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, April 21, 2007

'Spykes' Sparks Concern, Activism Over Kid-Friendly Mix of Alcohol, Energy Drinks

April 13, 2007

News Feature
By Bob Curley

The recent controversy about Anheuser-Busch's "Spykes" energy drinks has prompted grassroots advocacy as well as broader concerns about mixing alcohol and energy drinks.

Sold in pocket-sized bottles and containing 12 percent alcohol, Spykes is being marketed as an additive for beer and other alcoholic beverages. "Spykes is a great alternative to hard liquor shots," according to the Anheuser-Busch product website for Spykes. "A Spykes pour takes beer up a notch by adding a caffeinated rush and a sweet taste that finishes hot ... Spykes gives your beer a kick, adds flavor to your drink, and is perfect for a shot."

But critics see the product's bright packaging and fruity flavors -- Spicy Lime, Hot Chocolate, Spicy Mango, and Hot Melons -- as a blatant attempt to market the product to children. Hope Taft, former first lady of Ohio and a board member of the group Leadership to Keep Children Alcohol Free, dashed off a March 30 letter to Anheuser-Busch president and CEO August Busch IV to protest Spykes' "appeal to those under the age of 21."

. . . . .



Press Statement - SPYKES

Statement Attributable to
Francine I. Katz
Vice President, Communications and Consumer Affairs
Anheuser-Busch Companies, Inc.
St. Louis, Missouri

Today’s contemporary adult consumers, 21 and older, are looking for innovative alcohol beverages to match their active lifestyles, and SPYKES responds to that customer demand. Frankly, we’re perplexed at this criticism, yet we know there are perennial, fear-mongering anti-alcohol groups whose members are in the business of spreading misinformation.

SPYKES is neither a high-alcohol content drink, nor an energy drink. SPYKES is simply a malt beverage with 12 percent alcohol by volume sold in 2-oz single servings. In fact, the amount of alcohol in a SPYKES bottle is equivalent to one-third of a glass of wine. And the amount of caffeine in a 2-ounce serving of SPYKES is equal to 1-ounce of dark chocolate.

. . . . .




Requests For Proposal (RFP) and Requests for Qualifications (RFQs)

RFQ #1: Telephone Peer Support Services Deadline: Friday, May 11, 2007.


The Department of Mental Health and Addiction Services (DMHAS) is requesting proposals from qualified nonprofit community-based organizations capable of providing person-centered, recovery-oriented Telephone Peer Support Services on a statewide basis.

This non-clinical recovery support service will be offered to individuals receiving outpatient treatment at a licensed clinical treatment provider and/or other designated services. Telephone Peer Support Services are designed to assist individuals in the community with their recovery process.

Further, the qualifying agency will collaborate with DMHAS, DMHAS-funded treatment service providers, and other community-based organizations to assist persons in sustaining their recovery.
. . . . .


Contributor: Don Phillips
Road traffic crashes leading cause of death among young people
New WHO report marks First UN Global Road Safety Week

Report: Youth and Road Safety [pdf 3.0Mb]

3. Preventing road traffic injuries among children and young people
3.2 Specific interventions that have proved effective


Alcohol consumption before using the roads – whether as a driver or a pedestrian – increases
the likelihood of a crash occurring, as well as the likelihood that death or serious injury will result.

The risk of a road traffic crash begins to increase significantly at a blood alcohol concentration (BAC) level of 0.04 g/dl and rises steeply after that for each small increase in BAC.

Youth and alcohol — In many countries, a high proportion of car and motorcycle drivers involved in crashes are under the influence of alcohol. Many of these are young road users under the age of 25 years. Age is a factor that has a bearing on the risk of young people who have consumed alcohol incurring road traffic injuries.

A number of interventions that have been tried, particularly in high-income countries, have led
to declining numbers of traffic deaths related to alcohol use among young road users.

