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, March 24, 2007

Association of Alcohol Craving With α-Synuclein (SNCA)

Studies have found that genomic variation in the gene SNCA, which encodes the protein α-synuclein, may contribute to the variation in alcohol consumption in an inbred rat model of alcohol preference. Studies in humans have provided support for an association between SNCA and craving for alcohol.

These results suggest that variation in SNCA contributes to alcohol craving, a common, although not uniform, feature of alcohol dependence.



Risk Factors for Suicide Attempts Among Alcohol Dependent Patients

Suicidal behavior is a common and important problem among alcohol dependent patients. The study was designed to examine risk factors for attempting suicide in 499 alcohol dependent patients.

Logistic regression analysis showed that gender, family history, and childhood sexual abuse history made significant and independent contributions to the risk of a suicide attempt.

Thus, developmental, personality, family history, social, and comorbidity risk factors may differentiate alcohol dependent patients who have attempted suicide from those who have not.



Contributor: Don Phillips
The effect of naltrexone and acamprosate on cue-induced craving, autonomic nervous system and neuroendocrine reactions to alcohol-related cues in alcoholics.

Acamprosate and naltrexone have been shown to be effective in relapse prevention of alcoholism. It is hypothesized that naltrexone exerts its effects primarily on cue-induced craving and neuroendocrine cue reactivity, whereas acamprosate exerts its effect primarily on autonomic nervous system reactions to alcohol-related cues.

The findings provide some evidence for differential effects of naltrexone and acamprosate: naltrexone may exert its effect, at least partly, by the reduction of cue-induced craving, whereas acamprosate may exert its effect, at least partly, by the reduction of autonomic nervous system reactions to alcohol-related cues.

CECA welcomes new federal anti-drug strategy, but urges greater attention to alcohol and prescription drug abuse

TORONTO, March 23 /CNW Telbec/ - The Canadian Executive Council on
Addictions (CECA), a national organization of senior executives of addiction
agencies across Canada, says it welcomes the new National Anti-Drug Strategy
outlined in Monday's federal budget, but is urging the federal government to
continue to treat addictions as a health problem and is also calling for a
greater focus on problems associated with alcohol and prescription drugs.

Alcohol drinking pattern and non-fatal myocardial infarction in women

Evidence continues to emerge indicating the pattern of alcohol consumption has important implications for cardiovascular disease (CVD) risk, although the majority of studies have focused on men. The aim of the study is to examine the association between alcohol volume and various drinking patterns and non-fatal myocardial infarction (MI) in women aged 35–69 years.

In this population of light to moderate drinkers, alcohol consumption in general was associated with decreased MI risk in women; however, episodic intoxication was related to a substantial increase in risk.



Friday, March 23, 2007

Suicidal behavior among adolescents with conduct disorder—the role of alcohol dependence

The results indicate that, among adolescents suffering from conduct disorder the risk of suicidal behavior is considerably increased by co-morbid alcohol dependence, which should therefore be carefully taken into account in clinical work.


Drinking in Context: Patterns, Interventions, and Partnerships

This book was commissioned by the International Center for Alcohol Policies (ICAP), with assistance of expertise from the International Harm Reduction Association (IHRA), World Federation for Mental Health (WFMH), and the Institut de Recherches Scientifiques sur les Boissons (IREB).

What is the main message of this book?
The impetus to write this book came from a shared conviction that the time had come to air
to alcohol policy. The three underlying themes of this book are that patterns of drinking are
understand alcohol’s place in society, that targeted interventions are the most sensitive to cultural
that partnerships offer the best opportunity to develop policies that reflect the values of society
the main title of the volume: Drinking, because it is the way people behave that matters most
outcomes, and in Context, because drinking is best viewed in relation to culture. In selecting
societies are faced with choices about how to encourage some behaviors and discourage others.
alcohol is here to stay. Putting drinking into context is how we learn to live with it best.


Budget changes to alcohol duty: only the Whisky industry is happy
Friday, March 23, 2007
  • Alcohol Concern criticised the 2007 Budget delivered to the House of Commons for failing to address the damage done by alcohol misuse.
Alcohol in the Budget 2007

Wednesday, March 21, 2007

The 2007 budget, announced by Gordon Brown today, includes inflationary rises in duty for beer, wine and cider, with no rise for spirits. This will disappoint many in the alcohol harm reduction field who want to see price increases to curb consumption.


