Column - Alcohol & Drug Abuse: Revisiting Employee Assistance Programs and Substance Use Problems in the Workplace: Key Issues and a Research Agenda
Psychiatr Serv 58:1262-1264, October 2007




This column describes employee assistance program EAPs) and identifies key issues for contemporary EAPs.

These programs began as occupational alcohol programs and have evolved into more comprehensive resources.

To better understand contemporary EAPs, the authors suggest a research agenda that includes descriptive studies to provide an up-to-date picture of services; investigations of how contemporary EAPs address substance use problems, including management consultation for early identification; further study of EAPs' effects on outcomes, such as productivity and work group outcomes; examination of the relationship between EAPs and other workplace resources; further examination of influences on EAP utilization; and development and testing of EAP performance measures.

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Request reprint E-Mail: merrick@brandeis.edu
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Predictors of injurious assault committed during or after drinking alcohol: a case-control study of young offenders
Aggressive Behavior Early View 5 October 2007


Studies of causal links between alcohol and aggression are often handicapped by threats to internal and external validity. Case-control methods employ an event-level analysis that can reduce some of these validity threats by the use of within-subject controls.

This study used a case-control approach, asking 39 male inmates in a Young Offenders' Institution to compare drinking behaviour before incidents where they reported commission of an injurious assault and a matched incident where they did not.

After controlling contextual differences, participants reported personally drinking more heavily and heavier drinking within their group, but not being more impaired when an assault was committed. The assault incidents were more likely to involve spontaneous, rather than planned, drinking and a higher proportion of males in the group. They were less likely to involve drinking in a pub.

Our confirmation of previous findings using a case-control methodology strengthens those findings. Limitations of this methodology are also discussed.

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Reprint Request E-Mail: s.brown2@derby.ac.uk
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Effects Of Moderate Sleep Deprivation and Low-Dose Alcohol On Driving Simulator Performance and Perception In Young Men
Journal SLEEP Volume 30/ Issue 10 - October 1, 2007; pp 1327-1333

To determine the combined effects of sleep restriction and low-dose alcohol on driving simulator performance, EEG, and subjective levels of sleepiness and performance in the mid-afternoon. These data indicate that combining low-dose alcohol with moderate sleep restriction results in significant decrements to subjective alertness and performance as well as to some driving performance and EEG parameters. This highlights the potential risks of driving after consumption of low and legal doses of alcohol when also sleep restricted.

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Request Reprint E-Mail: :Stuart.Baulk@unisa.edu.au

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The Interactive Effects of Extended Wakefulness and Low-dose Alcohol on Simulated Driving and Vigilance
Journal SLEEP Volume 30/ Issue 10 - October 1, 2007; pp 1334-1340


Sleep deprivation and alcohol both impair driving performance. This study assessed the interactive effect of low-dose alcohol and extended wakefulness.

The combination of legal low-dose alcohol and extended wakefulness results in impairment worse than that at an alcohol level known to increase accident risk. Avoiding alcohol when driving after extended wakefulness may reduce accident risk.

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Request Reprint E-Mail: mark.howard@austin.org.au

News Release - Early school success protects against teen and young adult drug use

ANN ARBOR, Mich.—Adolescents who do well in school are less likely to smoke, drink or do drugs. But which comes first: drug use or school failure?

Researchers at the University of Michigan Institute for Social Research (ISR) provide an answer in a new book. Patterns of educational success or failure are well established for most adolescents by the time they reach the end of eighth grade, while drug use has only begun to emerge by that time.

When more opportunities for substance use do emerge, students already doing well in school are less likely to engage in such behaviors, whereas those doing poorly are more likely to do so, the researchers say.
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Substance Use Treatment among Women of Childrearing Age

Highlights:

• Combined data from SAMHSA's National Surveys on Drug Use & Health conducted from 2004 to 2006 indicate that an annual average of 6.3 million women (9.4%) aged 18 to 49 needed treatment for a substance use problem.

• Of the women aged 18 to 49 who met criteria for needing substance use treatment in the past year, 84.2% neither received it nor perceived the need for substance use treatment. Only 5.5% of women in this age group had a perceived unmet treatment need (i.e., did not receive substance use treatment even though they thought they needed it).

