Editorial - The Right Age for Drinking

It isn't 18, whatever some college officials think.

Sunday, August 24, 2008; Page B06

COLLEGE OFFICIALS who have signed on to the provocative proposition that the legal drinking age of 21 isn't working say that they just want to start a debate. Perhaps when they get done with that, they can move on to whether Earth really orbits the sun. Any suggestion that the current drinking age hasn't saved lives runs counter to the facts.
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Adolescent Risk Taking, Neighborhood Social Capital, and Health
Journal of Adolescent Health Volume 43, Issue 3, September 2008, Pages 246-252

To assess the roles of a neighborhood measure of social capital, family affluence, and risk taking on adolescent self-rated health.

Using binary logistic regression models, it is found that higher levels of risk taking and lower levels of neighborhood social capital and family affluence are independently associated with worse overall perceptions of health. These influences are not found to interact with each other.

Neighborhood social capital, risk taking, and family affluence are important factors to consider when addressing the health of adolescents. Results are discussed in terms of possible health promoting interventions.

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Request Reprint E-Mail: boycew@queensu.ca

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Invited Commentary: Is Alcohol a Risk Factor for Trauma and Chronic Disease Mortality? Narrowing the Gap Between Evidence and Action
American Journal of Epidemiology Advance Access published online on August 20, 2008


Alcohol has been linked with over 60 chronic diseases and types of trauma, and in developed countries alcohol consumption is ranked third in terms of disability-adjusted life years (of 26 risk factors considered).

In this issue of the Journal, two papers from Finland and Canada provide new evidence of the negative effects of alcohol consumption on trauma and mortality. Herttua et al. (Am J Epidemiol. 2008;000(00):000–00) used data from a natural experiment involving an increase in access to alcohol and its links to mortality; they offer provocative findings on differential impacts by gender, age, and socioeconomic level. Taylor et al. (Am J Epidemiol. 2008;000(00):000–00) focused on lifetime risk of alcohol-related injury mortality, exploring the implications for high-risk drinking patterns.

These authors offer agendas for future research on the differential impacts of policy changes according to demographic dimensions, and they highlight the need for a refined measurement of alcohol intake—since the amount of alcohol in a "standard drink" consumed by heavier drinkers is probably not the same as it is for other consumers.

There is still a substantial gap between alcohol's position as a significant contributor to mortality and disability and the implementation of effective interventions.


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Request Reprint E-Mail: Norman_giesbrecht@camh.net
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Fetal alcohol syndrome: a prospective national surveillance study
Archives of Disease in Childhood 2008;93:732-737

Fetal alcohol syndrome: a prospective national surveillance study -- Elliott et al. 93 (9): 732 -- Archives of Disease in Childhood

To describe the epidemiology of cases of fetal alcohol syndrome (FAS) seen by Australian paediatricians.

Over 1150 paediatricians submitted reports each month to the APSU. Of 169 reported cases, 92 fulfilled the study criteria for FAS. There was a significant increase in the number of children reported each year from 2001 to 2004. Of 92 children, 53.3% were male, 35.7% were preterm (<37> and 64.6% were of low birth weight (<2.5> had high risk exposure to alcohol in utero and 78.3% were exposed to one or more additional drugs. The median age at diagnosis was 3.3 years (range: newborn to 11.9 years): 6.5% were diagnosed at birth and 63% by 5 years of age. Of the 92 cases, 56% had growth deficiency, 53.2% had microcephaly, 85.9% had evidence of central nervous system dysfunction, 24% had additional birth defects, 5.4% had sensorineural deafness and 4.3% had visual impairment. Of children with FAS, 65% were Indigenous, 51% had a sibling with FAS, and only 40.2% lived with a biological parent.

Our data are the only prospective national data available on FAS throughout the world. These findings highlight the severity, complexity and impact of FAS, the need for effective strategies for prevention, and the necessity for education to facilitate earlier diagnosis, referral and reporting of cases.

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Request Reprint E-Mail: elizabe2@chw.edu.au

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Elevated synaptophysin I in the prefrontal cortex of human chronic alcoholics
Synapse Published Online: 20 Aug 2008


Convergent lines of evidence suggest potentiation of glutamatergic synapses after chronic ethanol exposure, and indicate that the presynaptic effect hereof is on modulators of synaptic strength rather than on executors of glutamate release.

To address this hypothesis in the context of ethanol dependence in humans, we used semiquantitative immunoblotting to compare the immunoreactivities of synaptophysin I, syntaxin 1A, synaptosome-associated protein 25, and vesicle-associated membrane protein in the prefrontal and motor cortices between chronic alcoholics and control subjects.