What Level of Alcohol Consumption Is Hazardous for Older People? Functioning and Mortality in U.S. and English National Cohorts

CONCLUSION: Functioning and mortality outcomes in older people with alcohol intakes above U.S. recommended levels for the old but within recommendations for younger adults are not poor. More empirical evidence of net benefit is needed to support screening and intervention efforts in community-living older people with no specific contraindications who drink more than one to two drinks per day.


A new 'matrix of harm' for drugs of abuse

A new study published today in the Lancet proposes that drugs should be classified by the amount of harm that they do, rather than the sharp A, B, and C divisions in the UK Misuse of Drugs Act.

The new ranking places alcohol and tobacco in the upper half of the league table. These socially accepted drugs were judged more harmful than cannabis, and substantially more dangerous than the Class A drugs LSD, 4-methylthioamphetamine and ecstasy.

Development of a rational scale to assess the harm of drugs of potential misuse



Substance use disorder (SUD) morbidity versus number of parents with SUD.

FINDINGS: Parental Substance Use Disorder affects the proband's Substance Use Disorder severity in a threshold fashion.



Validation of the Drinking Refusal Self-Efficacy Questionnaire--Revised in an Adolescent Sample (DRSEQ-RA).

FINDINGS: The Drinking Refusal Self-Efficacy Questionnaire--Revised Adolescent Version (DRSEQ-RA) is designed to assess an individual's belief in their ability to resist drinking alcohol. The original DRSEQ-R consists of three factors reflecting social pressure refusal self-efficacy, opportunistic refusal self-efficacy and emotional relief refusal self-efficacy.

Using confirmatory factor analysis, the three factor structure was confirmed. All three factors were negatively correlated with both frequency and volume of alcohol consumption. Drinkers reported lower drinking refusal self-efficacy than non-drinkers.

Taken together, these results suggest that the adolescent version of the Drinking Refusal Self-Efficacy Questionnaire (DRSEQ-RA) is a reliable and valid measure of drinking refusal self-efficacy.


Thursday, March 22, 2007

Adding an Alcohol-Related Risk Score to an Existing Categorical Risk Classification for Older Adults: Sensitivity to Group Differences

Journal of the American Geriatrics Society

Volume 55 Issue 3 Page 445 - March 2007

  • From the *Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California; +David Geffen School of Medicine, School of Public Health, University of California at Los Angeles, Los Angeles, California; Langley Research Institute, Pacific Palisades, California; §Department of Clinical Pharmacy, School of Pharmacy, University of California at San Francisco, San Francisco, California; ||Healthcare Division, Palo Alto Medical Foundation, Palo Alto, California; and Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
Address correspondence to Sandra R. Wilson, PhD, 795 El Camino Real, Ames Building, Palo Alto, CA 94301. E-mail:



To evaluate a new alcohol-related risk score for research use.


Using data from a previously reported trial of a screening and education system for older adults (Computerized Alcohol-Related Problems Survey), secondary analyses were conducted comparing the ability of two different measures of risk to detect postintervention group differences: the original categorical outcome measure and a new, finely grained quantitative risk score based on the same research-based risk factors.


Three primary care group practices in southern California.


Six hundred sixty-five patients aged 65 and older.


A previously calculated, three-level categorical classification of alcohol-related risk and a newly developed quantitative risk score.


Mean postintervention risk scores differed between the three experimental conditions: usual care, patient report, and combined report (P<.001). The difference between the combined report and usual care was significant (P<.001) and directly proportional to baseline risk. The three-level risk classification did not reveal approximately 57.3% of the intervention effect detected by the risk score. The risk score also was sufficiently sensitive to detect the intervention effect within the subset of hypertensive patients (n=112; P=.001).


As an outcome measure in intervention trials, the finely grained risk score is more sensitive than the trinary risk classification. The additional clinical value of the risk score relative to the categorical measure needs to be determined.
Epidemiological trends in drinking by age and gender: Providing normative feedback to adults

Addictive Behaviors
Volume 32, Issue 5 , May 2007, Pages 967-976

Karen K. Chana, , Email:

Clayton Neighborsb,

Michael Gilsonc,

Mary E. Larimerb and

G. Alan Marlattb

aRAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 United States
bUniversity of Washington, Department of Psychiatry and Behavioral Sciences, Box 354694, Seattle, WA 98105-6099, United States
cUniversity of Washington, School of Law, Box 353020, Seattle, WA 98195–3020, United States



The purpose of this research was to evaluate drinking rates as a function of age and gender and to disseminate current estimates of U.S. population drinking norms based on age and gender.


