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

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


Saturday, April 12, 2008

Effect of Naltrexone and Ondansetron on Alcohol Cue–Induced Activation of the Ventral Striatum in Alcohol-Dependent People
Arch Gen Psychiatry. 2008;65(4):466-475.

Medication for the treatment of alcoholism is currently not particularly robust. Neuroimaging techniques might predict which medications could be useful in the treatment of alcohol dependence.

To explore the effect of naltrexone, ondansetron hydrochloride, or the combination of these medications on cue-induced craving and ventral striatum activation.

Functional brain imaging was conducted during alcohol cue presentation.

The combination treatment decreased craving for alcohol. Naltrexone with (P = .02) or without (P = .049) ondansetron decreased alcohol cue–induced activation of the ventral striatum. Ondansetron by itself was similar to naltrexone and the combination in the overall analysis but intermediate in a region-specific analysis.

Consistent with animal data that suggest that both naltrexone and ondansetron reduce alcohol-stimulated dopamine output in the ventral striatum, the current study found evidence that these medications, alone or in combination, could decrease alcohol cue–induced activation of the ventral striatum, consistent with their putative treatment efficacy.

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The Neurobiology of Free Will and Drug Addiction

SAN DIEGO —Advances in brain-imaging technology have shown what many researchers have long suspected—that drug addiction is a disease of the brain, and not simply a failure of free will. One of the most instrumental leaders in that effort has been Nora Volkow, MD. The sometimes controversial work of Dr. Volkow and others during the past 15 years has provided a better understanding of how neurobiological changes in the brain can lead a person to lose control over his or her behavior and become addicted to drugs. That research and understanding may soon yield more effective medications and better overall treatment for patients with addiction, said Dr. Volkow at the 2007 Annual Meeting of the American Psychiatric Association.

A primary focus of addiction research has been the dopaminergic system, as drugs of abuse increase dopamine in limbic areas of the brain, which can then trigger a sensation of pleasure. “But what has become clear is that dopamine is not just about pleasure,” said Dr. Volkow, Director of the National Institute on Drug Abuse in Rockville, Maryland. Imaging studies have shown that multiple systems in the brain are affected by long-term substance abuse, including those relating to motivation, drive, memory, inhibitory control, and what we perceive as salient. Drug use can lead to plastic changes in the brain that “ultimately underlie the compulsive drug intake and loss of control that causes drug addiction,” said Dr. Volkow.

In an early study that challenged the reward theory of drug addiction, Dr. Volkow used positron emission tomography to observe the effects of IV methylphenidate in persons addicted to cocaine and in healthy controls. She found that the subjects addicted to cocaine had a reduced amount of dopamine released in the striatum when given IV methylphenidate and a reduced “high” relative to that of controls. Persons addicted to cocaine also had an increased thalamic response associated with craving—a finding not observed in controls. “What we documented was that the controls and the cocaine addicts differed not just in terms of the qualitative response to the drug, but they actually had a quantitatively different response,” said Dr. Volkow. “So contrary to what we hypothesized—that cocaine abusers would report a more intense high than controls—we saw exactly the opposite.”

In a recently completed, but as yet unpublished, study comparing 20 alcoholics and 20 healthy controls, Dr. Volkow found that the amount of dopamine released in alcoholics was 70% lower than in controls, “indicating, indeed, that decreases in reward circuitry are not just specific for cocaine,” she noted.
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Friday, April 11, 2008

Open Alcohol Forum – Brussels, Thursday 17 April 2008

Within the framework of the European Alcohol and Health Forum, the Commission services will organise an 'Open Forum' on Thursday, 17 April 2008 in Brussels.

The European Alcohol and Health Forum

As one cornerstone for the implementation of the Commission's 2006 Communication on an EU strategy to support Member States in reducing alcohol-related harm1, the Commission has established a European Alcohol and Health Forum. The overall objective of the Forum is to provide a common platform for all interested stakeholders at EU level that pledge to step up actions relevant to reducing alcohol-related harm, notably in the following areas:

• strategies aimed at curbing under-age drinking;

• information and education programmes on the effect of harmful drinking and on responsible patterns of consumption;

• possible development of efficient common approaches throughout the Community to provide adequate consumer information;

• actions to better enforce age limits for selling and serving alcohol;

• interventions promoting effective behavioural change among children and adolescents;

• cooperation to promote responsibility in and prevent irresponsible commercial communication and sales

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EUROPA Alcohol Home Page
Effectiveness of the CAGE questionnaire, gamma-glutamyltransferase and mean corpuscular volume of red blood cells as markers for alcohol-related problems in the workplace
Addictive Behaviors Volume 33, Issue 6, June 2008, Pages 772-781

To evaluate the usefulness of gamma-glutamyltransferase (GGT) and mean corpuscular volume (MCV), as well as that of the CAGE questionnaire, in workplace screening for alcohol abuse/dependence.

