Center, Connecticut Mental Health Center, New Haven, Connecticut.,
• Kwang-Ik Hong¹
• ¹Department of Psychiatry, Yale University School of Medicine, Substance Abuse Center, Connecticut Mental Health Center, New Haven, Connecticut., and
• Rajita Sinha¹
• ¹Department of Psychiatry, Yale University School of Medicine, Substance Abuse Center, Connecticut Mental Health Center, New Haven, Connecticut.

• ¹Department of Psychiatry, Yale University School of Medicine, Substance Abuse Center, Connecticut Mental Health Center, New Haven, Connecticut.

Reprint requests: Helen Fox, Department of Psychiatry, Yale University, School of Medicine, Substance Abuse Center, Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519; Fax:1-203-974-7076; E-mail: helen.fox@yale.edu

Abstract

Background:

Research has shown that exposure to stress/negative affect and to alcohol cues can each increase alcohol craving and relapse susceptibility in alcohol-dependent individuals. However, whether the emotional and physiological states associated with stress-induced and alcohol cue-induced craving are comparable has not been well studied.

Therefore, this study examined the craving, emotional, and physiological responses to stress and to alcohol cues in treatment-engaged, 4-week abstinent, alcohol-dependent individuals using analogous stress and alcohol cue imagery methods.

Method:

Twenty treatment-seeking, alcohol-dependent participants (18 males/2 females) were exposed to a brief 5-minute guided imagery procedure that involved imagining a recent personal stressful situation, a personal alcohol cue-related situation, and a neutral-relaxing situation, 1 imagery per session presented in random order.

Alcohol craving, anxiety and emotion rating scales, cardiovascular measures, and salivary cortisol were compared across the 3 conditions.

Results:

Exposure to stress and to alcohol cues each produced significant increases in alcohol craving, anxiety, and negative emotions and decreases in positive emotions.

Stress-induced alcohol craving was significantly correlated with increases in sadness, anger, and anxiety ratings, but alcohol cue-induced craving was associated with decreases in positive affect (joy and neutral relaxed state) and increases in anxiety and fear ratings.

Furthermore, stress increased systolic and diastolic blood pressure responses, but significant increases in salivary cortisol were only observed in the alcohol cue condition.

Conclusions:

Although both stress and alcohol cues produce increases in anxiety associated with alcohol craving, each produced a dissociable psychobiological state involving subjective emotional, cardiovascular, and cortisol responses.

These data could have significant implications for understanding the specific psychobiology associated with stress or alcohol cue exposure and their potential effects on alcohol relapse susceptibility

Effect of Memantine on Cue-Induced Alcohol Craving in Recovering Alcohol-Dependent Patients

Am J Psychiatry 164:519-523, March 2007




Evgeny M. Krupitsky, M.D., Ph.D.,
Olga Neznanova, M.D.,
Dimitry Masalov, M.D.,
Andrey M. Burakov, M.D., Ph.D.,
Tatyana Didenko, M.D.,
Tatyana Romanova, Ph.D.,
Marina Tsoy, M.D.,
Anton Bespalov, M.D., Ph.D.,
Tatyana Y. Slavina, M.D., Ph.D.,
Alexander A. Grinenko, M.D., Ph.D.,
Ismene L. Petrakis, M.D.,
Brian Pittman, M.S.,
Ralitza Gueorguieva, Ph.D.,
Edwin E. Zvartau, M.D., D.M.Sci. and
John H. Krystal, M.D. E-mail: john.krystal@yale.edu

Brief Report

OBJECTIVE: Ethanol blocks N-methyl-D-aspartic acid (NMDA) glutamate receptors. Increased NMDA receptor function may contribute to motivational disturbances that contribute to alcoholism. The authors assessed whether the NMDA receptor antagonist memantine reduces cue-induced alcohol craving and produces ethanol-like subjective effects.

METHOD: Thirty-eight alcohol-dependent inpatients participated in three daylong testing sessions in a randomized order under double-blind conditions. On each test day, subjects received 20 mg of memantine, 40 mg of memantine, or placebo, and subjective responses to treatment were assessed. The level of alcohol craving was assessed before and after exposure to an alcohol cue.