• The reasons for not receiving substance use treatment among the women with an unmet treatment need were as follows: 36.1% were not ready to stop using alcohol or illicit drugs, 34.4% could not cover their treatment costs because of no or inadequate health insurance coverage, and 28.9% did not seek substance use treatment because of social stigma.

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ADH7 Variation Modulates Extraversion and Conscientiousness in Substance-Dependent Subjects.
Am J Med Genet Part B. Early View Online 4 October 2007



Human personality traits have been closely linked to substance dependence (SD), and are partially genetically determined. Recently, associations between alcohol dehydrogenase 7 (ADH7) and SD have been reported, which led us to investigate the relationship between ADH7 variation and personality traits.

We assessed dimensions of the five-factor model of personality and genotyped 4 ADH7 markers and 38 unlinked ancestry-informative markers in 244 subjects with SD [178 European-Americans (EAs) and 66 African-Americans (AAs)] and 293 healthy subjects (253 EAs and 40 AAs).

The present study demonstrated that the ADH7 variation may contribute to the genetic component of variation in personality traits, with the risk for SD and personality traits being partially shared.

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Reprint Request E-Mail: Xingguang.Luo@yale.edu
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Grant to aid drug, alcohol patients

UNION-TRIBUNE

October 5, 2007

San Diego County has received a $7.7 million grant to offer drug and alcohol screenings and treatment referrals to consenting patients at local hospitals.

The money, to be spent over three years, comes from two state agencies: the Substance Abuse and Mental Health Services Administration and the state Department of Alcohol and Drug Programs.

The idea is that patients seeking emergency care for health problems caused or worsened by alcohol or drug use might be more willing to join a treatment program than those at a police station, said Jennifer Schaffer, director of the county's Behavioral Health Services department.
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Changing Systems: Outcomes from the RWJF Reclaiming Futures Initiative on Juvenile Justice and Substance Abuse(Research Report)
Author(s): Jeffrey A. Butts, John Roman



Reclaiming Futures (RF) is an initiative of the Robert Wood Johnson Foundation (RWJF) that seeks to improve outcomes for drug-involved youth in the juvenile justice system. The first phase of Reclaiming Futures (2002–07) was a ten-site demonstration effort that relied on organizational change and system reform to improve substance abuse interventions for youthful offenders.

As part of a national evaluation of Reclaiming Futures, the Urban Institute and Chapin Hall Center for Children at the University of Chicago conducted biannual surveys in each community participating in the initiative. The surveys measured the quality of juvenile justice and substance abuse treatment systems as reported by expert informants in each community.

The pattern of their responses over six survey administrations (December 2003 to June 2006) suggests that RF is a promising strategy for improving substance abuse interventions for youth. Positive and significant changes were reported in all ten RF communities. In several communities, most quality indicators measured by the evaluation improved significantly during the course of the RF initiative.

Download Full Report (PDF)
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Press Release - CASA* RECEIVES $3 MILLION DOLLAR NIDA GRANT TO LAUNCH NEW TREATMENT MANAGEMENT SYSTEM WITH NEW YORK STATE SUBSTANCE ABUSE OFFICE

NEW YORK, NY,
October 4, 2007 –

The National Center on Addiction and Substance Abuse (CASA) at Columbia University and the New York State Office of Alcoholism and Substance Abuse Services (OASAS) have joined forces to create CASACCARE - Chronic Care Approaches to Recovery, a new approach to better help individuals struggling with the chronic disease of drug and alcohol abuse and addiction and to save taxpayers money.
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Euro-court throws out Swedish booze ban

Published: 4th October 2007

Sweden's ban on the private importation of alcohol breaches European law, the European Court of Justice has ruled.