A total of 183 male employees were submitted to structured interviews (Structured Clinical Interview for DSM-IV 2.0 and CAGE questionnaire). Blood samples were collected. Diagnostic accuracy and odds ratio were determined for the CAGE, GGT and MCV.

The CAGE questionnaire presented the best sensitivity for alcohol dependence (91%; specificity, 87.8%) and for alcohol abuse (87.5%, specificity, 80.9%), which increased when the questionnaire was used in combination with GGT (sensitivity, 100% and 87.5%, respectively; specificity, 68% and 61.5, respectively). CAGE positive results and/or alterations in GGT were less likely to occur among employees not presenting alcohol abuse/dependence than among those presenting such abuse.

The use short, simple questionnaires, combined with that of low-cost biochemical markers, such as GGT, can serve as an initial screening for alcohol-related problems, especially for employees in hazardous occupations. The data provided can serve to corroborate clinical findings.

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Assessing reactivity to virtual reality alcohol based cues
Addictive Behaviors Volume 33, Issue 6, June 2008, Pages 743-756

The use of virtual reality (VR) programs in behavioral science research has been gaining prominence over the past several years. In the field of substance abuse, VR cue reactivity programs have been successfully tested for feasibility in nicotine and cocaine dependent samples.

Seeking to expand VR applications in alcohol cue research, a novel VR alcohol cue reactivity assessment system incorporating visual, auditory, and olfactory stimuli was developed and tested.

In a controlled trial, 40 non-treatment-seeking drinkers with alcohol use disorders were exposed to VR alcohol cue environments. Subjective craving, attention to alcohol cues, and level of presence (realism of experience) in VR were assessed across the environments. Overall, subjective craving for alcohol increased across the VR alcohol-related cue environments versus VR neutral cue environments.

Participants reported high levels of presence in VR, indicating that the environments were perceived as realistic and compelling.

These initial findings support the use of VR based cue reactivity environments for use in alcohol cue-based treatment and research.

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Alcohol Drinking and Colorectal Cancer in Japanese: A Pooled Analysis of Results from Five Cohort Studies
American Journal of Epidemiology Advance Access published online on April 11, 2008

Colorectal cancer is an alcohol-related malignancy; however, the association appears to be stronger among Asian populations with a relatively high prevalence of the slow-metabolizing aldehyde dehydrogenase variant.

To examine the association between alcohol consumption and colorectal cancer in Japanese, the authors analyzed original data from five cohort studies that measured alcohol intake using validated questionnaires at baseline. Hazard ratios were calculated in the individual studies, with adjustment for a common set of variables, and then combined using a random-effects model.

During 2,231,010 person-years of follow-up (ranging variously from 1988 to 2004), 2,802 colorectal cancer cases were identified.

In men, multivariate-adjusted pooled hazard ratios for alcohol intakes of 23–45.9 g/day, 46–68.9 g/day, 69–91.9 g/day, and ≥92 g/day, compared with nondrinking, were 1.42 (95% confidence interval (CI): 1.21, 1.66), 1.95 (95% CI: 1.53, 2.49), 2.15 (95% CI: 1.74, 2.64), and 2.96 (95% CI: 2.27, 3.86), respectively (p for trend <> the colon and the rectum. A significant positive association was also observed in women.

One fourth of colorectal cancer cases in men were attributable to an alcohol intake of ≥23 g/day.

An alcohol-colorectal cancer association seems to be more apparent in Japanese than in Western populations. Whether this difference can be ascribed to genetic or environmental factors needs to be clarified.

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Thursday, April 10, 2008

Governor to review crucial bills
April 9, 2008

Annapolis - Dozens of bills were enacted by the General Assembly on Monday and sent to Gov. Martin O’Malley for his review and signature.
. . . . . .

- Beer: Fruity malt beverages such as Mike’s Hard Lemonade or Smirnoff Ice would be considered beer under Maryland law. Previously, malt beverages were classified as distilled spirits but taxed as beer, which is 9 cents per gallon compared to $1.50 for spirits. The new classification means the “alcopops” will be available anywhere beer is sold, including convenience stores.
. . . . . .

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Partnership Led By Howard County Health Officer Organizes Strong and Diverse Opposition to “Alcopops” Legislation

The Maryland Partnership Against Alcopops held a press conference yesterday in Annapolis voicing its strong objections to Senate Bill 745, the legislation protects “alcopops” (popular among novice drinkers) with low state excise tax rates and widespread appeal to teens.

