You save money when you buy in bulk: does volume-based pricing cause people to buy more beer?

Health Economics Early View 3 Sep 2008

This paper uses supermarket scanner data to estimate brand- and packaging-specific own- and cross-price elasticities for beer. We find that brand- and packaging-specific beer sales are highly price elastic. Cross-price elasticity estimates suggest that individuals are more likely to buy a higher-volume package of the same brand of beer than they are to switch brands. Policy simulations suggest that regulation of volume-based price discounts is potentially more effective than a tax increase at reducing beer consumption. Our results suggest that volume-based price discounting induces people to buy larger-volume packages of beer and may lead to an increased overall beer consumption Read Full Abstract Request Reprint E-Mail: bray@rti.org ________________________________________________________________

Recovery in the United States: Past, Present, and Future

Recovery is not simply a 30-day inpatient program or a monthly trip to a clinic: it is a long-term coordinated effort on the part of the individual and the community. This program will look back on some of the successes the recovery movement has enjoyed as well as current policy initiatives to increase and enhance treatment services. It will also look forward, focusing on what remains to be done to ensure that all persons with a substance abuse and/or mental health condition get the sustained, comprehensive treatment they need.

Complete Webcast

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The NSDUH Report: Underage Alcohol Use: Where Do Young People Drink?

Highlights

• SAMHSA's 2006 National Survey on Drug Use & Health indicated that more than a fourth of the persons under the legal age for drinking actually drank in the past month, that is, there were 10.8 million current underage drinkers;

• Over a half (53.4%) of the current underage alcohol users drank at someone else's home the last time they used alcohol and another 30.3% drank in their own home.

• Younger female underage drinkers were more likely than older ones to have had their most recent drink in a car or other vehicle. For example, female underage drinkers aged 16 were eight times more likely to have had their last drank in a car than those aged 20 (12.8% vs. 1.6%).

• Among current underage drinkers aged 20, females were almost twice as likely as males to have had their most recent drink in a restaurant, bar, or club (20.0% vs. 10.2%).

Read Full Report (PDF)
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Radio DJs 'promote excessive drinking'


By Rebecca Smith, Medical Editor
04 Sep 2008

Radio presenters are encouraging binge drinking with BBC Radio 1's Chris Moyles among those to blame, says a Government funded report.

Researchers analysed comments on BBC and commercial radio shows about drinking and found presenters talked about drinking on air, being hungover at work and wetting themselves while drunk.

There were few references to responsible drinking and being drunk was made to sound 'cool', the report said.

The report, Alcohol and the Media, included an analysis of 1,200 hours of radio shows by a team at the University of the West of England in Bristol and 703 extracts were found to contain references to alcohol.

. . . . . .

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Alcohol Alert
No. 76: Alcohol and Other Drugs (2008)

Drug and alcohol dependence often go hand in hand. Research shows that people who are dependent on alcohol are much more likely than the general population to use drugs, and people with drug dependence are much more likely to drink alcohol (1). For example, Staines and colleagues (2) found that, of 248 alcoholics seeking treatment, 64 percent met the criteria for a drug use disorder at some point in their lifetime.

Patients with co-occurring alcohol and other drug use disorders also are likely to have more severe dependence-related problems than those without combined disorders—that is, they meet a higher number of diagnostic criteria for each disorder (three out of seven criteria are required to meet the diagnosis of dependence) (3). People with co-occurring alcohol and other drug use disorders are more likely to have psychiatric disorders such as personality, mood, and anxiety disorders; they are more likely to attempt suicide and to suffer health problems (3). People who use both alcohol and drugs also are at risk for dangerous interactions between these substances. For example, a person who uses alcohol with benzodiazepines, whether these drugs are prescribed or taken illegally, is at increased risk of fatal poisoning (3).

This Alcohol Alert features the latest research on alcohol and other drug use disorders, examining the frequency with which these disorders occur and overlap, evidence for common genetic risk factors, and how co-occurring disorders can be most effectively diagnosed and treated.