We found a region-specific elevation in synaptophysin I immunoreactivity in the prefrontal cortex of alcoholics, but detected no significant differences between the groups in the immunoreactivities of the other three proteins.

Our findings are consistent with an effect of repeated ethanol exposure on modulators of synaptic strength but not on executors of glutamate release, and suggest a role for synaptophysin I in the enduring neuroplasticity in the prefrontal cortical glutamate circuitry that is associated with ethanol dependence.

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Request Reprint E-Mail: richard.henriksson@ki.se
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The Cost of Alcohol in California
Alcoholism: Clinical and Experimental Research Published Online: 20 Aug 2008

California is the largest alcohol market in the United States. In 2005 alone, Californians consumed almost 14 billion alcoholic drinks, which contributed to many severe and potentially fatal alcohol-related illnesses and conditions. Alcohol use also causes violent and nonviolent crimes, as well as injuries and traffic collisions. While several studies have estimated the magnitude and cost of these problems nationally and others have analyzed underage drinking costs, no overall cost estimate at the state level currently exists for California.

We present the first comprehensive estimate of the cost of alcohol consumption in California.

Alcohol consumption in California led to an estimated 9,439 deaths and 921,929 alcohol-related problems, such as crime and injury in 2005. The economic cost of these problems is estimated at between $35.4 billion and $42.2 billion. Our main estimate is $38.5 billion, of which $5.4 billion was for medical and mental health spending, $25.3 billion in work losses, and $7.8 billion in criminal justice spending, property damage and public program costs. In addition, alcohol is responsible for severe reductions in individuals' quality of life in California. We estimate that the disability caused by injury, the personal anguish of violent crime victims, and the life years lost to fatality are the largest costs imposed by alcohol. The total value for this reduced quality of life in California is between $30.3 billion and $60.0 billion. Our main estimate for quality-of-life costs is $48.8 billion.

In light of the associated substantial illness, injuries, death, and high cost to society, alcohol consumption in California needs serious attention. In addition, the methods developed in this paper can be expanded to estimate the cost of alcohol in other states.

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Request Reprint E-Mail: simonr@marininstitute.org

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Binge drinking challenge



Our view: The legal drinking age of 21 should remain

August 20, 2008

A number or respected academic leaders in Maryland believe the legal drinking age should be lowered from 21 to 18, to help confront what they describe as a hidden crisis in binge drinking among students. But they offer no convincing evidence that lowering the drinking age would reduce excessive alcohol use by college students.

What we do know is that since 1984, when Congress effectively raised the national drinking age to 21, the number of young drivers charged with drunken driving has declined significantly, as has the number of alcohol-related highway deaths. That persuades us that the legal drinking age of 21 has been an effective deterrent to youthful problem drinking and should remain in place.
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Determination of Lifetime Injury Mortality Risk in Canada in 2002 by Drinking Amount per Occasion and Number of Occasions
American Journal of Epidemiology Advance Access published online on August 20, 2008

Injury is the leading cause of alcohol-attributable mortality in Canada. Risk is determined by amount consumed per occasion and accumulates across drinking episodes.

The authors estimated alcohol-attributable injury mortality in Canada for 2002 by combining the absolute risk of injury unrelated to alcohol with relative risks that were specific to gender and consumption per occasion, while taking into account lifetime number of drinking occasions.

The absolute risk increased as number of drinking occasions and number of drinks per occasion increased. The absolute risk remained relatively low at fewer than 2 drinking occasions per month, regardless of number of drinks. Absolute risk levels reached 1 in 1,000 at 5 or more drinks once per month for men and at 5–7 drinks once per month for women. The probability of mortality was 1 in 100 for all levels of consumption above 3 drinks 3 times per week for men and above 5 drinks 3 times per week for women.

No safe level of consumption is recommended based on these results, although risk is much lower for consuming 3 standard drinks or less fewer than 3 times per week.

Absolute risk reflects long-term effects of drinking patterns and is important for risk-communication and alcohol-control policy.

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Changes in Alcohol-Related Mortality and its Socioeconomic Differences After a Large Reduction in Alcohol Prices: A Natural Experiment Based on Register Data
American Journal of Epidemiology Advance Access published online on August 20, 2008


The authors examined the effect of a large reduction in the price of alcohol in Finland in 2004 on alcohol-related mortality by age and socioeconomic group.

Alcohol-related mortality increased by 16% among men and by 31% among women; 82% of the increase was due to chronic causes, particularly liver diseases. The increase in absolute terms was largest among men aged 55–59 years and women aged 50–54 years. Among persons aged 30–59 years, it was biggest among the unemployed or early-age pensioners and those with low education, social class, or income. The relative differences in change between the education and social class subgroups were small. The employed and persons aged <35> did not suffer from increased alcohol-related mortality during the 2 years after the change.