These strategies have included the following:

o Introducing laws on blood alcohol concentration

o Enforcing blood alcohol limits

o Restricting young or inexperienced drivers

o Raising the legal drinking age

o Introducing disincentives for drink–driving

o Restricting the availability of alcohol to young drivers

o Implementing designated driver programmes

o Mass media campaigns

Drinking heavily in college may lead to heart disease later in life

Abstract P149

Meeting Report

CHICAGO, April 19 – College-age students who drink heavily may increase their risk for future heart disease, researchers reported at the American Heart Association’s 8th Annual Conference on Arteriosclerosis, Thrombosis and Vascular Biology.

In a small study, Minnesota researchers found that a group of college students who drank heavily had higher levels of C-reactive protein (CRP), a blood marker for inflammation that can increase the risk for heart disease. Increased CRP placed heavy drinkers at moderate risk for cardiovascular disease in early adulthood. Moderate drinkers had the lowest CRP levels.



Chronic Smoking Is Associated With Differential Neurocognitive Recovery in Abstinent Alcoholic Patients: A Preliminary Investigation

Alcoholism: Clinical and Experimental Research
(OnlineEarly Articles). 19 April 2007

Approximately 50 to 90% of individuals in North America seeking treatment for alcoholism are chronic smokers. A growing body of evidence suggests that chronic cigarette smokers show a pattern of neurocognitive dysfunction similar to that observed in alcoholic patients.

However, previous studies investigating neurocognitive recovery in abstinent alcoholic patients did not specifically consider the potential effects of chronic cigarette smoking.

These preliminary results suggest that chronic smoking may modulate neurocognitive recovery in abstinent alcoholic patients. More generally, chronic smoking may impact neurocognition in other conditions where is it a prevalent behavior.




Friday, April 20, 2007

Alcohol Alert edition 1 2007:Alcohol Alert 16/4/07

Also in this issue: READ FULL ISSUE (PDF)
National Alcohol and Drug Addiction. Recovery Month 2007. Join the Voices for Recovery. Saving Lives, Saving Dollars.
Friday, April 20, 2007

SAMHSA's Road to Recovery Update

The Road to Recovery Update keeps you informed about activities leading up to National Alcohol & Drug Addiction Recovery Month (Recovery Month) in September. Feel free to forward this information to friends and colleagues, include it in newsletters or listservs, or link to it from your Web site.

Last Chance to Submit a Question to the Expert For the April Webcast

Get answers to your questions about the topics covered in the "Alcohol en la Comunidad Latina"—Producido en español" Webcast. Submit your questions using our anonymous online form, and answers from our expert will be posted in early May.

Visit Ask the Expert before April 26th to submit questions for this month's expert: Rita L. Nieves, RN, MPH. Ms. Nieves is the Director of the Bureau of Substance Abuse Services at the Boston Public Health Commission.

Next Webcast

View the Trailer

Wednesday, May 2: "Helping Families Find Recovery"

Families can be involved in the treatment of an individual with addiction. This show will focus on how they can by examining how foster care programs, family drug courts, mutual support groups, community-based organizations, and other services are helping families walk the road to recovery together. It also highlights treatment options available to family members of an individual with addiction.

Webcast Promotion

SAMHSA provides free DVDs or VHS tapes to Public, Educational and Government (PEG) access television channels. See if your local PEG access television channel is receiving the Road to Recovery programming by checking their programming schedules or by clicking on the following link and entering your state:
. If not, encourage them to carry the programming. They can email to request the programming.

About Recovery Month

National Alcohol and Drug Addiction Recovery Month, celebrating 18 years of observance in 2007, is an initiative of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration's (SAMHSA's) Center for Substance Abuse Treatment (CSAT). For more information about Recovery Month, visit

eNewsletter: April 20, 2007


Faces & Voices web site’s new look

We’ve launched a revamped web site to make it easier to use Faces & Voices to continue building our growing recovery advocacy movement. A special thanks to Dannie Greenberg, who spent countless hours putting all of this together. Still to come: more Profiles of Recovery Advocacy in Action featuring Lisa Mojer-Torres, John Shinholser and Mike Barry and an expanded Mutual Support Resources Guide. And don’t forget to visit and use our new Online Advocacy Action Center.

Take Action to End Insurance Discrimination Today!