RESULTS: Memantine did not stimulate alcohol craving before exposure to an alcohol cue, and it attenuated alcohol cue-induced craving in a dose-related fashion. It produced dose-related ethanol-like effects without adverse cognitive or behavioral effects.

CONCLUSIONS: These data support further exploration of whether well-tolerated NMDA receptor antagonists might have a role in the treatment of alcoholism.

Focus 4:505, September 2006

Acamprosate for Alcohol Dependence: An Update for the Clinician

Barbara J. Mason, Ph.D.

Correspondence: Address correspondence to: Barbara J. Mason, Ph.D., Professor and Director, Laboratory of Clinical Psychopharmacology; Co-Director, Pearson Center for Alcoholism and Addiction Research, The Scripps Research Institute, 10550 North Torrey Pines Road, TPC-5, La Jolla, CA 92037; Tel: 858-784-7324; Fax: 858-784-7340; email: mason@scripps.edu

REVIEW

Alcohol dependence is a chronic, relapsing disorder affecting more than 8 million Americans who are at increased risk for negative interpersonal and health consequences from pathological drinking.

Successful treatment would potentially decrease these risks and lessen the tremendous personal and societal burdens attributed to this disorder. Psychosocial interventions without pharmacotherapy have long been the traditional treatment approach, but relapse is common.

Advances in the identification of neurotransmitter systems involved in the addiction cycle have led to the development of new medications that, used in combination with counseling, further improve treatment outcome over that with counseling alone.

Acamprosate is one of the medications that have shown success in promoting abstinence in alcohol-dependent individuals. For some patients, integrating acamprosate therapy into clinical practice as a complement to psychosocial interventions would enhance therapeutic options to assist in recovery.

This article provides a clinically focused review of alcohol dependence as well as evidence of the safety and efficacy of acamprosate for treating this disorder.

News Release - Study Finds Reduced Brain Growth in Alcoholics with Family Drinking History National Institute on Alcohol Abuse and Alcoholism (NIAAA) http://www.niaaa.nih.gov FOR IMMEDIATE RELEASE: Wednesday, February 21, 2007 Contact: NIAAA Press Office, 301-443-3860 The brains of alcohol-dependent individuals are affected not only by their own heavy drinking, but also by genetic or environmental factors associated with their parents’ drinking, according to a new study by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH). Researchers found reduced brain growth among alcohol-dependent individuals with a family history of alcoholism or heavy drinking compared to those with no such family history. Their report has been published online in Biological Psychiatry at http://www.sciencedirect.com/science/journal/00063223 as an article in press. “This is interesting new information about how biological and environmental factors might interact to affect children of alcoholics,” notes George Kunos M.D., Ph.D., Scientific Director, Division of Intramural Clinical and Biological Research, NIAAA. Many studies have shown that alcohol-dependent men and women have smaller brain volumes than non-alcohol-dependent individuals. It is widely believed that this is due to the toxic effects of ethanol, which causes the alcoholic’s brain to shrink with aging to a greater extent than the non-alcoholic’s. “Our study is the first to demonstrate that brain size among alcohol-dependent individuals with a family history of alcoholism is reduced even before the onset of alcohol dependence,” explains first author Jodi Gilman, B.S., a NIAAA research fellow and Ph.D. candidate at Brown University working with senior author Daniel Hommer, M.D., of the NIAAA Laboratory of Clinical and Translational Studies (LCTS) and co-author James Bjork, Ph.D., also of the NIAAA/LCTS. Children of alcoholics are known to have a greater risk for alcohol dependence than individuals without a parental history of alcohol dependence. In addition to inheriting genes that predispose them to alcoholism, children of alcoholics may experience adverse biological and psychological effects from poor diets, unstable parental relationships, and alcohol exposure before birth, all of which could contribute to their increased risk for alcoholism. In a search for direct physical evidence of these assumed genetic and environmental mediators of family-transmitted alcoholism, the NIAAA researchers used magnetic resonance imaging (MRI) techniques to measure the volume of the cranium – the part of the skull that encloses the brain – in a group of individuals being treated for alcohol dependence. The intracranial volume (ICV), they note, is determined by skull growth, which occurs as the brain expands to its maximum size around puberty. Because ICV does not change as the brain shrinks with age, it provides a good estimate of the lifetime maximum volume of the brain. The researchers found that the average ICV of adult alcoholic children of alcoholic parents was about 4 percent smaller than the average ICV of adult alcoholics without family histories of alcoholism or heavy drinking. Family history did not affect the frequency, quantity, or other aspects of drinking behavior of the alcoholics themselves, suggesting that differences in ICV between family history positive and negative alcoholics are not the result of different drinking patterns. The researchers also found that adult alcoholic children of alcoholic parents had IQ scores that averaged 5.7 points lower than IQs of alcohol dependent individuals with no parental drinking, but that were still within the range of normal intelligence. The authors note that a possible implication of their findings is that the increased risk for alcoholism among children of alcoholics may be due to a genetic or environmental effect, or both, related to reduced brain growth. “Although ICV is known to be influenced primarily by genetic factors,” says Dr. Hommer, “many studies have found that living in an enriched environment promotes central nervous system growth and development. It seems likely that alcoholics, in general, are raised in less than optimal environments and thus that genetics and environment both contribute to the smaller ICV observed in family history positive alcoholics.” The authors report that ICV of women, but not men, in the study appeared to be affected more by their mothers’ drinking than their fathers’, perhaps due to a greater maternal influence on a child’s nutritional, social, and intellectual environment. None of the participants in the study were diagnosed with fetal alcohol syndrome (FAS). “It is possible that some participants might have experienced subtle fetal alcohol effects,” notes Dr. Hommer. “However, there were no differences between the effects of maternal and paternal drinking on ICV of men in our study. Thus, fetal alcohol effects do not appear to account for the reduced ICV we saw in men with a positive family history for drinking. Future studies should determine more precisely how parental drinking affects brain size among children of alcoholics and whether smaller ICV is a more specific risk factor for the development of alcohol dependence than family history.” Contributor: Don Phillips

