Ethanol Enhances GABAergic Transmission Onto Dopamine Neurons in the Ventral Tegmental Area of the Rat
Alcoholism: Clinical and Experimental Research Online Early Articles 15 April 2008


Activation of the dopaminergic (DA) neurons of the ventral tegmental area (VTA) by ethanol has been implicated in its rewarding and reinforcing effects. At most central synapses, ethanol generally increases inhibitory synaptic transmission; however, no studies have explored the effect of acute ethanol on GABAergic transmission in the VTA.

Acute exposure of VTA-DA neurons to ethanol (25 to 50 mM) robustly enhanced GABAergic spontaneous and miniature IPSC frequency while inducing a slight enhancement of spontaneous IPSC (sIPSC) amplitude. Ethanol (50 mM) enhanced paired-pulse depression of evoked IPSCs, further suggesting enhanced GABA release onto VTA-DA neurons. The frequency of sIPSCs was suppressed by the GABA_B agonist, baclofen (1.25 μM) and enhanced by the antagonist, SCH50911 (20 μM); however, neither appeared to modulate or occlude the effects of ethanol on sIPSC frequency.

The present results indicate that ethanol increases postsynaptic GABA_A receptor sensitivity, enhances action potential-independent GABA release onto VTA-DA neurons, and that this latter effect is independent of GABA_B auto-receptor inhibition of GABA release.

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Clinical Characteristics of Carbohydrate-Deficient Transferrin (%Disialotransferrin) Measured by HPLC: Sensitivity, Specificity, Gender Effects, and Relationship with other Alcohol Biomarkers
Alcohol and Alcoholism Advance Access published online on April 14, 2008


The sensitivity and specificity of the relative disialotransferrin amount (%DST), considered the primary single target for measurement of the alcohol biomarker carbohydrate-deficient transferrin (CDT), were compared with the absolute CDT amount determined by the CDTect assay and with GGT and AST.

No gender difference in %DST was noted for nondrinkers, but light/moderate and heavy drinking males had significantly higher levels than females. Of the alcohol biomarkers examined, %DST showed the strongest correlation with self-reported alcohol intake, except for female heavy drinkers. The area under the %DST ROC curve for male (0.83) and female (0.82) heavy drinkers was significantly higher compared with CDT by CDTect (0.68) and GGT (0.69). At the 40, 60, or 80 g ethanol/day thresholds, %DST showed lower test sensitivity in women but there was no significant gender difference in overall accuracy according to ROC curve analysis.

%DST measured by HPLC showed overall higher sensitivity for "heavy drinking" and better correlation with recent high alcohol intake, compared with the absolute CDT amount, and GGT and AST.

The observation that several "light/moderate drinkers" had elevated %DST levels and some also a measurable asialotransferrin indicated misclassification with the WHO/ISBRA Interview Schedule and emphasize the limitations of self-reports of drinking.


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The Tachykinin Receptor 3 Is Associated With Alcohol and Cocaine Dependence
Alcoholism: Clinical and Experimental Research OnlineEarly Articles 15 April 2008



A broad region on chromosome 4q was previously linked to the phenotype of alcohol dependence in the Collaborative Study on the Genetics of Alcoholism sample.

A strong positional candidate gene was identified within this region: tachykinin receptor 3 gene (TACR3), which encodes tachykinin receptor 3 (NK3R), the receptor for the tachykinin 3 (neurokinin B) peptide. Pharmacological studies have provided evidence that the administration of NK3R agonists attenuates the intake of alcohol and NK3R can also mediate the acute and chronic behavioral effects of cocaine.

Seven of the 9 SNPs in the 3' region of TACR3 provided significant evidence of association with alcohol dependence (p ≤ 0.05). Further analyses suggest that the evidence of association is strongest among those subjects with more severe alcohol dependence (defined by ICD-10) and those with co-morbid cocaine dependence. Haplotype analyses further strengthen the evidence of association in the 3' region of the gene.

These results indicate that sequence variations in TACR3 contribute to the variation in more severe alcohol dependent individuals and those who are also cocaine dependent.

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Impact of parents' alcohol dependency on children: new report

Saturday, April 19, 2008

Alcohol Concern have jointly produced a report with the Princess Royal Trust for Carers on the impact of parental alcohol dependency on children. The report, titled 'Keeping it in the family' estimates that around one million children currently live with a parent who is alcohol dependent. Looking at a range of research and findings the document considers the serious impact of parental alcohol misuse including long term psychological damage and a range of other pressures put on children, such as being forced into taking the role of carers themselves. It argues that there are not enough services currently available to support young carers or alcohol dependent parents.

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Minimum pricing for alcohol? The debate hots up..

