To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.


Saturday, March 22, 2008

Exposure to the tsunami disaster, PTSD symptoms and increased substance use - an internet based survey of male and female residents of Switzerland
BMC Public Health 2008, 8:92

After the tsunami disaster in the Indian Ocean basin an Internet based self-screening test was made available in order to facilitate contact with mental health services. Although primarily designed for surviving Swiss tourists as well as relatives and acquaintances of the victims, the screening instrument was open to anyone who felt psychologically affected by this disaster.

The aim of this study was to evaluate the influences between self-declared increased substance use in the aftermath of the tsunami disaster, trauma exposure and current PTSD symptoms.

In women PTSD symptoms and degree of exposure, enlarged the odds of increased alcohol, pharmaceuticals and cannabis use significantly. In men the relationship was more specific: PTSD symptoms and degree of exposure only enlarged the odds of increased pharmaceutical consumption significantly. Increases in alcohol, cannabis and tobacco use were only significantly associated with the degree of PTSD symptoms.

The tsunami was associated with increased substance use. This study not only replicates earlier findings but also suggests for a gender specificity of post-traumatic substance use increase.

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Push to lift drink age to 21

Jason Dowling

March 23, 2008

RAISING the legal drinking age to 21 should be considered if attempts to curb dangerous levels of teenage drinking fail, according to the Government's top alcohol adviser.

Professor Jon Currie, chairman of the Victorian Drug and Alcohol Prevention Council, which will make recommendations soon on how the Brumby Government can deal with youth alcohol abuse, also indicated a controversial proposal to ban parents from serving alcohol to children other than their own could work in Victoria.
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Shops defy attempt to curb binge drinking

· Leak reveals bid to offset tax rise
· Supermarkets peg alcohol prices

  • The Observer,
  • Sunday March 23 2008
Shops are defying attempts by the government to clamp down on cheap alcohol and binge drinking, according to a leaked letter seen by The Observer

Alistair Darling, the Chancellor, raised taxes on beer, wine and spirits in his Budget following warnings from doctors that supermarkets and corner shops were selling drink too cheaply and irresponsibly. Rather than putting their prices up, however, stores are attempting to force suppliers to absorb the cost of the rise so that they can carry on aggressively price-cutting. Brewers which refuse to co-operate have been warned their contracts may not be renewed. Brewers pay the duty at source but would normally recoup the extra cost through the price they charge retailers.

A letter from one major off-licence chain to its suppliers, warns that the 'aggressive market we're all trading in' has put it under huge pressure. It says discounts in major supermarkets mean 'we are not confident the Budget will result in material increases in retail prices' or that the tax will be passed on to consumers. The letter from the Bargain Booze chain, which has 600 stores nationwide, continues: 'We will have to review the position of any brands where the retail ticket is increased in our business ... We regret to say that we cannot absorb the increases in costs that the Budget would seem to demand.' It asks suppliers to help 'by absorbing these increases within your own company'.
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Finding groups using model-based cluster analysis: Heterogeneous emotional self-regulatory processes and heavy alcohol use risk.
Developmental Psychology. 2008 Mar Vol 44(2) 481-495

Model-based cluster analysis is a new clustering procedure to investigate population heterogeneity utilizing finite mixture multivariate normal densities. It is an inferentially based, statistically principled procedure that allows comparison of nonnested models using the Bayesian information criterion to compare multiple models and identify the optimum number of clusters.

The current study clustered 36 young men and women on the basis of their baseline heart rate and heart rate variability (HRV), chronic alcohol use, and reasons for drinking. Two cluster groups were identified and labeled the high alcohol risk and normative groups.

Compared to the normative group, individuals in the high alcohol risk group had higher levels of alcohol use and more strongly endorsed disinhibition and suppression reasons for use. The high alcohol risk group showed significant HRV changes in response to positive and negative emotional and appetitive picture cues, compared to neutral cues.

In contrast, the normative group showed a significant HRV change only to negative cues.

Findings suggest that individuals with autonomic self-regulatory difficulties may be more susceptible to heavy alcohol use and use of alcohol for emotional regulation.

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Acting Surgeon General Kicks Off 1,600 Town Hall Meetings Throughout the Nation to Address the Underage Drinking Problem First Lady of Wyoming, Nancy Freudenthal, Will Host Kick-Off Meeting on Call to Action against Underage Drinking

Other Leaders Will Participate in Town Hall Meetings Nationwide

In response to the Surgeon General’s Call to Action to prevent and reduce underage drinking, more than 1,600 town hall meetings will take place all across the country in March and April 2008. These meetings are designed to raise awareness about new information on the public health risk that this problem poses as well as the steps that communities and individuals can take to combat and prevent it.