It’s time to put a public spotlight on the need for meaningful insurance reform in this session of Congress! You can use our sample Letters to the Editor and Oped to get out the story about insurance discrimination and build support for Congressional action this year! More…

Faces & Voices Advocacy Organizing Network

Is your organization planning an event for this year’s Rally for Recovery! Do you want to collaborate with other recovery community organizations and use Rally for Recovery! to build support for our recovery advocacy agenda? Faces & Voices National Field Director Tom Coderre is hosting bi-monthly organizing teleconferences with recovery community organizations. For more information, contact Tom.

Job Opening at Faces & Voices of Recovery

Faces & Voices is pleased to announce a new position as Administrative Assistant. The application deadline is Tuesday, May 1st.

State of CT Releases Telephone Peer Support Services RFQ

Connecticut’s Department of Mental Health and Addiction Services (DMHAS) is requesting proposals from qualified nonprofit community-based organizations capable of providing person-centered, recovery-oriented Telephone Peer Support Services on a statewide basis. This exciting initiative is the first of its kind and the non-clinical recovery support services will be offered to individuals receiving outpatient treatment at a licensed clinical treatment provider and/or other designated services.

Join us today!

Become a member of Faces & Voices of Recovery today!

NSDUH Report: Youth Activities, Substance Use, and Family Income,

a 3 page short report based on SAMHSA's National Survey on Drug Use and Health (NSDUH), provides data on youth participation in activities by detailed age & family income, and indicates the association between such participation and alcohol, cigarette & illicit drug use.


  • Based on SAMHSA's 2005 National Survey on Drug Use and Health, 92.4% of youths aged 12 to 17 participated in one or more school-based, community-based, church or faith-based, or other such activities during the past year: 27.1% participated in one to three activities, 31.4% participated in four to six activities, and 33.9% participated in seven or more activities in the past year.
  • Youth in families of lower income were more likely not to participate in any school-based, community-based, church or faith-based or related activities; however, regardless of family income those youth who did participate had lower rates of cigarette, alcohol, or illicit drug use than those who did not participate in such activities.
  • The greater the number of activities, the lower the rates of past year use of cigarettes, alcohol, or illicit drugs among youth. For example, the rates of illicit drug use were 18.3% for youth who participated in no such activities, 11.9% for those with 1-3 activities, 9.4% for 4-6 activities, and 6.8% for 7 or more youth activities in the past year.
Patterns of Alcohol Drinking and All-Cause Mortality: Results from a Large-Scale Population-based Cohort Study in Japan
American Journal of Epidemiology 2007 165(9):1039-1046;

To evaluate the hypothesis that, in terms of all-cause death, drinking alcohol 1–4 days per week is less harmful than daily (5–7 days/week) drinking of the same quantity of alcohol, a prospective cohort study using a self-administered questionnaire was conducted in Japan between 1990 and 2003 of 88,746 subjects (41,702 men and 47,044 women) aged 40–69 years at baseline.

Among male regular drinkers consuming alcohol more than 1 day per week, light drinkers (<300> no increase in all-cause mortality irrespective of frequency of alcohol intake.

Heavy drinkers (≥300 g/week), however, showed an increased risk of all-cause mortality among those who consumed alcohol 5–7 days per week, while no obvious increase was observed among those who consumed alcohol less than 4 days per week.

These findings support the Japanese social belief that "liver holidays," abstaining from alcohol for more than 2 days per week, are important for heavy drinkers.


Call for 24-hour pubs to be closed

Jonathan Pearlman
April 20, 2007

THE state's chief adviser on alcohol, Ian Webster, says the Government is in denial about the extent of alcohol abuse and it should close 24-hour pubs and limit new licences in areas where heavy drinking is recorded.

Professor Webster, the chairman of the NSW Expert Advisory Group on Drugs and Alcohol, said state and federal governments had been more focused on combating the abuse of illicit drugs, even though alcohol caused more harm.


Source: Robin GW Room
More alcohol, more often is hardly the solution to a growing problem

Wayne Hall
April 20, 2007

Research recently released by the NSW Bureau of Crime Statistics show that the only criminal offence that became more common in the state in the past two years was malicious damage to property. Other research by the bureau has found that a substantial proportion of these offences were committed by intoxicated males late at night on weekends in the vicinity of licensed premises.