E-UPDATE	3/2/2007
SUCCESS STORY A New Hampshire family with three adolescent children has helped change policy at the Ninety-Nine Restaurant in Londonderry. One night, as the family was being seated in the restaurant section, a waitress included Sam Adams beverage coasters at each place setting. When the family got home, the mother, a New Futures CLI Partner, looked on the restaurant's website for a way to complain. She was able to submit an electronic message to the company, which even called her. The message she shared with the company made it clear that she was concerned about a family restaurant apparently promoting alcoholic beverages to children. Someone was paying attention! On two subsequent visits to their local Ninety-Nine Restaurant over the next few months, Sam Adams coasters were still in use, but provided only to the parents. Imagine the impact we could have if we all spoke up when we saw things that didn't seem quite right! If you're interested in learning how to become a New Futures CLI Partner, contact Linda King at lking@new-futures.org. Back to Top ^ NEW FUTURES NEWS Two New Resources to Help Reduce the Availability of Alcohol to Youth Two new documents to accompany the State Strategy to Reduce Underage Alcohol Problems are now available in the publications section of our website. One provides a brief history and rationale for maintaining the minimum legal drinking age (MLDA) at 21. The other provides a user friendly description of the Party Host Liability law in New Hampshire. We will have a limited supply of hard copies available for community use as well. Check them out at: http://www.new-futures.org/resources/publications.asp Back to Top ^ LEGISLATIVE UPDATE a. Update on the 2008-2009 Biennial Budget The Governor announced his budget to the legislature on February 15th. The Governor's budget funded the Alcohol Fund at $2.54 million for each year of the biennium. Although this amount represents a 10% increase in funding over the last biennium, it is significantly less than if the budget had fully funded the Alcohol Fund. Full funding of the Alcohol Fund would provide $5.6 million per year to support prevention and treatment services for those with alcohol and other drug problems. b. Public Hearings on the Budget According to the Vice-Chair of the House Finance Committee, "If you breathe the air, drink the water, drive on a road, run a business, go to school, or enjoy the scenery, the budget affects your quality of life. The budget impacts all of us, and we want to make sure everyone has a say." For the first time there will be 5 public hearings on the Governor's Budget scheduled across the state to gather public input. Please mark your calendar and attend a session in your area: March 5th, 4-7 pm, Dartmouth Hitchcock Medical Center Auditorium E and F, Lebanon March 6th, 5-8 pm, Alumni Recital Hall, Redfern Arts Center , Keene State College, Keene March 8th, 4-7 pm, Rochester Community Center , Rochester March 12th, 4-7 pm, PSNH Auditorium, Manchester March 15th, 4-7 pm, White Mountain Regional High School Auditorium, Lancaster c. HB 567 to Reduce the Legal Drinking Age to 18 Heard in House Judiciary Committee Last week the House Judiciary Committee held a public hearing on HB 567 which would reduce the legal drinking age from 21 to 18 for all New Hampshire residents. Among those expressing strong opposition to HB 567 were the Departments of Safety and Health and Human Services, the Police Chiefs Association, the New Hampshire Alcohol and Drug Abuse Counselors Association, representatives of the medical community, New Futures and legislators. Last year the House killed a bill that would have reduced the legal drinking age to 18 for members of the military. Back to Top ^ RESOURCES a. NH Inhalant Abuse On-line Training for Adults Educate yourself before your kids do. Free, at your finger-tips, easy 15-minute training for parents and guardians on the dangers, signs and symptoms of inhalant abuse. www.inhalantabusetraining.org b. 2007 Resource Guide for Alcohol and Drug Prevention & Treatment Services Hot off the press - 42 pages of state-funded alcohol and drug abuse prevention and treatment programs and other resources related to alcohol and other drugs. The book includes: 12-Step Programs, Impaired Driving Intervention Programs, Alcohol and Drug Abuse Prevention Coalitions, New Hampshire Correctional Academies and their Providers, and Alcohol and Other Drug Abuse-Related Web Sites. www.dhhs.state.nh.us/DHHS/ATOD/LIBRARY/Brochure/res-guide.htm c. "Drugs, Brains, and Behavior: The Science of Addiction" This