The Swedish government had been taken to court by the European Commission, which claimed that the Swedish ban limited free trade.
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Thursday, October 4, 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. Attention Event Planners - Add Details From Your Event and Submit Photos! Congratulations to everyone who coordinated and/or participated in a Recovery Month event this September! We want to capture all of the events around the country so please click here to submit your pictures and videos. Be sure to add any comments from your event and send photos and any samples of materials. You can continue to post your events throughout the year. How to Tag PSAs for Local Use in Three Easy Steps To tag Recovery Month PSAs for local use, please complete the following steps: Click here to order Recovery Month PSAs. Follow the ordering instructions listed at the top of the page and request "Open-ended PSAs in Beta SP format." Once you receive your order, bring the PSAs to a local production company with a high-resolution logo for your organization and your phone number. Stories of Recovery September may be over, but recovery is a year long event to promote and celebrate! Just a few weeks ago, The "Stories of Recovery" video was shown during The White House Office of Faith-Based and Community Initiatives (OFBCI) White House Compassion in Action Roundtable, "Expanding the Substance Abuse Treatment Paradigm: Faith-Based and Community Partnerships Toward Recovery Support." The Roundtable was held on September 20, 2007 in the Eisenhower Executive Office Building in Washington, DC. View streaming video of "Stories of Recovery" (5 min) 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 www.recoverymonth.gov. ________________________________________________________________

BBC's Holby City criticised for binge drinking


By Nicole Martin, Digital and Media Correspondent

04/10/2007

The BBC has been accused of encouraging excessive drinking after an episode of its hospital drama Holby City showed two medics "necking" five tequila shots at the end of a stressful day at work.

The Portman Group, the regulatory body for the drinks industry, has complained to the television watchdog Ofcom and directly to the BBC about the "graphic and gratuitous portrayal of harmful drinking behaviour" in the show. The episode, broadcast at 8pm last month, featured a woman medic asking a barman to "line them up" before telling a male colleague, "neck these and come to mine".
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Inservice Training for Treatment Improvement Protocol (TIP) 42, Substance Abuse Treatment for Persons With Co-Occurring Disorders







The Substance Abuse Treatment for Persons With Co-Occurring Disorders Inservice Training manual is based on Treatment Improvement Protocol (TIP) 42. This inservice training manual introduces substance abuse treatment counselors and other practitioners to state-of-the-art treatment for people with both substance use and mental disorders. Participants will become familiar with the evidence-based knowledge presented in TIP 42 and learn how to apply that knowledge in their treatment practices.

Download Manual (PDF)

Contributor: Don Phillips
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Madison bar owners fixed prices, lawyer alleges

WED., OCT 3, 2007

RYAN J. FOLEY
Associated Press

Drinkers in Madison were wrongly cut off from two-for-one beer deals and cheap shots of liquor by bar owners who fixed their prices, a lawyer told the Wisconsin Supreme Court on Wednesday.

Lawyer Kay Hunt asked the justices to reinstate a lawsuit claiming a 2002 agreement by bars to ban drink specials on weekend nights was an illegal price-fixing conspiracy. Her Minneapolis law firm represents drinkers who claim they were overcharged as a result of the ban.

"Here you have a group of competitors that bound together to eliminate drink specials," she said. Their deal, she added, "constituted an unreasonable restraint of trade."
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News Release - New practitioner’s guide on continuous transdermal alcohol monitoring available

September 28, 2007



The Traffic Injury Research Foundation (TIRF) is pleased to announce the release of its second report on transdermal alcohol monitoring entitled, Continuous Transdermal Alcohol Monitoring: A Practitioner’s Guide. Transdermal technology is used to monitor alcohol consumption by measuring vaporous sweat excreted through the skin. It is currently being used in more than 40 U.S. States.
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Read Guide Executive Summary

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Herbal Mixtures Consisting of Puerarin and Either Polyenylphosphatidylcholine or Curcumin Provide Comprehensive Protection Against Alcohol-Related Disorders in P Rats Receiving Free Choice Water and 15% Ethanol in Pure Water
Journal of Medicinal Food. 2007, 10(3): 526-542.



This study describes possible therapeutic potency of puerarin (PU) from kudzu root, polyenylphosphatidylcholine from soy (SPCh), and curcumin (CU) from turmeric against alcohol's addiction-related and inflammatory-related abnormalities in alcohol-preferring P rats receiving free choice water and 15% ethanol in water.

PU suppressed the addiction-mediated abnormalities but did not affect the inflammation-related abnormalities, while SPCh or CU suppressed only the inflammation-related abnormalities in alcohol-drinking rats subjected to LPS-induced pleurisy.

A combination of PU with SPCh or CU suppressed both the addiction-related and inflammation-related abnormalities of alcohol drinking.