The press event, headed by Dr. Peter Beilenson, Howard County Health Officer who was representing both public health officials and the Maryland Association of County Health Officials (MACHO), addressed the many ways our teens are adversely affected by alcopops. Maryland Delegates Bill Bronrott - MD-16 and Heather Mizeur - MD-20 (Health & Government Operation Committee) stressed the ease with which teens have access to these drinks if they continue to be taxed at the beer rate of 9 cents a gallon as opposed to distilled spirits taxes at $1.50 a gallon.
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Drunken youths flood into hospital

By ANNA CHALMERS - The Dominion Post | Friday, 11 April 2008

A six-fold increase in the number of drunken youths admitted to Wellington Hospital has forced doctors to become alcohol counsellors.

New figures show up to 600 patients under 20 years were admitted to the hospital's emergency department in the past year for intoxication or alcohol-related injuries. Hospital emergency medicine specialist Paul Quigley said it was a "six-fold blowout" on the 100 cases previously calculated.

Young females, particularly those aged 14 or 15, were leading the increase and, if current rates continued, would account for 60 per cent of all alcohol admissions under 20 by the end of the year, Dr Quigley said.
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Comparability of Neuropsychological Test Profiles in Patients with Chronic Substance Abuse and Mild Traumatic Brain Injury
The Clinical Neuropsychologist, Volume 22, Issue 2 March 2008 , pages 209 - 227

The purpose of this study was to compare 104 patients with acute uncomplicated mild traumatic brain injury (MTBI) to a sample of 104 patients from an inpatient substance abuse program to determine whether these patients could be differentiated by their pattern of relative cognitive strengths and weaknesses.

Patients were matched on age, education, and gender. Eight cognitive measures were used that included tests of attention, memory, and processing speed. There were no statistically significant differences between the two groups on any of the cognitive measures. Using a two-step cluster analysis procedure (i.e., hierarchical and k-means analyses), seven common profiles were identified.

There was no significant difference in the proportions of patients from the MTBI or substance abuse group in each of the seven profiles. These results show that patients with uncomplicated MTBIs could not be reliably differentiated from patients with substance abuse problems on these cognitive measures.

This is of particular concern for clinicians evaluating the neuropsychological effects of MTBI in individuals with a comorbid history of substance abuse.

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(Washington, D.C.)—Today, the White House Office of National Drug Control Policy (ONDCP) announced that approximately 5.6 million Federal workers with Federal health insurance will now be covered for a substance abuse prevention and treatment procedure called Screening and Brief Intervention (SBI). The new coverage will reimburse doctors who screen their patients for a full spectrum of substance use behaviors, including for alcohol, illicit drugs, and prescription drug abuse/addiction, and provide appropriate intervention.
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The costs of tobacco, alcohol and illicit drug abuse to Australian Society in 2004/05

This booklet summarises the results of a study by Collins and Lapsley (2007) that estimates the social costs of drug abuse in Australia in the financial year 2004/05, with ‘drugs’ including alcohol, tobacco and illicit drugs. The study is the fourth in a series prepared for the Department of Health and Ageing by these authors; previous studies were undertaken for 1988, 1992 and the financial year 1998/99.

The full report examines the study’s methods, concentrating on the economic aspects, with three appendixes detailing the demographic, epidemiological and criminological methods used. Bibliographical details of the full report, and a list of all tables that it contains, can be found at the end of this booklet.

The costs of tobacco, alcohol and illicit drug abuse to Australian Society in 2004/05 – Monograph Series No 64 (PDF 499 KB)

Summary Version (Monograph Series No 66): The costs of tobacco, alcohol and illicit drug abuse to Australian Society in 2004/05 (PDF 350 KB)

Wednesday, April 9, 2008

Preference-weighted health-related quality of life measures and substance use disorder severity
Addiction Online Early 7 Apr 2008

Examine the validity of preference-weighted health-related quality of life measures in a sample of substance use disorder (SUD) patients. The implications of cost–utility analyses (CUAs) of SUD interventions are discussed.

Subjects completed the following preference-weighted measures: self-administered Quality of Well-Being scale (QWB-SA) and Medical Outcomes Study SF-12 (standard gamble weighted or SF-12 SG); and clinical measures: Addiction Severity Index (ASI) and a symptom checklist based on the DSM-IV.

In unadjusted analyses, the QWB-SA was correlated significantly with six of seven ASI subscales and the SF-12 SG was correlated with four of seven. In adjusted analyses, both preference-weighted measures were significantly correlated with diagnostic, physical health, mental health and drug use measures, but not with legal or alcohol use measures. The QWB-SA was also correlated with employment problems and the SF-12 SG was correlated with family/social problems.