Participants included 42,706 men and women 18 years and older who provided information about their drinking from the National Epidemiologic Survey on Alcohol and Related Conditions [National Alcohol Survey on Alcohol and Related Conditions (NESARC, 2001) dataset collected between 2001 and 2002 from a representative, non-institutionalized sample.


Results revealed greater frequency and typical quantity of alcohol consumption among men versus women. Age differences in drinking frequency suggests a sharp increase with legal drinking age followed by a period of reduced frequency, in turn followed by gradual increase up to retirement age. Age differences in typical drinking quantity suggest a sharp increase with legal drinking age followed by a gradual linear decline in number of drinks per occasion. Age differences in typical quantity were more pronounced among men.


Analyses provide epidemiological trends in drinking rates by age and gender, and emphasize the importance of within group differences when examining drinking rates. Discussion focuses on explaining how to incorporate norms information in prevention and treatment.

Responding to the Challenge of Early Intervention for Fetal Alcohol Spectrum Disorders.

Infants & Young Children. 20(2):172-189, April/June 2007.

Olson, Heather Carmichael PhD;
Jirikowic, Tracy PhD;
Kartin, Deborah PhD;
Astley, Susan PhD Email:


Prenatal alcohol exposure can lead to significant neurodevelopmental disabilities, now recognized as fetal alcohol spectrum disorders (FASD). This includes both fetal alcohol syndrome, a lifelong birth defect, and a wider range of enduring learning and behavior deficits often called alcohol-related neurodevelopmental disorder (ARND).

Diagnostic classification systems have been developed to identify children with FASD, and early interventionists from multiple disciplines can be central in identification and referral for diagnosis, and in providing the known protective influence of intervention early in life.

With the recent federal mandates to better address needs of children born prenatally affected by substances, or those impacted by abuse and/or neglect, by referring them for screening and possible early intervention services, there is heightened need for providers to understand FASD.

There is a growing body of research data describing the teratogenic effects of alcohol on central nervous system function and physical development, the diversity of children with prenatal alcohol exposure and their families, and the developmental and behavioral characteristics of this clinical population.

This article reviews the latest research evidence, bearing in mind what is important to early intervention. This article also gives practical guidance on FASD prevention, methods for early screening, and referral of young children for diagnosis of FASD (and referral for needed services once diagnosed), and how to provide education, support, advocacy assistance, and anticipatory guidance for families raising children with FASD.

Alcohol at work guide for employers

Occupational health and safety
Health & Safety Executive
Year of publication
The Health and Safety Executive (HSE) has recently produced an employers’ guide to alcohol at work, entitled Don’t mix it. The guide focuses on topics such as the effects on individuals, the legal position and the implications of introducing alcohol screening. All employers have a legal duty under the Health and Safety at Work Act 1974 to ensure, as far as is reasonably practicable, the health, safety and welfare at work of all their employees and others on their premises. This guide aims to help employers meet that duty.
Date added
Created by
  • Julie Jacks
University of Mississppi Medical Center News Release - Medical Center Scientist Finds First Evidence Of Alcohol-Cancer Link

Dr. Jian-Wei Gu came to Mississippi to study the cardiovascular system with a special interest in the process of blood vessel growth.

So how does a cardiovascular physiologist attract national headlines about his research in cancer?

According to Gu, assistant professor of physiology and biophysics at the University of Mississippi Medical Center, it was completely by accident.

Reports of Gu’s research have appeared in USA Today, Science News, the New Scientist and on CBS News. It was big news because Gu has done what many scientists before him have failed to do: describe the mechanism by which alcohol consumption causes tumor growth.

“Scientists have known for a hundred years that there was a strong association between alcohol consumption and several types of cancer,” Gu said. He cites a study from Paris in 1910 that showed that 80 percent of patients with cancer of the esophagus or gastric track were alcoholics.

