The Gordie Foundation Presents Inaugural National GORDIEday to Promote Alcohol Awareness on College & University Campuses Across the Country

Event to Commemorate Gordie Bailey & 1,700 Students Who Die Annually as a Result of Alcohol Misuse

DALLAS, TX, Oct 10, 2008 (MARKET WIRE via COMTEX) -- On October 22, 2008, thousands of college students across the nation will participate in National GORDIEday in observance of National Collegiate Alcohol Awareness Week to raise awareness about the dangers of binge drinking and hazing and commemorate the lives of more than 1,700 students who die each year as a result of alcohol-related incidents.

National GORDIEday is presented by The Gordie Foundation, a nonprofit organization founded in memory of Lynn Gordon Bailey, Jr., a freshman who died of alcohol poisoning following a fraternity hazing incident at the University of Colorado in 2004. The Gordie Foundation's mission is to provide today's young people with the skills to navigate the dangers of alcohol, binge drinking, peer pressure, and hazing.

As part of that mission, the organization created a peer-to-peer advocacy program on campuses across the country called the Circle of Trust. To date there are more than 100 Circle of Trust chapters on university and college campuses in the United States that have been invited to participate in National GORDIEday. For a complete list of participating campuses, please visit www.gordie.org.
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Energy Intake Estimates of Respondent-Measured Alcoholic Beverages
Alcohol and Alcoholism Advance Access published online on October 8, 2008


The aim of this study was to demonstrate a methodology for estimating detailed energy intake from alcoholic beverages.

Participants were 315 monthly drinkers who completed a drink-measuring exercise. Energy intake from alcohol and non-alcohol ingredients was calculated for all beverages consumed.

Measured alcoholic beverages had on average 140 kilocalories, with 26% of the energy coming from non-alcohol ingredients. The average monthly kilocalorie intake, from all alcoholic beverage types, was 6423 kilocalories. Self-measured wine and spirits drinks contained more energy than reference standards for size and ethanol concentration.

Amount and sources of kilocalories differ by drink type, gender, age, education and BMI. Researchers and consumers should be aware of this variation and its sources.

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Assessing the General Health of Diagnostic Orphans Using the Short Form Health Survey (SF-12v2): A Latent Variable Modelling Approach
Alcohol and Alcoholism Advance Access published online on October 8, 2008


Research has demonstrated that diagnostic orphans (i.e. individuals who experience only one to two criteria of DSM-IV alcohol dependence) can encounter significant health problems. Using the SF-12v2, this study examined the general health functioning of alcohol users, and in particular, diagnostic orphans.

Current drinkers (n = 26,913) in the National Epidemiologic Survey on Alcohol and Related Conditions were categorized into five diagnosis groups: no alcohol use disorder (no-AUD), one-criterion orphans, two-criterion orphans, alcohol abuse and alcohol dependence. Latent variable modelling was used to assess the associations between the physical and mental health factors of the SF-12v2 and the diagnosis groups and a variety of background variables.

n terms of mental health, one-criterion orphans had significantly better health than two-criterion orphans and the dependence group, but poorer health than the no-AUD group. No significant differences were evident between the one-criterion orphan group and the alcohol abuse group. One-criterion orphans had significantly poorer physical health when compared to the no-AUD group. One- and two-criterion orphans did not differ in relation to physical health.

Consistent with previous research, diagnostic orphans in the current study appear to have experienced clinically relevant symptoms of alcohol dependence. The current findings suggest that diagnostic orphans may form part of an alcohol use disorders spectrum severity.

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Serotonin transporter (5-HTTLPR) and monoamine oxidase (MAOA) promoter polymorphisms in women with severe alcoholism
Archives of Women's Mental Health Online First October 01, 2008

The serotonin system is known to play a pivotal role for mood, behaviour and psychic illness as e.g. alcoholism. Alcoholism in both males and females has been associated with polymorphisms in genes encoding for proteins of importance for central serotonergic function.