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Alcohol and Other Drugs
Volume 31, Number 2, 2008


WHAT IS ADDICTION? (PDF)

Alcohol and other drug (AOD) use, abuse, and dependence are far-reaching phenomena. The terms substance abuse, dependence, and addiction seek to define and describe compulsive drug use; however, these terms are imprecise and must be further validated empirically. Refining these terms will help researchers and clinicians understand these phenomena more fully, which will lead to more effective diagnosis and treatment of co-morbid AOD use disorders. This introduction by Drs. Henry R. Kranzler and Ting-Kai Li reviews the articles in this issue of Alcohol Research & Health and describes the prevalence of AOD use disorders; the complex mechanisms behind AOD use; adverse consequences of these disorders; and challenges to the evaluation and treatment of co-occurring use, abuse, and dependence on AODs. As researchers continue to explore AOD use, these terms will continue to evolve.

TIMING OF ALCOHOL AND OTHER DRUG USE (PDF)

The use of two or more drugs in combination at approximately the same time (i.e., simultaneous polydrug use [SPU]) is a major public health concern. When alcohol and other drugs are used together, the interaction can lead to dangerous consequences, such as overdose and even death. Dr. Christopher S. Martin discusses the functions of SPU for substance users, as well as the prevalence, patterns, and consequences of SPU.

AN EPIDEMIOLOGIC ANALYSIS OF CO-OCCURRING ALCOHOL AND OTHER DRUG USE AND DISORDERS (PDF)

Over the past two to three decades, researchers have intensely studied the relationships between alcohol use disorders and other drug use disorders to determine how often and why these disorders co-occur. This article by Drs. Daniel Falk, Hsiao-ye Yi, and Susanne Hiller-Sturmhöfel presents epidemiologic data obtained in the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) on alcohol and other drug co-use in the general adult population of the United States, as well as in various population subgroups. These findings are providing health care policymakers and treatment planners with a comprehensive assessment of the state of the use, co-use, and co-morbidity of alcohol and other drugs and may aid researchers in developing prevention and intervention approaches.

THE GENETICS OF ALCOHOL AND OTHER DRUG DEPENDENCE (PDF)

Studies show that certain genetic factors increase a person’s risk of both alcohol abuse and dependence and other drug abuse and dependence. Some of these factors also increase the risk of various psychiatric disorders that are characterized by uncontrolled or disinhibited behavior (i.e., externalizing disorders), including antisocial personality disorder, attention deficit/hyperactivity disorder, and conduct disorder. This article by Drs. Danielle M. Dick and Arpana Agrawal reviews and summarizes research that has identified specific genes associated with these disorders. The authors speculate that a person’s genetic risk for alcohol and other drug dependence results from both general externalizing factors and from drug use disorder–specific factors.

THE INFLUENCE OF STRESS ON THE TRANSITION FROM DRUG USE TO ADDICTION (PDF)

Stress generally is defined as any stimulus that challenges the body’s normal physiological balance. This can include disturbances induced by alcohol and other drugs. The relationship between stress and alcohol and other drug use disorders is complex. In this article, Dr. Gary Wand reviews evidence that stress and drug use are intimately related: Stress can make a person more likely to use alcohol and other drugs, and alcohol and other drug addiction can induce stress, especially in the later stages of addiction, as drug use becomes less rewarding. Thus, a dangerous interaction between stress and drug-seeking behaviors likely exists throughout the different stages of addiction.

SHARED MECHANISMS OF ALCOHOL AND OTHER DRUGS (PDF)

To understand alcohol and other drug addiction, researchers must first understand the changes that occur in the brain as a result of alcohol and other drug use. Although alcohol does not appear to activate specific brain chemical binding molecules, it does influence the activity of a key brain chemical (i.e., neurotransmitter) involved in addiction (γ-aminobutyric acid [GABA]), as well as endogenous opioids and cannabinoids. GABA is involved in both the immediate actions of alcohol and its long-term effects, including the development of tolerance and dependence. This article by Drs. Maureen T. Cruz, Michal Bajo, Paul Schweitzer, and Marisa Roberto reviews the current understanding of how alcohol, opioids, and cannabinoids interact with the neurotransmitter GABA and with each other.

DIAGNOSING CO-MORBID DRUG USE IN PATIENTS WITH ALCOHOL USE DISORDERS (PDF)

Co-occurring alcohol and other drug use disorders can have serious medical and social consequences, especially when they co-occur. However, properly diagnosing alcohol and other drug use disorders can be difficult. This article by Drs. Bachaar Arnaout and Ismene L. Petrakis discusses the importance of accurately diagnosing alcohol and other drug use disorders as a first step toward treatment and recovery. It presents a step-by-step overview of how to diagnose a substance use disorder, with a special emphasis on diagnosing drug use disorders in patients who also have alcohol use disorders.