More recently, epidemiological studies show a strong correlation between alcohol consumption and cancer of the mouth, pharynx, larynx, esophagus, liver, and large bowel. Alcohol consumption seems to be a risk factor even for breast cancer. But experiments in the lab have failed – until now – to show the effects in animals that observers knew to be true in humans.

The problem, it turns out, was that investigators were using too much alcohol.

“Most all the previous studies used alcohol concentrations of 20 percent, far more than the equivalent human consumption,” Gu said. The animals wasted away but they didn’t show abnormal tumor growth, he said.

Gu used alcohol concentrations of one percent, about the equivalent of one or two drinks a day in humans, or moderate alcohol consumption. Using what he terms “physiologically relevant” levels of alcohol, he stimulated tumor growth in both chick embryos and in mice.

Gu came to Mississippi in 1995 to work on angiogenesis, or blood vessel growth, and what stimulates or controls it. Seven years ago, working in the lab, he and his colleagues noticed that the growth factor that stimulates vessel growth (vascular endothelial growth factor or VEGF) increased “unexpectedly” in certain cell cultures.

They determined that it was the alcohol they used as a solvent, in very low concentrations, that caused the increase in the growth factor.

That serendipitous finding by Gu in 2000 led to the study in chick embryos and, most recently, to a study showing that melanoma cancers in mice grew significantly faster and larger in the mice who consumed the equivalent of one or two alcoholic drinks a day than the mice that received no alcohol.

The mice used in the most recent study were given drinking water that had an alcohol concentration of one percent for 12 hours. The next 12 hours, they received water with no alcohol. Another group of mice received no alcohol in their water.

After a week, Gu and his colleagues inoculated all the animals with mouse melanoma cells. Three weeks later, the tumors were removed to be analyzed. All the mice had tumors, but the mice given alcohol had tumors that had progressed much more rapidly than the mice that had no alcohol. The larger tumors also had more blood vessel growth.

Dr. Thomas Adair, professor of physiology and biophysics and Gu’s mentor when he came to Mississippi, said that Gu’s findings have been confirmed by other scientists.

“When he presented his findings at a FASEB (Federated Societies for Experimental Biology) meeting, someone from a group in San Diego came up to me afterward and told me they had found the same thing in their lab and didn’t know what to make of it. They went back and did a study on rats and found the same thing.”

Angiogenesis is an area of keen interest for its application to cancer therapy. Right now, Adair estimates there may be as many as 40 drugs that act by controlling angiogenesis in clinical trials.

But angiogenesis isn’t necessarily pathological, according to Adair. Stimulating angiogenesis would be helpful in repairing heart tissue damaged by a heart attack or in wound healing.

Gu’s research is funded by the National Alcohol Abuse and Alcoholism Institute of the National Institutes of Health (NIH), the National Heart, Lung and Blood Institute of NIH and the American Cancer Society.

— Janis Quinn (3-12-07)

Contributor: Don Phillips
News Release - UTEP Program Effective at Reducing Binge Drinking

News Release

March 13, 2007

Media Contact: Laura Cruz

Writer, University Communications


UTEP Program Effective at Reducing Binge Drinking

Several UTEP students once identified as being at risk of becoming binge drinkers have overcome the danger with the help of the university’s Brief Alcohol Screening and Intervention for College Students (BASICS) program.

Program officials released preliminary results of the effectiveness of the intervention program. BASICS encourages moderation in drinking and teaches safety skills to college-aged drinkers.

About 130 participants who were identified as at-risk for binge drinking recently completed a six-month follow up. Of those students, 67 percent no longer fall in the at-risk category and 50 percent are showing a decline in risk compared to their pre-intervention levels.

Launched in January 2006, the BASICS program uses a screening process to identify at-risk students and a motivational interviewing approach to educate them about the dangers of binge drinking.

“We believe that our project can become a model for the way that college campuses provide intervention services for risky alcohol use, both nationally and among campuses with high Hispanic enrollment,” said Joe Tomaka, Ph.D., program director and UTEP health promotion professor.

The program is supported by a $1.4 million, three-year grant from the Substance Abuse and Mental Health Services Administration within the U.S. Department of Health and Human Services.

BASICS is housed in the Center for Lifestyle Enhancement in Union West, Room 211.

The center performs overall health awareness programs, and works with the counseling, swimming and fitness, and student health centers and other entities to improve student health.