Therefore, a mixture consisting of PU and either SPCh or CU may provide alternative therapy for alcohol-related disorders.

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Reprint Request E-Mail: singh001@umn.edu
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The Influence of Alcohol on Basic Motoric and Cognitive Disinhibition
Alcohol and Alcoholism Advance Access published online on September 18, 2007

It has been proposed that alcohol weakens control processes, which in turn supports the occurrence of disinhibited behaviours.

Two studies were run, in parallel (both with 32 participants) using a between-subject design to investigate any disinhibiting effects of a moderate dose of alcohol (0.6 g/kg compared to placebo), previously found to trigger increased desire for alcohol.

The data suggest that a moderate dose of alcohol, which induces priming to want more alcohol, had disinhibiting effects both on a basic motoric and a cognitive inhibitory task.

Thus the idea that priming may be mediated by the disinhibitory effects of alcohol is supported.

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Request Reprint E-Mail: t.duka@sussex.ac.uk

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The prevalence and significance of substance use disorders in bipolar type I and II disorder
Substance Abuse Treatment, Prevention, and Policy 2007, 2:29 1 october 2007


The aim of this paper is to provide a systematic review of the literature examining the epidemiology, outcome, and treatment of patients with bipolar disorder and co-occurring substance use disorders (SUDs).

Prior epidemiological research has consistently shown that substance use disorders (SUDs) are extremely common in bipolar I and II disorders. The lifetime prevalence of SUDs is at least 40% in bipolar I patients. Alcohol and cannabis are the substances most often abused, followed by cocaine and then opioids. Research has consistently shown that co-occurring SUDs are correlated with negative effects on illness outcome including more frequent and prolonged affective episodes, decreased compliance with treatment, a lower quality of life, and increased suicidal behavior.

Recent research on the causal relationship between the two disorders suggests that a subgroup of bipolar patients may develop a relatively milder form of affective illness that is expressed only after extended exposure to alcohol abuse. There has been very little treatment research specifically targeting this population.

Three open label medication trials provide limited evidence that quetiapine, aripiprazole, and lamotrigine may be effective in treating affective and substance use symptoms in bipolar patients with cocaine dependence and that aripiprazole may also be helpful in patients with alcohol use disorders.

The two placebo controlled trials to date suggest that valproate given as an adjunct to lithium in bipolar patients with co-occurring alcohol dependence improves both mood and alcohol use symptoms and that lithium treatment in bipolar adolescents improves mood and SUD symptoms.

Given the high rate of SUD co-occurrence, more research investigating treatments in this population is needed. Specifically, double blind placebo controlled trials are needed to establish the effectiveness of medications found to be efficacious in open label treatments.

New research also needs to be conducted on medications found to treat either bipolar disorder or a SUD in isolation. In addition, it may be advisable to consider including patients with prior SUDs in clinical trials for new medications in bipolar disorder.

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Contributor: Don Phillips

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Association analysis of genes encoding the nociceptin receptor (OPRL1) and its endogenous ligand (PNOC) with alcohol or illicit drug dependence
Addiction Biology (OnlineEarly Articles). 2 October 2007


Recent studies in animal models have shown that the nociceptin system, comprising nociceptin (or OFQ/N, encoded by PNOC) and the nociceptin receptor (an opioid receptor-like protein encoded by OPRL1), may be involved in alcohol and other drug reward pathways.

To determine whether the nociceptin system is associated with alcohol or illicit drug dependence in humans, we analyzed 10 single nucleotide polymorphisms (SNPs) in OPRL1 and 15 SNPs in PNOC in a sample of 1923 European Americans from 219 multiplex alcohol dependent families ascertained by the Collaborative Study on the Genetics of Alcoholism.

The SNPs spanned both genes and several kb of their flanking sequences, and were in high linkage disequilibrium.

Neither gene was associated with alcohol or illicit drug dependence, although two SNPs in PNOC showed marginal association with alcoholism and one with illicit drug dependence.

Secondary analyses suggested that two adjacent SNPs in intron 1 of OPRL1 were marginally associated with opioid dependence; none of the SNPs in PNOC were associated with opioid dependence.

