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, June 16, 2007

Identification of Candidate Genes for Alcohol Preference by Expression Profiling of Congenic Rat Strains
Alcoholism: Clinical and Experimental Research 31 (7), 1089–1098.
This study was undertaken to identify genes in the chromosome 4 QTL interval that might contribute to the differences in alcohol consumption between the alcohol-naïve congenic and background strains.
Analyses within individual brain regions that focused on genes within the QTL interval detected differential expression in all 5 brain regions; a total of 35 genes were detected in at least 1 region, ranging from 6 genes in the nucleus accumbens to 22 in the frontal cortex.
Analysis of the whole genome detected very few differentially expressed genes outside the QTL. Combined analysis across brain regions was more powerful.
Analysis focused on the genes within the QTL interval confirmed 19 of the genes detected in individual regions and detected 15 additional genes. Whole genome analysis detected 1 differentially expressed gene outside the interval.

Cis-regulated candidate genes for alcohol consumption were identified using microarray profiling of gene expression differences in congenic animals carrying a QTL for alcohol preference.
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Acute Ethanol Administration Rapidly Increases Phosphorylation of Conventional Protein Kinase C in Specific Mammalian Brain Regions in Vivo
Alcoholism: Clinical and Experimental Research 31 (7), 1259–1267.
The purpose of this study was to determine whether acute ethanol exposure alters phosphorylation of conventional PKC isoforms at a threonine 674 (p-cPKC) site in the hydrophobic domain of the kinase, which is required for its catalytic activity.

Immunohistochemical data show that the highest dose of ethanol (2 g/kg) rapidly increases p-cPKC immunoreactivity specifically in the nucleus accumbens (core and shell), lateral septum, and hippocampus (CA3 and dentate gyrus). Western blot analysis further showed that ethanol (2 g/kg) increased p-cPKC expression in the P2 membrane fraction of tissue from the nucleus accumbens and hippocampus.
Although p-cPKC was expressed in numerous other brain regions, including the caudate nucleus, amygdala, and cortex, no changes were observed in response to acute ethanol. Total PKCγ immunoreactivity was surveyed throughout the brain and showed no change following acute ethanol injection.

These results suggest that ethanol rapidly promotes phosphorylation of cPKC in limbic brain regions, which may underlie effects of acute ethanol on the nervous system and behavior.
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Alcohol Use Disorders Increase the Risk for Mechanical Ventilation in Medical Patients
Alcoholism: Clinical and Experimental Research 31 (7), 1224–1230.
The objective of this study is to determine whether the presence of AUD and the development of alcohol withdrawal are associated with an increased use and duration of mechanical ventilation in patients with medical disorders that commonly require intensive care unit admission.

In patients with medical diagnoses associated with intensive care unit admission, AUD increases the risk for mechanical ventilation while the development of alcohol withdrawal is associated with a longer duration of mechanical ventilation.
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Time Course of Elevated Ethanol Intake in Adolescent Relative to Adult Rats Under Continuous, Voluntary-Access Conditions
Alcoholism: Clinical and Experimental Research 31 (7), 1159–1168.
The purpose of the present study was to examine the time course and pattern of elevated ethanol intake during adolescence and the adolescent-to-adult transition, contrast this intake with ontogenetic patterns of food and water intake, and determine whether adolescent access to ethanol elevates voluntary consumption of ethanol in adulthood.
Ethanol consumption plateaued at approximately 7.5 g/kg/d during the first 2 weeks of measurement (i.e., P28–39) in early adolescence, before declining sharply at approximately P40 to levels that were only modestly elevated compared with adult-typical consumption patterns that were reached by approximately P70.
In contrast, intake of food and total calories showed a more gradual decline into adulthood with no distinguishable plateaus in early adolescence. When adolescent-initiated and adult-initiated animals were tested at the same chronological age in adulthood, animals drank similar amounts regardless of the age at which they were first given voluntary access to ethanol.

Taken together, these data suggest that the elevated ethanol intake characteristic of early-to-mid adolescence is not simply a function of adolescent-typical hyperphagia or hyperdipsia, but instead may reflect age-related differences in neural substrates contributing to the rewarding or aversive effects of ethanol, as well as possible modulatory influences of ontogenetic differences in sensitivity to novelty or in ethanol pharmacokinetics.
Voluntary home cage consumption of ethanol during adolescence, however, was not found to subsequently elevate ethanol drinking in adulthood.
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Cloninger’s typology and treatment outcome in alcohol-dependent subjects during pharmacotherapy with naltrexone
Addiction Biology (OnlineEarly Articles) 16 June 2007

Naltrexone is an opiate receptor antagonist mainly at the µ-receptor that is thought to reduce the positively reinforcing, pleasurable effects of alcohol and to reduce craving. An increase in time to first relapse to heavy drinking has been the most consistent finding obtained with naltrexone, although not all trials including two of the largest have been positive.