While property offences related to heroin and other drug use have been in decline for more than five years, alcohol-related offences are the only drug-related offences showing an increase.


Source: Robin GW Room
Health Minister challenges industry to show that voluntary initiatives can produce results

19 April 2007

Speaking at the WSTA Annual Spring Conference and Lunch, Public Health Minister Caroline Flint MP warned that if voluntary initiatives on issues like labelling did not produce results, there were many voices calling for stronger regulation of the alcohol sector.


Thursday, April 19, 2007

Raise the legal drinking age to tackle Britain’s binge-drinking youth?

15 April 2007

The legal drinking age should be raised to 21, according to columnist Jasper Gerard, in an article to be published this week in the latest edition of Public Policy Research, the Institute for Public Policy Research’s journal.

Gerard argues that the UK has ‘lost the plot’ when it comes to regulating alcohol. He proposes raising the drinking age to 21 or requiring 18-year-olds to carry smart cards which record how much they have drunk each night and restrict under-21s to three units of alcohol. He also recommends:

  • increasing the number of prosecutions and the level of fines on retailers selling alcohol to minors
  • increasing taxes on drinks targeted at young people, such as alcopops
  • restricting advertising of drinks aimed at youngsters
  • allowing 16 and 17-year-olds limited amounts of alcohol in pubs, bars and restaurants when consumed with a full meal and accompanied by someone over 21.
From mother's milk to alcopops is too short a step

Jasper Gerard
Sunday April 15, 2007
The Observer

Round-the-clock drinking was meant to uncork, even in the moodiest boulevards of Bognor, a sophisticated Left Bank cafe society, with bright young things charging glasses of chilled pinot grigio while discussing existentialist philosophy.

Alas, a year-and-a-half later, the nearest we typically come to existential angst in the early hours is when concerned friends asking paramedics: 'Is she dead or just unconscious?'

Such evenings can now render even the most infamous roistering session of Oliver Reed a rather dainty meeting of the Temperance League. The papers are full of pictures of youngsters semi-naked and wasted; they might be sprawled across a road, or throwing up, or having sex, or rather, given their awareness levels, having sex done to them. Even ministers concede this is hardly the Sartrean cafe society they had in mind.

Being no stranger to the devil's milk, I'd opposed 'booze crackdowns', despite observing the ravages of alcohol on somebody close to me. Well, if teenagers are mature enough to die for their country and bleed for the Exchequer, can you leave them gasping for a Bacardi Breezer? But then the IPPR think-tank invited me to investigate the effects of drinking on youngsters and I was forced to conclude the drinking age should rise to 21 - if only as an experiment - because we face an epidemic. . . . . .



Drinking Age Paradox

Thursday, April 19, 2007;

Public policy often illustrates the law of unintended consequences. Society's complexity -- multiple variables with myriad connections -- often causes the consequences of a policy to be contrary to, and larger than, the intended ones. So, when assessing government actions, one should be receptive to counterintuitive ideas. One such is John McCardell's theory that a way to lower the incidence of illness, mayhem and death from alcohol abuse by young people is to lower the drinking age. . . . .



Wednesday, April 18, 2007

Smoking Status as a Clinical Indicator for Alcohol Misuse in US Adults

Arch Intern Med.

Screening for alcohol use in primary care settings is recommended by clinical care guidelines but is not adhered to as strongly as screening for smoking. It has been proposed that smoking status could be used to enhance the identification of alcohol misuse in primary care and other medical settings, but national data are lacking.

Our objective was to investigate smoking status as a clinical indicator for alcohol misuse in a national sample of US adults, following clinical care guidelines for the assessment of these behaviors.

Occasional and daily smokers were at heightened risk for hazardous drinking and alcohol use diagnoses. Smoking status can be used as a clinical indicator for alcohol misuse and as a reminder for alcohol screening in general.