This study generally supports the construct validity of preference-weighted health-related quality of life measures in SUD patients. However, the QWB-SA and SF-12 SG did not correlate with all ASI scales. Cost–benefit analysis may be preferable when policy-makers are interested in evaluating the full range of SUD intervention outcomes.

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Not in Front of the Children - Child Protection and Advertising
This report sets out:

• Background of alcohol advertising and children

• An introduction to the broadcasting and regulatory framework

• Alcohol Concern’s research into the scheduling of alcohol adverts

• An analysis of a small sample of adverts linked to programmes with a significant share of children’s audience

• Alcohol Concern’s conclusions and recommendations

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Risky drinking in North West school children and its consequences: A study of 15 and 16 year olds

Key Findings and Recommendations

Over five sixths (84.0%) of pupils drank alcohol, a decrease from the level reported in 2005 (87.9%). However among drinkers, there was an increase in the percentage drinking in public places (e.g. bars, parks) and the frequency of consumption.

• Of the 189,731 15 and 16 year olds in the North West, we calculate that around 56,900 (30.0%) binge drink at least weekly (i.e. drink five or more drinks in one session).

• For the first time, estimates of total alcohol consumption by 15 and 16 year olds in the North West have been calculated. We estimate that 65.9% of 15 and 16 year olds in the region drink at least monthly and that their total annual consumption is 83,943,726 units. This is equivalent to 44.2 bottles of wine (177.0 pints of beer) per year for every 15 and 16 year old in the region, or 67.2 bottles of wine (268.7 pints of beer) per year for each 15 and 16 year old that drinks at least once a month.

• Substantial levels of binge drinking, frequent drinking and drinking in public places were seen in all demographics. However, binge drinking in particular was more frequent amongst those living in more deprived areas (31.1% of drinkers binge drank at least once a week in the most affluent areas compared to 39.1% in the least affluent [quintiles]).

• Among drinkers, 34.1% stated that they bought their own alcohol. These individuals were more likely to engage in a risky drinking behaviour (e.g. three times more likely to binge drink once or more a week). • Consistent with findings in 2005, those who had alcohol provided to them by parents (48.5% of drinkers) were 1.64 times less likely to binge drink each week and 1.28 times less likely to drink in public places.

• Having a hobby or being involved in sports was protective against most risky drinking behaviours with, for instance, those having a hobby or sports pastime being 1.59 times less likely to binge drink.

• Among those that drank once a week or more, 39.7% of females and 42.0% of males had been involved in violence following alcohol use. Those from the two poorest deprivation quintiles of residence were around 50% more likely to have been involved in alcohol-related violence than those in the most affluent quintile.

• Engaging in binge drinking, drinking more frequently, and drinking greater amounts of alcohol each week, were also associated with alcohol-related violence. Thus, those binge drinking three or more times per week were over five times more likely to have been involved in alcohol-related violence (than those who drank each week but did not binge drink).

• Among those that drank once a week or more, 20.7% of females and 15.4% of males reported regretted sex following alcohol. Females; those aged 16; those binge drinking more frequently; and those drinking at greater volumes per week were more likely to have had regretted sex following alcohol consumption. For instance, those drinking over 40 units per week were two and a half times more likely to have had sex they later regretted following alcohol (than those who drank each week but consumed up to five units per week).

• Heavy drinking patterns were associated with higher levels of smoking. While only 2.1% of those that drink at least once a week but never binge drink smoked more than five cigarettes per day this rises to 47.7% amongst those that binge drink three or more times per week.

• With over a third of drinkers stating that they bought their own alcohol, it is essential that all retailers prevent underage sales, as results here identify that such behaviour is strongly linked to the problematic use of alcohol by youths.

• With substantial levels of alcohol being consumed by teenagers, parents require much better information on how much alcohol their children can consume, as well as the health and anti-social behaviours associated with alcohol consumption.

• Consistent messages regarding the risks associated with alcohol consumption should be delivered through educational settings to provide young people with an understanding of the dangers associated with alcohol use and to counter the promotional effects of alcohol advertising to which children are exposed on a regular basis.

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Restoration and Recovery - The Neuroscience of Joyful Recovery!
2008 NET Training Institute

For nearly a quarter century, NET Recovery Conferences have been a source of uplifting fellowship, spiritual renewal and exceptional training. Come join us!

Our Goals:

Celebrate the mission & methods of people of faith who serve hurting and addicted people.

Offer ways to develop new knowledge, skills & services. CEUs available.

Support your faith journey & personal growth.

Provide a genuinely Faith- based Recovery Association.

Focus on the Joyful aspects of Recovery!!