new publication from the National Institute on Drug Abuse (NIDA), is a 30-page full-color booklet that explains in how science has revolutionized the understanding of drug addiction as a brain disease that affects behavior. To download your free copy, visit: www.nida.nih.gov d. NIDA Launches Drug Info 'Centers of Excellence' The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH), announced four Centers of Excellence for Physician Information - these Centers will serve as national models to support the advancement of addiction awareness, prevention, and treatment in primary care practices. www.nih.gov/news/pr/jan2007/nida-25a.htm e. ONDCP Prevention News Wire The Office of National Drug Control Policy (ONDCP) has launched a News Wire. This service allows any coalition, organization, or individual to automatically receive and display the latest ONDCP prevention headlines on their own Web site or blog. No programming is required. Just follow the instructions on this page: http://pushingback.com/blogs/pushing_back/categoryrssinstructions.aspx Back to Top ^ IN THE NEWS a. ADDICTION series on HBO HBO's groundbreaking 14-part series ADDICTION premieres March 15. AddictionAction.org is a grassroots partnership to help communities mobilize around it, bringing the hope of treatment and long-term recovery to individuals and families affected by addiction to alcohol and drugs. For more information, including how you can view the series for FREE visit www.addictionaction.org. b. Researchers Call for More Focus on Excessive Drinking Most alcohol-related problems in the U.S. are caused by excessive drinking, not by alcoholism, according to a new study. Binge drinking and other forms of problem drinking are far more common than alcoholism, researchers say. For more information, visit: http://presszoom.com/story_123480.html c. Number of New Methamphetamine Users Drops The number of U.S. household residents age 12 or older who used methamphetamine for the first time in the past year decreased significantly from 2004 to 2005,according to data from the most recent National Survey on Drug Use and Health. For more information, visit: http://www.cesar.umd.edu/cesar/cesarfax/vol16/16-06.pdf d. Wealthier Communities Experience More Youth Substance Use Kids in affluent areas have lower alcohol and other drug use rates in the lower grades, but often catch up or surpass drug-use rates among poorer youth when they reach high school. Adults in many wealthy areas often are loathe to acknowledge that such problems exist in their world. www.contracostatimes.com/mld/cctimes/news/local/states/california/16732303.htm e. More U.S. Prison Growth Projected A new study projects that the U.S. prison population will grow by about 200,000 inmates over the next five years. The increase, tied to factors like three-strikes laws and "truth in sentencing" policies, is expected to cost states more than $27 billion. The report from the Pew Charitable Trusts' Public Safety Performance Project projects growth on a state-by-state basis, based in part on local criminal-justice policies and demographics. For more information, visit: http://www.pewtrusts.com f. Smoking Harms Financial Health Too Smokers can pay $2,000 in direct and indirect costs to support their addiction. Americans spend $80 billion annually on cigarettes. At $5 per pack, and considering other related costs, a pack-a-day smoker can spend thousands of dollars each year -- more than most Americans spend on clothing and almost as much as they spend on health care, entertainment and eating out. To read this article in the Chicago Tribune, visit: http://www.chicagotribune.com/business/yourmoney/chi-0702110019feb11,0,6227038.story?coll=chi-businessyourmoney-hed g. Teens Turn Away from Street Drugs, Move to Prescription Drugs The National Youth Anti-Drug Media Campaign is releasing an alarming new report showing that teens are turning away from street drugs, such as marijuana and cocaine, and are now abusing prescription drugs to get high. For more information, visit: http://www.theantidrug.com/drug_info/prescription_drugs.asp h. JOIN TOGETHER: Researchers Call for More Focus on Excessive Drinking Most alcohol-related problems in the U.S. are caused by excessive drinking, not by alcoholism, according to a new study. Binge drinking and other forms of problem drinking are far more common than alcoholism, researchers say. www.jointogether.org/news/research/summaries/2007/researchers-call-for-more.html Back to Top ^ UPCOMING EVENTS See all this and more at: www.new-futures.org/calendar a. Working with Retailers: Self