TREATMENT OF CO-OCCURRING ALCOHOL AND OTHER DRUG USE DISORDERS (PDF)

An estimated 1.1 percent of the U.S. population has co-occurring alcohol and other drug use disorders. Relatively few studies have been conducted on the effectiveness of different treatment methods in people with co-occurring disorders; however, the evidence to date suggests that the most effective approaches are similar to those used to treat people with individual substance use disorders. This article by Drs. Albert J. Arias and Henry R. Kranzler examines how behavioral therapies such as motivation enhancement provide the “backbone” or main component of treatment for patients with alcohol and other drug use disorders and how that treatment can be supplemented by medications. The use of medications to improve outcomes in patients with co-occurring alcohol and other drug use disorders has shown initial promise, particularly for co-occurring alcohol and cocaine dependence.

ADOLESCENTS AT RISK FOR SUBSTANCE USE DISORDERS (PDF)

Adolescents with alcohol-related problems typically also use other drugs. Accordingly, researchers are trying to identify characteristics that may predict substance use disorders in adolescents. In this article, Drs. Dawn L. Thatcher and Duncan B. Clark explain that behavioral dysregulation—a pattern of behaviors characterized by cognitive, behavioral, and emotional difficulties—can predict substance use disorders in adolescents. Other studies focus on characteristics, such as certain brain waves, that are not directly observable but which link a person’s genetic makeup to disease. This research may reveal pathways that connect genetic and early environmental influences to later substance use disorders.

GLOSSARY (PDF)

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'Big bottle' binges shock staid Swiss


Peter Beaumont
The Observer,
Sunday August 31 2008

IT IS the phenomenon scandalising large parts of Switzerland, launching a feverish debate about the behaviour of the younger generation. The country of John Calvin is in the grip of a sudden predilection of its youth for mass open-air drinking parties in public parks, called botellons

The tabloid newspaper Blick has warned that 'a wave of alcohol is washing over all of Switzerland'. Far from being a peaceful gathering, it added: 'Botellon is mainly about drinking until you drop.'

. . . . . .

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Self-reported health functioning in Swedish alcohol-dependent individuals: Age and gender perspectives
Nordic Journal of Psychiatry 1 September 2008

The aim of this study was to investigate health functioning and drinking patters in a Swedish alcohol-dependent treatment sample. Gender and two age groups were, respectively, compared in these characteristics.

Differences between genders were found in drinking patterns, where men had earlier onset of first drink, earlier onset of problematic alcohol consumption and longer duration of problematic consumption. No differences between genders were found regarding somatic and psychiatric health.

When comparing the two age groups (29-47 years and 49-69 years), the younger individuals had more lifetime and current psychiatric symptoms (including depression, anxiety, suicidal ideation etc.), whereas the older individuals had more chronic somatic disorders. The younger individuals had also an earlier onset of first drink of alcohol and had started a problematic consumption at earlier ages. They had also more lifetime experience of illicit drugs (including benzodiazepines and analgesics).

The findings from the present study indicate that an age-perspective in treatment planning may be of more importance than a gender perspective, where younger individuals probably need more of psychiatric consultation and their older counterparts need more of consultations by medical professionals.

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Request Reprint E-Mail: Kristina.Berglund@psy.gu.se _______________________________________________________________

Ethanol potentiates dopamine uptake and increases cell surface distribution of dopamine transporters expressed in SK-N-SH and HEK-293 cells
Alcohol Volume 42, Issue 6, September 2008, Pages 499-508


Ethanol increases dopaminergic release in the reward and reinforcement areas of the brain. The primary protein responsible for terminating dopamine (DA) neurotransmission is the plasma membrane-bound dopamine transporter (DAT). In vitro electrophysiological and biochemical studies in Xenopus laevis oocytes have previously shown ethanol potentiates DAT function and increases transporter-binding sites. The potentiating effect of ethanol on the transporter is eliminated in Xenopus oocytes by the DAT mutation glycine 130 to threonine. However, ethanol's action on DAT functional regulation has yet to be examined in mammalian cell expression systems.