Inconsistent outcome data suggest that effectiveness varies among different subgroups of patients.

This paper re-evaluates recent data on the effectiveness of naltrexone in subjects differentiated according to Cloninger Type I and II. Moreover, it combines and cross-validates results of two recent European studies that found naltrexone treatment more beneficial in alcohol-dependent patients with early age at onset of drinking problems (Cloninger Type II).

It is discussed whether especially these subjects should be targeted for pharmacological relapse prevention treatment with naltrexone.

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There and Back Again: A Tale of Norepinephrine and Drug Addiction
Neuropsychopharmacology (2007) 32, 1433–1451

Fueled by anatomical, electrophysiological, and pharmacological analyses of endogenous brain reward systems, norepinephrine (NE) was identified as a key mediator of both natural and drug-induced reward in the late 1960s and early 1970s.

However, reward experiments from the mid-1970s that could distinguish between the noradrenergic and dopaminergic systems resulted in the prevailing view that dopamine (DA) was the primary 'reward transmitter' (a belief holding some sway still today), thereby pushing NE into the background.

In recent years new tools, such as genetically engineered mice, and new experimental paradigms, such as reinstatement of drug seeking following withdrawal, have propelled NE back into the awareness of addiction researchers.

The purpose of this review is to synthesize the new data linking NE to critical aspects of DA signaling and drug addiction, with a focus on psychostimulants (eg, cocaine), opiates (eg, morphine), and alcohol.

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Role of Endocannabinoids in Alcohol Consumption and Intoxication: Studies of Mice Lacking Fatty Acid Amide Hydrolase
(2007) 32, 1570–1582;

Endocannabinoid signaling plays the important role in regulation of ethanol intake. Fatty acid amide hydrolase (FAAH) is a key membrane protein for metabolism of endocannabinoids, including anandamide, and blockade of FAAH increases the level of anandamide in the brain.

To determine if FAAH regulates ethanol consumption, we studied mutant mice with deletion of the FAAH gene. Null mutant mice showed higher preference for alcohol and voluntarily consumed more alcohol than wild-type littermates. There was no significant difference in consumption of sweet or bitter solutions.

To determine the specificity of FAAH for ethanol intake, we studied additional ethanol-related behaviors. There were no differences between null mutant and wild-type mice in severity of ethanol-induced acute withdrawal, conditioned taste aversion to alcohol, conditioned place preference, or sensitivity to hypnotic effect of ethanol. However, null mutant mice showed shorter duration of loss of righting reflex induced by low doses of ethanol (3.2 and 3.4 g/kg) and faster recovery from motor incoordination induced by ethanol.

All three behavioral phenotypes (increased preference for ethanol, decreased sensitivity to ethanol-induced sedation, and faster recovery from ethanol-induced motor incoordination) seen in mutant mice were reproduced in wild-type mice by injection of a specific inhibitor of FAAH activity—URB597.

These data suggest that increased endocannabinoid signaling increased ethanol consumption owing to decreased acute ethanol intoxication.

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Alcohol use self-assessment: Rate your drinking habits is offering a new alcohol self-assessment tool to help people become better informed about their drinking habits. While the assessment can't diagnose an alcohol abuse problem, it can provide an understanding of alcohol consumption and information related to treatment.

Based on NIAAA guidelines, 2005, and Alcohol Use Disorders Identification Test (AUDIT), WHO, 2001 ©. Adapted by Mayo Foundation for Medical Education and Research with permission.

Mayo Clinic alcohol use self-assessment tool


Friday, June 15, 2007

Assessment and Treatment of Anxiety Disorders and Co-Morbid Alcohol Other Drug Dependency
Alcoholism Treatment Quarterly: Volume: 20 Issue: 1 Page Range: 45 - 59

Current models of assessment and treatment of co-morbid Axis I anxiety disorders and chemical dependency are examined.

Since the scope of this class of disorder is so heterogeneous, the most encountered disorders are discussed, including Post Traumatic Stress Disorder (PTSD); Panic Disorder (PD); Social Phobia; Generalized Anxiety Disorder (GAD); and Obsessive Compulsive Disorder (OCD).

Problems encountered in past approaches to this dual diagnosis population are explored. Proposals for methods of differential diagnosis, comprehensive assessment and various modalities of service delivery are made.

A discussion regarding current methodology liabilities and strengths follow a synopsis of current research.