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SAMHSA Data Strategy
eNewsletter - April 1, 2008

The Substance Abuse and Mental Health Services Administration (SAMHSA) Data Strategy for fiscal year 2007 through fiscal year 2011 for the first time includes collecting data on individuals in recovery.

By the end of fiscal year 2011, SAMHSA’s milestones include “to use or obtain data on persons in recovery from substance abuse and/or mental illness and services they need as well as the services they use.” Faces & Voices of Recovery advocated for the inclusion of recovery information in SAMHSA’s Data Strategy and in 2005, met with SAMHSA officials and recovery researchers to discuss the need for this critical information.


Brown-Forman donates $200K to UK to fight aclohol abuse
By Alex Davis • April 9, 2008

Efforts to fight alcohol abuse at the University of Kentucky will get a $200,000 boost due to a gift from Brown-Forman Corp.

The Louisville distiller said this morning that it will provide the money over a three-year period to the school’s Office of Alcohol and Health Education.

“We will be able to expand our “Question Authority” campaign to reach out to the freshman class during the first week of classes in the fall, a time when young people are particularly vulnerable to excessive alcohol consumption,” Andrew Smith, director of the health and education office, said in a statement.
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Binge drinking in Europe

Some 80million Europeans aged 15 years plus (over one fifth of the adult EU population) reported binge drinking (defined as five or more drinks on an occasion, 50g alcohol) at least once a week in 2006, a proportion that has increased since 2003, at least for the adult population of the EU151. Some 25million Europeans aged 15 years plus (1 in 15 of the adult population) reported that binge drinking was their usual pattern of consumption during the previousmonth.

Whereas 24% of those aged 15-24 years reported binge drinking at least once a week in 2006, binge drinking was also common amongst those aged 55+ years, with 18% binging at least once a week. The average amount of alcohol consumed by EU 15-16 years olds on their last drinking occasion was six drinks, 60g alcohol (2003 data).Over 1 in 6 (18%) of EU 15-16 year olds have binged (5+ drinks on a single occasion, 50g alcohol) three times ormore in the last month (2003 data).

Binge drinking has increased across Europe amongst 15-16 years olds since 1995, although less so in recent years.

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The NHS is failing to deliver adequate treatment for dependent drinkers, a new report by Alcohol Concern finds.

The NHS is failing to deliver adequate treatment for dependent drinkers, a new report by Alcohol Concern finds. The poor relation-has the emphasis on 'localism' really improved alcohol commissioning? reveals massive differences across the country in terms of the quality of support laid on to support the recovery of people who have become dependent on alcohol. The report's authors argue that the government's focus on 'binge' drinking means that health service managers are under pressure to put money into short interventions for people entering A&E due to drunken mishaps rather, than more intensive treatment aimed at chronic drinkers. In some cases, local support was practically unavailable for anyone wanting professional help for chronic drinking.
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SAMHSA Strategic Plan

The Substance Abuse and Mental Health Services Administration (SAMHSA), United States Department of Health and Human Services (HHS), is the lead Federal agency addressing substance abuse and mental health services. These issues have a far reaching and critical impact. To ensure that the agency utilizes public resources as effectively as possible, SAMHSA has developed this strategic plan. The Strategic Plan covers Fiscal Years 2006 through 2011. The six year period (the current fiscal year and five years forward) spans the minimum time period for a strategic plan as prescribed by the Government Performance and Results Act (GPRA).

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The SAMHSA Data Strategy

The purpose of this data strategy is to describe the goals, objectives, and associated actions to help guide the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) data-related activities. The SAMHSA Data Strategy outlines general directions and milestones, which SAMHSA hopes to achieve by the end of fiscal year (FY) 2011.

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Tuesday, April 8, 2008

Third National Conference on Women, Addiction and Recovery

SAMHSA co-sponsors 3rd National Conference on Women, Addiction and Recovery

September 15-17, 2008
Marriott Tampa Waterside Hotel and Marina
Tampa, Florida

Don’t miss the 3rd National Conference on Women, Addiction and Recovery. This conference brings together the leaders, directors and other stakeholders in women’s services to hear current research, discuss implementation and promote effective leadership to professionals and stakeholders to assist women with substance use disorders and their families.

Visit the conference Web site for more information.


National Indicator set definitions released

The definitions for the National Indicators have been released by the Department for Communities and Local Government. Definitions are provided for the 198 National Indicators, 185 of which came into force on the 1st of April 2008. Local Strategic Partnerships should by now know which indicators they will set as key improvement targets (up to 35) as part of their Local Area Agreements (LAAs).