These results imply that a large reduction in the price of alcohol led to substantial increases in alcohol-related mortality, particularly among the less privileged, and in chronic diseases associated with heavy drinking.

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Request Reprint E-Mail: kimmo.herttua@helsinki.fi
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BINGE DRINKERS TOO HELPED TO CUT DOWN BY NALTREXONE

In Spain the medication naltrexone helped young regular binge drinkers cut back, potentially extending its role from alcoholics seeking treatment at specialist clinics to problem drinkers identified in other settings such as primary care.

Choose NALTREXONE HELPS HEAVY DRINKERS GAIN CONTROL from the issue 9 listing or go direct to:

http://findings.org.uk/count/downloads/download.php?file=nug_9_8.pdf
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STARTING WITH A MOTIVATIONAL SESSION MAKES THE MOST OF TREATMENT

At a US outpatient alcohol service an initial motivational interview was more effective than 'role induction' (informing the patient about the treatment) at encouraging new clients to stay longer and to gain more from the treatment which followed.

Choose INITIAL MOTIVATIONAL SESSION... from the issue 9 listing or go direct to:

http://findings.org.uk/count/downloads/download.php?file=nug_9_7.pdf
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BRIEF COUNSELLING MAY BE ENOUGH FOR LESS SEVERELY AFFECTED PATIENTS

Usually brief interventions are reserved for people not actually seeking treatment for their substance use (eg, see entry above) but this Australian study confirmed that relatively brief counselling has a potential role as a first-line response for less severely affected treatment-seeking drinkers.

Choose ALCOHOL COUNSELLING: TRY BRIEF THERAPY FIRST from the issue 9 listing or go direct to:

http://findings.org.uk/count/downloads/download.php?file=nug_9_6.pdf
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NURSES CAN NOT JUST TREAT DRINK-RELATED INJURIES BUT HELP PREVENT THEM

This British study found that young men who had suffered facial injuries after heavy drinking significantly cut back after brief motivational counselling in a hospital clinic specialising in these types of injury. The fact that these clinics see many heavy drinkers makes such work particularly worthwhile. Importantly, the clinic's own nurses were able to conduct the intervention.

Choose NURSES HELP PREVENT HAZARDOUS DRINKING... from the issue 9 listing or go direct to:

http://findings.org.uk/count/downloads/download.php?file=nug_9_5.pdf

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Press Release - BMA Scotland response to the Scottish Government's proposed strategy to tackle alcohol misuse
(issued by BMA Scotland Wednesday 20 Aug 2008)



Doctors today (Wednesday 20 August 2008) called for action, not words, to tackle alcohol misuse in Scotland.

The BMA Scotland response to the Scottish Government’s proposed strategy to tackle alcohol misuse, argues that voluntary measures have failed* and states that legislation and practical action is now required.
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Lower Drinking Age Is Criticized


Politics and Safety Cloud College-Led Bid to Spur Debate

Washington Post Staff Writers
Thursday, August 21, 2008; Page A01

On the face of it, the notion seems counterintuitive, but to the presidents of some of the nation's most prestigious colleges, it makes a lot of sense: Lowering the legal drinking age might get students to drink less.
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Battle of the binge

Colleges that want to lower the drinking age need to first try innovative prevention.

By | The Monitor Editorial Board

August 21, 2008

Do college students really like to get drunk? The question should be thrown at the nearly 100 college presidents asking government to consider lowering the legal drinking age to 18 from 21. If colleges simply assumed most young people prefer not to imbibe, they'd find ways to help them be teetotal rather than tipsy.

It's all too easy for American colleges and universities to push for a lower drinking age and avoid the hard work and innovative ways to discourage alcohol consumption, on campus or off.

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Negative symptoms are associated with less alcohol use, craving, and “high” in alcohol dependent patients with schizophrenia
Schizophrenia Research Article in Press, Online 13 August 2008

Alcohol use disorders (AUDs) frequently co-occur with and exacerbate schizophrenia, yet the specific relationships between schizophrenia symptoms and alcohol use remain unclear.

PANSS scores were correlated with measures of alcohol and other substance use in patients with schizophrenia-spectrum disorders and AUDs entering a trial of monitored naltrexone treatment. Data were analyzed from the first 80 participants; 55% had schizophrenia and 45% had schizoaffective disorder. All had AUDs; 95% had alcohol dependence and 5% alcohol abuse; 34% also had cannabis abuse/dependence and 31% cocaine abuse/dependence.