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Breaking the Cycle of Alcohol Problems Among Native Americans: Culturally-Sensitive Treatment in the Lakota Community
Alcoholism Treatment Quarterly: Volume: 20 Issue: 1 Page Range: 19 - 44

This study explores methods of improving the treatment of alcoholism among Native American people by integrating culturally relevant practices into treatment methodology.

Primary to the findings of this study are the opinions and experiences of four Lakota people living on the Rosebud Reservation in South Dakota, individuals who have worked with alcoholism in their community for a number of years.

Also important is an understanding of the history of alcoholism among Native American people, including forms of cultural breakdown that lead to increased levels of alcohol problems.

Findings suggest that alcoholism treatment programs that integrate Native American culture and traditions into the recovery process will be more likely to be accepted by Native American alcoholics than mainstream rehabilitation programs that ignore cultural factors.

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Facilities Offering Special Treatment Programs or Groups

  • SAMHSA's National Survey of Substance Abuse Treatment Services (N-SSATS) provides information as to whether substance abuse treatment facilities offered special services. These special treatment services include specially designed treatment programs for adolescents, clients with co-occurring substance abuse and mental disorders, criminal justice clients, persons with HIV or AIDS, gays or lesbians, pregnant or postpartum women, adult women, adult men, seniors or older adults, and persons arrested for driving under the influence of alcohol or drugs (DUI) or driving while intoxicated (DWI).
  • A total of 13,371 substance abuse treatment facilities responded to the 2005 National Survey of Substance Abuse Treatment Services and 83% of them offered at least one special program or group addressing particular needs of specific client types.
  • The most commonly offered special program or group was for persons with co-occurring substance abuse and mental disorders (38%).
  • Facilities providing hospital inpatient care were the most likely to offer special programs for persons with co-occurring substance abuse and mental disorders (56%). They also provided special programs for adolescents (26%), and adult women (26%).
  • Facilities providing outpatient care were most likely to offer special programs or groups for persons arrested for driving under the influence of alcohol or drugs or driving while intoxicated (38%), persons with co-occurring substance abuse and mental disorders (38%), adolescents (36%), and adult women (33%).
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Congratulations to the EULAR Abstract Awardees

On Wednesday, EULAR will present 12 awards to the lead authors of six clinical and six basic science abstracts. This winners were selected by the EULAR scientific programme committee based on the quality of their abstracts’ scientific content. Each winner will receive 1,000 euros.

Henrik Källberg of the Karolinska Institutet, Stockholm, Sweden, will receive a clinical science award for his work on the link between alcohol consumption and RA risk. In a population-based, casecontrol study of 1,204 cases and 871 controls, researchers observed that consumption of three or more units per week of alcohol was tied to a decreased RA risk. Additionally, Mr. Källberg noted a dose-dependent relationship: The more alcohol consumed, the lower the RA risk. This protective effect persisted regardless of whether the RA patients were anti- CCP positive RA or anti-CCP negative. The investigators also found smoking and HLA-DRB1 SE alleles modified this link

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Alcoholics Anonymous and Church Involvement as Predictors of Sobriety Among Three Ethnic Treatment Populations
Alcoholism Treatment Quarterly: Volume: 20 Issue: 1 Page Range: 61 - 77

This study examines the impact of spirituality and religiousness, and involvement in Alcoholics Anonymous (AA) on sobriety among three ethnic groups, African Americans, Caucasians, and Hispanics.

Results indicated that among the three groups, African Americans, who described themselves as more religious, were less likely to substitute church attendance for participation in Alcoholics Anonymous.

African Americans reporting high AA attendance at the end of one year, in addition to church attendance, were more likely to report sobriety over the past 30 days than were those African Americans reporting only high church attendance.

Among Caucasians and Hispanics, participants reporting primarily high AA attendance were more likely to report past 30 day sobriety.

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Several studies indicate a suppression of the immune system by ethanol. In a recent study on mice (1), ethanol prevented development of destructive arthritis via effects of the NFB signalling pathways.

Epidemiological investigations on the effects of ethanol on RA are scarce and inconsistent, and there is a need for large epidemiological studies in order to elucidate whether ethanol consumption may influence also human arthritis development.

The aim of the present investigation was to study the relationship between alcohol consumption and risk of developing RA in total as well risk of developing subtypes of RA defined by presence or absence of antibodies toward citrullinated peptides (anti-CCP2), respectively, and also to investigate if potential associations are modified by smoking or HLA-DRB1 SE alleles.