Saturday, April 19, 2008

As Government ministers consider options for setting minimum prices on alcohol, the debate is hotting up amongst the industry and public alike as to whether such a move would make any difference, or is politically acceptable. This month the Daily Telegraph suggested that preparations to bring in minumum pricing are underway. However it understood that minsters are still only considering such options and awaiting further reviews as to the effectiveness and impacts of such policies.
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Alcohol Use Disorders: Old Insights, New Treatments/ Markus Heilig.

This lecture will cover alcoholism, its symptoms, and the latest research on the disease.

Alcohol Use Disorders: Old Insights, New Treatments Wednesday, October 03, 2007 Markus Heilig, M.D., Ph.D., National Institute of Alcohol Abuse and Alcoholism Total Running Time: 01:02:59 Category: Medicine for the Public more information

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Genetic and environmental influences on alcohol drinking behavior / Ting-Kai Li.

Throughout his career, Dr. Li has been at the center of advances that have transformed both the way alcoholism is understood and the means of investigating alcohol's effects on the body and the brain. A major focus of Dr. Li's research has been to characterize the structure and dynamics of the multiple genetic variants of alcohol dehydrogenase (ADH), the enzyme that catalyzes the first step in the metabolism of ethanol. Dr. Li was honored with a MERIT award for research on the molecular basis of differences among individuals in the physiology of these enzymes. Dr. Li also pioneered the development of animal models in which marked differences in the level of voluntary alcohol consumption could be observed, paralleling the same inborn variation seen in human behavior. The development of these animal lines helped cement the once radical notion that alcohol consumption behavior was genetically influenced. NIH Neuroscience Seminar Series.

Genetic and Environmental Influences on Alcohol Drinking Behavior Monday, November 03, 2003 Ting-Kai Li, M.D., NIAAA Director Total Running Time: 00:54:13 Play Relevant Content (08:20) Category: Neuroscience more information

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NIAAA NEWSLETTER - featuring information from the National Institute on Alcohol Abuse and Alcoholism
SPRING 2008 Number 15


CONTENTS

• Free Online Training for Clinicians

• Personnel News

• APIS Updates Alcohol Information Policy

• NIH Vodcast on YouTube Features Interview with Director Willenbring

• New Publications

• Conference Series Spotlights Mechanisms of Behavior Change

• Calendar

Download Full Newsletter (PDF)
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International survey of diagnostic services for children with Fetal Alcohol Spectrum Disorders
BMC Pediatrics 2008, 8:12

Early diagnosis and intervention for children with Fetal Alcohol Spectrum Disorder (FASD) reduces the risk of developing a range of secondary social, emotional and behavioural problems and provides an opportunity for prevention of further alcohol exposed pregnancies. The objective of this study was to describe specialist clinical service provision for the diagnosis and assessment of children exposed to alcohol in pregnancy.

Fetal Alcohol Spectrum Disorder (FASD) diagnostic clinics were identified through literature and internet searches. Clinics were sent a questionnaire asking for information on the clinic population, clinic staff, assessment process and other services provided.

Questionnaires were completed for 34 clinics: 29 were in North America, 2 in Africa, 2 in Europe and 1 in South America. No clinics were identified in Asia or Australasia. There was a variety of funding sources, services offered, clinic populations, staff and methods of assessment. Thirty-three clinics had a multi-disciplinary team. In 32 clinics, at least one member of the team had specialist training in assessment of FASD. Neurobehavioural assessment was completed in 32 clinics. Eleven clinics used more than one set of diagnostic criteria or an adaptation of published criteria.

Diagnostic services are concentrated in North America. Most responding clinics are using a multidisciplinary approach with neurobehavioural assessment as recommended in published guidelines. Agreement on diagnostic criteria would enable comparison of clinical and research data, and enhance FASD research particularly for intervention trials.

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Genetic variation in the CHRNA5 gene affects mRNA levels and is associated with risk for alcohol dependence
Molecular Psychiatry advance online publication 15 April 2008



Alcohol dependence frequently co-occurs with cigarette smoking, another common addictive behavior. Evidence from genetic studies demonstrates that alcohol dependence and smoking cluster in families and have shared genetic vulnerability.

Recently a candidate gene study in nicotine dependent cases and nondependent smoking controls reported strong associations between a missense mutation (rs16969968) in exon 5 of the CHRNA5 gene and a variant in the 3'-UTR of the CHRNA3 gene and nicotine dependence.

In this study we performed a comprehensive association analysis of the CHRNA5–CHRNA3–CHRNB4 gene cluster in the Collaborative Study on the Genetics of Alcoholism (COGA) families to investigate the role of genetic variants in risk for alcohol dependence.

Using the family-based association test, we observed that a different group of polymorphisms, spanning CHRNA5-CHRNA3, demonstrate association with alcohol dependence defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) criteria.

Using logistic regression we replicated this finding in an independent case-control series from the family study of cocaine dependence.