PANSS Negative scores were inversely correlated with Addiction Severity Index alcohol composite scores, alcohol craving, quality of alcohol “high” (euphoria), and with frequency of cannabis use. An exploratory analysis indicated that the negative symptoms that may most strongly correlate with less alcohol use, craving and/or euphoria were passive/apathetic social withdrawal, blunted affect, difficulty in abstract thinking, and stereotyped thinking. Higher PANSS Composite scores, indicating the predominance of positive over negative PANSS symptoms, correlated with more alcohol craving and cannabis use. Higher PANSS General scores were associated with more alcohol craving.

These findings extend previous reports of the association of negative schizophrenia symptoms with less alcohol and substance use to patients with AUDs and indicate that this relationship also includes less alcohol craving and less alcohol euphoria. The findings may also provide some initial evidence that specific negative symptoms may be keys to these relationships.

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Request Reprint E-Mail: steven.batki@ucsf.edu

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Decreased neural activity in reward circuitry during personal reference in abstinent alcoholics - A fMRI study
Human Brain Mapping Published Online: 18 Aug 2008


Two of the most striking features in alcoholism are the irresistible craving for alcohol and the proceeding neglect of other activities and pleasures that were formerly relevant. Craving has been investigated extensively and is commonly due to a dysfunctional reward system. The neural basis of the neglect of self-relevant interests, which can be described as altered personal reference, and its association to the reward system, however, remains unclear.

Using fMRI, we investigated neural activity during a paradigm that tested for both reward and personal reference with regard to the same stimuli, i.e., alcoholic and nonalcoholic pictures, in healthy subjects and abstinent alcoholic patients.

Alcoholic patients showed slightly reduced signal changes in the brain stem adjacent to ventral tegmental area (VTA) and in the ventromedial prefrontal cortex (VMPFC) during the reward task, while we found no alterations in the right and left ventral striatum (VS). The same regions (VS, VTA, and VMPFC), however, showed reduced signal changes during personal reference with lack of neural differentiation between high and low referenced stimuli in alcoholic patients.

In summary, we demonstrate for the first time neurophysiological alterations in reward circuitry during personal reference in alcoholic patients. Our results underline the important role of the reward circuitry during personal reference in the pathophysiology of alcohol addiction.

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Request Reprint E-Mail: moritz.degreck@med.ovgu.de
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Reforming the Soviet model: Alcohol treatment services in Kazakhstan
Addiction Research & Theory, Volume 16, Issue 4 August 2008 , pages 319 - 330

Based on documentary and interview material this article reviews key aspects of the current alcohol treatment services in Kazakhstan and assesses the extent to which the Soviet model has been superseded.

Before 1991, alcohol services in Kazakhstan were typical for the USSR: government providers delivered psychiatry-led treatments free of charge as part of a centralised and hierarchical system in which compulsion and breaches of confidentiality were integral.

Since independence, the collapse of the communist state and the introduction of a market economy have altered the context in which the Soviet model of treatment services operates. There is no longer a single centralised provider and treatment is no longer necessarily free at the point of delivery. However, within the statutory sector, which still dominates service provision, the individual components of the Soviet model are relatively unchanged.

Reforms in methods and delivery of treatments are likely to take place as economic prosperity increases and professional isolation weakens; the extension of patient rights may depend on wider social and political developments in the republic.

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Toping, not tax, on Nelson's agenda



Mark Metherell and Phillip Coorey
August 20, 2008

IT WAS a case of no one mention the war when Brendan Nelson opened his forum on teenage binge drinking at Parliament.

The Opposition Leader made it clear to the 20 or so alcohol interest-group representatives he was not expecting them to debate the issue that actually triggered the forum: the controversial 70 per cent tax increase on alcopops announced by the Government earlier this year.

In his opening remarks, Dr Nelson said he accepted that some of the leaders at the forum would back the Government's tax increase while others would oppose it. However, his "very strong view" was that there was a problem with alcohol abuse that was "overstated to some extent by various sections of the media and some people in public life".

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College presidents seek debate on drinking age

By JUSTIN POPE

The Associated Press
Monday, August 18, 2008

-- College presidents from about 100 of the nation's best-known universities, including Duke, Dartmouth and Ohio State, are calling on lawmakers to consider lowering the drinking age from 21 to 18, saying current laws actually encourage dangerous binge drinking on campus.

The movement called the Amethyst Initiative began quietly recruiting presidents more than a year ago to provoke national debate about the drinking age.