Overall, an increased alcohol consumption (>3 units per week) was associated with a decreased risk of developing RA (OR 0.5, (95% CI 0.4 - 0.7)). There was evidence for a dose dependency; the more alcohol consumed the lower risk of RA. The estimated odds ratio associated with alcohol consumption was about the same regarding the risk of anti-CCP positive RA as the risk of developing anti-CCP negative RA. Furthermore, the association between alcohol consumption and RA was modified by both smoking, and HLA-DRB1 SE alleles.
The results from the present study indicate that ethanol consumption is associated with a protective effect in relation to risk of developing RA, and that this effect is independent of anti-CCP status. The study points to the needs to investigate mechanisms behind the protective effect of ethanol in both man and mice in order to both understand the effect of life style on RA, and to identify new targets for therapy.

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Alcohol Problems, Alcoholism and Spirituality: An Overview of Measurementand Scales

Alcoholism Treatment Quarterly: Volume: 20 Issue: 1 Pages 1-18

This paper presents a brief overview of current interest in the relationship of alcohol and other drug problems, addiction and religiousness/ spirituality.

Some basic issues involved in this area of assessment and scientific investigation are addressed. Brief reviews of several clinical and research instruments that may prove useful in addiction studies are presented.

Providing an overview of measurement issues and potential scales for use in research related to addiction and spirituality is seen as beneficial to interested researchers and treatment providers.

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Thursday, June 14, 2007

Drivers face big cut in drink limit and random tests

· Crackdown on alcohol-related road deaths
· European safety figures show UK falling behind

Dan Milmo, transport correspondent
Friday June 15, 2007
The Guardian

Drivers face a drastic reduction in the drink-drive limit and the introduction of random roadside breath tests in a government crackdown on alcohol-related road deaths.

Stephen Ladyman, the roads minister, said a cut in the alcohol limit for motorists from 80mg to the European average of 50mg could be introduced, limiting drivers to a half pint of beer or small glass of wine.

Speaking after the publication of a Europe-wide study which showed the UK falling behind France and Sweden in reducing road deaths, Mr Ladyman said a public consultation this year would propose a reduction in the drink-drive limit.
. . . . . .

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Cologne and antiseptic: Russia's killer drinks

Sarah Boseley, health editor and Luke Harding in Moscow
Friday June 15, 2007
The Guardian

  • Study reveals soaring toll among working-age men
  • ·Jobless alcoholics turn to cheap substitutes

Almost half of working-age men in Russia who die are killed by alcohol abuse, according to a new medical study which says the country's males die in excessive numbers not just because they drink lots of vodka but because they also consume products containing alcohol, such as eau de cologne, antiseptics and medicinal tinctures. Some products contain 95% alcohol by volume, equating to 200 proof.

An international group of scientists looked at a single city in the Urals to establish the effects of the drinking in Russia. Izhevsk was chosen for being a typical industrial city where life is much the same as elsewhere and where death rates match the Russian average.
. . . . . .

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Hazardous alcohol drinking and
premature mortality in
Russia: a population based case-control study

The Lancet 2007; 369:2001-2009 16 June 2007

The reason for the low life expectancy in Russian men and large fluctuations in mortality are unknown. We investigated the contribution of alcohol, and hazardous drinking in particular, to male mortality in a typical Russian city.

751 (51%) cases were classed as problem drinkers or drank non-beverage alcohol, compared with 192 (13%) controls. The mortality odds ratio (OR) for these men, compared with those who either abstained or were non-problematic beverage drinkers, was 6·0 (95% CI 5·0–7·3) after adjustment for smoking and education. The mortality ORs for drinking non-beverage alcohol in the past year (yes vs no) was 9·2 (7·2–11·7) after adjustment for age. Adjustment for volume of ethanol consumed from beverages lowered the OR to 8·3 (6·5–10·7), and further adjustment for education and smoking reduced it to 7·0 (5·5–9·0).

A strong direct gradient with mortality was seen for frequency of non-beverage alcohol drinking independent of volume of beverage ethanol consumed. 43% of mortality was attributable to hazardous drinking (problem drinking or non-beverage alcohol consumption, or both) adjusted for smoking and education.

Almost half of all deaths in working age men in a typical Russian city may be accounted for by hazardous drinking. Our analyses provide indirect support for the contention that the sharp fluctuations seen in Russian mortality in the early 1990s could be related to hazardous drinking as indicated by consumption of non-beverage alcohol.

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Tracking binge drinking among U.S. childbearing-age women
Preventive Medicine Volume 44, Issue 4, April 2007, Pages 298-302

The purpose of this analysis was to track the estimated prevalence of binge drinking for the years 2001–2003 among U.S. women of childbearing age in order to inform ongoing efforts to prevent alcohol-exposed pregnancies.