These variants show low linkage disequilibrium with the SNPs previously reported to be associated with nicotine dependence and therefore represent an independent observation.

Functional studies in human brain reveal that the variants associated with alcohol dependence are also associated with altered steady-state levels of CHRNA5 mRNA.


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Modulatory potential of ellagic acid, a natural plant polyphenol on altered lipid profile and lipid peroxidation status during alcohol-induced toxicity: A pathohistological study
Journal of Biochemical and Molecular Toxicology Volume 22, Issue 2 , Pages 101 - 112

Polyphenol-rich dietary foodstuffs, consumed as an integral part of vegetables, fruits, and beverages have attracted attention due to their antioxidant and anticancer properties. Ellagic acid (EA), a polyphenolic compound widely distributed in fruits and nuts, has been reported to scavenge free radicals and inhibit lipid peroxidation.

Chronic consumption of alcohol potentially results in serious illness including hepatitis, fatty liver, hypertriglyceridemia, and cirrhosis. A little is known about the influence of EA on alcohol toxicity in vivo.

Accordingly, in the present study, we have evaluated the protective effects of EA on lipid peroxidation and lipid levels during alcohol-induced toxicity in experimental rats. Forty female albino Wistar rats, which were weighing between 150-170 g were used for the study. The toxicity was induced by administration of 20% alcohol orally (7.9 g/kg body wt.) for 45 days. Rats were treated with EA at three different doses (30, 60, and 90 mg/kg body wt.) via intragastric intubations together with alcohol. At the end of experimental duration, liver marker enzymes (i.e., aspartate transaminase, alanine transaminase), lipid peroxidative indices (i.e., thiobarbituriacid reactive substances and hydroperoxides) in plasma, and lipid levels (i.e., cholesterol, free fatty acids, triglycerides and phospholipids) in tissues were analyzed to evaluate the antiperoxidative and antilipidemic effects of EA.

Liver marker enzymes, lipid peroxidative indices, and lipid levels, i.e., cholesterol, triglycerides and free fatty acids, were significantly increased whereas phospholipid levels were significantly decreased in the alcohol-administered group.

EA treatment resulted in positive modulation of marker enzymes, peroxidative indices, and lipid levels. EA at the dose of 60 mg/kg body wt. was found to be more effective when compared to the other two doses. Histological changes observed were also inconsistent with the biochemical parameters.

Our study suggests that EA exerts beneficial effects at the dosage of 60 mg/kg body wt. against alcohol-induced damage, and it can be used as a potential drug for the treatment of alcohol-abuse ailments in the near future.


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Diet, alcohol consumption, and serum lipid levels of the middle-aged and elderly in the Guangxi Bai Ku Yao and Han populations
Alcohol Volume 42, Issue 3, May 2008, Pages 219-229

Bai Ku Yao is an isolated subgroup of the Yao minority in China. The special customs and cultures including their clothings, intraethnic marriages, corn wine and rum intakes are still completely conserved to the present day. Little is known about the association of diet and alcohol consumption with serum lipid levels in this population.

The aim of this study was to compare the differences in diet, alcohol consumption, and serum lipid levels of the middle-aged and elderly between the Guangxi Bai Ku Yao and Han populations.

A total of 485 subjects of Bai Ku Yao and 501 participants of Han Chinese aged 40 and over were surveyed by a stratified randomized cluster sampling. Information on dietary intake and alcohol consumption was collected by standard questionnaires. Serum lipid levels were measured.

Education level, height, weight, body mass index, waist circumference, blood pressure, hypertension, and total energy, fat, protein, dietary cholesterol, and salt intakes were lower in Bai Ku Yao than in Han (P < .05–.001), whereas physical activity level, carbohydrate, vegetal protein, and total dietary fiber intakes were higher in Bai Ku Yao than in Han (P < .001 for all).

Serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (Apo) A1, and Apo B levels were lower in Bai Ku Yao than in Han (P < .001 for all).

The levels of triglyceride, HDL-C, Apo A1, and the ratio of Apo A1 to Apo B in Bai Ku Yao were higher, but the levels of LDL-C and Apo B were lower in drinkers than in nondrinkers.

The levels of triglyceride, HDL-C, LDL-C, Apo A1, Apo B, and the ratio of Apo A1 to Apo B in Bai Ku Yao were also influenced by the amount of alcohol consumed (P < .05–.001). High-density lipoprotein cholesterol levels in Han were higher and LDL-C levels were lower in drinkers than in nondrinkers (P < .01 for each). Serum total cholesterol, HDL-C, and LDL-C levels in Han were also associated with the amount of alcohol consumed (P < .05–.001).

The differences in the lipid levels between the two ethnic groups may partially attribute to the differences in dietary habits and alcohol consumption.