Genotyping of two functional polymorphisms in the promoter region of the serotonin transporter and monoamine oxidase-A, respectively, (5-HTT-LPR and MAOA-VNTR), was performed in a group of women with severe alcohol addiction. A large sample of adolescent females from a normal population was used as controls.

A significantly higher frequency of the LL 5-HTT genotype (high activity) was found in female addicts without a known co-morbid psychiatric disorder than in the controls. Genotype of the MAOA-VNTR polymorphism did not differ significantly between addicts and controls.

However, within the group of alcoholics, when the patients with known co-morbid psychiatric disorders were excluded, aggressive anti-social behaviour was significantly linked to the presence of the high activity MAOA allele.

The pattern of associations between genotypes of 5-HTT-LPR and MAOA-VNTR in women with severe alcoholism differs from most corresponding studies on males.


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Request Reprint E-Mail: Jarmilla.Hallman@UASPsyk.uu.se
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An Assessment of the Economic Evidence Base Underlying the Scottish Alcohol Consultation

A Report for ASDA

September 2008

This report aims to assess the recommendations in the Scottish government in their consultation paper: ‘Changing Scotland’s relationship with alcohol: a discussion paper on our strategic approach’, in particular its recommendation to impose a minimum price for alcohol. We study the responsiveness of demand for alcohol to price and how this may vary between different alcohol users. We also consider the distributional consequences of alcohol taxation and regulation and the evidence on the wider influences on alcohol consumption.

2. Key findings

The key findings in this report are:

• While increases in prices are likely to reduce demand, there is uncertainty over the responsiveness of demand to changes in price
• The evidence shows that in many cases demand for alcohol is relatively price inelastic; the lowest estimate for beer demand shows that a 50 per cent increase in price would result in a 2 per cent reduction in consumption
• Digging deeper, heavy drinkers tend to be least responsive to price changes yet these are the people the government wishes to target and whom impose social costs upon the rest of society. An important US study finds the heaviest drinkers do not significantly respond to changes in price
• The literature finds factors other than price play a role in determining the demand for alcohol
• There is a clear distributional issue in taxing alcohol; taxes on alcohol impact lower income groups more
• The Scottish minimum price proposal is even more regressive than alcohol taxation – and is therefore likely to have a greater negative welfare impact on the lower income groups.

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The Self-Rating of the Effects of Alcohol Questionnaire as a Predictor of Alcohol-Related Outcomes in 12-Year-Old Subjects
Alcohol and Alcoholism Advance Access published online on October 8, 2008


A low level of response (LR), or low sensitivity, to alcohol as established by alcohol challenges has been shown to predict future heavier drinking, alcohol-related problems and alcohol use disorders. To date, only one study has evaluated the predictive validity of a second measure of LR as determined by the Self-Report of the Effects of Alcohol (SRE) Questionnaire. The current analyses evaluate the ability of SRE scores as determined at age 12 to predict heavier drinking and alcohol-related problems 2 years later in a sample from the United Kingdom.

The subjects were 156 boys (54.5%) and girls from the Avon Longitudinal Study of Parents and Children (ALSPAC) who had reported consuming one or more standard drinks by age 12 and who were followed up 2 years later.

The age 12 SRE scores correlated with the number of drinks per week, maximum drinks and the number of alcohol problems both at baseline and at age 14 follow-ups. In these evaluations, a larger number of drinks required for effects on the SRE (i.e. a lower LR per drink consumed) related to heavier intake and alcohol-related difficulties. Simultaneous entry multiple regression analyses revealed that the age 12 SRE score maintained a significant relationship with age 14 higher number of drinks per week and the number of alcohol problems even when the age 12 values for alcohol intake and problems were used as covariates.

The SRE scores appear to have value in predicting future heavier drinking and alcohol problems in 12-year olds that go beyond the information offered by the earlier drinking pattern alone.


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Radical health moves floated

• Jill Stark
• October 11, 2008

PRICE rises for junk food, cigarettes and alcohol; a ban on tobacco-vending machines, and tax breaks for gym memberships are among recommendations in a Federal Government report that could change the way we live.