The estimated binge drinking prevalence among childbearing-age women 18–44 years for the years 2001, 2002, and 2003 was 11.9%, 12.4%, and 13.0%, respectively. The estimated number of childbearing-age women who engaged in binge drinking rose from 6.2 million in 2001 to 7.1 million in 2003, an increase of 0.9 million.

The results of this analysis provide support for enhancing efforts among healthcare providers to identify and intervene with childbearing-age women who engage in alcohol use that can increase their risks for various health problems, including an alcohol-exposed pregnancy.

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Preventing Alcohol-Exposed Pregnancies A Randomized Controlled Trial
Am J Prev Med 2007;32(1):1–10)

A randomized controlled trial (2002–2005; data analyzed 2005–2006) of a brief motivational intervention to reduce the risk of an alcohol-exposed pregnancy (AEP) in preconceptional women by focusing on both risk drinking and ineffective contraception use

This randomized trial found that a brief motivational intervention considerably decreased the risk of AEP in high-risk women by altering the targeted behaviors of risky drinking and ineffective contraception use. Although men in both intervention and control groups reduced their risk for an AEP by instituting changes in the targeted risk behaviors over the 9-month
follow-up, the odds of being at reduced risk for AEP were more than double in the group that received the Project CHOICES intervention compared to the control group.

Further, women receiving the intervention were more likely to adopt changes in both targeted behaviors simultaneously, thereby maximizing the likelihood of avoiding an AEP.

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State data on alcohol consumption rates
among women of childbearing age in 2005

Monitoring Alcohol Use Among Women of Childbearing Age

CDC monitors the prevalence of alcohol use among women of childbearing age in the United States using the Behavioral Risk Factor Surveillance System (BRFSS).

The BRFSS is an ongoing, state-based, random-digit – dialed telephone survey of adults 18 years of age or older. Data from the BRFSS are important for monitoring alcohol use patterns in women of childbearing age to assess and inform public health efforts to reduce alcohol-exposed pregnancies by identifying populations at increased risk and designing prevention programs aimed at reducing risk behaviors and improving pregnancy outcomes.

To determine the potential number of women at risk for an alcohol-exposed pregnancy, data from the BRFSS are analyzed for women 18 through 44 years of age in all 50 states. Women are asked about their use of alcohol during the 30 days before the survey. Three alcohol drinking patterns frequently are examined: any alcohol use (one or more drinks), binge drinking (five or more drinks on any one occasion)*, and frequent drinking (seven or more drinks per week and/or binge drinking).

These prevalence estimates vary from state to state and region to region. CDC publishes analyses of these data in peer reviewed journals and the Morbidity and Mortality Weekly Report (MMWR).

To view your state’s alcohol consumption rates among women of childbearing age in 2005, click here.

*In 2006, the definition of binge drinking for women was changed to four or more drinks on any one occasion


September 2007

SMART Recovery® now offers a distance training program for individuals interested in starting or facilitating an existing SMART Recovery F2F or online meeting within 3 months of training program completion.

The Meeting Facilitator Training Program is comprised of a combination self-study and Evoice voice on-line discussions, is available for those desiring to start a local SMART Recovery Meeting, and those desiring to volunteer within the SMART Recovery Online Community.
. . . . . .

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Examining the effect of perceived availability on craving for alcohol: A quasi-experimental approach

Addiction Research & Theory, Volume 15, Issue 3 January 2007 , pages 231 - 245

The impact of contextual cues in motivating alcohol and other drug use may be influenced by the perceived availability of the substance.

This study examined the relationship between perceived availability and alcohol cue reactivity using a quasi-experimental design that harnessed the legal age of alcohol availability in the United States.

The results indicated significant main effects of cue type, with alcohol cues eliciting significantly larger increases in subjective urge to drink and positive affect, as well as increased consumption of placebo alcohol. Moreover, a significant main effect of availability information was detected, with unavailability information generating a greater urge to drink.

Potential mechanisms underlying this effect and future directions are discussed.

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Time to change - an exploratory study of motivation among untreated and treated substance abusers

Addiction Research & Theory, Volume 15, Issue 3 January 2007 , pages 247 - 261

This exploratory study examines whether the attitudes towards change and treatment of untreated non-abstinent substance abusers differ from those of patients undergoing treatment in residential care.

The attitudes of the three groups - untreated, voluntarily and compulsorily treated subjects - differed with respect to lifestyle change. Factor analysis of the measures revealed one component of primary interest, general willingness to change.

Results show that willingness to change was correlated with other attitudinal characteristics in the three groups. The stability of substance abusers' motivation is discussed with the focus on different social contexts' influence on change-compliant attitudes and behaviour.

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Voices of sobriety: Exploring the process of recovery through patient testimonials
Addiction Research & Theory, Volume 15, Issue 2 2007 , pages 127 - 140

A qualitative content analysis was conducted in a Hungarian therapeutic community for substance abusers to explore processes of recovery and identify possible threats of relapse.