To further understand the molecular mechanisms of ethanol's action on DAT, we determined the direct mechanistic action of short-term (≤2 h) ethanol exposure on transporter function and cell surface distribution in non-neuronal human embryonic kidney cells-293 (HEK-293) and neuronal SK-N-SH neuroblastoma cells expressing the transporter. Wild-type or G130T mutant DAT were overexpressed in HEK-293 and SK-N-SH cells.

Ethanol potentiated DAT mediated [³H]DA uptake in a dose (25, 50, 100 mM), but not time dependent manner in cells expressing wild-type DAT. Ethanol-induced potentiation of uptake was significantly reduced in cells expressing the G130T mutant. Analysis of DA uptake kinetic parameters indicates 100-mM ethanol exposure increased [³H]DA uptake velocity (V_max), while affinity for DA (K_m) remained unchanged. The effect of ethanol on wild-type DAT surface expression was measured by biotinylation cell surface labeling. DAT surface expression increased 40%–50% after 1-h, 100-mM ethanol exposure.

These studies show ethanol potentiates DAT functional regulation in both neuronal and non-neuronal cells, suggesting a direct mechanistic action of ethanol on transporter trafficking in mammalian systems.

Our findings demonstrate ethanol's action on DAT function and regulation is consistent across multiple model systems.

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Request Reprint E-Mail: dayne.mayfield@mail.utexas.edu
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Chronic ethanol exposure increases the association of hippocampal mu-opioid receptors with G-protein receptor kinase 2
Alcohol Volume 42, Issue 6, September 2008, Pages 493-497



Opioid receptors (ORs) have been shown to have a significant role in the central nervous system (CNS) effects of chronic ethanol consumption. The OR antagonist, naltrexone, is used clinically to reduce continued intake.

We previously observed that chronic ethanol consumption, by adult male Sprague-Dawley rats, induced a reduction in functional coupling of mu- and delta-ORs to G-proteins in rat CNS regions, including the hippocampus. G-protein receptor kinase (GRK) 2 phosphorylates G-protein coupled receptors, including ORs, after agonist binding, as part of normal regulation and desensitization.

We tested the hypothesis that chronic ethanol exposure affects the association of the GRK2 with the mu-OR. Co-immunoprecipitation methods were used to determine if mu-OR association with GRK2 is elevated in the hippocampus after chronic ethanol, when compared to controls. Hippocampal homogenates from chronic ethanol and pair-fed control rats were treated with affinity-purified rabbit polyclonal antibodies (ab) to mu-OR, and immune complexes were probed for GRK2 by immunoblotting techniques.

Results demonstrate an association of GRK2 with mu-ORs in chronic ethanol-treated rats, but not in the controls. Possible changes in GRK2 association with ORs after chronic ethanol may be related to levels of phosphorylation and subsequent trafficking of the receptors.


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Request Reprint E-Mail: LSaland@salud.unm.edu
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Differences in ethanol drinking between mice selected for high and low swim stress-induced analgesia
Alcohol Volume 42, Issue 6, September 2008, Pages 487-492


Alcoholism is a complex disorder, still not fully understood, in which environmental and inherited risk factors play essential roles. Of particular importance may be chronic exposure to stress thought to increase preference for ethanol in genetically susceptible individuals. Animal and human data suggest that the opioid system may be involved in the development of alcohol dependence.

We studied the effects of chronic mild stress (CMS) on the voluntary intake of 8% ethanol in the mouse lines displaying high (HA) or low (LA) swim stress-induced analgesia. These lines differ in the activity of the endogenous opioid system. Normally, 8% ethanol is aversive to rodents.

We found that LA mice with the low opioid system activity exposed to CMS manifested greater ethanol intake than under no stress conditions. No such effect of CMS on ethanol consumption was observed in HA mice that display the enhanced opioid system activity.

We conclude that CMS imposed on individuals with a genetically determined low opioid activity may favor the development of ethanol abuse.

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Request Reprint E-Mail: M.Sacharczuk@ighz.pl
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Restraint stress and exogenous corticosterone differentially alter sensitivity to the sedative-hypnotic effects of ethanol in inbred long-sleep and inbred short-sleep mice
Alcohol Volume 42, Issue 6, September 2008, Pages 477-485


Decreased sensitivity to ethanol is a genetically mediated trait implicated in susceptibility to developing alcoholism.