Under the radical proposals, alcohol companies would be banned from sponsoring sporting events such as the AFL grand final, legal blood-alcohol concentration levels for drivers would be lowered and movies featuring smoking would be reclassified with a mature (M) rating.

The National Preventative Health Taskforce's inaugural report revealed that almost a third of all illness was caused by "lifestyle" diseases linked to smoking, drinking, poor diet and lack of exercise.

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Australia: the healthiest country by 2020

From the Minister for Health and Ageing:

As a nation we must recognise that doing more to stay healthy and well will be key to coping with the human and financial costs of chronic and preventable illness.

The Rudd Government was elected on a platform that recognised that things need to be done differently in health care in the future. Prevention of illness and chronic disease is central to a sustainable health system and a fuller life for all members of the Australian community.

Too often in the past, individuals, communities and governments have focussed on the immediate issues of treating people after they become sick. Whilst this will always remain vital, and there is much to do in this area, we cannot afford to limit our focus to treatment and ignore prevention.
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Single large document:
Australia: the healthiest country by 2020 (PDF 1026 KB)

The same publication in smaller sections:

• Cover, Copyright, Acknowledgement (PDF 174 KB)
• Foreword (PDF 63 KB)
• Invitation from the Chair (PDF 44 KB)
• Contents (PDF 98 KB)
• Executive summary (PDF 172 KB)
• 1. Introduction (PDF 209 KB)
• 2. The case for prevention: overweight and obesity (PDF 217 KB)
• 3. The case for prevention: tobacco (PDF 224 KB)
• 4. The case for prevention: alcohol (PDF 202 KB)
• 5. Supporting prevention (PDF 124 KB)
• 6. Choosing performance indicators (PDF 136 KB)
• 7. Towards a National Preventative Health Strategy – your views (PDF 102 KB)
• References (PDF 122 KB) (PDF 122 KB)

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Future Funding For Mental Health And Substance Abuse: Increasing Burdens For The Public Sector
Health Affairs 27, no. 6 (2007): w513-w522

Spending on mental health (MH) and substance abuse (SA) treatment is expected to double between 2003 and 2014, to $239 billion, and is anticipated to continue falling as a share of all health spending. By 2014, our projections of SA spending show increasing responsibility for state and local governments (45 percent); deteriorating shares financed by private insurance (7 percent); and 42 percent of SA spending going to specialty SA centers. For MH, Medicaid is forecasted to fund an increasingly larger share of treatment costs (27 percent), and prescription medications are expected to capture 30 percent of MH spending by 2014.

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Reduced Oral Ethanol Avoidance in Mice Lacking Transient Receptor Potential Channel Vanilloid Receptor 1
Behavior Genetics OnlineFirst 08 October 2008

Ethanol is a known oral trigeminal stimulant and recent data indicate that these effects are mediated in part by transient receptor potential channel vanilloid receptor 1 (TRPV1). The importance of this receptor in orally mediated ethanol avoidance is presently unknown.

Here, we compared orosensory responding to ethanol in TRPV1-deficient and wild type mice in a brief-access paradigm that assesses orosensory influences by measuring immediate licking responses to small stimulus volumes. TRPV1^−/− and control mice were tested with six concentrations of ethanol (3, 5, 10, 15, 25, 40%), capsaicin (0.003, 0.01, 0.03, 0.1, 0.3, 1 mM), sucrose (0.003, 0.01, 0.03, 0.1, 0.3, 1 M), and quinine (0.01, 0.03, 0.1, 0.3, 1, 3 mM) and psychophysical concentration-response functions were generated for each genotype and stimulus.

TRPV1 knockouts displayed reduced oral avoidance responses to ethanol regardless of concentration, insensitivity to capsaicin, and little to no difference in sweet or bitter taste responding relative to wild type mice.

These data indicate that the TRPV1 channel plays a role in orosensory-mediated ethanol avoidance, but that other receptor mechanisms likely also contribute to aversive oral responses to alcohol.