EVENT: National Kick-off: Town Hall Meeting to Address Underage Drinking Problem

WHO: Acting Surgeon General Rear Admiral Steven K. Galson, M.D., M.P.H.

First Lady of Wyoming, Nancy Freudenthal

The Honorable John Barrasso, U.S. Senator

WHEN: March 24, 2008, 6:30 pm

WHERE: Central Wyoming College

Arts Center

2660 Peck Avenue

Riverton, Wyoming 82501

Acting Surgeon General Rear Admiral Steven K. Galson, M.D., M.P.H., will join with the First Lady of Wyoming, Nancy Freudenthal, to kick off this nationwide effort at a Town Hall meeting in Wyoming on March 24, 2008. Special guest is the Honorable John Barrasso, who will speak on the topic. The meetings will provide greater insight into the nature and scope of the problem and steps for preventing it through reduced demand, availability and access. Parents and other concerned citizens will be given knowledge and tools to connect with today’s youth about the dangers of underage drinking.


Functional Interactions of Alcohol-sensitive Sites in the N-Methyl-D-aspartate Receptor M3 and M4 Domains
J. Biol. Chem., Vol. 283, Issue 13, 8250-8257, March 28, 2008

The N-methyl-D-aspartate receptor is an important mediator of the behavioral effects of ethanol in the central nervous system. Previous studies have demonstrated sites in the third and fourth membrane-associated (M) domains of the N-methyl-D-aspartate receptor NR2A subunit that influence alcohol sensitivity and ion channel gating.

We investigated whether two of these sites, Phe-637 in M3 and Met-823 in M4, interactively regulate the ethanol sensitivity of the receptor by testing dual substitution mutants at these positions.

A majority of the mutations decreased steady-state glutamate EC50 values and maximal steady-state to peak current ratios (Iss/Ip), whereas only two mutations altered peak glutamate EC50 values. Steady-state glutamate EC50 values were correlated with maximal glutamate Iss/Ip values, suggesting that changes in glutamate potency were attributable to changes in desensitization.

In addition, there was a significant interaction between the substituents at positions 637 and 823 with respect to glutamate potency and desensitization. IC50 values for ethanol among the mutants varied over the approximate range 100–325 mM. The sites in M3 and M4 significantly interacted in regulating ethanol sensitivity, although this was apparently dependent upon the presence of methionine in position 823.

Molecular dynamics simulations of the NR2A subunit revealed possible binding sites for ethanol near both positions in the M domains. Consistent with this finding, the sum of the molecular volumes of the substituents at the two positions was not correlated with ethanol IC50 values.

Thus, there is a functional interaction between Phe-637 and Met-823 with respect to glutamate potency, desensitization, and ethanol sensitivity, but the two positions do not appear to form a unitary site of alcohol action.

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Prenatal Alcohol Exposure: Foetal Programming, the Hypothalamic-Pituitary-Adrenal Axis and Sex Differences in Outcome
Journal of Neuroendocrinology 20 (4) , 470–488

Prenatal exposure to alcohol has adverse effects on offspring neuroendocrine and behavioural functions. Alcohol readily crosses the placenta, thus directly affecting developing foetal endocrine organs. In addition, alcohol-induced changes in maternal endocrine function can disrupt the normal hormonal interactions between the pregnant female and foetal systems, altering the normal hormone balance and, indirectly, affecting the development of foetal metabolic, physiological and endocrine functions.

The present review focuses on the adverse effects of prenatal alcohol exposure on offspring neuroendocrine function, with particular emphasis on the hypothalamic-pituitary-adrenal (HPA) axis, a key player in the stress response. The HPA axis is highly susceptible to programming during foetal and neonatal development.

Here, we review data demonstrating that alcohol exposure in utero programmes the foetal HPA axis such that HPA tone is increased throughout life. Importantly, we show that, although alterations in HPA responsiveness and regulation are robust phenomena, occurring in both male and female offspring, sexually dimorphic effects of alcohol are frequently observed.

We present updated findings on possible mechanisms underlying differential effects of alcohol on male and female offspring, with special emphasis on effects at different levels of the HPA axis, and on modulatory influences of the hypothalamic–pituitary–gonadal hormones and serotonin.