"This is a law that is routinely evaded," said John McCardell, former president of Middlebury College in Vermont who started the organization. "It is a law that the people at whom it is directed believe is unjust and unfair and discriminatory."

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Colleges: Drinking age 'not working'

Presidents say lowering from 21 may cut binges

By Stephen Kiehl |Sun reporter

August 19, 2008

Top university officials in Maryland - including the chancellor of the state university system and the president of the Johns Hopkins University - say the current drinking age of 21 "is not working" and has led to dangerous binges in which students have harmed themselves and others.

Six college presidents in Maryland are among more than 100 college and university presidents nationwide who have signed a statement calling for a public debate on rethinking the drinking age.
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Welcome to the Amethyst Initiative

Launched in July 2008, the Amethyst Initiative is made up of chancellors and presidents of universities and colleges across the United States. These higher education leaders have signed their names to a public statement that the 21 year-old drinking age is not working, and, specifically, that it has created a culture of dangerous binge drinking on their campuses.

The Amethyst Initiative supports informed and unimpeded debate on the 21 year-old drinking age. Amethyst Initiative presidents and chancellors call upon elected officials to weigh all the consequences of current alcohol policies and to invite new ideas on how best to prepare young adults to make responsible decisions about alcohol use.

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Self-concept disturbances: Cognitive vulnerability for early drinking and early drunkenness in adolescents at high risk for alcohol problems
Addictive Behaviors Volume 33, Issue 10, October 2008, Pages 1282-1290


We tested the hypotheses that adolescents with few positive and many negative self-schemas would drink and get drunk earlier than adolescents with many positive and few negative self-schemas.

When considering the combined effects of the number of positive and negative self-schemas, antisociality, and parental alcoholism on drinking outcomes, the number of negative self-schemas directly predicted early drinking onset, whereas the number of positive self-schemas moderated the effects of antisociality on early drunkenness.

Moreover, although self-concept properties at baseline did not differentiate level of alcohol involvement at follow-up in mid-adolescence, they did distinguish earlier from later age of onset among those who initiated, with effects tending to be somewhat stronger for boys than girls.

Self-schemas appear to be an additional risk factor in the pathway to problem alcohol involvement in adolescence, above and beyond the contributions of such known risk factors as antisocial behavior and parental alcoholism.

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Alcohol significantly lowers the seizure threshold in mice when co-administered with bupropion hydrochloride
Annals of General Psychiatry 2008, 7:

Bupropion HCl is a widely used antidepressant that is known to cause seizures in a dose-dependent manner. Many patients taking antidepressants will consume alcohol, even when advised not to. Previous studies have not shown any interactions between bupropion HCl and alcohol. However, there have been no previous studies examining possible changes in seizure threshold induced by a combination of alcohol and bupropion HCl.

The results show that administration of IP bupropion HCl alone induced seizures in mice in a dose-dependent manner, with the 120 mg/kg dose having the largest effect. The percentage of convulsing mice were 0%, 20%, 30% and 60% in the 0 (vehicle), 100, 110, and 120 mg/kg dose groups, respectively. Pretreatment with ethanol produced a larger bupropion HCl-induced convulsive effect at all the doses (70% each at 100, 110 and 120 mg/kg) and a 10% effect in the ethanol + vehicle only group. The convulsive dose of bupropion HCl required to induce seizures in 50% of mice (CD50), was 116.72 mg/kg for bupropion HCl alone (CI: 107.95, 126.20) and 89.40 mg/kg for ethanol/bupropion HCl (CI: 64.92, 123.10).

These results show that in mice alcohol lowers the seizure threshold for bupropion-induced seizures. Clinical implications are firstly that there may be an increased risk of seizures in patients consuming alcohol, and secondly that formulations that can release bupropion more readily in alcohol may present additional risks to patients.

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Biphasic Effects of Moderate Drinking on Prolactin During Lactation
Alcoholism: Clinical and Experimental Research Published Online: 18 Aug 2008



Contrary to the popular lore that encourages women to drink alcohol as an aid to lactation, we previously showed that alcohol consumption disrupted lactational performance and the hormonal milieu of the lactating mother in the short term.

Alcohol consumption increased basal PRL levels (p < class="i">p < class="i">p <>

Effects of alcohol on suckling-induced PRL were biphasic in nature, but could not explain the deficits in lactational performance. Such findings provide further evidence that the dynamic changes in neuroendocrine state are integrally involved in alcohol's effects over time and underscore the complexity of lactation.

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Request Reprint E-Mail: mennella@monell.org

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Likelihood of Illegal Alcohol Sales at Professional Sport Stadiums
Alcoholism: Clinical and Experimental Research Published Online: 18 Aug 2008

Several studies have assessed the propensity for illegal alcohol sales at licensed alcohol establishments and community festivals, but no previous studies examined the propensity for these sales at professional sport stadiums.