Here, we explore genotype by environment differences in ethanol sensitivity. The relationship between acute- and repeated-restraint stress, corticosterone (CORT) levels, and sensitivity to sedative-hypnotic properties of ethanol was explored using inbred long-sleep (ILS) and inbred short-sleep (ISS) mice.

In ILS mice, acute restraint decreased ethanol sensitivity at a 4.1 g/kg dose, as measured by a decrease in the duration of loss of the righting reflex (LORE) and an increase in blood ethanol concentration at regain of the righting response (BECRR).

Repeated restraint also decreased LORE duration, but had no effect on BECRR. In the ISS mice, there was no effect of acute restraint on either LORE duration or BECRR. However, repeated restraint increased ethanol sensitivity at a 4.1 g/kg dose; with an increase in LORE duration, but a decrease in BECRR.

Differences in hypothalamic-pituitary-adrenal (HPA) axis responsiveness to restraint stress (as measured by plasma CORT) were also examined between genotypes. ILS mice displayed habituation to repeated restraint, whereas ISS mice did not. Lastly, the effect of enhanced CORT levels independent of psychological stress was examined for its effects on the sedative-hypnotic effects of ethanol.

There were no effects of CORT pretreatment on LORE duration or BECRR in ILS mice compared to saline- or noninjected littermates. In contrast, ISS mice injected with CORT showed a decreased duration of LORE, but no effects on BECRR.

These findings suggest that in addition to genetic susceptibility, environmental factors (e.g., restraint stress, exogenous CORT administration) also influence sensitivity to the sedative effects of ethanol through alteration of central nervous system sensitivity and pharmacokinetic parameters, and do so in a genotype-dependent manner.

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Request Reprint E-Mail: clarissa.parker@colorado.edu
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Acute mild footshock alters ethanol drinking and plasma corticosterone levels in C57BL/6J male mice, but not DBA/2J or A/J male mice
Alcohol Volume 42, Issue 6, September 2008, Pages 469-476




Stress is an often-reported cause for alcohol consumption in humans. Acute intermittent footshock is a frequently used paradigm to produce stress in laboratory animals including mice. The effect produced by intermittent footshock stress on ethanol self-administration has been inconsistent: both increases and decreases in ethanol consumption have been reported.

The current set of studies further investigates, in three commonly studied mouse strains, the effect of footshock stress on ethanol self-administration. Furthermore, the effect of footshock on plasma corticosterone levels was determined to investigate potential biochemical correlates.

Mild footshock stress altered ethanol self-administration and increased plasma corticosterone levels in C57BL/6J mice. Footshock stress did not alter ethanol self-administration or plasma corticosterone levels in DBA/2J or A/J mice.

These data demonstrate that mild footshock stress is a suboptimal method of modeling the stress-induced increases in ethanol consumption often reported by humans.


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Request Reprint E-Mail: doug_matthews@baylor.edu
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Intermittent binge alcohol exposure during the periadolescent period induces spatial working memory deficits in young adult rats
Alcohol Volume 42, Issue 6, September 2008, Pages 459-467


Human and animal studies suggest adolescence is a period of heightened sensitivity to adverse cognitive sequelae of alcohol exposure.

The present study assessed the effects of intermittent binge ethanol intoxication during the periadolescent period of Wistar rats on subsequent performance in a Morris water maze spatial navigation task. On postnatal days 32–56, rats were exposed to ethanol or air 3 days/week via vapor inhalation chambers. Acquisition of spatial navigation was assessed beginning 5 days after the final day of exposure, with 3 days of training in the Morris Water maze (four trials per day spaced at 90-s intertrial intervals [ITIs]). Rats were placed into the water maze at one of four positions along the perimeter, with a different release position to begin each trial. A probe trial assessed retention of platform location on the day after the final set of training trials. Four days after this probe trial, rats entered a working memory phase in which the platform was in a new location each day and a variable ITI of 1, 2, or 4 h was inserted between Trials 1 and 2; Trials 3 and 4 followed at 90-s intervals after Trial 2 on each day. The “savings” in latency to find the platform and distance traveled before finding it from Trial 1 to Trial 2 on each day served as an index of working memory.