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Reprint Request E-Mail: xxuei@iupui.edu
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HPA-axis activity in alcoholism: examples for a gene-environment interaction
Addiction Biology (OnlineEarly Articles). 2 october 2007




Genetic and environmental influences are both known to be causal factors in the development and maintenance of substance abuse disorders.

This review aims to focus on the contributions of genetic and environmental research to the understanding of alcoholism and how gene–environment interactions result in a variety of addiction phenotypes.

Gene–environment interactions have been reviewed by focusing on one of the most relevant environmental risk factors for alcoholism, stress. This is examined in more detail by reviewing the functioning of the hypothalamic-pituitary-adrenal (HPA) axis and its genetic and molecular components in this disorder.

Recent evidence from animal and human studies have shown that the effects of stress on alcohol drinking are mediated by core HPA axis genes and are associated with genetic variations in those genes.

The findings of the studies discussed here suggest that the collaborations of neuroscience, psychobiology and molecular genetics provide a promising framework to elucidate the exact mechanisms of gene–environment interactions as seen to convene upon the HPA axis and effect phenotypes of addiction.

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Reprint Request E-Mail: g.schumann@iop.kcl.ac.uk
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October 02, 2007

Inside this Issue:

• Congress Passes Continuing Resolution to Fund Programs through November 16th; Senate Action on Labor-HHS Bill Expected After Columbus Day Recess

• House Ways and Means Committee Approves Paul Wellstone Mental Health and Addiction Equity Act of 2007

• Legislation with TANF Drug Testing Requirement Introduced in the House; Sanction Includes Loss of Benefits for Entire Family

• Gang Prevention Legislation Introduced in Congress; Bill Seeks to Improve Access to Education and Job Services for Young People in the Juvenile Justice System

• Legislation Aimed at Better Integrating Health Care Delivery Introduced in the House; Bill Includes Provisions for Addiction and Mental Health Treatment Services
  

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October 2007

vol. 8 issue 10

Binge Drinking Appears to be on the Rise in Mediterranean Countries Genetic Update: The Ankyrin Repeat & the Kinase Domain Containing 1 Gene may Influence Alcoholism Computerized Craniofacial Anthropometry Can Help Identify Patients with Fetal Alcohol Syndrome Mixing Energy Drinks with Alcohol Appears To Be Popular among Italian University Students

NIH Grant: Co-Occurring Mental Illness, Alcohol &/or Drug Abuse & Medical Conditions The Robert Wood Johnson Foundation Scholars in Health Policy Research Project is Now Accepting Applications

The NSDUH Report: Gender Differences in Alcohol Use & Alcohol Dependence or Abuse: 2004 & 2005

Institutos Nacionales de la Salud: Instituto Nacional Sobre el Envejecimiento

Reclaiming Futures Report: Families, Communities & Juvenile Justice Systems Help Teens in Trouble with Drugs, Alcohol & Crime NIDA Networking Project Continuing Education Credits are Now Available for National Center for PTSD Online Courses

October is Domestic Violence Awareness Month 21st Annual National Meeting on Alcohol & Other Drug Abuse & Violence Prevention in Higher Education - October 18th-21st American Association for the Treatment of Opioid Dependence National Conference - October 20th-24th American Public Health Association Annual Meeting & Exposition - Nov 3rd-7th

Online/Correspondence Course: Women & Chemical Dependency Online/Correspondence Course: Drug Treatment Courts - An Integrated Approach

Faces & Voices of Recovery - September 12, 2007 National GAINS Center eNews - September 2007 Northwest Frontier ATTC Addiction Messenger - Motivational Incentives Part 2: Reward Systems & Benefits - Vol. 10, Issue 8 (PDF)

National Daily News from Join Together

SPIRAL: Selected Patient Information Resources in Asian Languages NIDA: Scholastic - Heads Up: Real News About Drugs & Your Body ___________________________________________________________________

Fetal Alcohol Spectrum Disorders
Subcontractors Program
Request for Proposals

Proposals are requested from State agencies; juvenile courts; and local public, private, or tribal non-profit organizations. There will be full and open competition in each of these three categories: States, juvenile courts, and local communities.