NEWS ALERT A few brief meetings with healthcare workers can curb excessive drinking in men
18 APRIL 2007

Between one and four standard appointments with a general practitioner or nurse can reduce a patient’s alcohol consumption by an average of five standard drink units a week, according to a Cochrane Review. The effect of brief advice about alcohol is more pronounced in men and a year later, they still had significantly reduced alcohol consumption. There is, however, less evidence that this approach helps curb excessive alcohol intake in women.



Gene-lifecourse interaction for alcohol consumption in adolescence and young adulthood: Five monoamine genes
American Journal of Medical Genetics Part B: Neuropsychiatric Genetics
Early View On-line 17 April 2007

Association analysis has suggested that common sequence variants of genes that affect monoamine function can affect substance use and abuse. Demonstration of these associations has been inconsistent because of limited sample sizes and phenotype definition.

Drawing on the life course perspective, we predicted a stronger association between the polymorphisms in 5HTT, DAT1, DRD4, DRD2, and MAOA and alcohol consumption in young adulthood than adolescence.

All five genes are significantly associated with the frequency of alcohol consumption, with the genotype effects ranging 7%-20% of the mean score of alcohol consumption and their P values being 0.014, 0.0003, 0.003, 0.007, 0.005, and 0.003, respectively.

The association is only observed in the life stage of young adulthood and not in adolescence. This analysis has demonstrated the potential usefulness of the life course perspective in genetic studies of human behaviors such as alcohol consumption.



Tuesday, April 17, 2007

Group of House Republicans Push for Beer Tax Apr-12-2007 11:41

For nearly 30 years, the state beer tax has been $2.60 per 31-gallon barrel, or eight-tenths of one-cent per bottle.

(SALEM) - A group of House Republicans wants a nickel-a-beer tax increase to help pay for 300 more state troopers, the Ashland Daily Tidings reported.

Reps. Sal Esquivel of Medford, Brian Boquist of Dallas and Wayne Krieger of Gold Beach want to give the Oregon State Police a dedicated funding source outside of the state's general fund, partly so the department can resume around-the-clock patrols.

. . . . .



Drinks With Youth Appeal Draw Growing Opposition

Published: April 13, 2007

SACRAMENTO — Three years ago, at the age of 15, Jimmy Jordan says, he got his first taste of what it was like “to be cool and fit in.” While watching a video with friends, a buddy urged him to try a Smirnoff Ice, one of dozens of flavored alcoholic beverages that look and taste like soda but offer the kick of a cocktail.

Speaking to a state board in February, Elianna Yanger, 17, of California Friday Night Live, said that similar packaging of an energy drink, left, and a malt beverage showed an effort to market alcohol to teenagers.

Jimmy Jordan, a high school senior in California, is campaigning against beverages known as alcopops that are popular with young drinkers.


Alcohol and Alcoholism 2007 42(2):108-112

Self-help groups such as Alcoholics Anonymous (AA) are widely recommended for aftercare of alcohol-dependent persons, even though scientific knowledge of its effectiveness is inconsistent.

The aim of the present analysis was to elucidate whether persons attending AA groups regularly after detoxification have lower relapse rates within 1 year, compared to person without self-help group attendance.

The present study was unable to show an advantage of self-help group attendance in reducing relapses compared to the control group.



Contributor: Don Phillips
SF/125 Monday April 16, 2007

Australia has a drinking problem. Alcohol is a legal substance which is killing Australians, particularly young Australians, and FAMILY FIRST is today launching a campaign to reduce the alcohol toll.
. . . .

Alcoholic cerebellar degeneration: A clinicopathological study of six Japanese autopsy cases and proposed potential progression pattern in the cerebellar lesion

Volume 27 Issue 2 Page 99 - April 2007

Alcoholic cerebellar degeneration (ACD) is one of the most common neurological complications in alcoholics. As far as we know, however, only four Japanese autopsy cases of ACD have been reported, and only limited clinicopathological data on this disease are now available in Japan.

The aims of this study were: (i) to examine the clinicopathological correlation of six Japanese autopsy cases of ACD, including three asymptomatic cases; and (ii) to elucidate the pattern of progression of the cerebellar lesion in ACD.

These findings suggest that in ACD, severe lesions successively develop: (i) in the anterior superior vermis; (ii) anterior superior hemisphere; (iii) anterior inferior hemisphere; and (iv) anterior inferior vermis.