Finally, possible mechanisms underlying foetal programming of the HPA axis, and the long-term implications of increased exposure to endogenous glucocorticoids for offspring vulnerability to illnesses or disorders later in life are discussed

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The ethanol response gene Cab45 can modulate the impairment
elicited by ethanol and ultraviolet in PC12 cells
Journal of Genetics and Genomics 2008 35 (3): 153-161

High consumption of ethanolic beverages facilitates neurodegeneration, but the mechanism of this process still remained elusive.

Sup-pression subtractive hybridization (SSH) is a technique for detection of rare transcripts. With SSH approach, we identified one ethanol response gene Cab45, which was down-regulated by ethanol with time-dependent manner in B104 cells.

The full-length sequence of Cab45 gene was obtained by 5′-RACE (5′Rapid Amplification of cDNA Ends) for the first time in rat. Based on the sequence of deduced amino acid of rat Cab45, the alignment was conducted with its counterparts in different species and displayed a high conservation. Using different tissues in rat and cell lines, Cab45 was characterized by a ubiquitous expression and differentiation dependent down-regulation.

Given that ethanol facilitates some cell differentiation, we hypothesize that Cab45 is involved in ethanol-mediated differentiation. With transient transfection, the function of Cab45 was investigated by up-regulation and down-regulation in PC12 cells. Ethanol treatment and UV exposure were conducted subsequently and cell proliferations were detected by MTT (Methyl Thiazolyl Tetrazolium) approach.

It revealed that the up-regulation of Cab45 modulated the impairment elicited by ethanol and UV in transfected cells.

As a member of new calcium binding protein family, the exact role of Cab45 still remains unclear.

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Friday, March 21, 2008

Women targeted in drink campaign

By Toby Helm, Public Policy Editor and Rebecca Smith, Medical Editor

Middle-aged women will be targeted in a hard-hitting anti-alcohol campaign after research found that just one large glass of wine per night could increase the risk of breast cancer by 60 per cent.

Up to 2,000 women every year die from breast cancer linked to drinking, with a growing number also suffering other cancers, liver damage and fertility problems.

Rising levels of alcohol consumption, particularly among the middle classes, have been blamed in part on an increase in the strength of many wines and a fashion for larger glasses, leading to confusion over how many units of alcohol each glass contains.

The Government has responded with a £10 million advertising campaign that aims to educate women about the health risks of drinking and the need to be aware of how much alcohol they are consuming.
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Plan to raise age limit for alcohol sales wins praise

March 22, 2008

Campaigners yesterday praised the Scottish Government for its "courage" in considering radical new plans to tackle alcohol abuse by upping the age limit.

However, representatives of the licensed trade industry said the proposals to raise the legal drinking age from 18 to 21, revealed in The Herald yesterday, were naive and unworkable.

The Scottish Government confirmed last night it is considering the move as part of a package to be unveiled later this year.
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Chronic ethanol exposure leads to divergent control of dopaminergic synapses in distinct target regions
Alcohol Article in Press, Corrected Proof 20 March 2008

Neuroadaptations following chronic exposure to alcohol are hypothesized to play important roles in alcohol-induced alterations in behavior, in particular increased alcohol drinking and anxiety like behavior.

Dopaminergic signaling plays a key role in reward-related behavior, with evidence suggesting it undergoes modification following exposure to drugs of abuse. A large literature indicates an involvement of dopaminergic signaling in response to alcohol.

Using a chronic inhalation model of ethanol exposure in mice, we have begun to investigate the effects of alcohol intake on dopaminergic signaling by examining protein levels of tyrosine hydroxylase and the dopamine transporter, as well as monoamine metabolites in three different target fields of three different dopaminergic nuclei.

We have focused on the dorsal lateral bed nucleus of the stria terminalis because of the reported involvement of dorsal lateral bed nucleus of the stria terminalis dopamine in ethanol intake, and the nucleus accumbens and dorsal striatum because of their dense dopaminergic innervation.

After either a chronic intermittent exposure or continuous exposure regimen, mice were killed, and tissue punches collected from the dorsal lateral bed nucleus of the stria terminalis, nucleus accumbens, and striatum for Western analysis.

Strikingly, we found divergent regulation of tyrosine hydroxylase and dopamine transporter protein levels across these three regions that was dependent upon the means of exposure.

These data thus suggest that distinct populations of catecholamine neurons may be differentially regulated by ethanol, and that ethanol and withdrawal interact to produce differential adaptations in these systems.

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Dissociable effects of ethanol consumption during the light and dark phase in adolescent and adult Wistar rats
Alcohol Volume 42, Issue 2, March 2008, Pages 83-89

In adolescence, high levels of drinking over short episodes (binge drinking) is commonly seen in a proportion of the population. Because adolescence is an important neurodevelopmental period, the effects of binge drinking on brain and behavior has become a significant health concern.