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News Release - Strong public policy measures on alcohol would be more effective than clinical treatments, say experts
08 October 2008

Three of Britain's leading experts in alcohol policy and treatments say that strong public policy measures on price and availability of alcohol would be far more successful than clinical treatments or current Government initiatives in reducing alcohol-related harm. In the same way that doctors use evidence-based medicine to treat individual patients, the Government should use the overwhelming evidence we already have to implement stronger public policy measures on alcohol instead of persisting with measures that have little or no evidence of success.

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Are Lifetime Abstainers the Best Control Group in Alcohol Epidemiology? On the Stability and Validity of Reported Lifetime Abstention
American Journal of Epidemiology 2008 168(8):866-871;


Lifetime abstainers have often been recommended as the comparison group in alcohol epidemiology.

The objective of this study was to provide insight into the validity and stability of lifetime abstention by using data derived from the National Alcohol Survey, a national probability survey of US households conducted in 1984, and its 2 follow-up surveys conducted in 1990 and 1992.

Results indicated that more than half (52.9%; all proportions were weighted to represent the US population) of those who reported never having a drink of any alcoholic beverage in the 1992 survey reported drinking in previous surveys. Depending on assumptions, this difference may result in an underestimation of alcohol-attributable mortality of 2%–15% in men and 2%–22% in women. Sociodemographic factors differentiated those who consistently reported lifetime abstention across surveys from the rest of the study population.

Results suggest that using reported lifetime abstainers as a sole comparison group is problematic, especially if reporting is based on 1 measurement only.

Establishing multiple measurement points and including irregular lifetime light drinkers with lifetime abstainers as the comparison group are recommended for future epidemiologic studies.

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Effects of Topiramate and Other Anti-Glutamatergic Drugs on the Acute Intoxicating Actions of Ethanol in Mice: Modulation by Genetic Strain and Stress
Neuropsychopharmacology advance online publication 8 October 2008



Compounds with anti-glutamatergic properties currently in clinical use for various indications (eg Alzheimer's disease, epilepsy, psychosis, mood disorders) have potential utility as novel treatments for alcoholism. Enhanced sensitivity to certain acute intoxicating effects (ataxia, sedative) of alcohol may be one mechanism by which anti-glutamatergic drugs modulate alcohol use.

We examined the effects of six compounds (memantine, dextromethorphan, haloperidol, lamotrigine, oxcarbazepine, and topiramate) on sensitivity to acute intoxicating effects of ethanol (ataxia, hypothermia, sedation/hypnosis) in C57BL/6J mice. Analysis of topiramate was extended to determine the influence of genetic background (by comparison of the 129S1, BALB/cJ, C57BL/6J, DBA/2J inbred strains) and prior stress history (by chronic exposure of C57BL/6J to swim stress) on topiramate's effects on ethanol-induced sedation/hypnosis.

Results showed that one N-methyl-D-aspartate receptor (NMDAR) antagonist, memantine, but not another, dextromethorphan, potentiated the ataxic but not hypothermic or sedative/hypnotic effects of ethanol. Haloperidol increased ethanol-induced ataxia and sedation/hypnosis to a similar extent as the prototypical NMDAR antagonist MK-801. Of the anticonvulsants tested, lamotrigine accentuated ethanol-induced sedation/hypnosis, whereas oxcarbazepine was without effect. Topiramate was without effect per se under baseline conditions in C57BL/6J, but had a synergistic effect with MK-801 on ethanol-induced sedation/hypnosis.

Comparing inbred strains, topiramate was found to significantly potentiate ethanol's sedative/hypnotic effects in BALB/cJ, but not 129S1, C57BL/6J, or DBA/2J strains. Topiramate also increased ethanol-induced sedation/hypnosis in C57BL/6J after exposure to chronic stress exposure.

Current data demonstrate that with the exception of MK-801 and haloperidol, the compounds tested had either no significant or assay-selective effects on sensitivity to acute ethanol under baseline conditions in C57BL/6J. However, significant effects of topiramate were revealed as a function of co-treatment with an NMDAR blocker, genetic background, or prior stress history.