For more information, call the center at 915/747-6328 or call Tomaka at 915/747-7237.

Contributor: Don Phillips


The NSDUH Report: Religious Involvement and Substance Use Among Adults


  • In 2005, about 168 million adults aged 18 or older (78.1%) reported that religious beliefs are a very important part of their lives, 75.1% reported that religious beliefs influence how they make decisions in their lives and 30.8% attended religious services 25 times or more in the past year.
  • Adults who attended religious services 25 times or more in the past year were less likely to have used cigarettes, alcohol, or illicit drugs in the past month than those who attended religious services fewer than 25 times.
  • About 6.1% of the adults who reported that religious beliefs are a very important part of their lives used illicit drugs in the past month compared with 14.3% of adults who reported that religious beliefs are not an very important part of their lives.

Religion and other risk and protective factors

Other topics

Other OAS publications and services

This Short Report, The NSDUH Report: Religious Involvement and Substance Use Among Adults , is based on SAMHSA's National Survey on Drug Use and Health (NSDUH), formerly called the National Household Survey on Drug Abuse (NHSDA). The NSDUH/NHSDA is conducted by the Office of Applied Studies (OAS) in the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA's survey (NHSDA/NSDUH) is the primary source of information on the prevalence, patterns, and consequences of drug and alcohol use and abuse in the general U.S. civilian non institutionalized population, age 12 and older. The NHSDA/NSDUH also provides estimates for drug use by State.
Concurrent and Predictive Validity of Drug Use and Psychiatric Diagnosis Among First-Time DWI Offenders

Alcoholism: Clinical and Experimental Research 31 (4), 619–624.

  • 1Department of Psychiatry, Division of Substance Abuse, Yale University School of Medicine, New Haven, Connecticut

This research was supported by National Institute on Alcohol Abuse and Alcoholism Grant RO1—AA09098 (SSO) and National Institute on Drug Abuse Grant T32—DA07238.

Reprint requests: Rebekka S. Palmer, PhD, Yale University School of Medicine, Department of Psychiatry, Clinical Research Unit, 1 Long Wharf Dr., Suite 10, New Haven, CT 06511; Fax: 203-781-4705; E-mail:



Previous studies have found that driving while intoxicated (DWI) offenders report high rates of substance dependence and other psychiatric disorders.


The current study evaluated the prevalence, clinical correlates at program admission, and prognostic significance over a 1-year follow-up of 2 diagnostic subgroup variables (drug abuse or dependence; mood or anxiety disorder) among 290 first-time DWI offenders receiving group counseling interventions.


A lifetime diagnosis of drug abuse or dependence (42% of sample) was associated with higher levels of alcohol consumption, lower coping confidence, greater readiness to change, increased alcohol, drug, and legal problems, and more alcohol-related negative consequences at the initiation of DWI intervention.

Significant decreases in drinking were noted at intervention termination for the drug diagnoses subgroup, but were not sustained at 1-year follow-up.

The presence of a lifetime diagnosis of anxiety or mood disorder (30% of sample) was associated with lower coping confidence, greater readiness to change, and with greater and more enduring negative consequences of drinking during the DWI intervention and 1-year follow-up period.


Results suggest that a psychiatric diagnosis might guide the intervention and aftercare planning for DWI offenders to reduce recidivism and drinking.
Naltrexone and cognitive behavioral coping skills therapy for the treatment of alcohol drinking and eating disorder features in alcohol-dependent women: a randomized controlled trial.

Alcohol Clin Exp Res. 2007 Apr;31(4):625-34

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.



Despite important gender differences in drinking patterns, physiological effects of alcohol, and co-occurring psychiatric conditions, relatively little is known about the efficacy of naltrexone for the treatment of alcohol dependence in women.

This study investigated the safety and efficacy of naltrexone in combination with Cognitive Behavioral Coping Skills Therapy (CBCST) in a sample of alcohol-dependent women, some with comorbid eating pathology.


One hundred three women meeting DSM-IV criteria for alcohol dependence (29 with comorbid eating disturbances) were randomized to receive either naltrexone 50 mg or placebo for 12 weeks in addition to weekly group CBCST. Subjects were enrolled between October 1995 and December 2000 at an outpatient research clinic.