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Request Reprint E-Mail: yinruixing@yahoo.com.cn
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The OPRD1 and OPRK1 loci in alcohol or drug dependence: OPRD1 variation modulates substance dependence risk
Molecular Psychiatry (2008) 13, 531–543


Eleven single-nucleotide polymorphisms (SNPs) spanning OPRD1 were examined in 1063 European Americans (EAs) (620 cases with substance dependence (SD), including 557 with alcohol dependence (AD), 225 with cocaine dependence (CD) and 111 with opioid dependence (OD), and 443 controls).

Nominally significant associations (P<0.05) class="u">GCAACT, which harbors G80T G-allele and C921T C-allele, was significantly associated with AD (²=14.82, degrees of freedom (d.f.)=1, P<0.001),>²=9.19, d.f.=1, P=0.002) and OD (²=20.68, d.f.=1, P<0.001).

Logistic regression analyses, with sex and age being considered, demonstrated that this haplotype had a risk effect on AD (P=0.03, =1.86, odds ratio (OR)=6.43) and especially on OD (P<0.001,>=3.92, OR=50.57). Moreover, seven SNPs covering OPRK1 were examined in the majority of the above subjects (390 cases, including 327 AD, 177 CD and 97 OD subjects, and 358 controls).

Although no significant differences in allele, genotype or haplotype frequency distributions were seen between cases and controls, a specific OPRK1 haplotype, GGCTTCT, was significantly associated with AD (²=8.12, d.f.=1, P=0.004).

Logistic regression analyses also revealed its risk effect on AD (P=0.009, =1.06, OR=2.90). Population stratification artifact was not observed in the sample.

Taken together, our findings supported a positive association between OPRD1 variants and SD, and a positive haplotypic association between OPRK1 and AD in EAs.

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Request Reprint E-Mail: joel.gelernter@yale.edu
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Anticipating problem alcohol use developmentally from childhood into middle adulthood: what have we learned?
Addiction 103 (s1) , 100–108

This commentary reviews and comments on six major longitudinal studies from the United States, Great Britain and Finland, that test predictive models of drinking and problem drinking behavior across a developmental span of one to two generations.

The large Ns, in two instances involving population samples, and the broad and study-overlapping variable domains make this collection of studies unique and of special interest vis-à-vis the issue of cross-study replicability of findings.

Significant cross-study commonalities are noted, involving the strong cross-study replicability of an undercontrol/externalizing domain as both a childhood and adolescent predictor of problem drinking outcomes in early to middle adulthood, the relative autostability of heavy and problem use of alcohol over intervals of time as long as a generation, the utility of early drinking behavior as an index for later drinking outcomes, the relative parallelism (with some exceptions) of male and female findings, albeit with greater predictability of male over female drinking outcomes and the relatively tighter relational networks of drinking and other behavioral characteristics for males.

This impressive group of quasi-replications also points the field to address several next-step questions, including: (i) the need to parse the undercontrol/externalizing domain to identify those subcomponential process characteristics that are causal to heavy and problem drinking outcomes; (ii) the need to develop models that will handle more effectively the uneven relationships of negative activity to drinking outcomes, in some instances operating protectively, in other instances operating as risk factors; (iii) the need for more carefully articulated, theoretically driven process models that will specify the ordering, developmental saliency and mediational properties of risk and protective factors as they come on line; and (iv) the need for more developmental testing of trait/context interaction models of problem drinking development.


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Adolescent risk factors for adult alcohol use and abuse: stability and change of predictive value across early and middle adulthood
Addiction 103 (s1) , 84–99

To examine age-18 risk factors for alcohol use and heavy drinking during early (ages 22 and 26) and middle (age 35) adulthood, and for symptoms of alcohol use disorders (AUDs) in middle adulthood.

Many predictor variables had stable associations with alcohol use over time, although their ability to explain variance in alcohol use declined with increasing time lags. Being white predicted alcohol use, but not symptoms of AUDs. Parental drinking, risk taking and use of cigarettes and marijuana predicted heavy drinking to age 35. Planning to attend college predicted more heavy drinking at age 22 and less frequent heavy drinking by mid-life. High school theft and property damage predicted later AUD symptoms. Most associations were invariant across gender, with variations typically taking the form of stronger associations between predictors and alcohol use for men. Invariance in findings across cohorts indicates that results reflect general developmental trends rather than specific historically bounded ones.

Many adolescent individual and contextual characteristics remain important predictors of adult alcohol use and abuse, and their predictive impact varies as a function of age and type of alcohol outcome. These associations are largely equivalent across gender and cohort, thus reflecting robust developmental linkages.

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Adolescent pathways to adulthood drinking: sport activity involvement is not necessarily risky or protective
Addiction 103 (s1) , 69–83

Use pattern-centered methods to examine how adolescents' alcohol use and sports activities are related both to childhood sport and problem behavior and to heavy drinking in early adulthood.