These findings raise the possibility that topiramate and possibly other anti-glutamatergic drugs could promote the acute intoxicating effects of ethanol in specific subpopulations defined by genetics or life history.

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Acute Interaction of Baclofen in Combination With Alcohol in Heavy Social Drinkers
Alcoholism: Clinical and Experimental Research Published Online: 6 Oct 2008

There is growing evidence that gamma-amino butyric acid-B receptor agonists may be effective in the treatment of alcohol abuse or dependence. The primary goal of this study was to determine the safety of baclofen in combination with alcohol consumption in heavy drinkers. In addition, the effects of baclofen alone, and in combination with alcohol, on subjective effects, cognitive performance effects, as well as alcohol craving, were assessed.

Baclofen, either alone or in combination with alcohol, produced only modest increases in heart rate and blood pressure and no adverse effects were reported. Baclofen did not increase positive subjective effects (e.g., Stimulant effects, Drug Liking) but did increase sedation and impair performance. Even though both baclofen and alcohol impaired performance, for the most part performance was not impaired to a greater extent when baclofen was combined with alcohol. Among this population of nondependent drinkers, baclofen did not alter alcohol craving or alcohol-induced positive subjective effects.

Baclofen alone has minimal abuse liability in heavy social drinkers, and baclofen is relatively well tolerated and safe when given in combination with intoxicating doses of alcohol.

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Request Reprint E-Mail: se18@columbia.edu

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Alcohol misuse, gender and depressive symptoms in community-dwelling seniors

International Journal of Geriatric Psychiatry Published Online: 6 Oct 2008

Alcohol misuse in seniors has been studied in clinical samples and in small communities, but relatively few studies are population-based. Objectives are: (1) to describe the characteristics of seniors who score 1 or more on the CAGE (Cut down; Annoyed; Guilty; Eye-opener) questionnaire of alcohol problems; (2) to determine if depressive symptoms are associated with alcohol misuse after accounting for other factors.

Cross-sectional study of community-dwelling older people (65+ years) sampled from a representative population registry in Manitoba, Canada. Participants were initially interviewed in 1991-1992 and reinterviewed in 1996-1997. Data from Time 2 were used; 1,028 persons were included in the analyses. Sociodemographic characteristics, the CAGE questionnaire, Activities of Daily Living (ADLs) and instrumental ADLs (IADLs), the Center for Epidemiologic Studies - Depression (CES-D) scale and the Mini-Mental State Examination (MMSE) were assessed by trained interviewers.

Males were more likely to score positive on the CAGE questionnaire. After adjusting for gender, age, and education, there was a strong association between depressive symptoms and alcohol misuse. Poor self-rated health and impairments in IADLs were also associated with alcohol misuse.

Male gender, depressive symptoms, and poor functional status were associated with alcohol misuse in this population-based study. Attention to depressive symptoms and functional status may be important in the care of seniors with alcohol misuse. Alternatively, physicians should enquire about alcohol use in seniors with functional impairment or depressive symptoms. Read Full Abstract Request Reprint E-Mail: pstjohn@hsc.mb.ca __________________________________________________________________

Alcohol consumption continues to slide

Thursday, 9 October 2008

An analysis carried out by the drinks industry has reported an accelerating decline in alcohol consumption during the first nine months of 2008.

The Drinks Industry Group of Ireland (DIGI) said excise receipts from Revenue showed that alcohol sales in the first nine months of the year were down 9% on the same period last year.

Sales are down a whopping 22% in the month of September alone compared to the same time last year. This compares to a fall of 14% in August.
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Opinion - Alcohol economics and politics: the case for policy activism

* JOWITT MBONGWE

An extra-ordinary public debate has been unleashed by the policy activism of the current national political leadership towards dealing with the challenges of alcohol abuse in the country.

Many perspectives are being offered with multivalent arguments coloured by economic, health, political, cultural and moral world views. As the debate rages and gains momentum, it is critical that the lessons on both democratic intentions and processes are learned.