Organizations will be asked to organize, implement, and evaluate programs that will either:

• Decrease the incidence of fetal alcohol spectrum disorders (FASD) by implementing evidence-based programs to eliminate alcohol consumption by pregnant women. The target audience will be pregnant women who drink or women of childbearing age in alcohol or substance abuse treatment;

or

• Improve the functioning and quality of life of people with an FASD and their families. This will be achieved by diagnosing those with an FASD and providing interventions based on the diagnosis.

Information about the request for proposals

Contributor: Peggy Seo Oba
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eNews- October 1, 2007

Rally for Recovery! Over 30,000 advocates for recovery came together at over 60 events across the country to Rally for Recovery! Congratulations to everyone who spent countless hours organizing and attending these exciting events that put a face and a voice on recovery. This year, Learn more… Mark Your Calendar! November 9 and 10 in Boston Our next media training, “Our Stories Have Power...A Media Workshop for Recovery Advocates” will be in Boston, MA on November 9 and 10. We’re collaborating with Massachusetts Organization for Addiction Recovery (MOAR) and the Addiction Technology Transfer Center of New England. You can register online October 5th and we will be sending out details to New England recovery advocates later this week. Congressional Action on Ending Insurance Discrimination The US House of Representatives and US Senate are moving forward to address the insurance discrimination faced by people with addiction and mental illness. The Paul Wellstone Mental Health and Addiction Equity Act, H.R. 1424, has been “reported out” or passed by the full House Ways and Means Committee, by a vote of 27 to 13. Learn more… America Honors Recovery awardees Congratulations to Faces & Voices board member Carol McDaid, Advisory Board member Donald J. Kurth, M.D.; and their fellow honorees Karen Casey-Elliott; Kitty S. Harris, Ph.D.; Benneth R. Lee; and Domingo Rodriguez for receiving the Johnson Institute’s annual award for their service to the recovery community. What is Recovery? There’s growing interest in understanding what we mean when we talk about recovery from addiction to alcohol and other drugs. Faces & Voices’ messaging and media training has given thousands of recovery advocates a way to talk with the public and policymakers about individual and family member experiences of long-term recovery from addiction. In 2005, SAMHSA’s Center for Substance Abuse Treatment (CSAT) held a Summit where a definition of recovery was developed. And in 2006, the Betty Ford Institute Learn more… Resources Faces & Voices National Field Director Tom Coderre can be heard on Rhode Island Public Radio’s This I Believe, speaking of the reality of long-term recovery from addiction. Addiction interview with William White. Thanks to Addiction for making its Conversation with William White (Volume 102, Issue 9, September 2007) available to recovery advocates. The 11-page interview traces Bill White’s involvement and engagement in making recovery a reality. TalkAboutAddiction.org is a new website launched by the state of Massachusetts as part of a public awareness campaign to address and reduce the stigma associated with addiction. The campaign focuses on five specific addictions: tobacco, alcohol, prescription drugs, illegal drugs and gambling. The website features "real life" testimonials from recovering addicts, facts designed to challenge common assumptions about addiction, and a variety of resources for individuals, healthcare professionals, employers, and other groups. Addiction and the Family: An Online Course for Faith Leaders is a new online course from the National Association for Children of Alcoholics. Learn more… Join Faces & Voices of Recovery today! Become member by lending your financial support to our growing recovery advocacy movement.

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Alcohol related crime down at UMass

October 2, 2007


AMHERST, Mass. (AP) - The University of Massachusetts at Amherst's annual safety report shows fewer arrests for illegal alcohol use at the campus in 2006.

Campus police say there were 227 arrests for liquor law violations, compared with 308 in 2005.

But the report also shows that the number of people reported to the dean of students for underage drinking increased to 1,009 from 836. Those students face university sanctions, but not criminal charges.
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Download 2007 Annual Safety Report (PDF)
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Does progressive stage transition mean getting better? A test of the Transtheoretical Model in alcoholism recovery
Addiction 102 (10), 1588–1596.

To test two central assumptions of stage movement in the Transtheoretical Model (TTM) vis-à-vis alcoholism recovery: (assumption 1) individuals making a forward transition to the action-oriented stages (i.e. preparation/action) will manifest relatively greater drinking improvements than their counterparts remaining in the pre-action stages (i.e. pre-contemplation, contemplation); and (assumption 2) individuals remaining in the pre-action stages across time will not demonstrate clinically relevant improvement in drinking outcomes.