Pattern-centered analyses revealed that the relation between adolescent sport activity and age 28 heavy alcohol use obtained primarily for sport participants who were also using more than the average amount of alcohol and other drugs at age 18. Similarly, children who were characterized by relatively high levels of sport participation, aggression and other problem behavior at age 12 were more likely than expected by chance to become sport participants who used more than the average amount of alcohol and other drugs at age 18.

The results indicate that childhood problem behavior and adolescent sport participation can, but do not necessarily, presage heavy drinking in adulthood and that pattern-centered analytical techniques are useful for revealing such theoretically generated predictions.

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A developmental approach to alcohol drinking behaviour in adulthood: a follow-up study from age 8 to age 42
Addiction 103 (s1) , 48–68

To study the links of family background, child and adolescent social behaviour, and (mal)adaptation with heavy drinking by age 20 and with the frequency of drinking, binge drinking, Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire scores and problems due to drinking at ages 27 and 42 years.

Family adversities, externalizing problem behaviours, low school success, truancy and substance use in adolescence were associated in early middle age with problems due to drinking in both genders, and to binge drinking and CAGE scores in females. The antecedents varied, however, across the indicators of drinking and gender. The frequency of drinking was least predictable by the studied antecedents. Childhood and adolescent antecedents and drinking up to age 20 explained 43% of males' and 31% of females' problem drinking at age 42; 31% and 19%, respectively, at age 27.

The early warning signs of drinking problems should be taken seriously in the preventive work for alcohol abuse. Problem drinking in early middle age is preceded by maladjustment to school, early age of onset of drinking and heavy drinking in adolescence even more significantly than problem drinking in early adulthood.

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Request Reprint E-Mail: tuuli.pitkanen@nic.fi

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Childhood and adolescent predictors of early and middle adulthood alcohol use and problem drinking: the Columbia County Longitudinal Study
Addiction 103 (s1) , 36–47

To examine the role of individually and contextually based factors measured during childhood and adolescence in predicting alcohol use and abuse measured during early and middle adulthood.

Path models showed that the effects of childhood individual variables (e.g. aggression, popularity, behavioral inhibition) on adulthood alcohol use and abuse generally were mediated by the same behavioral variables in adolescence. Specifically, both for males and for females, lower levels of behavioral inhibition and higher levels of aggression predicted adulthood alcohol variables. Childhood contextual variables (family socio-economic status and negative family interaction) were relatively weak predictors of adulthood alcohol use and abuse.

Alcohol use and abuse in adulthood, when considered in a long-term developmental–contextual framework, appear to be consistent with a general deviance model of problem behavior whereby individually based factors from childhood and late adolescence predict long-term indices of adulthood alcohol use and abuse.

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Request Reprint E-Mail: edubow@bgnet.bgsu.edu

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Childhood and adolescent predictors of heavy drinking and alcohol use disorders in early adulthood: a longitudinal developmental analysis
Addiction 103 (s1) , 23–35

To identify childhood and adolescent factors differentiating heavy alcohol users in early adulthood from more moderate users or abstainers.

For men: (i) higher amounts of alcohol consumption at age 16 increased the odds of being a heavy drinker compared to an abstainer (age 19) and a moderate drinker (ages 23 and 26); (ii) lower achievement scores at age 12 and having a mother who drank more when the participant was age 16 increased the odds of being a heavy drinker compared to moderate drinker (age 26). Higher levels of externalizing behavior problems at age 9 and drinking more when the participants were age 16 increased the odds that men would have a current alcohol use disorder at age 28.

For women: (i) drinking more at age 16 increased the odds of being a heavy drinker compared to being either an abstainer or a moderate drinker (age 26); (ii) having higher levels of achievement at age 12 increased the odds of being a heavy drinker compared to an abstainer at age 23. Adolescent alcohol use mediated the relation between externalizing behavior at age 9 and alcohol use at age 26 for women.

Problem drinking may be the result of a long-term developmental process wherein childhood externalizing behavior problems sets a pathway leading to heavy drinking during and after adolescence.

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Request Reprint E-Mail: englu008@umn.edu
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Childhood and adolescent predictors of alcohol use and problems in adolescence and adulthood in the National Child Development Study
Addiction 103 (s1) , 7–22

To identify childhood and adolescent predictors of alcohol use and harmful drinking in adolescence and adulthood.

Previous drinking was controlled in final models to predict change. Drinking was heavier among those with greater childhood and adolescent social advantage (especially females), less harmonious family relationships, more social maladjustment, greater academic performance, less internalizing problems, more truancy and earlier school-leaving plans.

Alcohol use and problems in adulthood can be predicted by indicators of social background, adjustment and behaviour in childhood and adolescence. Results demonstrate that the early roots of adolescent and adult alcohol use behaviours begin in childhood.