In addition, cerebellar symptoms may frequently occur if the anterior superior hemisphere and anterior inferior hemisphere, in addition to the anterior superior vermis, are involved.


CONFERENCE: Alcohol in the Atlantic World: Historical and Contemporary Perspectives

Oct 24, 2007 to Oct 27, 2007

This International Workshop on Alcohol in the Atlantic World: Historical and Contemporary Perspectives is an assembly of established researchers and new scholars examining alcohol throughout the Atlantic World from a variety of historical and contemporary perspectives and disciplinary traditions.

The geographic focus of the workshop is Africa, the Americas, the Caribbean and Europe within the context of the Atlantic world. Its major themes include, but are not limited to, production, trade and consumption.

Location: Founders College
Sponsor: Harriet Tubman Resource Centre on the African Diaspora
Posted by: José C. Curto and David V. Trotman
Web Site:

Source: Alcohol and Drug History Society
Testing association in the presence of linkage - a powerful score for binary traits
Genetic Epidemiology
Early View Published Online 13 April 2007

We present a score for testing association in the presence of linkage for binary traits. The score is robust to varying degrees of linkage, and it is valid under any ascertainment scheme based on trait values as well as under population stratification.

The score test is derived from a mixed effects model where population level association is modeled using a fixed effect and where correlation among related individuals is allowed for by using log-gamma random effects.

We show that a random effects formulation of co-inheritance can improve the power substantially.

We apply the method to data from the Collaborative Study on the Genetics of Alcoholism. We compare our findings to previously published results.


Press Release: New A.A. Stories Speak Directly to Very Young Alcoholics

For Immediate Release

April 5, 2007 -

• “If I could have stayed cool, I’d still be drinking. Very quickly, though, I started getting into trouble. Going to sixth grade got in the way of my life, which consisted of getting drunk as much as possible.” [After rehab] “I was going to A.A. meetings. Everyone was older, even most of the kids at the young people meetings. But I found that alcoholics understand other alcoholics. . . . Regardless of how young or old or ‘special’ I am, in A.A. I’m just a drunk.” Tina, who joined A.A. at 13

• “I loved drinking and was as addicted to the lies, the shady people and places as I was to the alcohol. My grades suffered until I stopped going to school altogether. . . . I found myself in places without any idea of how I had gotten there. I overdosed on alcohol.” Since coming to A.A., “I have been given an opportunity to grow up with the Twelve Steps in my life. It is with utmost gratitude that I have just celebrated my 19th year of continuous sobriety.” Kevin, who joined A.A. at 14

NEW YORK CITY—Tina and Kevin are two of the 19 very young alcoholics who relate their experience as recovering alcoholics in a revised pamphlet just released by Alcoholics Anonymous: “Young People and A.A.” Eight recollections by early teen and preteen alcoholics are included in the new edition, which also contains most of the original stories by alcoholics 25 and under.


NEWS RELEASE: Drink driving – good progress in some countries, but others hold Europe back

17 April 2007, Brussels –

A new study published today under ETSC’s Road Safety Performance Index (PIN)(1) indicates that in Europe, improvements in drink driving contribute their share to enhancing road safety. However, in nine countries, insufficient progress on reducing drink driving deaths has slowed down overall improvement over the last decade.


Road Safety Performance Index (PIN) Flash 5 Reducing death from drink driving

Monday, April 16, 2007

Revolving Door for Addicts Adds to Medicaid Cost

Published: April 17, 2007

With grim humor, some doctors in New York call them “frequent fliers” — addicts who check into hospital detoxification units so often that dozens of them spend more than 100 nights a year in those wards.

Through its Medicaid program, New York spends far more than other states on drug and alcohol treatment, including more than $300 million a year paid to hospitals for more than 30,000 detox patients. One reason for the high cost is that $50 million is spent just on the 500 most expensive patients, at a cost of about $100,000 a person. These patients check in and out of detox wards, on average, more than a dozen times a year — a practice that experts say would not be tolerated in most states.