Let me state at the outset that it is the responsibility of every accountable Government to seek strategic interventions to solving what cannot simply be brushed aside as matters of personal choice. Alcohol is not simply another economic commodity whose trade should be left to forces of supply and demand in a free market playground, it is destructive and addictive.

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Gov't ropes in media in alcohol war

EPHRAIM KEORENG

Staff Writer

In a desperate effort to win the liquor war, the Office of the President (OP) has reportedly ordered the state media to run stories and programmes emphasising the negative effects of alcohol.

The directive orders the state electronic and print media to depict alcohol as socially unacceptable and destructive to society.

Reliable sources say the anti-alcohol directive was issued this week. Government attempts to introduce a punitive 70 percent levy on the sale of alcohol to control excessive drinking has been hobbled after a strong resistance from brewers and other stakeholders in the industry. Even after the levy was reduced to 30 percent, the government found no respite after a court stopped the introduction of the tax pending the outcome of a case filed by stakeholders.

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Minimum pricing: the thin end of the wedge?

9 October, 2008

By James Wilmore

Pressure for the government to act is building, but where will it lead?

In the government’s attempts to tackle the problems around alcohol, one solution has provoked more reaction than most. Minimum pricing.

A significant number of people, inside and outside of Westminster, now believe introducing a minimum price on a unit of alcohol will help curb some of the problems associated with booze.

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Drink prices must rise to cut alcohol deaths, doctors advise

By Lucy Cockcroft
09 Oct 2008

The price of alcohol must be increased and beer, wine and spirits companies should be banned from advertising, doctors have advised.

They believe Government and industry measures to tackle binge drinking are failing, and that more needs to be done to reduce the toll of alcohol-related deaths.

More people die annually from alcohol-related causes than from breast cancer, cervical cancer and MRSA infection combined.

The deaths of around one in four young men and 10 per cent of young women in Europe are alcohol-related.

Doctors writing in the British Medical Journal publication Gut say that tough measures such as increasing the cost of alcohol, banning advertising and reducing its availability will work.

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Press Release - Perryman Study Finds Alcohol Beverage Sales Stimulate Economic Activity

Changing From “Dry” to “Wet” Spurs Retail Sales, Creates Jobs, Increases Tax Revenues

AUSTIN - Communities that vote to allow beverage alcohol sales can expect millions of dollars in increased economic activity, hundreds of additional jobs and a steady source of new tax revenue, according to a new study by The Perryman Group.

“Our analysis found that even after all other economic trends and retail patterns are taken into account, there is a statistically significant increase in retail sales following a change from ‘dry’ to ‘wet’. And, an area can reasonably expect a substantial gain in retail sales taxes the year after approval of a local option alcohol election,” said Dr. Ray Perryman, president of The Perryman Group.

The 52-page study by the Waco-based economic and financial analysis firm measured the economic impact of beer, wine and distilled spirits sales on three hypothetical areas that changed from “dry” to “wet.”
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Asda sells beer cheaper than water


By Lucy Cockcroft
07 Oct 2008

A supermarket chain has been heavily criticised for selling cans of lager for less than 23p each - cheaper than the price of bottled water

Asda is charging just 90p for the four pack of 440ml Skol lager, at 3.2 per cent strength, which works out at 51p a litre.

In comparison, a pack of four 750ml bottles of Evian water costs £2.91, or 97p a litre.

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Alcohol industry braced for attack on price promotions

08-Oct-08

The drinks industry is bracing itself for a "damning report" on the way alcohol is promoted on price. The Sheffield University report is expected to present the first evidence linking cheap booze to binge drinking.

Its imminent release will follow the launch this summer of the Department of Health’s “Safe, Sensible, Social” consultation on alcohol strategy.

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Invitation to a WHO public hearing on strategies to reduce alcohol-related harm

In a press release 2 October the World Health Organization (WHO) invites all interested parties to participate in a web-based public hearing to present their views on effective strategies to reduce the burden resulting from the harmful use of alcohol. WHO was asked by its Member States in May at the World Health Assembly to develop a global strategy to combat the harmful use of alcohol. The hearing is a part of this work. Submissions must be given before 31 October.