However, robust animal models of binge drinking in rats are still being developed and therefore further efforts are needed to optimize paradigms for inducing maximal self-administration of alcohol.

In the present experiment, 1-h limited-access self-administration sessions were instituted to model excessive drinking behavior in adolescent and adult Wistar rats. In addition to age, the involvement of sex and phase within the light/dark cycle (i.e., drinking in the light or dark) on sweetened 5% ethanol intake were also evaluated over 14 limited-access sessions using a between-groups design.

The results of the experiment showed that over 14 limited-access sessions, sweetened ethanol intake (g/kg) was significantly higher for adolescents compared to adults. Females were also found to drink more sweetened ethanol as compared to males.

Additionally, drinking in the light produced a robust increase in sweetened ethanol intake (g/kg) in adolescents, as compared to adults during the light phase and as compared to both adolescent and adult rats drinking in the dark. Furthermore, the increase in ethanol consumption observed in adolescents drinking during the light phase was dissociable from sweetened solution intake patterns.

These results identify that age, sex, and time of day all significantly influence consumption of sweetened ethanol in Wistar rats.

Knowledge of these parameters should be useful for future experiments attempting to evaluate the effects of self-administered ethanol exposure in adult and adolescent rats.

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Association study of dopamine D2, D4 receptor gene, GABAA receptor β subunit gene, serotonin transporter gene polymorphism with children of alcoholics in Korea: A preliminary study
Alcohol Volume 42, Issue 2, March 2008, Pages 77-81

The studies on the genetic risk factors of the children of alcoholics (COAs) are still in an early stage. The A1 allele of the dopamine receptor 2 gene (DRD2) may be associated with positive alcohol expectancy of the COAs. In addition, several researchers reported that the COAs might be associated with the GABAA receptor β3 subunit gene (GABRB3) and serotonin transporter gene (5-HTTLPR).

In this study, we investigated the association of the polymorphism of the DRD2, Dopamine D4 receptor gene (DRD4), GABRB3, 5-HTTLPR with the COAs.

Twenty-two COAs and 23 age and sex-matched control children were included for the genetic study (children of nonAlcoholics; nonCOAs). All COAs aged 6–18 were recruited and selected from family of alcoholic patients in Alcohol Clinic of the University hospital.

The genotyping of the DRD2, DRD4, GABRB3, 5-HTTLPR was carried out. We used the Chi-square method for evaluating the association of genetic polymorphic allelic status with the COAs.

The frequency of the A1+ allele at DRD2 in the COAs was significantly higher than nonCOAs. Significant association between the genotype at DRD4 and the COAs was found.

The G1− alleles of the GABRB3 in COAs were significantly higher than nonCOAs.

However, no association of the polymorphic alleles of the 5-HTTLPR with the COAs was found.

We found that the children of alcoholics had a significantly increased number of risk alleles of candidate genes of alcohol drinking expectancy. Despite of several limitations, this study provides some preliminary information on the risk and protective factors associated with the COAs, which can be used as a foundation for prevention and intervention of future psychopathology.

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Are treated alcoholics representative of the entire population with alcohol use disorders? A magnetic resonance study of brain injury
Alcohol Volume 42, Issue 2, March 2008, Pages 67-76

Almost all we know about neurobiological brain injury in alcohol use disorders has been derived from convenience samples of treated alcoholics. Recent research has demonstrated more comorbid conditions, poorer psychosocial functioning, and higher dependence levels in treated alcoholics than in their treatment-naive counterparts.

Thus, it is not clear whether neuroimaging results from convenience samples of treated alcoholics can be generalized to the entire population with alcohol use disorders.

We compared 35 treated alcoholics at 1 week of abstinence (ALC) and 32 treatment-naive heavy drinkers (HD) on regional brain volumes and metabolite concentrations obtained by in vivo magnetic resonance at 1.5 Tesla to evaluate for potential group differences. Then, we evaluated whether comorbid cigarette smoking and common demographic and clinical variables mediated any existing neurobiological group differences.

ALC demonstrated smaller lobar gray matter volumes and thalami than HD, exacerbated by chronic smoking. Furthermore, concentrations of N-acetyl-aspartate (an accepted marker of neuronal viability), choline-containing metabolites (involved in membrane turnover), and myo-inositol (a putative marker of glial cells and osmolyte) were lower in multiple brain regions of ALC compared to HD. The lower N-acetyl-aspartate concentrations in white matter of ALC versus HD were explained by average number of drinks per month over the year preceding study. However, the other group differences were not explained by common drinking, demographic, and clinical variables (used as covariates at the same time) or by excluding participants with comorbid mood disorders.