One in Four Hospital Patients Is Admitted With a Mental Health or Substance Abuse Disorder
Press Release Date: April 10, 2007

Almost one-fourth of all stays in U.S. community hospitals for patients age 18 and older—7.6 million of nearly 32 million stays—involved depressive, bipolar, schizophrenia and other mental health disorders or substance use related disorders in 2004, according to a new report by HHS' Agency for Healthcare Research and Quality.

This study presents the first documentation of the full impact of mental health and substance abuse disorders on U.S. community hospitals. According to the report, about 1.9 million of the 7.6 million stays were for patients who were hospitalized primarily because of a mental health or substance abuse problem. In the other 5.7 million stays, patients were admitted for another condition but they also were diagnosed as having a mental health or substance abuse disorder.

Nearly two-thirds of costs were billed to the government: Medicare covered nearly half of the stays, and 18 percent were billed to Medicaid. Roughly 8 percent of the patients were uninsured. Private insurers were billed for the balance. The study also found that one of every three stays of uninsured patients was related to a mental health or substance abuse disorder.

"Community hospitals play an important role in the treatment of people with mental health and substance abuse disorders," said AHRQ Director Carolyn M. Clancy, M.D. "This report gives health care policymakers an in-depth look at the impact of mental health and substance abuse care on the health care system."

Substance Abuse and Mental Health Services Administration Administrator Terry Cline, Ph.D., said, "The significant number of hospital stays related to mental health and substance use disorders signals the need for an increased national effort to identify and intervene early before the conditions require a hospital stay. Too often because of social stigma or lack of understanding, individuals and health care providers don't recognize the signs or treat mental health or substance use disorders with the same urgency as other medical conditions."

AHRQ found that most patients with mental health and substance abuse disorders were older. For example, although people age 80 and older comprised only 5 percent of the U.S. population in 2004, they accounted for nearly 21 percent of all hospital stays for these conditions—principally for dementia. There were also gender differences. The most frequent admitting diagnosis for women was mood disorders, while that for men was substance abuse.

AHRQ also found that patients who have been diagnosed with both a mental health condition and a substance abuse disorder—those with "dual diagnoses"—accounted for 1 million of the nearly 8 million stays. Nearly half of these cases with dual diagnoses involved drug abuse, a third involved alcohol abuse, and one in five involved both drug and alcohol abuse.

In addition, 240,000 women hospitalized for childbirth or pregnancy also had mental health or substance abuse problems. Four of every 10 of these patients were between 18 and 24 years of age.

Suicide attempts accounted for nearly 179,000 hospital stays. Of these, 93 percent involved a mental health condition—most commonly mood disorders—and/or substance abuse. Nearly three-quarters of these patients were between ages 18 and 44 and more than half were women. Poisoning, by overdosing prescription medicines or ingesting a toxic substance was the most common way patients attempted suicide.

The report is based on 2004 data—the latest currently available—from AHRQ's Healthcare Cost and Utilization Project Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of all short-term, non-federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured. For details, go to Care of Adults with Mental Health and Substance Abuse Disorders in U.S. Community Hospitals, 2004 at


The concentration-dependent effects of ethanol on Caenorhabditis elegans behaviour

The Pharmacogenomics Journal
advance online publication 27 February 2007;

The effects of ethanol on the brain are concentration dependent. Low concentrations (mM) intoxicate, while greater than 100 mM anaesthetize.

Of most relevance to human alcohol addiction are mechanisms of intoxication. Previously, Caenorhabditis elegans has been employed in genetic screens to define effectors of intoxication.

Here, we inform interpretation of these studies by providing evidence that ethanol rapidly equilibriates across C. elegans cuticle.

Thus, modelling intoxication in C. elegans requires exposure to external ethanol less than 100 mM.

Furthermore, the permeability of the cuticle to ethanol enables analysis of precisely controlled concentration-dependent effects of acute, chronic, and episodic ethanol exposure on behaviour.


Apolipoprotein E polymorphism, homocysteine serum levels and hippocampal volume in patients with alcoholism: an investigation of a gene–environment interaction

The Pharmacogenomics Journal advance online publication 10 April 2007;

There is growing evidence that disadvantageous influences of the apolipoprotein E4 allele in the central nervous system are modified by environmental and dietary conditions.