There are marked differences between the groups both in the emerging themes and in the sequential development of certain themes. Texts of recovering addicts are characterised by reflections on personal transformation experienced as a rite of passage and experiential knowledge on the care of self and spirituality while those who relapse often raise "profane" content and copy their fellows' speeches. Possible impact of these differences on recovery and relapse are discussed.

Results suggest that spirituality may have a major role in recovery.

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News Release - Bariatric surgery can make more people sensitive to alcohol, Stanford surgeon finds

June 14 , 2007

STANFORD, Calif. — An Oprah Winfrey-inspired study done by researchers at the Stanford University School of Medicine has found that patients who undergo gastric bypass surgery to lose weight will get drunk faster and take longer to get sober.

“It may sound strange, but Oprah really did inspire this study,” said John Morton, MD, MPH, assistant professor of surgery and senior author of the study, who presented the information June 14 at the annual meeting of the American Society for Bariatric Surgery. Referring to an episode of The Oprah Winfrey Show, Morton said, “After the Oprah show ‘Suddenly Skinny aired in October 2006, I got question after question from patients asking, ‘What happens when I drink alcohol?’”
. . . . . .

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Adolescents & Alcohol: Problems related to Drinking

Institute of Alcohol Studies
17 April 2007

This factsheets contains specific information on problems related to adolescents drinking alcohol.

The peak age for drunkenness convictions and cautions is 18 for both men and women. In 1995, under 18s accounted for 7% of all drunkenness convictions/cautions, and 18-21 year olds for 16% of the total. However, rates of convictions are difficult to interpret as they reflect police practices as much or more than the actual incidence of drunkenness. It is certain there is much more drunkenness among young people than the figures for convictions make it appear.

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Adolescents and Alcohol

Institute of Alcohol Studies
5 April 2007

In the interwar period in the UK young people aged 18-24 were the lightest drinkers in the adult population and the group most likely to abstain. Nor did alcohol play a significant part in the youth culture that came into existence in the 1950s, this being more likely to involve the coffee bar than the pub. It was not until the 1960s that pubs and drinking became an integral part of the youth scene. By the 1980s, those aged 18-24 years had become the heaviest drinkers in the population, and the group least likely to abstain.

By the year 2002, hazardous drinking i.e. drinking bringing the risk of physical or psychological harm now or in the future, was most prevalent inteenagers and young adults.

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By Jonathan Goodliffe, solicitor

Problem drinking may lead to financial problems for the drinker and those affected by his behaviour. In England 21% of adults have an alcohol use disorder likely to cause problems for them. 3.6% of adults are alcohol dependent (i.e. in common language they might be labelled "alcoholics")

Alcohol is a proven factor often causing or contributing to the occurrence of many risks against which insurance is commonly taken out. These include, for instance, death and ill health, crime, accidents (including motor accidents) and fire. There are other risks in relation to which a link with problem drinking has been suggested but has yet to be scientifically established. These include professional negligence and marine collisions.

Insurance can sometimes pay for treatment for the effect of alcohol misuse. It can help to meet the cost of alcohol related harm. Sometimes the insured may be encouraged to avoid alcohol problems, by risk management procedures required by the insurer or by the prospect of paying higher premiums if those procedures are not adopted.

Often alcohol related risks may be excluded from the scope of the cover. Sometimes the non-payment of an insurance claim is an alcohol problem in its own right. Nondisclosure of (among other things) problem drinking by the person applying for cover ("the proposer") may invalidate the insurance. Insurance can also be problematic when it contributes to dangerous behaviour by protecting people from the consequences, as when an alcoholic makes a suicide attempt believing that his family will be able to claim on his insurance.

This paper focuses on the non-disclosure issues whilst also touching other aspects of insurance's relationship with alcohol related risk. I hope to show that there are areas of common interest between the field of alcohol studies on the one hand and of insurance on the other. Focus on common ground may lead to the development of more constructive policies for the reduction of alcohol related harm, for the management of alcohol related risk and for the development of fairer sales techniques.

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Reducing the Harm Caused by Alcohol: A Coordinated European Response

Events : Conference details

With financial support from the European Commission

Tuesday 13 November 2007

Venue: Royal College of Physicians

Location: London

This one day conference, organised by the Royal College of Physicians, aims to bring together representatives of the medical professions from the United Kingdom and from Europe to share the latest evidence and experience and to agree and prod

Conference Organiser: Royal College of Physicians

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Development of a bibliography on religion, spirituality and addictions.
Drug Alcohol Rev 2007;26:389 - 395]

The aim of this study was to develop a comprehensive annotated public-domain bibliography of the literature on spirituality and addictions to facilitate future research and scholarship.