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Request Reprint E-Mail: jmaggs@psu.edu

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Destiny matters: distal developmental influences on adult alcohol use and abuse
Addiction 103 (s1) , 1–6

A foundational assumption in the fields of addiction and developmental psychopathology is that child and adolescent experiences set the stage for adult functioning and adjustment.

However, the empirical literature documenting life-span linkages with adult alcohol (and other drug) use and abuse is sparse. This gap is due to a slow adoption of life-span developmental conceptualizations and the lack of long-term prospective longitudinal studies.

This supplemental issue provides evidence for such linkages from six long-term longitudinal studies, which together follow individuals from birth through to the late 40s. The data sets include national and regional samples from Britain, Finland and the United States.

In this introductory paper, we consider conceptual issues concerning linkages across the life-span culminating in adult alcohol use and disorders, and provide a summary of the purposes and common themes.

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Mutual Support Resources

This resource guide to mutual aid or support resources was developed by Linda and Ernie Kurtz and is updated on a monthly basis. Many of these groups offer both face-to-face meetings and some form of online participation. These useful resources are intended primarily for people seeking or in long-term recovery from addiction to alcohol or other drugs, family members, friends and loved ones.
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Training: Science of Addiction and Recovery

Detroit, MI
June 7, 2008
Sponsored by: Detroit Recovery Project, NCADD– Greater Detroit Area, Brighton Hospital and Greater Macomb Project Vox

Registration Deadline is 5pm, June 4th! Only 40 spaces available, so register today!

Use our flyer to let others know about the upcoming training

• About the Training
• About the Trainer
• Training Follow-up
• Registration Fee
• Important Dates
• Training Schedule
• Training Location and Transportation
• Misc.

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Screening Works: Update from the Field

In the 5 years since SAMHSA launched the Screening, Brief Intervention, and Referral to Treatment (SBIRT) Initiative, the program has increasingly become an integral part of medical practice in clinics, emergency rooms, and other treatment settings.

The acceptance and value of the SBIRT approach is evidenced by the large number of patients screened, the decrease in their substance use, and the recent adoption of billing codes by insurance companies and Government payers that enable treatment providers to be reimbursed for these services.
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Life Beyond Treatment: Focusing on Recovery
Recovery-Oriented Systems of Care

The National Conference of State Legislatures (NCSL), the National Association of State Alcohol and Drug Abuse Directors (NASADAD), the State Associations of Addiction Services (SAAS), and Faces & Voices of Recovery (Faces & Voices) are embarking on a joint project that will educate state legislators and legislative staff about recovery-oriented systems of care (ROSC) for people with addiction. There are two overarching goals:

1. to significantly raise the level of awareness and knowledge among legislators and legislative staff regarding recovery-oriented systems of care; and
   
2. to provide the necessary information for state legislators to examine the policy options that will be required and to begin to take the policy actions necessary to use a recovery-oriented systems of care approach.

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Doubts raised over alcohol guidelines
April 16, 2008

Safe drinking guidelines that could soon be adopted in Australia have been slammed as flawed and unlikely to have any impact on the problem of binge drinking.

The federal government is reviewing a set of draft guidelines relating to alcohol consumption and health that recommend a more moderate approach to drinking.

The new guidelines, which would replace those issued by the National Health and Medical Research Council (NHMRC) in 2001, suggest men stick to just two standard drinks a day - down from four - and that pregnant and breastfeeding women cut alcohol out of their diets altogether.

The previous recommendation for pregnant and breastfeeding women was a maximum of one standard drink per day.

For other women, the guidelines have not changed, recommending they have no more than two standard drinks a day.

The aim of the guidelines is to minimise the risk of alcohol-related harm, such as accidents, injuries and disease.

However, a report produced by Access Economics on behalf of the Distilled Spirits Industry Council of Australia said there was a significant lack of evidence-based conclusions in the draft guidelines.
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Injury risk and drinking: technical critique


The Distilled Spirits Industry Council of Australia Inc engaged Access Economics to review a research document prepared for the Government of Australia in September 2007 titled 'Determination of injury mortality risk by volume and number of drinking occasions.

The methodology in the document was examined to determine how well the document met its aim to: 'Estimate the absolute risk of alcohol attributable injury mortality for Australians during the lifetime based on their drinking occasions, taking into account both the number of occasions and the amount consumed during these drinking occasions.'

Download Injury risk and drinking: technical critique.pdf

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Chronic ethanol exposure leads to divergent control of dopaminergic synapses in distinct target regions
Alcohol Volume 42, Issue 3, May 2008, Pages 179-190


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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Request Reprint E-Mail: julie.healey@Vanderbilt.Edu
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Employment Status and Substance Abuse Treatment Admissions, 2006

Highlights

• 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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Substance Use and Dependence Following Initiation of Alcohol or Illicit Drug Use

Highlights:

• Alcohol and illicit drug dependence were defined in SAMHSA's National Survey on Drug Use and Health using the DSM-IV diagnostic criteria which includes such symptoms as withdrawal, tolerance, unsuccessful attempts to cut down on use, and continued use despite health and emotional problems caused by the substance.