The new national indicators will be the only means of measuring national priorities that have been set by the Government. For alcohol, the key indicators are as follows:

  • NI 39 Alcohol-harm related hospital admission rates
  • NI 41 Perceptions of drunk or rowdy behaviour as a problem
  • NI 115 Substance misuse by young people

A further indicator is associated with alcohol:

  • NI 20 Assault with injury crime rate
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Social trends: alcohol, recycling and births
By Caroline Gammell


Alcohol-related deaths: Number has doubled since 1991

The number of alcohol-related deaths in the UK more than doubled between 1991 and 2006, the ONS said.

The figure was particularly startling among men, with the number of deaths rising from 9.1 to 18.3 per 100,000, compared with 5.0 to 8.8 per 100,000 in women. For both men and women, the age group with the highest death rate was between 55 and 74.

Between 2002 and 2004, Scotland had the highest rates of alcohol deaths for men and women in all age groups, while Yorkshire, Humber and the East Midlands had the lowest rates.
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Social Trends 38

Social Trends draws together social and economic data to provide a comprehensive guide to UK society and how it has been changing

Chapter 7: Health indicates that although we are living longer, we are spending more years in poor health. Initiatives for promoting healthy lifestyles and diet have had some impact, with higher proportions of girls and boys in England and Wales in 2006 having consumed at least five or more portions of fruit and vegetables per day than in 2004. Nevertheless, levels of obesity continue to rise in both children and adults and the proportion of alcohol-related deaths in the UK has more than doubled between 1991 and 2006.

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Cannabinoids enhance susceptibility of immature brain to ethanol neurotoxicity
Annals of Neurology Early View 7 Dec 2007

Marijuana and alcohol are most widely abused drugs among women of reproductive age. Neurocognitive deficits have been reported in children whose mothers used marijuana during pregnancy. Maternal consumption of ethanol is known to cause serious developmental deficits

Infant rats and mice received systemic injections of 9-tetrahydrocannabinol (THC; 1-10mg/kg) or the synthetic cannabinoid WIN 55,212-2 (1-10mg/kg), alone or in combination with subtoxic and toxic ethanol doses, and apoptotic neurodegeneration was studied in the brains

Acute administration of THC (1-10mg/kg), the principal psychoactive cannabinoid of marijuana, markedly enhanced proapoptotic properties of ethanol in the neonatal rat brain. THC did not induce neurodegeneration when administered alone. Neuronal degeneration became disseminated and severe when THC was combined with a mildly intoxicating ethanol dose (3gm/kg), with the effect of this drug combination resembling the massive apoptotic death observed when administering ethanol alone at much higher doses. The detrimental effect of THC was mimicked by the synthetic cannabinoid WIN 55,212-2 (1-10mg/kg) and counteracted by the CB1 receptor antagonist SR141716A (0.4mg/kg). THC enhanced the proapoptotic effect of the GABAA agonist phenobarbital and the N-methyl-D-aspartate receptor antagonist dizocilpine. Interestingly, infant CB1 receptor knock-out mice were less susceptible to the neurotoxic effect of ethanol. Furthermore, the CB1 receptor antagonist SR141716A ameliorated neurotoxicity of ethanol

These observations indicate that CB1 receptor activation modulates GABAergic and glutamatergic neurotransmission and primes the developing brain to suffer apoptotic neuronal death

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News Release - Pediatricians Alerted to the Developmental Nature of Underage Drinking in Special Journal Supplement
April 7, 2008,

In a special supplement to Pediatrics, edited and sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), physicians will have access in one place to the reviews and analyses of current research on biological, behavioral, and environmental changes during childhood and adolescence that foster the initiation, maintenance, and acceleration of illegal use of alcohol by underage youth. This is a first time collection of where science is in our understanding of underage drinking as a developmental issue. NIAAA, one of the institutes of the National Institutes of Health, is committed to moving scientific discovery to strategic prevention and intervention strategies in order to decrease the toll that alcohol is taking on our youth--and as these youth grow--to our society.

“We now recognize that underage drinking must be addressed, not as an isolated phenomenon, but as one fully embedded in the context of child and adolescent development,” said NIAAA Director Ting-Kai Li, M.D. “From birth through adolescence, a complex cascade of biological, psychological and social development interacts with dynamic environmental influences, leading to behavior that may either move individuals toward or away from underage drinking.”

Looking at developmental perspectives to determine the risk of alcohol dependence is a relatively new scientific approach that is bearing results. For example, according to recent research, binge drinking by young people makes them more vulnerable to the development of alcohol dependence over a lifetime. Further, risk of an individual’s becoming alcohol dependent is related to how early the young person starts drinking. NIAAA’s Pediatrics supplement includes researchers from a wide range of scientific disciplines.