A search was conducted of all citations listed in the MEDLINE, PsychINFO and ALTA Religion databases covering a period from 1941 to 2004 using the following search terms: substance abuse, substance dependence, addiction, religion, spirituality.

The literature is voluminous, but has focused primarily in a few areas. Common findings included an inverse relationship between religiosity and substance use/abuse, reduced use among those practising meditation and protective effects of 12-Step group involvement during recovery.

Although sound instruments are available for measuring spirituality, studies have tended to use simplistic, often single-item measures.

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Wednesday, June 13, 2007

Prodynorphin gene promoter repeat associated with cocaine/alcohol codependence
Addiction Biology (OnlineEarly Articles). 8 June 2007

There is strong evidence for a genetic contribution to individual differences in vulnerability to drug addictions. Studies have shown that the 68-base pair repeat polymorphism in the promoter region of the human prodynorphin gene contains a putative AP-1 binding site, and that three or four repeat copies result in greater transcriptional activation.

The promoter region of the prodynorphin gene containing the repeat was amplified from genomic DNA by polymerase chain reaction and analyzed via gel electrophoresis. Statistical tests were performed with data stratified by the three major ethnic groups studied: African American, Caucasian and Hispanic.

For analyses, genotypes were grouped into short (1,1; 1,2; 2,2), short/long (1,3; 2,3; 1,4; 2,4) and long (3,3; 3,4; 4,4) repeats. Deviation from Hardy–Weinberg Equilibrium in the African American control group necessitated testing for association using grouped genotypes rather than grouped alleles. In controls, a significant difference was found in grouped genotype distribution among ethnicities.

We found a point-wise, but not experiment-wise across-ethnicities, significant difference in grouped genotype frequency between the cocaine/alcohol-codependent group and the controls in African Americans, with genotypes containing longer alleles found at higher frequency in the codependent group.

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Accumbens Homer2 Overexpression Facilitates Alcohol-Induced Neuroplasticity in C57BL/6J Mice

Neuropsychopharmacology advance online publication 13 June 2007;

Homer proteins are integral components of the postsynaptic density that are necessary for alcohol-induced neuroplasticity within the nucleus accumbens (NAC).

In this report, we describe the effects of chronic alcohol consumption upon NAC Homer expression and investigate the functional consequences of mimicking the alcohol-induced changes in Homer expression vis-à-vis alcohol-induced changes in NAC neurochemistry and behavior.

Chronic alcohol consumption under continuous access (3 months; daily intake 11.21.5 g/kg/day) produced a robust increase in NAC Homer2 protein levels that was apparent at 2 days, 2 weeks, and 2 months following withdrawal from alcohol drinking.

The increased Homer2 expression was accompanied by a less enduring elevation in total mGluR1 and NR2b levels that were evident at 2 days and 2 weeks but not at the 2-month time point. Mimicking the alcohol-induced increase in Homer2 levels by viral transfection of NAC neurons in alcohol-preferring C57BL/6J inbred mice enhanced behavioral output for alcohol reinforcement and increased alcohol intake under both preprandial and postprandial conditions. Moreover, NAC Homer2 overexpression facilitated the expression of an alcohol-conditioned place preference, as well as the development of motor tolerance.

Finally, NAC Homer2 overexpression facilitated NAC glutamate and dopamine release following an acute alcohol injection and augmented alcohol-induced dopamine and glutamate sensitization, but did not affect NAC -aminobutyric acid levels.

Thus, an upregulation in NAC mGluR–Homer2–N-methyl-D-aspartic acid receptor signaling appears to be an important molecular adaptation to alcohol that promotes neuroplasticity facilitating motivational drive for alcohol and the development of alcoholism-related behaviors.

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Stress-response-dampening effects of alcohol: Attention as a mediator and moderator.
Journal of Abnormal Psychology. 2007 May Vol 116(2) 362-377

The present study sought to characterize alcohol's stress-response-dampening (SRD) effects on multiple measures of stress and whether these effects are mediated by reductions in sustained attention and, further, whether baseline levels of sustained attention moderate SRD.

As hypothesized, differences in sustained attention partially mediated the effects of alcohol on skin conductance (but not heart rate or self-reported anxiety) and served as a moderator of alcohol's effects on skin conductance response.

Findings are discussed in terms of theoretical links among alcohol consumption, specific cognitive abilities, and stress reactivity.

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Nonnormality and divergence in posttreatment alcohol use: Reexamining the Project MATCH data "another way."