Policing Strategies and Collaborative Initiatives Teleconference March 15, 2007 3:00 - 4:15 p.m. This presentation will, from the retail perspective, highlight the barriers to gaining participation from the retail community and provide insights into proven ways to increase retail stakeholder involvement and increase self-policing efforts to reduce underage drinking. Participants will also learn strategies for addressing retailers who do not "get on board." Learn more and register at www.udetc.org. b. DATE CHANGE: Governor's Commission on Alcohol and Other Drug Prevention, Intervention and Treatment New date: April 6, 9:30-11:30AM, Concord NH Attend this public meeting of the Governor's Commission from 9:30 - 11:30 a.m., in Rooms 305-307 of the Legislative Office Building in Concord. c. Peer to Peer Parent Support Group Facilitator Training April 7 and April 14, 2007, 8:30 a.m. to 4:30 p.m. Concord, NH There is an expectation that trained Group Facilitators will establish a community based support group or join an existing one. The NAMI model is designed to furnish the fundamental structures and group processes which will enable peer facilitators to run meetings that are both empathetic, upbeat, and informative. The training is a total of 18 hours. For further information e-mail Denise Devlin at neias@mva.net or call at 642-8719. d. Alcohol and Crime Among Youth Teleconference April 19, 2007, 3:00 - 4:15 p.m. How strong is the relationship between youth alcohol use and criminal behaviors? Presenters for this call will discuss the relationship between alcohol and crime among youth and provide strategies for preventing alcohol-related criminal activity among youth. Learn more and register at www.udetc.org. e. Recovery as Prevention April 21, 2007, 1:00 pm via Telephone and Online RSVP by April 19 by emailing webinar@facesandvoicesofrecovery.org your full name, organization, and preferred email address. f. New Hampshire Initial Training on Substance Abuse May 11, 2007 August 10, 2007 November 9, 2007 This 6-hour workshop is designed to give participants the ability to recognize alcohol and other drug problems of their clients and to understand the holistic nature of the disease of addiction. It also presents information on effects on the family, intervention strategies, and recovery. To register, contact lois.a.davieau@dhhs.state.nh.us, (603) 271-5889, (800) 852-3345, ext. 5889. g. Student Athlete Codes of Conduct That Work Teleconference May 17, 2007 3:00 - 4:15 p.m. Research shows that High School athletes drink more than other students. Call participants will learn about the purpose of alcohol codes for High School athletes, code components, and the positive results emerging from implementation of such codes. Learn more and register at www.udetc.org. h. Co-Occurring Recovery: Supporting Recovery from Substance Use & Mental Disorders May 24-25, 2007 North Haven CT This conference will highlight recovery-oriented and integrated care for people in recovery, particularly from co-occurring substance use and mental disorders. The call for papers, sponsorship, exhibit, and registration information are available at www.ctcertboard.com/details.aspx?n=24 i. The 38th Annual New England School of Addiction Studies June 11-15, 2007 at Bowdoin College in Brunswick, Maine. The Summer School is an intensive week-long experience for participants to further their knowledge, skills, and experience in the field of substance abuse through in-depth coursework. www.neias.org/SS/SATSSCATTC06x.html j. Minority Women's Health Conference: Strengthening Our Communities by Strengthening Ourselves June 30, 2007, 8:00 a.m. - 4:00 pm: Crowne Plaza Hotel, Nashua, New Hampshire. For more information contact the Office of Minority Health at 603-271-3986 or by email at marianela.ramirez@dhhs.state.nh.us k. The 9th Annual National Leadership Conference: Empowering Leadership to Enhance What Works August 2-4, 2007 in Orlando, FL at the Rosen Centre Hotel. Plenary sessions and workshops will offer guidance on how to establish, maintain and strengthen linkages between law enforcement and community agencies, including adult allies and youth. Go to www.udetc.org for more information. l. New England School of Best Practices in Addiction Treatment August 20-23, 2007, Waterville Valley The New England Institute of Addiction Studies is pleased to announce the fifteenth annual clinical and administrative skills program for people working in the treatment system. http://www.neias.org/BP/SATBPCATcover07xSTD.html Back to Top ^
8 Continental Drive, Unit G, Exeter, NH 03833