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Evidence-Based Treatments for Alcohol Use Disorders in Adolescents
PEDIATRICS Vol. 121 Supplement April 2008, pp. S348-S354

The prevalence of adolescent alcohol use and its related consequences underscore the need for evidenced-based treatments in this population.

During the past decade, much progress has been made in treating adolescent alcohol use disorders with evidenced-based modalities developed specifically for adolescents.

Controlled treatment outcome studies that compared ≥1 modality, used random assignment to treatment conditions, and were published between 1990 and 2004 are discussed in this review.

Psychosocial treatments such as family-based interventions, motivational enhancement therapy (motivational interviewing), behavioral therapy, and cognitive-behavioral therapy, as well as the limited pharmacotherapy studies, are discussed. All of the studies used assessment tools validated for use in adolescent populations.

Overall, great strides have been made in the area of adolescent alcohol treatment, and the treatment modalities presented have more than adequate potential for replication.

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Developmentally Informed Research on the Effectiveness of Clinical Trials: A Primer for Assessing How Developmental Issues May Influence Treatment Responses Among Adolescents With Alcohol Use Problems
PEDIATRICS Vol. 121 Supplement April 2008, pp. S337-S347

The goal of this article is to familiarize readers with the adolescent developmental issues and processes most likely to affect responses to treatment for alcohol use problems.

Although the need for research that blends developmental science and treatment outcome research is widely acknowledged, scant information exists about developmentally informed approaches to treatment research with alcohol-abusing teens. Exactly how developmental issues may influence treatment responses among adolescents with alcohol use problems remains an open question.

In the hope of moving developmentally informed research forward, this article reports findings from a literature review regarding the degree to which developmental issues and processes have been considered in adolescent alcohol treatment research. Moreover, promising concepts and methods from applied developmental science are discussed, as are various developmental processes and transitions that may influence adolescent risk behavior.

Finally, guidance is provided regarding how applied developmental science conceptualizations and methods may be incorporated successfully into randomized, clinical trials with adolescents with alcohol use problems.

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Preventive Interventions Addressing Underage Drinking: State of the Evidence and Steps Toward Public Health Impact
PEDIATRICS Vol. 121 Supplement April 2008, pp. S311-S336

The epidemiological features of underage drinking and evidence of its social, health, and economic consequences suggest compelling reasons for the development and dissemination of effective preventive interventions.

To clarify the nature and extent of the current evidence base on preventive interventions addressing underage drinking, a review of the literature was conducted through extensive searches of the research literature on outcome evaluations, existing reviews of this body of outcome research (N = 25), and summary reports of evidence on specific interventions. More than 400 interventions were identified and screened, and the evidence for 127 was reviewed.

Criteria for the evaluation of evidence were established for intervention studies with alcohol-specific outcome measures for 3 developmental periods (<10,> and 16 to ≥20 years of age). Ultimately, 12 interventions met criteria for "most promising" evidence and 29 met criteria for "mixed or emerging" evidence.

Conducting this review revealed clear advances in the number of evidence-based interventions available and the quality of outcome research; however, much work remains to achieve greater public health impact through evidence-based interventions.

This work should consider (1) the great need for intervention research related to understudied developmental phases, intervention domains (eg, family, school, community, and media), and populations (eg, early tweens, late teens, young adults not attending college, and nonmajority populations); (2) the critical importance of addressing key issues in research design and methods (eg, limited longitudinal studies, replication studies, and dissemination research); and (3) the need for improved consistency in application of evidence and reporting standards.

Finally, we recommend the application of emerging consumer-oriented and community-participatory models for intervention development and research, designed to increase the likelihood of "real-world" public health impact through improved translation of intervention science into practice.

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A Developmental Perspective on Alcohol and Youths 16 to 20 Years of Age
PEDIATRICS Vol. 121 Supplement April 2008, pp. S290-S310

Late adolescence (ie, 16–20 years of age) is a period characterized by escalation of drinking and alcohol use problems for many and by the onset of an alcohol use disorder for some. This heightened period of vulnerability is a joint consequence of the continuity of risk from earlier developmental stages and the unique neurologic, cognitive, and social changes that occur in late adolescence.

We review the normative neurologic, cognitive, and social changes that typically occur in late adolescence, and we discuss the evidence for the impact of these transitions on individual drinking trajectories.

We also describe evidence linking alcohol abuse in late adolescence with neurologic damage and social impairments, and we discuss whether these are the bases for the association of adolescent drinking with increased risks of mental health, substance abuse, and social problems in adulthood.

Finally, we discuss both the challenges and successes in the treatment and prevention of adolescent drinking problems.