• Based on SAMHSA's National Survey on Drug Use and Health, 3.2% of the persons aged 12 or older who first used alcohol 13 to 24 months prior to the survey interview were dependent on alcohol in the past 12 months.

• Of the persons aged 12 or older who first used marijuana 13 to 24 months prior to the survey interview, 5.8% were dependent on marijuana in the past year.

• Among new users of crack cocaine in the 13 to 24 months prior to the survey interview, 9.2% were dependent on any type of cocaine in the past year.

• Of the new users of heroin in the 13 to 24 months prior to the survey interview, 13.4% were dependent on heroin in the past year.

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Quantity and Frequency of Alcohol Use among Underage Drinkers

Highlights

• SAMHSA's 2005 and 2006 National Surveys on Drug Use & Health were combined to examine the quantity and frequency of alcohol use among drinkers under the legal age, i.e., drinkers aged 12 to 20.

• Based on combined data from SAMHSA's 2005 to 2006 National Surveys on Drug Use & Health, an annual average of 28.3% of underage drinkers (10.8 million persons aged 12 to 20) drank alcohol in the past month.

• Underage drinkers who drank in the past month used alcohol an average of 5.9 days in the past month and consumed an average of 4.9 alcoholic drinks per day on the days they drank in the past month.

• Person under the legal age consumed, on average, more drinks per days on the days they drank in the past month than drinkers of legal age (4.9 drinks vs. 2.8 drinks).

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Danger as nation drowns in alcohol

Published on April 17, 2008,

By Omwa Ombara

They literally live like fish. But whereas water is the natural abode for fish, theirs is dangerous indulgence in alcohol.

Many Kenyans will recall their first alcoholic drink with nostalgia or pain. A rehabilitated alcoholic and author, Mr David Ogot ‘s first tot made his life a nightmare.

At a recent midnight strip show at Nairobi’s Florida Club on Koinange Street, I watched a group of university students initiate a female colleague into drinking.

She cried, wretched and emptied the contents from her stomach as drunken colleagues forced more alcohol down her throat. They laughed hysterically, impressed by their success in initiating one of them into the club. They did not seem to care about the implications.

Medical reports at Kenyatta National Hospital indicate that cases related to alcohol are many.
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Press Release - Androulla VASSILIOU Member of the European Commission, Responsible for HEALTH Curbing Alcohol Abuse in Europe European Alcohol and Health Forum
Brussels, 16 April 2008

Ladies and gentlemen,

As the new Commissioner for Health, I am very pleased to have the opportunity to meet you, the members and observers of the European Alcohol and Health Forum. It is now around 10 months that my predecessor Markos Kyprianou launched the European Alcohol and Health Forum. It was established as a formal and openprocess, bringing together players willing to enter into binding and verifiable commitments that could help to reduce alcohol-related harm.

I think we all agree on the need to reduce alcohol-related harm and on the fact that this is something we all need to contribute to. It is among the main Public Health challenges and, as Commissioner for Health, among my main priorities.
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Highlights from the CAMH Monitor eReport: Addiction and Mental Health Indicators Among Ontario Adults, 1977-2005

This eBulletin highlights the main findings from the 2005 CAMH Monitor, an Ontario-wide telephone survey of 2,445 adults aged 18 and older. Also highlighted are trends in alcohol, tobacco, and cannabis use, based on 20 surveys conducted between 1977 and 2005. The resulting compilation of these surveys represents the longest ongoing study of adult substance use in Canada.

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Domestic Violence and Abuse experienced by Children and Young People living in Families with Alcohol Problems: Results from a Cross-European Study


This project set out to look at children and young people across Europe, to discover what impacts having parents with both of these problems combined had on children, and then to suggest ways of improving practice and policy, within individual countries and across the EU, that would help these children.

Experts in issues relating to addiction or violence within the family from eleven institutions located within ten EU states participated in planning and overseeing this project: Germany, where experts also coordinated the project, and Austria, England, Finland, Hungary, Ireland, Malta, Netherlands, Poland and Spain.


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Alcohol in Teens Leads to Adult Woes

April 14, 2008
Nancy Shute

Like all parents, I have a long list of prayers for my daughter's safety. One of the biggies is that she'll make it through high school without killing herself or someone else because she's driving drunk. Science now says I should worry not just about car wrecks but whether drinking at a time when her brain is forming its adult connections will make her sick, sad, and lonely for the rest of her life.