RESEARCH REPORT

Ethnic composition of schools affects episodic heavy drinking only in ethnic-minority students

Addiction (OnlineEarly Articles). 2 march 2007

• Karin Monshouwer¹
• ¹Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands, Karin Monshouwer, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), PO Box725, 3500 AS, Utrecht, the Netherlands. E-mail: kmonshouwer@trimbos.nl ,
• Saskia Van Dorsselaer¹
• ¹Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands, ,
• Jim Van Os²
• ²Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, the Netherlands and ,
• Marjan Drukker²
• ²Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, the Netherlands and ,
• Ron De Graaf¹
• ¹Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands, ,
• Tom Ter Bogt³
• ³University of Utrecht, Faculty of Social and Behavioural Sciences, Utrecht, the Netherlands ,
• Jacqueline Verdurmen¹
• ¹Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands, &
• Wilma Vollebergh^1,3
• ¹Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands,
• ³University of Utrecht, Faculty of Social and Behavioural Sciences, Utrecht, the Netherlands

• ¹Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands,
  
• ²Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, the Netherlands and
• ³University of Utrecht, Faculty of Social and Behavioural Sciences, Utrecht, the Netherlands

Karin Monshouwer, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), PO Box725, 3500 AS, Utrecht, the Netherlands. E-mail: kmonshouwer@trimbos.nl

ABSTRACT

Aims

To investigate if school-related contextual factors (school alcohol policy and school ethnic composition) explain episodic heavy drinking by individual students, while taking individual-level variables into account.

Design and participants

Data were derived from the 2003 Dutch National School Survey on Substance Use, a nationally representative cross-sectional study with a total of 7324 respondents aged 12–16 years.

Methods

Student-level data were collected by written questionnaire administered in classroom settings, assessing alcohol and drug use as well as socio-demographic and behavioural variables. School-level data were gathered by written questionnaire completed by the school principal, assessing school policy on substance use and school compositional factors. The data were analysed using a multi-level logistic regression model.

Findings

The study revealed an association between ethnic composition of the school and episodic heavy drinking: a relatively high percentage of ethnic minorities (10–30%) at the school was associated with a lower probability of episodic heavy drinking, but only in interaction with individual-level ethnicity.

Thus, ethnic-minority students attending schools of high minority density had less risk of episodic heavy drinking (OR = 0.69, 95% CI: 0.47–1.00).

None of the school policy factors was associated with episodic heavy drinking.

Conclusions

Within a school context, peer modelling and reinforcement mechanisms can affect individual students' alcohol use, but a certain level of identification with the group and the resulting social control may be necessary.