No significant differences were observed on the primary outcomes of time to first drinking day, time to first day of heavy drinking, or the percentage of participants who continued to meet the criteria for alcohol dependence.

Secondary analyses revealed that naltrexone significantly delayed the time to the second (chi(2)=5.37, p=0.02) and third (chi(2)=4.35, p=0.04) drinking days among subjects who did not maintain abstinence from alcohol.

Among those with eating disturbances, symptoms of eating pathology improved during treatment, but the effects did not differ according to medication condition.


When used in conjunction with CBCST, naltrexone did not significantly improve drinking outcomes in the overall sample of alcohol-dependent women.

However, naltrexone may be of benefit to women who are unable to maintain total abstinence from alcohol.

For women with concurrent eating pathology, participation in treatment for alcoholism may be associated with improvements in eating pathology.

What role does measuring medication compliance play in evaluating the efficacy of naltrexone?

Alcohol Clin Exp Res. 2007 Apr;31(4):596-603.

Charleston Alcohol Research Center, MUSC, Charleston, South Carolina, USA.



Compliance with medication in pharmacotherapy trials of alcoholism has been shown to be equal to, or more, important than in other areas of medicine. Research has suggested that naltrexone's effectiveness can be greatly influenced by the compliance of participants in clinical trials.

Presently, we compare 2 compliance measurement methods [urine riboflavin and medication event monitoring system (MEMS)] used simultaneously to evaluate naltrexone's efficacy and the impact of compliance on the size of observable treatment effects.


One hundred and thirty-seven of 160 randomized alcoholic patients completed 12-weeks (84 days) of naltrexone or placebo and cognitive behavioral therapy (CBT) or motivational enhancement therapy (MET).

Urine riboflavin was determined during study weeks 2, 6, and 12.

The MEMS provided a detailed computerized record of when a participant opened their medication bottle throughout the trial.

Baseline predictors of MEMS (80% openings) and urine riboflavin (>/=1,500 ng/mL by fluorimetry) compliance were examined.

The effects of the treatments in the compliant participants defined by one, the other, or both methods were compared and contrasted with a previously reported intent-to-treat analysis where compliance was not taken into account.


Age was predictive of compliance. 105 participants were deemed compliant via urine riboflavin criteria, 87 via MEMS, and 77 when both criteria were met, with no significant differences between treatment groups.

The most compliant participants showed a significant medication by therapy interaction. Those treated with naltrexone/CBT showed more abstinence days (p<0.03), less heavy drinking days (p<0.03) and less total drinks (p<0.03) than the other groups. The effect size of this interaction increased from about 0.2 in the intent-to-treat analysis, to about 0.4 to 0.5 in the compliant group analyses, with little difference between compliance measurement methods.


Compliance measurement does appear to influence the evaluation of the efficacy of naltrexone within the context of CBT.

Treatment effect sizes approximately doubled in the most compliant individuals. Measuring compliance by either of 2 distinct methods provides approximately similar results.

As compliance with naltrexone within the context of CBT has such a large impact of treatment outcome, methods of enhancing compliance during treatment should be given the utmost attention.

Is There a College Substance Abuse Crisis?

Are things really getting worse or did Columbia’s National Center on Addiction and Substance Abuse get the media’s attention through the selective use of statistics?

Are we “Wasting the Best and the Brightest?” as the latest report on use of alcohol and other drugs by college students by Columbia’s National Center on Addiction and Substance Abuse claims? Or is what Stats has dubbed the “Center for Abuse of Statistical Analysis” (and others have labeled the “Center for Alcohol Statistics Abuse”) up to its old tricks?

Unfortunately, while cliché watchers will have a field day with this report, so too will those who need examples of misleading uses of statistics for their Stats 101 classes. In this case, the problem is not CASA’s usual confusion of correlation and cause, but rather its selectively choosing a date with which to compare college students so as to make today’s kids look worse than previous generations and, by implication, worse than those who do not attend college.

Careful readers of the report – a category which excludes almost all the journalists who reported its findings verbatim – may have wondered why CASA chose to look at trends in alcohol and other drug use from 1993 to 2005, rather than from the more obvious ten-year starting point, 1995 – or from the 1970s, when statistics on the issue first began to be kept. Informed readers might also be curious about why the comparison point wasn’t the highest level of drug use measured in teens (which occurred in 1979-81, depending on the particular drug); and they also might wish to know why the students were compared with the general population rather than with others their own age who do not attend college.