In this study, we assessed the likelihood of alcohol sales to both underage youth and obviously intoxicated patrons at professional sports stadiums across the United States, and assessed the factors related to likelihood of both types of alcohol sales.

The overall sales rates to the pseudo-underage and pseudo-intoxicated buyers were 18% and 74%, respectively. In the multivariate logistic analyses, we found that the odds of a sale to a pseudo-underage buyer in the stands was 2.9 as large as the odds of a sale at the concession booths (30% vs. 13%; p = 0.01). The odds of a sale to an obviously intoxicated buyer in the stands was 2.9 as large as the odds of a sale at the concession booths (89% vs. 73%; p = 0.02).

Similar to studies assessing illegal alcohol sales at licensed alcohol establishments and community festivals, findings from this study shows the need for interventions specifically focused on illegal alcohol sales at professional sporting events.

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Request Reprint E-Mail: toome001@umn.edu

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Acute Ethanol Effects on Local Cerebral Glucose Utilization in Select Central Nervous System Regions of Adolescent Alcohol-Preferring (P) and Alcohol-Nonpreferring (NP) Rats
Alcoholism: Clinical and Experimental Research Published Online: 18 Aug 2008

Alcohol abuse among adolescents is a major health and developmental problem. The 2-[¹⁴C]deoxyglucose (2-DG) technique allows for the in vivo quantification of local cerebral glucose utilization (LCGU) as a measure of functional neuronal activity.

Acute ethanol injection significantly decreased LCGU rates in select brain regions including the olfactory tubercles, the frontal cortex (Fr), and subregions of the posterior hippocampus (pCA1 and pCA3). Acute ethanol had no significant effects on LCGU rates in any region of the adolescent NP rats. Significant basal LCGU rate differences were apparent between the rat lines in a nearly global fashion with adolescent P rats having much higher basal LCGU rates compared

These findings suggest that the adolescent P and NP rats are less sensitive to the effects of acute ethanol than their adult counterparts. The adolescent P rat is relatively more sensitive to the initial effects of acute ethanol in select brain regions as compared with the adolescent NP rat.

Additionally, the innate hyper-excited state of the adolescent P central nervous system is a likely factor in the development of their high alcohol drinking behaviors.

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Request Reprint E-Mail: wstrothe@iupui.edu

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Markers of Oxidative Stress and Systemic Vasoconstriction in Pregnant Women Drinking ≥48 g of Alcohol per Day
Alcoholism: Clinical and Experimental Research Published Online: 18 Aug 2008

The precise pathway by which alcohol causes the characteristic features of fetal alcohol spectrum disorders is unknown. Proposed mechanisms for fetal injury from maternal alcohol use include cellular damage from oxidative stress and impaired fetal oxygenation related to maternal systemic vasoconstriction.
\
Our objective was to compare the levels of urinary markers of oxidative stress and systemic vasoconstriction between women consuming large amounts of alcohol during pregnancy and women who did not drink alcohol during pregnancy.

In crude analyses, there was no significant difference in 8-isoprostane F2α between pregnant drinkers and nondrinkers (2.16 vs. 2.08 ng/mg creatinine, respectively, p = 0.87). There were no significant differences between the drinking and nondrinking groups in levels of 2,3-dinor-6-keto-prostaglandin F1α (1.03 vs. 1.17 ng/mg creatinine, repectively, p = 0.50), 11-dehydro-thromboxane B2 (0.72 vs. 0.59 ng/mg creatinine, respectively, p = 0.21), or the ratio of vasodilatory metabolite to vasoconstrictive metabolite (1.73 vs. 2.72, respectively, p = 0.14). Adjusting for maternal age, marital status, smoking, and gestational age at sampling did not substantially alter the results.

Our results show no difference in levels of urinary eicosanoid markers of oxidative stress and systemic vasoconstriction between pregnant women who drink heavily and pregnant women who abstain. These findings speak against a role for maternal oxidative stress or systemic vasoconstriction in the pathogenesis of alcohol damage to the fetus.

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Request Reprint E-Mail: MillsJ@mail.nih.gov
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Neuropsychological Characteristics of Italian Children With Fetal Alcohol Spectrum Disorders
Alcoholism: Clinical and Experimental Research Published Online: 18 Aug 2008


Children with fetal alcohol spectrum disorders (FASD) display many problems ranging from deficits in intelligence to behavioral difficulties. Thus, many studies have aimed at defining the neuropsychological characteristics of children with FASD.