Our findings challenge not only the criterion validity associated with stage movement in the TTM account of alcoholism recovery, but also recent TTM-based substance abuse treatment approaches which systematically promote forward stage transition as a primary clinical goal and marker of therapeutic success.

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Reprint Request E-Mail: russell_callaghan@camh.net
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The Amygdala Regulates the Antianxiety Sensitization Effect of Flumazenil During Repeated Chronic Ethanol or Repeated Stress
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles). 1 October 2007

The benzodiazepine receptor antagonist flumazenil reduces anxiety-like behavior and sensitization of anxiety-like behavior in various models of ethanol withdrawal in rodents. The mechanism and brain region(s) that account for this action of flumazenil remain unknown.

This investigation explored the potential role of several brain regions (amygdala, raphe, inferior colliculus, nucleus accumbens, and paraventricular hypothalamus) for these actions of flumazenil.

Intra-amygdala flumazenil inhibits the development of anxiety sensitized by repeated ethanol withdrawal, stress/ethanol withdrawal, or DMCM/ethanol withdrawal.

These actions suggest that site-specific and persistent effects of flumazenil on γ-aminobutyric acid-modulatory processes in this brain region are relevant to sensitized behavioral effects seen in alcoholism.

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Request Reprint E-Mail: djkjas@med.unc.edu

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Effect of DOV 102,677 on the Volitional Consumption of Ethanol by Myers’ High Ethanol-Preferring Rat
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles). 1 October 2007

Inhibitors of monoamine neurotransmitter transporters are well established as antidepressants. However, the evidence that single (serotonin) or dual (serotonin–norepinephrine) neurotransmitter uptake inhibitors can treat ethanol abuse, either as a comorbidity with depression or as a separate entity, is inconsistent.

Drugs that have, in addition, the ability to inhibit dopamine uptake may have an advantage in the treatment of alcohol abuse. Therefore, the inhibitor of norepinephrine, serotonin and dopamine uptake, DOV 102,677, was tested for its effects on the volitional consumption of ethanol by an ethanol-preferring rat strain.

DOV 102,677 significantly decreased the volitional consumption of ethanol with minimal alterations in the intake of food or on body weight in an ethanol-preferring rat strain, suggesting that triple reuptake inhibitors may find utility in treating alcohol abuse.

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Reprint Request E-Mail: mcmillenb@mail.ecu.edu

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Are Racial Disparities in Alcohol Treatment Completion Associated With Racial Differences in Treatment Modality Entry? Comparison of Outpatient Treatment and Residential Treatment in Los Angeles County, 1998 to 2000
Alcoholism: Clinical and Experimental Research (OnlineEarly Articles). 1 October 2007

To determine whether racial and ethnic disparities in publicly funded alcohol treatment completion are due to racial differences in attending outpatient and residential treatment.

Among these patients, African American and Hispanic patients were significantly less likely to complete treatment as compared with White patients. We found that the odds of being in outpatient versus residential care were 1.42 and 2.05 for African American and Hispanic alcohol treatment patients, respectively, compared with White patients. Adjusting for addiction characteristics, employment, other patient-level factors that might influence treatment enrollment, and unobserved facility-level differences through a random effects regression model, these odds increased to 1.89 for African American and to 2.12 for Hispanics.

We developed a conditional probability model to assess the contribution of racial differences in treatment modality to racial disparities in treatment completion. Estimates from this model indicate that were African American and Hispanic patients observed in outpatient care in this population to have the same probability of receiving residential care as White patients with otherwise similar characteristics, the White–African American difference in completion rates would be reduced from 13.64% to 11.09% and the White–Hispanic difference would disappear, changing from 2.63% to −0.45%.

It appears that reductions in racial disparities in treatment completion could be gained by increasing enrollment in residential alcohol treatment for African American and Hispanic alcohol abusers in Los Angeles County.

Further research addressing why minority alcohol abusers are less likely to receive residential alcohol treatment should be conducted, as well as research that examines why African American alcohol treatment patients have lower completion rates as compared with White patients regardless of treatment modality.

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Request Reprint E-Mail: rickyb@rand.org

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