Taken together, this suggests that the degree of brain atrophy, as well as neuronal and membrane injury in clinical samples of alcoholics cannot be generalized to the much larger population with alcohol use disorders that does not seek treatment.

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Advertisers and alcohol industry prepare for inquiry showdown

Julian Lee

March 20, 2008

THE marketing industry's peak bodies have unveiled how they plan to meet the biggest threat to the industry since the fast food advertising debate of recent years.

As a senate inquiry into alcohol advertising begins, the industry will mount a two-pronged approach, with the advertising agency peak body concentrating its efforts on talking up self-regulation for the $12 billion a year alcohol industry.

In its submission to a senate inquiry, its counterpart for advertisers will seek to attack claims that there is a link between advertising and excessive consumption of alcohol.
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Editorial - Pushing 'Alcopops'
A bad bill in Annapolis would promote teen drinking.
March 21, 2008 pg. A16

LIKE THE fruity-flavored, alcohol-laced beverages that appeal so much to the under-21 set, a bill making its way through the Maryland legislature this week may seem non-threatening but could lure more illegal novice drinkers to dangerous habits. As it is, teens are getting their hands on "alcopops" -- also called "flavored malt beverages" and "malternatives" -- thanks in large part to a current practice, which treats these drinks for sales distribution and tax purposes as beer rather than distilled spirits. The result is lower prices and easier access for underage drinkers.

That's the way the industry likes it, but Maryland Attorney General Douglas F. Gansler has issued an opinion that, under state law, these drinks are distilled spirits and should be taxed and distributed as such. The action has prompted an end-around by state lawmakers cozy with the beer and liquor industry, including Democratic Senate President Thomas V. Mike Miller Jr. (D-Calvert). Their bill, passed by the Senate yesterday and now before the House, would formally define the drinks as beer, which would keep the drinks teen-friendly.

The proposed definition is blatantly dishonest. Findings by the U.S. Alcohol and Tobacco Tax and Trade Bureau show that most of the alcohol in these flavored drinks is derived from distilled spirits. As for taxes, which generally get passed along to the buyers, the Maryland tax rate for beer is 9 cents a gallon; for distilled spirits it's $1.50 a gallon. For a six-pack, the beer tax is a nickel, but the distilled spirits tax would be 84 cents. It's well established that entry-level drinkers are sensitive to such price differences. Then there's the loss of tax revenue in a bad year for the state budget.

Ease of access to these sweet but loaded beverages -- which are cutely disguised as cola, lemonade, iced tea or fruit punch -- also depends on how they are classified. Distilled spirits can be sold only by holders of retail liquor licenses. When classified as beer, the alcohol-flavored beverages can be sold by any location holding a beer license -- convenience stores and other spots more likely to be frequented by young people. True, underage consumption of any alcohol is already against the law, and, yes, kids can find older buyers to get any drink. But why increase the ease of access? Maryland lawmakers should reflect on that question before the final vote on this bad bill.


Thursday, March 20, 2008

By Now, "Harm Reduction" Harms Both Science and the Public Health
Clinical Pharmacology & Therapeutics (2008); 83, 4, 513–514

There are few terms used in both the science and the public policy of drug abuse and addiction that are fuzzier or more controversial than "harm reduction." The most straightforward use of the term refers to public health or social policy strategies designed to reduce the negative consequences of drug abuse and addiction to an individual, his or her family, or the broader community in which addicted individuals live. For other people, however, "harm reduction" has over time become distorted into a euphemism for policies and programs that could increase drug use, such as legalization or decriminalization of drug activities. This ambiguity, coupled with the paucity of clear data on the effectiveness of most harm-reduction strategies, has led many people to hold—often with almost religious fervor—very strong positions for or against "harm reduction," however it is conceptualized. That ideology has prevented important science from being done and prevented the implementation of potentially successful social and public health strategies. This suggests that the term should be expunged from the jargon of our fields. It has taken on ideological meanings that get in the way of dealing successfully with serious drug problems around the world.
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Addiction: Damping down alcohol dependence
Nature Reviews Neuroscience 9, 251 (April 2008)

Stress is a well-known trigger of alcoholism relapse in susceptible individuals, and it has been suggested that neural systems that mediate behavioural stress responses could be targets for pharmacotherapy of alcoholism. Now, Heilig and colleagues demonstrate that antagonism of neurokinin 1 receptor (NK1R; also known as TACR1) — a receptor that is highly expressed in brain areas involved in stress responses and brain reward — effectively reduces alcohol cravings.