Journal of Abnormal Psychology. 2007 May Vol 116(2) 378-394

Alcohol lapses are the modal outcome following treatment for alcohol use disorders, yet many alcohol researchers have encountered limited success in the prediction and prevention of relapse. One hypothesis is that lapses are unpredictable, but another possibility is the complexity of the relapse process is not captured by traditional statistical methods.

Data from Project Matching Alcohol Treatments to Client Heterogeneity (Project MATCH), a multisite alcohol treatment study, were reanalyzed with 2 statistical methodologies: catastrophe and 2-part growth mixture modeling. Drawing on previous investigations of self-efficacy as a dynamic predictor of relapse, the current study revisits the self-efficacy matching hypothesis, which was not statistically supported in Project MATCH.

Results from both the catastrophe and growth mixture analyses demonstrated a dynamic relationship between self-efficacy and drinking outcomes. The growth mixture analyses provided evidence in support of the original matching hypothesis: Individuals with lower self-efficacy who received cognitive behavior therapy drank far less frequently than did those with low self-efficacy who received motivational therapy.

These results highlight the dynamical nature of the relapse process and the importance of the use of methodologies that accommodate this complexity when evaluating treatment outcomes.

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Tuesday, June 12, 2007

SAMHSA FASD Center for Excellence


What’s New From the SAMHSA FASD Center for Excellence
NOFAS Affiliates Summit, Hill Day and Leadership Awards Benefit: June 12-13, 2007
Second National Summit on Preconception Health and Health Care: October 29-31, 2007 _________________________________________________________________________________________________________________________

The SAMHSA FASD Center for Excellence has several new publications available on the Web site. The publications include:
Five “What You Need To Know” Fact Sheets:
The Physical Effects of Fetal Alcohol Spectrum Disorders
Adopting and Fostering Children With Fetal Alcohol Spectrum Disorders
Preventing FASD: Healthy Women, Healthy Babies
Effects of Alcohol on a Fetus
Effects of Alcohol on Women

The fact sheets can be accessed on the Grab and Go section under Fact Sheets and Brochures at

Two Family-Oriented Booklets:
My Sibling Has a Fetal Alcohol Spectrum Disorder. Can I Catch It?
What Do I Do? Helping Your Kids Understand Their Sibling’s Fetal Alcohol Spectrum Disorder

The booklets are available in print from NCADI. Ordering information can be accessed at

Native Resource Kit:
The materials in this kit have been specially designed for the needs of Native American communities. The kit can be accessed on the Grab and Go section under

Native Resource Kit at

Two New Courses:
FASD - The Course

This course provides an overview of risk factors for FASD, signs and symptoms, and prevention and treatment methods. It is designed primarily for health, mental health, and social service providers, educators, and other professionals who work with children, adolescents, and adults with an FASD. Parents, caregivers, and family members may also find it helpful

FASD—The Course can be accessed on the Education/Training section at

Curriculum for Addiction Professionals (CAP): Level 1 CAP 1 is intended for social workers, certified addiction counselors, psychologists, psychiatrists, and others in the treatment and recovery field. Parents, caregivers, and other family members may also find it helpful. Although the information in this curriculum pertains primarily to working with women and women with children in substance abuse treatment, some of the information also applies to adult men and adolescents in treatment programs.

You can access CAP 2 on the Education/Training section at

2. NOFAS will host their Affiliates Summit, Hill Day, and Leadership Awards Benefit on June 12-13, 2007 in Washington, D.C. The sixteen NOFAS Affiliates will meet on Tuesday, June 12 from 9:00 a.m. until 4:00 p.m. to feature current programs and set the coalition’s priorities. The fourth annual Hill Day will be held on Wednesday, June 13 beginning with a breakfast orientation leading into a full day of FASD constituent meetings with lawmakers and Congressional staff. The fifteenth annual awards reception hosted by United States Senator Lisa Murkowski and the Honorable Tom Daschle and Linda Hall Daschle (NOFAS founding members) will begin at 6:00 p.m. on Capitol Hill.

For more information about the events and to register, contact Tom Donaldson at or (202) 785-4585.

3. The Second National Summit on Preconception Health and Health Care will be held October 29-31, 2007 in Oakland, California. The Summit is being hosted by the Preconception Care Council of California, March of Dimes California Chapter, and the California Department of Health Services, in collaboration with the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA). Abstracts for oral or poster presentations, as well as proposals for special sessions, including case studies, are currently being accepted. The deadline for abstract and proposal submission is June 18, 2007.

For more information about the Summit, abstract and proposal submission, and to register, access the March of Dimes California Chapter’s Web site at The deadline for early registration is September 15, and the deadline for all registration is October15, 2007.

Contributor: Peggy Seo Oba