Ethanol-exposed rats showed similar acquisition of spatial navigation as control rats during training, as well as similar retention of platform location during the probe trial. However, rats exposed to average blood alcohol level (BAL) >200 mg% showed accelerated forgetting, with decreased retention of platform location at the 2-h ITI (P < .05), compared to control rats.

Therefore, a 4-week history of intermittent ethanol exposure at BAL in excess of 200 mg% during periadolescence led to a working memory deficit in young adult rats, demonstrated by accelerated forgetting of novel information.

These behavioral data are consistent with findings from adolescent human studies, indicating that binge-style alcohol exposure during the periadolescent stage of development is associated with deficits in retention of information.


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Request Reprint E-Mail: gschulteis@vapop.ucsd.edu
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The impact of co-morbid alcohol use disorder in bipolar patients
Alcohol Volume 42, Issue 6, September 2008, Pages 451-457


Alcohol use is highly prevalent in patients with bipolar disorder (BD) and is associated with significant mortality and morbidity. The detrimental effects of each condition are compounded by the presence of the other.

The objective of this study was to examine the impact of alcohol abuse and of alcohol dependence in BD in a Brazilian sample, as indicated by clinical severity, functional impairment, and quality of life (QOL).

A cross-sectional survey of 186 bipolar outpatients were interviewed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders—4th Edition. The primary outcome measures were functioning, as indicated by the Global Assessment of Functioning Scale scores and QOL, as indicated by the World Health Organization Quality of Life Instrument. Secondary outcomes were clinical severity features.

Alcohol abuse and dependence were associated with male gender, lower education, earlier age of onset, psychosis within first episode, depressive symptoms, and worse functioning.

In addition, the presence of alcohol abuse or dependence was associated with remarkably high rates of suicide attempt.

Our findings suggest that the co-occurrence of alcohol abuse/dependence with BD increases the risk for suicide attempt, which may reflect in part the greater severity of symptoms and impaired functioning. This subgroup of bipolar patients requires a treatment tailored to address both conditions.

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Request Reprint E-Mail: kapcz@terra.com.br
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The relationships of sociodemographic factors, medical, psychiatric, and substance-misuse co-morbidities to neurocognition in short-term abstinent alcohol-dependent individuals
Alcohol Volume 42, Issue 6, September 2008, Pages 439-449


Co-morbidities that commonly accompany those afflicted with an alcohol use disorder (AUD) may promote variability in the pattern and magnitude of neurocognitive abnormalities demonstrated.

The goal of this study was to investigate the influence of several common co-morbid medical conditions (primarily hypertension and hepatitis C), psychiatric (primarily unipolar mood and anxiety disorders), and substance use (primarily psychostimulant and cannabis) disorders, and chronic cigarette smoking on the neurocognitive functioning in short-term abstinent, treatment-seeking individuals with AUD.

Seventy-five alcohol-dependent participants (ALC; 51 ± 9 years of age; three females) completed comprehensive neurocognitive testing after approximately 1 month of abstinence. Multivariate multiple linear regression evaluated the relationships among neurocognitive variables and medical conditions, psychiatric, and substance-use disorders, controlling for sociodemographic factors.

Sixty-four percent of ALC had at least one medical, psychiatric, or substance-abuse co-morbidity (excluding smoking). Smoking status (smoker or nonsmoker) and age were significant independent predictors of cognitive efficiency, general intelligence, postural stability, processing speed, and visuospatial memory after age-normed adjustment and control for estimated pre-morbid verbal intelligence, education, alcohol consumption, and medical, psychiatric, and substance-misuse co-morbidities.

Results indicated that chronic smoking accounted for a significant portion of the variance in the neurocognitive performance of this middle-aged AUD cohort.

The age-related findings for ALC suggest that alcohol dependence, per se, was associated with diminished neurocognitive functioning with increasing age.

The study of participants who demonstrate common co-morbidities observed in AUD is necessary to fully understand how AUD, as a clinical syndrome, affects neurocognition, brain neurobiology, and their changes with extended abstinence.