Previous studies have shown that genetic deletion or pharmacological blockade of NK1R dampens behavioural responses to psychological stressors. So, the authors proposed that modulation of NK1R signalling may also influence stress- and reward-related processes that are important for excessive alcohol use and relapse.
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A Pan-European Programme Promoting Responsibility
and Moderation in Wine Consumption

The WINE in MODERATION Programme is an initiative of the European wine sector aimed at promoting moderation and responsibility in wine consumption and contributing towards preventing excessive consumption and misuse of alcoholic beverages in Europe.

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Wednesday, March 19, 2008

Disordered eating and substance use in high-school students: Results from the Youth Risk Behavior Surveillance System
International Journal of Eating Disorders Early View 17 Mar 2008

To examine the association between disordered eating (fasting, diet product use, and vomiting or laxative use) and use of 10 substances (cigarettes, alcohol, marijuana, cocaine, inhalants, heroin, methamphetamines, ecstasy, steroids, and hallucinogens) in a nationally representative adolescent sample.

Disordered eating was significantly associated with the use of each substance. Using effect size estimates that take base rates into consideration, for female students, associations between substance use and disordered eating were weak for all but three forms of substance use: current smoking, binge drinking, and inhalants. Among male students, strong (marijuana, steroids, and inhalants) or moderate effects (all other substances) were observed.

Future research needs to focus on inhalant use and methamphetamine use in males. Increased medical attention should be directed toward adolescents who practice disordered eating behaviors because they are also at elevated risk for using cigarettes, alcohol, inhalants, methamphetamines, and steroids

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Men’s and Women’s Patterns of Substance Use Around Pregnancy
Birth Issues in Perinatal Care Volume 35 Issue 1 Page 50-59, March 2008

Little is known about men’s patterns of substance use around their partner’s pregnancy, despite evidence from studies of pregnant women that men’s substance use may reduce women’s ability to desist from substance use during pregnancy, increase the probability that women will return to use postpartum, and increase the risk of adverse child outcomes.

The purpose of this study was to describe the association between pregnancy or partner’s pregnancy and month-by-month patterns of binge drinking, daily smoking, and marijuana use among young men and women.

Births during the calendar period were reported by 131 women and 77 men. Hierarchical generalized linear modeling analyses showed that men’s rates of binge drinking and marijuana use were unaffected by their partner’s pregnancy. Pregnancy decreased the probability of substance use among women, but use returned to prepregnancy levels within 2 years postpartum.

Men’s substance use was not affected by their partner’s pregnancy. Pregnancy decreased the probability of substance use among women, but substantial proportions of women users of cigarettes and marijuana used these substances during pregnancy. Many of the women who desisted from substance use while pregnant returned to use after their child was born.

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Drinking and Driving 2007: Prevalence, Decision Making and Attitudes
- Scottish Government - March 2007

  • While much progress has been made in the field of drink-driving, road safety statistics and conviction statistics show that the area still requires further work. In 2007, the Scottish Government commissioned research from TNS System Three into this issue. This followed on from research on this topic carried out on 2001 ( NFO, 2001) and was designed to allow comparisons to be made over time.
  • Both quantitative research, in the form of a survey of a representative sample of 1034 current drivers in Scotland, and qualitative research, in the form of 6 focus groups and 6 depth interviews with those who admitted to driving after consuming alcohol, was undertaken. The purpose of the research was to measure prevalence of driving after consuming alcohol, both within and above the legal limit, and to provide insight into attitudes to drink-driving and the thought process behind the decision either to do or not to do so.
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The DASIS Report: Employment Status and Substance Abuse Treatment Admissions, 2006


  • Of the substance abuse treatment admissions aged 18 to 64 reported to SAMHSA's Treatment Episode Data Set (TEDS), 31% in 2006 were employed full- or part-time at the time of admission, 33% were unemployed, and 36% were not in the labor force (i.e., not employed and not looking for work).
  • Full time employed substance abuse treatment admissions were more likely to report alcohol as their primary substance of abuse (58%) than substance abuse treatment admissions who were homemakers (35%), unemployed (39%), labor force dropouts (39%), or disabled (46%).
  • Substance abuse treatment admissions who were labor force dropouts were more than twice as likely as admissions who were employed full time to report daily use of their primary substance in the past month (56% vs. 26%).
Substance abuse treatment admissions who were homemakers (59%) or who were employed full time (57%) were more likely to report entering treatment for the first time than admissions who were unemployed (40%), labor force dropouts (47%), or disabled (41%)

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Tuesday, March 18, 2008

Leading questions
Jean Collingwood, chief executive, Drinkaware Trust
  • Interview by Alexandra Topping
  • Wednesday March 19 2008
What is the aim of the Drinkaware Trust?