Drinking is part of teenage life—a part that can range from having one beer at a party every now and then to becoming wasted enough to pass out every Saturday night. Decades of prevention efforts and parental harangues haven't changed that picture much, despite increased recognition that teen drinking is a major cause of traffic deaths.
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Use of baseline and updated information on alcohol intake on risk for breast cancer: importance of latency
International Journal of Epidemiology, Online Early 4 April 2008


Alcohol intake has been shown to be associated with an increased risk for breast cancer. In the analysis of longitudinal prospective cohort studies, however, the analysis of repeated measurements of alcohol intake might not be straightforward.

The association between alcohol intake at first measurement (baseline alcohol intake) and breast cancer was positive and approximately linear. When alcohol intake was updated during follow-up, no association was observed between breast cancer and alcohol intake. It is suggested that this difference in results may be attributable to long latency time between alcohol intake and breast cancer occurrence, because a markedly increased risk was estimated on the basis of direct lagging of risk time.

Our results support the hypothesis that baseline alcohol intake is more strongly associated with breast cancer risk than updated intake, and we suggest that this is due to the long latency between alcohol intake and breast cancer.

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Visual Aids and Standard Drink Equivalent Conversion Chart For estimating alcohol consumption In the Alcohol Use Disorders Identification Test

This study tested reliability and accuracy of the Alcohol Use Disorders Identification Test (AUDIT) screening instrument and its abbreviated versions, AUDIT-C, the first three question items, and AUDIT-3, only the third question item, after incorporating beverage specific visual aids and standard drink equivalent conversion chart into second and third question items.

Internal consistencies for AUDIT and AUDIT-C were Cronbach’s alphas 0.89 and 0.84 respectively. Areas under receiver operating characteristic curves (AUROCs) for AUDIT, AUDIT-C and AUDIT-3 were 0.96, 0.97 and 0.99 respectively.

New tools make AUDIT useful detecting early - stage alcohol related problems in settings in the world similar to Sri Lanka, a small island in South Asia, where the concept of standard drink is unknown.

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EDITORIAL - Safer Bars, Safer Streets?
Journal of Substance Use, June 2007; 12(3): 151–155




The debate about controlling alcohol-related problems is rather different from that related to either tobacco or illicit drugs. Tobacco is now increasingly viewed as being a pariah substance in most industrial societies, while the prevailing approach to illicit drugs is a punitive one. The consumption of beverage alcohol, outside much of the Moslem and Hindu world, is normative and esteemed. This is true even though the heavy and inappropriate consumption of alcohol causes massive health and social problems.

There are two distinctive approaches to alcohol control policies. The first of these is known as the ‘Public Health Approach.’ The second is called ‘Harm Minimization’ or ‘Harm Reduction.’

The Public Health Approach aims to curb the overall level of alcohol-related problems by reducing the per capita alcohol consumption (e.g. Bruun, Edwards, Lumio, Ma¨kela¨, Pan, Popham, Room, Schmidt, Skog, Sulkunen, & O ˝ sterberg, 1975; Edwards et al., 1995; Babor, Caetano, Casswell, Edwards, Giesbrecht, Graham, Grube, Gruenwald, Hill, Holder, Homel, O¨ sterberg, Rehm, Room, & Rossow, 2003). Harm Minimization aims to reduce the level of allcohol-related problems without necessarily reducing per capita alcohol consumption (Plant, Single, & Stockwell, 1997).

Apart from the degree of emphasis on reducing overall alcohol consumption levels, most of the measures suggested under the rubric of both approaches are similar. Recent reviews of the effectiveness of alternative approaches to bringing down the levels of alcohol-related problems have reached broadly similar conclusions (e.g. Plant et al., 1997; Babor et al., 2003; Stockwell, Gruenewald, Toumbourou, & Loxley, 2005; Plant & Plant, 2006). It could now be argued that these two approaches should no longer be viewed as being opposed to each other. This view is expounded below.
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Bad bars: A review of risk factors
Journal of Substance Use, June 2007; 12(3): 157–189



Bars, inns, taverns, and hotels have been popular settings for recreational alcohol consumption for centuries. The bar is firmly established as an important adjunct of leisure in many societies. Alcohol consumption in bars is mainly convivial, restrained and problem-free. Even so it has long been apparent that heavy drinking in bars is associated with aggression, violence, public disorder and injuries.

This paper examines published empirical evidence related to the possibility that problematic behaviours are associated with identifiable characteristics of a bar.

It is concluded that evidence suggests that a number of factors are associated with elevated risks that a bar will be a focus for problematic behaviour. These risk factors are considered under the following main headings: internal physical characteristics and atmosphere (e.g. layout, crowding), organizational factors (e.g. beverage promotions, entertainment), patron characteristics (e.g. gender, age), beverage choice and external characteristics (e.g. location, density).

It is concluded that the type of evidence presented here should be taken into account when reviewing licensing arrangements, designing bars and planning the location, type and density of bars in any locality where such establishments are situated.

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