School policy seems to have no impact on students' alcohol use, possibly because students are faced with these only during special events, including school parties and excursions.

March 2007

vol. 8 issue 3

Eye Movement Tasks can be used to Assess Fetal Alcohol Spectrum Disorders Greater Deficits in Emotional Facial Expression can Indicate More Severe Alcoholism Report from Sweden: Alcohol Interventions that Teach Practical Skills Work Best with High-Risk University Students Stress & Alcohol Cues Appear to Target the Brain Differently to Produce Craving

NIH Grant: Collaborative Clinical Trials in Drug Abuse NIDA Research Education Grants in Drug Abuse & Addiction NIH Grant: Drug Abuse, Risky Decision Making & HIV/AIDS

The DASIS Report: Methamphetamine/Amphetamine Treatment Admissions in Urban & Rural Areas: 2004

NIDA InfoFacts: Los Inhalantes

SAMHSA Matrix: Workforce Development Resources TAP 21A: Competencies for Substance Abuse Treatment Clinical Supervisors NIDA: Drugs, Brains, & Behavior - The Science of Addiction

5th Annual Problem Gambling Awareness Week - March 5-11 HBO's 14-Part Series "Addiction" Premieres March 15 SECAD Online Program: New Developments in Medication Treatment for Alcohol Dependence - How Do They Impact Your Practice?

Online/Correspondence Course: Theories of Clinical Supervision Online/Correspondence Course: Boundary Issues & Dual Relationships

Faces & Voices of Recovery - February 13, 2007 NIATx eNews Update - February 2007 Northwest Frontier ATTC Addiction Messenger - Nicotine Cessation Part 1: The Risks - Volume 10, Issue 1 (PDF) SAMHSA News - Treatment for Older Adults: What Works Best? - Vol. 15, No. 1

National Daily News from Join Together

AddictionAction.org CDC: Tuberculosis Education & Training Network

Action Plan for Behavioral Health Workforce Development Now Available

Dear Colleague:

The Annapolis Coalition on the Behavioral Health Workforce is pleased to announce the release of An Action Plan for Behavioral Health Workforce Development. This is the culmination of a two-year effort of work to create a national strategic plan to strengthen the mental health and addictions workforce. More than 5,000 individuals were engaged in the planning process. The plan is available for download without charge at the Coalition’s website (www.annapoliscoalition.org). In addition to the full plan, an Executive Summary is also available. The plan was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and can also be accessed through its website.

There has been widespread recognition of a national workforce crisis. It is characterized, in part, by problems of recruitment and retention; minimal workforce diversity; inadequate access to training; the questionable relevance and effectiveness of many educational programs; and a lack of cultural competence among those providing care. Until now, there was no single planning resource that encompassed workforce development for prevention, treatment, and recovery across the mental health and addiction sectors of this field. This Action Plan is designed to bridge those sectors and the traditional professional disciplines. Further, it addresses preparation and support of a workforce to meet the needs of persons across the lifespan. The Action Plan places major emphasis on expanded roles in the “workforce” for persons in recovery, youth, family members, and community coalitions in caring for themselves and as educators of the traditional workforce.

We urge you to access, read, and ACT on the plan. There are detailed implementation tables included in the document, which can serve as a blueprint for action by individuals, organizations, government agencies and community coalitions. There is a need for “all hands” to redouble their efforts to address this crisis. This Action Plan can inform those efforts.

We are disseminating the action plan broadly. Similarly, we encourage you to forward this e-mail message to colleagues who share your concerns about the workforce.

The Annapolis Coalition is committed to sustaining the momentum that has been generated on this critical issue. Via our website, we invite you to provide us with your feedback on the Action Plan and your recommendations for moving forward on this important agenda.

Sincerely,

THE ANNAPOLIS COALITION ON THE BEHAVIORAL HEALTH WORKFORCE

The Annapolis Coalition is a not-for-profit organization committed to promoting the development of the behavioral health workforce. The Coalition provides consultation and technical assistance to organizations and governments and can assist those seeking to implement the plan’s recommendations. More information about the Annapolis Coalition and its capabilities can be found by visiting www.annapoliscoalition.org.

Contributor: Don Phillips