To positively change the UK drinking culture and minimise and reduce alcohol-related harm.

What challenges do you face?

The biggest challenge is getting Britain's drinkers to take stock of their own attitudes toward alcohol, encouraging them to be more personally responsible. This needs a large-scale cultural shift because of the unique relationship Britain has with alcohol, which for centuries has been a major part of our lives and part of our societal DNA.

Why is the work of the trust important?

The long-term harm caused by alcohol misuse is significant, so our work in educating consumers is very important.

Do you think there is an alcohol crisis?

Sensationalism in the media is not helpful, simply because most of the public would struggle to identify what constitutes binge drinking. Young people, in particular, seem to be associated with the "crisis" we are facing, but we must recognise that peer pressure and social anxiety are key drivers in their approach to alcohol, which can sometimes mean drinking to excess.

How can we tackle the problem in Britain?

Education is key to creating an open and honest dialogue. This will encourage people to think and talk - and to play a responsible role in our society.

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Development of an outcome prediction measure for alcoholism therapy by multimodal monitoring of treatment processes
Journal of Psychiatric Research Article in Press, Corrected Proof 14 Mar 2008

Outcome prediction in alcoholism therapy is of major sociopolitical and economic significance. Instruments based on psychotherapeutic processes are lacking.

Therefore, treatment processes of 64 chronic alcohol dependent patients have been investigated at three time-points, t1 (week 3), t2 (month 6), and t3 (month 12) during the first year of a comprehensive outpatient treatment program, guaranteeing strictly controlled alcohol abstinence.

Main focus of the study was the prediction of cumulative abstinence probability over a follow-up period of up to 4 years based on these treatment processes.

One hundred and seventy-five video recordings of therapy sessions were analyzed with the behavior observational system VAMP (Video-Assisted Monitoring of Psychotherapeutic Processes in Chronic Psychiatric Disease). Patients’ self-rating of treatment processes was measured with questionnaires for self-efficacy, abstinence confidence, self-consciousness and stress coping. Prediction of cumulative abstinence probability was determined with Cox regression analysis.

By integrating the observer rated process variables with the highest predictive validity, the composite score TOPPS (Therapy Orientation by Process Prediction Score) was constructed. It includes the process variables experience of resources, abstinence self-efficacy, implicit craving, relapse alertness, relapse risk, disease concept, dysfunctional therapeutic engagement, and dysfunctional problem solving of current problems.

Whereas patients’ self-rating of treatment processes was insufficiently predictive, the TOPPS strongly predicted four-year abstinence probability at any of the 3 time-points (p < 0.001). The results suggest to validate the item combination described in the TOPPS in addiction therapy as a treatment guideline of individual relapse prevention strategies.

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Phenomic, Convergent Functional Genomic, and biomarker studies in a stress-reactive genetic animal model of bipolar disorder and co-morbid alcoholism
American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Volume 147B, Issue 2 , Pages 134 - 166

We had previously identified the clock gene D-box binding protein (Dbp) as a potential candidate gene for bipolar disorder and for alcoholism, using a Convergent Functional Genomics (CFG) approach.

Here we report that mice with a homozygous deletion of DBP have lower locomotor activity, blunted responses to stimulants, and gain less weight over time.

In response to a chronic stress paradigm, these mice exhibit a diametric switch in these phenotypes. DBP knockout mice are also activated by sleep deprivation, similar to bipolar patients, and that activation is prevented by treatment with the mood stabilizer drug valproate.

Moreover, these mice show increased alcohol intake following exposure to stress.

Microarray studies of brain and blood reveal a pattern of gene expression changes that may explain the observed phenotypes. CFG analysis of the gene expression changes identified a series of novel candidate genes and blood biomarkers for bipolar disorder, alcoholism, and stress reactivity.

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Low level of harm avoidance is associated with serotonin transporter functional haplotype in alcohol-dependent individuals.
Psychiatric Genetics. 18(2):59-63, April 2008.

The serotonin transporter gene (SLC6A4) encodes a trans-membrane protein (5-HTT) that plays an important role in regulating serotonergic neurotransmission, which is known to be involved in many psychiatric disorders. A polymorphism in the transcriptional control region containing long (L) and short (S) variants (5-HTTLPR) as well as alleles of the variable number tandem repeats (VNTR) region were demonstrated.