If such readers go to the source for most of CASA’s data, the government’s Monitoring the Future (MTF) and National Household Survey on Drug Use and Health (NHSDUH) studies, they will rapidly discover why.

Take, for example, the startling claim that in 2005 “almost one in four college students (22.9%) met the medical criteria for substance abuse or dependence, almost triple the proportion (8.5%) in the general population.” The source of this statistic appears to be a re-analysis of data collected for MTF or NHSDUH done by CASA.

This makes it appear as though college students are more likely to be addicts or alcoholics than non-college students, which is something that confounds common sense when you consider that the most severe cases of addiction start young and often result in failure to complete high school, let alone attend college – and that addiction itself often causes college dropout. (Note: “substance dependence” is the medical term for addiction; “substance abuse” is the medical term for use of substances that is potentially harmful but is not characterized by compulsion or long-term problems).

When you look at the NHSDUH figures for the general population age 18-25, you find a rate of substance abuse or dependence for 2005 of 21.8%. While this sounds equally as horrifying, the reason the rate is probably slightly higher for college attendees is that college binge drinking can often result in a “substance abuse” diagnosis: in other words, it’s potentially dangerous but is not necessarily indicative of a long-term problem.

What CASA fails to point out (but is hinted at in the 8.5% substance abuse/dependence rate for the general population) is that the vast majority of college binge-drinking ends when graduates realize it is not compatible with employment that requires 9am cognitive clarity at work. The substance/abuse dependence rate for those over 26 is just 7.1%. In other words, stop the presses: many young people experiment with drugs and alcohol before they settle down and grow up.

CASA was forced to admit that college binge drinking itself has been steady between 1993 and 2005, so they problematized this as being an instance of “no significant decline” and pointed out minor changes in subcategories like a 16% increase in binge drinking “three or more times in the past two weeks.”

In the field, this is known as “data dredging:” Your main finding is not really that significant, so you parse enough subcategories in order to find something that looks scary or important. (Which, naturally enough, media reports in the vein of the Associated Press’s “Binge Drinking Rises at Colleges,” via, repeat without qualification or analysis).

Now we come to the curious choice of 1993 as the comparison year for the findings taken from Monitoring the Future . CASA notes that during that period the number of daily marijuana users more than doubled, going from 1.9% to 4%. If they had chosen 1995, however, the figure would have been 3.7%, which would have made the increase far less impressive. Even less scary would have been to note that in 1980, in the peak period of U.S. drug use, 7.2% of college students smoked marijuana daily and the nation did not collapse (in fact, this is the generation that produced the Internet boom).

CASA’s focus on a “tripling” of past-year heroin use is even more misleading: In 1993, 0.1% of college students reported past-year heroin use; in 2005, the figure was 0.3%. But this “tripling” had happened by 1995 and had bounced all the way up to 0.6% in 1998, before falling back to 0.1% again in 2002. In other words, if they’d used 1995 as a starting point, they’d have been forced to say that heroin use was unchanged. And this was probably true because most researchers believe that because heroin use is so rare, trends in these numbers among college students (who are less likely to use heroin than high school graduates, drop-outs and non-students) probably don’t mean much anyway.

CASA’s highlighting of a “52% increase” in use of “drugs other than marijuana” since 1993 shares the cut-off problem with the other figures. The 1993 statistic is 5.4% but by 1995 it’s already up to 6.3%, yielding only a 30% rise to hit 2005’s 8.2%. The comparable 1980 figure is a whopping 20.7%. The same problem is seen in the cocaine trend as well.

CASA did point out what appears to be a genuine recent increase in misuse of prescription drugs, but it buries the fact that this is far less common among college students than among those who do not attend college, failing to mention this in the press release or introductory letter. In fact, nearly twice as many of those who are not enrolled in college misused prescription opioids like Vicodin in the past month (5.6%) compared to 3.1% for college students.

CASA says it wants to take the “high” out of “higher education;” but because college graduates are far less likely to have long term substance misuse problems than those who do not attend or do not graduate, maybe it should focus more on keeping students in school rather than hyping fears about college drinking and other drug use.