The current article describes the neuropsychological characteristics of Italian children with severe diagnosis within FASD and compares them with controls. It was expected that intellectual functioning, language comprehension, academic skills, and inattention/hyperactivity would discriminate children with FASD from randomly selected peers without FASD.

Children diagnosed with a FASD achieved lower scores than control children on Verbal, Performance, and Full Scale IQ. Profile analysis of the WISC-R indicates overall differences between the groups. However, some intact functioning within the FASD group was found, as the Similarities and Vocabulary subtests were similar to the controls. After an alpha adjustment to 0.004, the Block Design, Object Assembly, and Mazes subtests were significantly different from controls. On tests of nonverbal reasoning, language comprehension, and academic achievement, the children with a FASD scored significantly lower. Moreover, teachers rated children with a severe diagnosis within FASD as showing more inattentive symptoms than controls, while hyperactive/impulsive characteristics among children with a FASD were comparable with the control children. Significant correlations between head circumference, child dysmorphology, WISC-R, and Raven CPM scores are also reported.

This study indicates that a sample of Italian children with a FASD, when compared with control children, display poorer functioning on measures of general intelligence, nonverbal reasoning, academic achievement, and teacher-rated problem behaviors. The findings also contribute to the formulation of a neuropsychological profile of children diagnosed with a FASD.

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Effects of Functional Polymorphisms Related to Catecholaminergic Systems on Changes in Blood Catecholamine and Cardiovascular Measures After Alcohol Ingestion in the Japanese Population
Alcoholism: Clinical and Experimental Research Published Online: 18 Aug 2008

The polymorphism of human aldehyde dehyrogenase-2 (ALDH2) Glu⁴⁸⁷Lys is well known to be a crucial factor underlying the genetic background for alcohol sensitivity in Asian populations. Subjects with the inactive Lys⁴⁸⁷ allele show a marked increase in blood acetaldehyde level after alcohol intake, which results in facial flushing and various cardiovascular-related symptoms. However, other polymorphisms related to catecholaminergic systems that tightly regulate the activity of the sympathetic nervous system may also influence the physiological changes after acute alcohol intake.

Among the polymorphisms examined in this study, haplotypes of the phenylethanolamine N-methyltransferase (PNMT) promoter [(−182bpG/A)_(−387bpG/A)] and catechol-O-methyltransferase (COMT) exon 4 [(Ex4 + 119bpC/G)_(Ex4 + 138bpG/A), Leu¹³⁶Leu_Val¹⁵⁸Met] are suggested to have functionally important effects on alcohol-induced cardiovascular symptoms by affecting blood catecholamine levels. The neuropeptide Y (NPY) promoter C-1450T genotype is also suggested to be involved in the individual differences in regulation of catecholamine secretion.

This study suggested that these common polymorphisms of genes related to catecholaminergic systems, as well as those of the alcohol metabolizing system, are significant for understanding the basis of individual differences in alcohol sensitivity.

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Reqiest Reprint E-Mail: saijohk@med.kanazawa-u.ac.jp

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Incidence of Cardiovascular and Cerebrovascular Disease in Danish Men and Women With a Prolonged Heavy Alcohol Intake
Alcoholism: Clinical and Experimental Research Published Online: 18 Aug 2008

Several epidemiological studies have found U- or J-shaped relationships between alcohol intake and cardiovascular conditions. The influence of heavy drinking is, however, sparsely studied. The objective of the present study was to examine whether alcohol addicts have higher incidence rates of cardio- and cerebrovascular diseases than the population in general.\

During the period 1977 to 2001 a total of 9,397 events of cardio- and cerebrovascular disease were observed. In both men and women, statistically significant higher incidence rates than would be expected in a standard population were observed for cardiovascular diseases (e.g., ischemic heart diseases, men: SIR = 1.76; 95% CI 1.69–1.83; women: SIR = 2.44; 95% CI 2.19–2.73) and cerebrovascular diseases (e.g., hemorrhagic stroke, men: SIR = 2.71; 95% CI 2.45–2.99; women: SIR = 2.77; 95% CI 2.18–3.48).

The study indicates increased risks of cardio- and cerebrovascular diseases in subjects with an excessive alcohol intake.

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Government set to give National Alcohol Policy a chance

by SUNDAY STANDARD REPORTER
17.08.2008

Government has decided to postpone the implementation of the 70 % alcohol levy to give stakeholders a chance to come up with alternative solutions to alcohol abuses that President Ian Khama has indicated he wants to resolve as a matter of urgency.