Higher serotonin levels among carriers of the S allele might exhibit increased liability of serotonin-mediated, psychopathology-like anxiety and depression and may impair social skills reflected by harm avoidance.

To analyze the data of alcohol-dependent, unrelated German individuals for a significant association between serotonin transporter gene and history of depression as well as TCI scales.

We characterized 368 alcohol-dependent participants by TCI and SSAGA/history of depression. HHT and VNTR genes were amplified by polymerase chain reaction.

No significant association was found between history of depression and 5-HTTLPR (F=0.42, P=0.65, d.f.=2) as well as between history of depression and VNTR (F=0.24, P=0.91, d.f.=2). As harm avoidance is often associated with history of depression, the TCI was used.

Regarding the TCI temperament and character scale scores, no significant association was found between harm avoidance and this genetic variant 5-HTTLPR (F=0.55, P=0.57, d.f.=2), and between harm avoidance and VNTR (F=0.39, P=0.81, d.f.=2).

Haplotype analysis showed significant relationship between low level of harm avoidance and haplotype S/12 ([chi]2=7.01, P=0.00). Haplotype analysis of history of depression ([chi]2=2.04, P=0.742) showed no significant result.

Our results indicate an association between S/12 haplotype of SLC6A4 and low level of harm avoidance

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Monday, March 17, 2008

ADHD and Co-Occuring Substance Use Disorders: New Clinical Insights and Emerging Therapies

Attention-deficit/hyperactivity disorder (ADHD)—a disorder of inattention, impulsivity, and hyperactivity—affects anywhere from 3% to 5% of all children in the United States. The course of the disorder is often chronic, and at least half of those affected will have prominent symptoms and impairment spanning into adulthood. In addition to learning dysfunction, ADHD is associated with psychiatric comorbidity—anxiety, mood disorders (eg, unipolar and bipolar depression), disruptive disorders (eg, oppositional and conduct disorders), and substance use disorders (SUDs). Studies have shown that young adults with ADHD are significantly more likely to have SUDs (eg, alcohol, drug, nicotine dependence) than their peers without ADHD.

Recent genetic and imaging studies, neuropsychologic data, and neurochemical findings support the biologic underpinningof ADHD. Despite the burden ADHD represents, it is a treatable disorder. Medication (eg, stimulants, antidepressants, antihypertensives) and psychotherapy are key to the management of ADHD across the lifespan. Because of the overlap between
ADHD and SUDs, appropriate treatment of ADHD is important to help reduce the risk for future SUDs.

This newsletter will provide an overview of the latest research on ADHD and co-occurring SUD. It will review factors that contribute to an increased risk of SUD in ADHD individuals. Treatment of comorbid individuals requires management of both ADHD and SUD, and this newsletter will review new approaches in ADHD pharmacotherapy and their implications for effectively treating individuals with ADHD and co-occurring SUD.

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Battle against teenage binge drinking 'must begin at home'
14 Mar 2008

A leading medical journal called on parents today to bear most of the responsibility for steering teenagers away from binge drinking and drunkenness.

Learning to enjoy alcohol without misusing it was "an important part of growing up" in many societies, said an editorial in The Lancet.

But the lesson did not appear to be taught in the UK, where young people were drinking more alcohol than ever before.
. . . . . .

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Sunday, March 16, 2008

Violent Behavior and DSM-IV Psychiatric Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions
J Clin Psychiatry 2008;69:12-22

To present nationally representative data on the lifetime prevalence and population estimates of violent behavior among individuals with DSM-IV psychiatric disorders.

After controlling for sociodemographic characteristics and other comorbidity, it was found that the odds of violent behavior were significantly increased (p < .05) among individuals with substance use disorders; pathological gambling; major depressive disorder; bipolar disorders; panic disorder without agoraphobia; specific phobia; and paranoid, schizoid, histrionic, and obsessive-compulsive personality disorders. Percentages of violent behavior among individuals with each comorbid disorder were, with few exceptions, significantly greater (p < .05-p < .001) than the corresponding percentages among those presenting with the pure form of each disorder. Alcohol and drug use disorders were the most significant contributors to the public health burden of violent behavior.

The majority of individuals with psychiatric disorders do not engage in violent behavior, and public perception associated with stereotypic violence among individuals with psychiatric disorders appears unwarranted. Elevated risks and burden of violent behavior were not equally shared across the spectrum of psychiatric disorders, with particular disorders, especially substance use disorders, contributing disproportionately to the burden. Future research should examine the circumstances under which violence among individuals with psychiatric disorders occurs with a view toward improving clinical prediction and developing more effective prevention strategies.

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