That college graduates remain less likely to get or stay addicted to alcohol or other drugs despite vastly expanded enrolment suggests that while “stay in school” may be a boring message, it may be the best widely-applicable form of addiction prevention we have yet to develop.


STATS address
The Social History of Alcohol and Drugs: An Interdisciplinary Journal (SHAD)

Volume 20 Number 2 (Spring 2006)

Contents (Available for Download as PDFs)

Editor's Note - 183 (PDF)


Drug Consumption in London and Western Berlin during the 1960s and 1970s: Local and Transnational Perspectives
Klaus Weinhauer - 187 (PDF)

Prohibition Possibly Prohibited: Iowans Voicing Temperance Concerns, 1929-1933
Lisa Ossian - 225 (PDF)

Temperance Internationalism: Guy Hayler and the World Prohibition Federation
David Fahey - 247 (PDF)

Addiction Concepts and International Control
Robin Room - 276 (PDF)

Reflection Essay

Teaching Alcohol and Drug History to Undergraduates
Cheryl Krasnick Warsh - 290 (PDF)

Book Reviews (PDF)

Jean Vigreux, La vigne du maréchal Pétain ou un faire-valoir bourguignon de la Révolution nationale (2005)
Joseph Bohling - 296

Eric Tagliacozzo, Secret Trades, Porous Borders: Smuggling and States Along a Southeast Asian Frontier, 1865-1915 (2005)
Anne L. Foster - 298

Richard W. Thatcher, Fighting Firewater Fictions: Moving Beyond the Disease Model of Alcoholism in First Nations (2004)
Greg Marquis - 300

Sarah W. Tracy, Alcoholism in America: From Reconstruction to Prohibition (2005)
Thomas R. Pegram - 302

Martin Torgoff, Can't Find My Way Home: America in the Great Stoned Age (2004)
Alexine Fleck - 306

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A Pilot Double-Blind Treatment Trial of Memantine for Alcohol Dependence

Alcoholism: Clinical and Experimental Research (OnlineEarly Articles).
22 March 2007

  • 1New York State Psychiatric Institute, New York, New York; 2Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York

This research was supported by NIAAA Grant R01 AA12599 and KO2 00465. We want to thank the staff of the Substance Treatment and Research Service (STARS) of the New York State Psychiatric Institute for their medical, clinical, and research support.

Reprint requests: Suzette M. Evans, PhD, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 66, New York, NY 10032; Fax: 212-543-6018; E-mail:



There is growing evidence that N-methyl-d-aspartate (NMDA) receptor antagonists may have potential for the treatment of alcohol disorders. Memantine is a selective noncompetitive NMDA receptor antagonist that has been shown to decrease alcohol craving in moderate drinkers.

This 16-week double-blind outpatient pilot clinical trial determined if memantine was more effective than placebo at reducing alcohol use in actively drinking alcohol-dependent patients.


Forty-four treatment-seeking alcohol-dependent individuals were enrolled, with 34 patients stratified to either the memantine group (n=19; maximum dose of 40 mg/d) or the placebo (PBO; n=15) group.

The primary outcome measures were related to alcohol use (average drinks per day, average drinks per drinking day, percentage of heavy drinking days, and percentage of days abstinent) based on the timeline follow-back (TLFB).

Secondary outcome measures included the Obsessive Compulsive Drinking Scale, Clinical Global Impression ratings, and γ-glutamyltransferase (GGT), a biomarker of recent alcohol use.

To enhance retention, patients received voucher incentives for clinic attendance.


Of those randomized, approximately 80% (27) completed the entire 16-week trial.

Longitudinal analysis of drinks per day and drinks per drinking day showed a significant reduction in alcohol use, but no difference between the 2 groups. Further, the percentage of heavy drinking days indicated that both groups showed a significant decrease in drinking behavior, but there was significant treatment effect in favor of the PBO group.

Similarly, for the percentage of days abstinent, the PBO group achieved a significantly greater percentage of days abstinent at a faster rate than the memantine group.

Lastly, the memantine group reported a greater number of side effects compared with the PBO group, such that 26% of patients had their drug dose decreased or discontinued due to memantine-related side effects.


The results of this double-blind placebo-controlled pilot trial do not support the use of memantine for the treatment of actively drinking alcohol-dependent patients.

However, voucher incentives did facilitate retention.