This past week, the leading brewer, Kgalagadi Breweries, together with other private sector stakeholders under the ambit of BOCCIM (Botswana Confederation of Commerce and Industry Manpower), started holding workshops aimed at coming at the National Alcohol Policy.
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Action group urges continued alcohol sales data

August 18, 2008

The spokesman for the People's Alcohol Action Coalition in Alice Springs says data collection on alcohol sales needs to change for evidence-based policies to be effective.

Dr John Boffa's call was in response to concerns the Australian Bureau of Statistics is considering abandoning its current practice of publishing annual alcohol sales statistics.

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One in three women drink while pregnant

August 17, 2008


One in three women drink during pregnancy and 16 per cent smoke, according to new research which argues policy makers should be tackling the two habits together.
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Alcohol sales data are essential for good public policies towards alcohol
MJA 2008; 189 (4): 188-189

Australians pay a substantial price for the pleasure they derive from alcohol. According to the latest estimate, on a net basis, alcohol accounts for 2.2% of the total disease burden in Australia.1 This is marginally more than illicit drugs (2.0%), but alcohol’s toll would be even higher if the 3430 deaths of young adults caused by alcohol-related road crashes, accidents, assaults, suicide and other causes were not partially offset by 2345 deaths from heart disease counted (some would argue erroneously) as having been averted by moderate drinking in adults over the age of 65.
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Parental drug use, early adversities, later childhood problems and children's use of tobacco and alcohol at age 10: birth cohort study
Addiction Published Online: 14 Aug 2008

To estimate the prevalence of alcohol and tobacco use among children at age 10 years and to investigate possible influences on this.

A total of 1.3% of children reported smoking and 1.8% reported drinking alcohol, with boys reporting higher use than girls. Parental social disadvantage was the strongest predictor of children's smoking and also predicted children's alcohol use. Some of this association appeared to be mediated through the greater experience of childhood behavioural and cognitive problems among the disadvantaged. Parental smoking and paternal alcohol use had little independent influence on offspring drug use. Postnatal, rather than prenatal, maternal alcohol use predicted children's alcohol use.

Strategies to prevent early initiation of tobacco and alcohol use should focus upon the reduction of childhood social disadvantage and the behavioural and cognitive problems associated with this.

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Will we ever find the genes for addiction?
Addiction Published Online: 14 Aug 2008

To assess the likelihood of finding genes which predispose to addiction and to present this information in a form accessible to the general readership of Addiction.

The search for the genetic susceptibility variants for many complex illnesses has been ongoing for decades, with increased pace in the last 20 years. However, until very recently only a small number of such variants have been found. Recent studies have used several thousand samples in genome-wide association studies and the latest genotyping technology and have reported a growing number of successes, but have highlighted the need for even larger samples and new statistical methods or new experimental approaches to identify fully the genes involved in the disease process. The phenotype for addiction to drugs is not well defined, and the heritability of addiction to drugs of abuse is far from clear and may be small compared to that of many other complex disorders. The absolute requirement for the administration of drugs before addiction can occur, and other environmental factors known to have a major effect, makes the selection of both probands and controls challenging for genetic studies. Many candidate genes put forward so far as susceptibility genes may be unrelated to the underlying process referred to as addiction but, rather, are related to the propensity to take drugs in the first place.

It is the underlying biological process which changes to an alternative state following addiction, which is the target of investigation, and it is not clear that even genome-wide association studies with sample sizes a magnitude greater than those reported so far would identify the genes involved which have the largest effect. Ultimately, modern neurobiological approaches may identify this process and the genes involved, and even at this stage identifying the susceptibility variants will require both biological as well as genetic analysis.

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Youth exposure to alcohol use and brand appearances in popular contemporary movies
Addiction Published Online: 14 Aug 2008

To describe alcohol use and alcohol brand appearances in popular movies and estimate adolescents' exposure to this alcohol-related content.

Most movies (83%, including 56.6% of G/PG-rated movies) depicted alcohol use and 52% (including 19.2% of G/PG movies) contained at least one alcohol brand appearance, which consisted of branded use by an actor 30.3% of the time. These movies exposed the average US adolescent 10–14 years of age to 5.6 [95% confidence interval (CI) 5.4, 5.7] hours of movie alcohol use and 243.8 (95% CI 238, 250) alcohol brand appearances (5 billion in total), mainly from youth-rated movies. Exposure to movie alcohol content was significantly higher among African American youth than youth of other races.

Alcohol use and brand appearances are portrayed frequently in popular US movies (which are distributed world-wide). Children and adolescents in the United States are exposed to hours of alcohol use depictions and numerous brand appearances in movies and most of this exposure is from movies rated for this segment of the population.

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