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Request Reprint E-Mail: timothy.durazzo@ucsf.edu
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50% of liver failures due to alcohol in Gujarat

1 Sep 2008,
Radha Sharma ,TNN

AHMEDABAD: In an irony of sorts, over 50 per cent of liver failures in the state are caused by alcoholism often claiming many lives in ‘dry’ Gujarat every year.

Doctors concede that alcoholism is indeed the leading cause of liver failure in the state - which is one of the few to continue embracing prohibition.

“Alcohol abuse accounts for 50 per cent of liver failure cases in the state,” says gastroenterologist Dr Nilay Mehta.
. . . . . .

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The developmental origin of adolescent alcohol use: Findings from the Mater University Study of Pregnancy and its outcomes
Drug and Alcohol Dependence Volume 98, Issues 1-2, 1 November 2008, Pages 136-143

It is unclear whether fetal alcohol exposure contributes to alcohol use in adolescence. In this study, we examine the association between maternal alcohol use in pregnancy and adolescents’ drinking patterns at age 14.

The association of maternal alcohol exposure with early drinking was examined in 4363 adolescents taking part to the Mater University Study of Pregnancy (MUSP) and its outcomes, a population based birth cohort study commenced in Brisbane (Australia) in 1981. Mothers and children were followed up at birth, 5 and 14 years after the initial interview. Maternal alcohol use was assessed before and during pregnancy and at the 5 years follow-up. Adolescents’ alcohol use was assessed at child age 14.

In multivariable analysis those born of mothers who consumed 3+ glasses during pregnancy were at increased risk to report drinking 3+ glasses compared with those whose mothers reported no drinking or drinking up to 2 glasses. Comparisons controlling for drinking before pregnancy and at age 5 found the averaged odds ratio of maternal drinking in pregnancy on risk of reporting alcohol consumption of 3 and more glasses at age 14 was 2.74 (CI 1.70, 4.22).

Our study suggests that they maybe a biological origin of early drinking. Further studies are needed to better disentangle the nature of the association and the role of other possible confounding factors.Rread Full Abyract

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Request Reprint E-Mail: r.alati@sph.uq.edu.au
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Using a factor mixture modeling approach in alcohol dependence in a general population sample
Drug and Alcohol Dependence Volume 98, Issues 1-2, 1 November 2008, Pages 105-114

Alcohol dependence (AD) is a complex and heterogeneous disorder. The identification of more homogeneous subgroups of individuals with drinking problems and the refinement of the diagnostic criteria are inter-related research goals. They have the potential to improve our knowledge of etiology and treatment effects, and to assist in the identification of risk factors or specific genetic factors.

Mixture modeling has advantages over traditional modeling that focuses on either the dimensional or categorical latent structure. The mixture modeling combines both latent class and latent trait models, but has not been widely applied in substance use research.

The goal of the present study is to assess whether the AD criteria in the population could be better characterized by a continuous dimension, a few discrete subgroups, or a combination of the two. More than seven thousand participants were recruited from the population-based Virginia Twin Registry, and were interviewed to obtain DSM-IV (Diagnostic and Statistical Manual of Mental Disorder, version IV) symptoms and diagnosis of AD. We applied factor analysis, latent class analysis, and factor mixture models for symptom items based on the DSM-IV criteria.

Our results showed that a mixture model with 1 factor and 3 classes for both genders fit well. The 3 classes were a non-problem drinking group and severe and moderate drinking problem groups. By contrast, models constrained to conform to DSM-IV diagnostic criteria were rejected by model fitting indices providing empirical evidence for heterogeneity in the AD diagnosis.

Classification analysis showed different characteristics across subgroups, including alcohol-caused behavioral problems, comorbid disorders, age at onset for alcohol-related milestones, and personality.

Clinically, the expanded classification of AD may aid in identifying suitable treatments, interventions and additional sources of comorbidity based on these more homogenous subgroups of alcohol use problems.


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Request Reprint E-Mail: pkuo@mail.ncku.edu.tw
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Focus on Foetal Alcohol Syndrome (FAS)

A number of members of the Global Alcohol Harm Reduction Network (GAHR-Net) recently noted the absence of any information on Foetal Alcohol Syndrome (FAS) – a specific alcohol-related harm to which harm reduction can be readily applied. A number of these members – including Peggy Seo Oba, Madaline Muir and Dr Barry Stanley – were asked to draft an introductory piece about this issue:
. . . . . .

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