The present study investigated the gene–environment interaction of apolipoprotein E4 with homocysteine serum levels in patients with alcohol dependence with regard to alcohol-related hippocampal volume loss usng volumetric high-resolution magnetic resonance imaging.

The ApoE4 allele constitutes a risk factor for hippocampal volume loss in patients with alcohol dependence under the conditions of hyperhomocysteinemia. We suggest that the disadvantageous effects of apolipoprotein E4 on alcohol-related brain volume loss are based on certain gene–environment interactions.


Men who habitually consume alcohol more likely to have a sleep-related breathing disorder

WESTCHESTER, Ill. -- Increased usual alcohol consumption among men is associated with an increased risk of a mild or worse sleep-related breathing disorder (SRBD), according to a study published in the April 15th issue of the Journal of Clinical Sleep Medicine (JCSM).

The study, authored by Paul E. Peppard, PhD, and colleagues at the University of Wisconsin-Madison, focused on 775 men and 645 women, who were evaluated for alcohol consumption and a sleep-related breathing disorder. It was discovered that, relative to men who consumed less alcohol, for each increment of one drink per day, men who consumed more alcohol had 25 percent greater odds of a mild or worse SRBD.

Among women, minimal to moderate alcohol consumption was not significantly associated with an increased risk of an SRBD. According to Peppard, possible explanations for this include the limited range of alcohol consumption reported by women in the study sample, reducing the ability to detect clinically important moderate associations. Alternatively, added Peppard, women may be more resistant than men to threats to nocturnal respiratory stability. Such protection may be due to hormonally-mediated increased ventilatory drive, anatomical differences or other characteristics that may provide general protection for women from events of an SRBD, noted Peppard, adding that women, for example, appear to require relatively greater increases in body mass to demonstrate weight-related increments in an SRBD compared to men.

“Experimental evidence is fairly consistent in demonstrating acute effects of alcohol exposure on initiating or exacerbating an SRBD, perhaps by reducing upper airway patency via reduced dilatory muscle tone, or by blunted ventilatory response to hypoxia,” said Peppard. “Based on the previous experimental evidence, men and women with an SRBD, or those particularly susceptible to an SRBD, should be advised to avoid alcohol near bedtime.”

Association of Alcohol Consumption and Sleep Disordered Breathing In Men And Women
Journal of Clinical Sleep Medicine
Vol. 3 No. 2 pp. 265-270

Experimental evidence indicates that alcohol use near bedtime may exacerbate sleep disordered breathing (SDB).

In this population based epidemiology study, our objective is to measure the association of SDB with usual alcohol consumption habits.

In men, increased usual alcohol consumption was associated with increased risk of mild or worse SDB. Persons with SDB might benefit from generally reduced alcohol consumption and not just avoidance near bedtime.


Alcohol and Alcoholism 2007 42(2):113-118;

Medications, when combined with psychosocial therapy, can improve treatment outcomes in alcoholics; however, medications are not widely utilized in community-based addiction treatment centres. Of interest is how non-medical addiction treatment professionals in these facilities view adjunctive pharmacotherapies for alcoholism.

The present report focuses on baseline data collected during the course of an educational intervention project and explores predictors of positive attitudes about adjunctive pharmacotherapies among community addiction counselors and administrators.

These data support that more widespread use of adjunctive pharmacotherapy for alcoholism may be impeded by the fact that addictions counselors, who are often the first contact for treatment-seeking individuals, have a lack of knowledge and a lack of confidence in the effectiveness of such treatments. Directed educational interventions are warranted for this population.



Sunday, April 15, 2007


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The alcoholic lung: epidemiology, pathophysiology, and potential therapies
Am J Physiol Lung Cell Mol Physiol
292: L813-L823, 2007

Epidemiological evidence gathered only in the past decade reveals that alcohol abuse independently increases the risk of developing the acute respiratory distress syndrome by as much as three- to fourfold.

This review focuses on the epidemiology and the pathophysiology of alcohol-induced lung dysfunction and discusses potential new treatments suggested by recent experimental findings.