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Transitions Into Underage and Problem Drinking: Developmental Processes and Mechanisms Between 10 and 15 Years of Age
PEDIATRICS Vol. 121 Supplement April 2008, pp. S273-S289

Numerous developmental changes occur across levels of personal organization (eg, changes related to puberty, brain and cognitive-affective structures and functions, and family and peer relationships) in the age period of 10 to 15 years. Furthermore, the onset and escalation of alcohol use commonly occur during this period.

This article uses both animal and human studies to characterize these multilevel developmental changes. The timing of and variations in developmental changes are related to individual differences in alcohol use.

It is proposed that this integrated developmental perspective serve as the foundation for subsequent efforts to prevent and to treat the causes, problems, and consequences of alcohol consumption.

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Monday, April 7, 2008

Early Developmental Processes and the Continuity of Risk for Underage Drinking and Problem Drinking
PEDIATRICS Vol. 121 Supplement April 2008, pp. S252-S272

Developmental pathways to underage drinking emerge before the second decade of life. Many scientists, however, as well as the general public, continue to focus on proximal influences surrounding the initiation of drinking in adolescence, such as social, behavioral, and genetic variables related to availability and ease of acquisition of the drug, social reinforcement for its use, and individual differences in drug responses.

In the past 20 years, a considerable body of evidence has accumulated on the early (often much earlier than the time of the first drink) predictors and pathways of youthful alcohol use and abuse. These early developmental influences involve numerous risk, vulnerability, promotive, and protective processes.

Some of these factors are not related directly to alcohol use, whereas others involve learning and expectancies about later drug use that are shaped by social experience. The salience of these factors (identifiable in early childhood) for understanding the course and development of adult alcohol and other drug use disorders is evident from the large and growing body of findings on their ability to predict adult clinical outcomes.

This review summarizes the evidence on early pathways toward and away from underage drinking, with a particular focus on the risk and protective factors and the mediators and moderators of risk for underage drinking that become evident during the preschool and early school years.

It is guided by a developmental perspective on the aggregation of risk and protection and examines the contributions of biological, psychological, and social processes within the context of normal development.

Implications of this evidence for policy, intervention, and future research are discussed.

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Underage Drinking: A Developmental Framework
PEDIATRICS Vol. 121 Supplement April 2008, pp. S235-S251

A developmental framework for understanding and addressing the problem of underage alcohol consumption is presented.

The first section presents the rationale for a developmental approach, including striking age-related data on patterns of onset, prevalence, and course of alcohol use and disorders in young people.

The second section examines the fundamental meaning of a developmental approach to conceptualizing underage drinking.

The third section delineates contemporary principles of developmental psychopathology as a guide to future research and intervention efforts.

Strategic, sensitive, and effective efforts to address the problem of underage drinking will require a developmentally informed approach to research, prevention, and treatment.

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Announcement of the 5th Conference of INEBRIA

International Network on Brief Interventions for Alcohol Problems:
Alcohol & Drug Problems in Developing Countries: The role of Brief Interventions for Improvement of Care and Prevention”
Call for Papers
08th – 10th October 2008 | Guarujá, São Paulo, Brazil

The 5th Annual Conference will take place in Brazil, beside the beautiful beaches on the South Atlantic coast of the State of São Paulo, in the famous City of Guarujá. This conference aims to promote and discuss a research agenda and practical experience regarding the dissemination and implementation of Brief Interventions in Developing Countries as well to extend the experience to other regions where Brief Interventions are as yet just beginning.
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News Release - Online Video Program Trains Clinicians to Help Patients Who Drink Too Much
April 7, 2008

A new, interactive video training program from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH), demonstrates quick and effective strategies for screening patients for heavy drinking and helping them to cut down or quit.

“The video scenarios demonstrate evidence-based techniques for assessing and managing at-risk drinking and alcohol use disorders,” says NIAAA Director Ting-Kai Li, M.D. “We want to make these techniques widely available to clinicians so that more people with alcohol use problems will get the help they need.” Called Video Case Studies: Helping Patients Who Drink Too Much, the program is available through the NIAAA website at

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Sunday, April 6, 2008

News Release - Tackling alcohol misuse

Justice Secretary Kenny MacAskill will discuss approaches to tackling alcohol misuse with Ministerial colleagues from across Europe at the Building Capacity for Action: European Alcohol Policy conference in Barcelona.

The conference will look at a wide range of issues including priorities for action, involvement of the industry, changing attitudes to drinking and being drunk, prevention of harm and the role of education.

The Scottish Government is currently working on a long term strategic approach to tackle the country's cultural problem with alcohol misuse. Mr MacAskill will find out more about methods being used in other countries, as well as being able to highlight action taken so far in Scotland.
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