We appeal to all interested civil society organizations, in particular NGOs in the South, to contribute to the hearing. It is important that the development dimensions of the global alcohol problem become a priority issue in the WHO global strategy in 2010. A submission does not have to be very comprehensive. The most important is that key issues are raised and that many organizations demonstrate their interest and commitment.

Each year, more than two million people die from alcohol-related causes. "The harmful use of alcohol is a leading risk factor for premature death and disability in the world. Every year at least 2.3 million people die from alcohol-related causes," says Dr Ala Alwan, Assistant Director-General of WHO's Non-communicable Diseases and Mental Health Cluster. "This web-based public hearing is broad and inclusive and will provide an opportunity for everyone, including the public, to present their views on effective strategies to reduce the burden resulting from the harmful use of alcohol."

Dedicated web site for the hearing

Contributions shall be posted on a WHO web site dedicated to the hearing. The submissions can form a part of the documentation to be considered and discussed at the round table meetings with economic operators from the alcohol industry (planned for 6 November 2008), and NGOs and health professionals (planned for 24-25 November 2008), as well as at regional technical consultations with Member States (planned to take place between January and April 2009).

"We encourage our Member States and other governmental institutions, as well as civil society groups, academic and research institutions, private companies, individuals and other interested parties to participate," says Dr Benedetto Saraceno, Director of WHO's Department of Mental Health and Substance Abuse. "We are particularly interested in getting views on integrated approaches that can protect at-risk populations, young people and those affected by harmful drinking by others."

Six alternative languages

Contributions can be submitted to the public hearing via the web site in any of the six official UN languages (Arabic, Chinese, English, French, Russian and Spanish) beginning 12:00 noon Geneva time on 3 October. Submissions should not exceed five A4 pages or 2000 words. Contributors are encouraged to provide a summary of their views, which should not exceed 500 words.

To make a submission, please go to one of these web pages:

English

Spanish

French

Russian

Chinese

Arabic

People without access to the Internet can send their submissions by fax to: +41 22 791 48 51

More information at the WHO web site or at www.add-resources.org

Published 07.10.2008 by

FORUT – Campaign for Development and Solidarity

E-mail: add.bulletin@forut.no

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COMBINE Data Set

Data Access Policy, Application and Agreement

COMBINE

A Multisite Trial of Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence

Introduction

The COMBINE Study (often times referred to as COMBINE) is the largest pharmacotherapy trial conducted for alcoholism in the United States, recruiting 1383 alcohol dependent patients, 31% women and 23% ethnic minorities, from 11 sites. This double-blind, randomized placebo-controlled trial evaluated the efficacy of naltrexone and acamprosate, both alone and in combination, in the context of medical management with and without Combined Behavioral Intervention (CBI). CBI is a therapy that integrates aspects of cognitive behavioral therapy, motivational interviewing and 12-step facilitation. The duration of treatment was four months with follow-ups for one year post treatment. There were nine groups including a CBI only group with no pills and no medical management. The main findings were published in JAMA 295:2003-2017, 2006. Other articles either published, or in press, can be found at the COMBINE Study website as indicated below. Individuals requesting the data set for specific analyses are urged to view the website to better understand what has been previously published..

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Cost and Cost-effectiveness of the COMBINE Study in Alcohol-Dependent Patients
Arch Gen Psychiatry. 2008;65(10):1214-1221.




The COMBINE (Combined Pharmacotherapies and Behavioral Intervention) clinical trial recently evaluated the efficacy of medications, behavioral therapies, and their combinations for the outpatient treatment of alcohol dependence. The costs and cost-effectiveness of these combinations are unknown and of interest to clinicians and policy makers.

To evaluate the costs and cost-effectiveness of the COMBINE Study interventions after 16 weeks of treatment.

The study included 9 treatment groups; 4 groups received medical management for 16 weeks with naltrexone, 100 mg/d, acamprosate, 3 g/d, or both, and/or placebo; 4 groups received the same therapy as mentioned earlier with combined behavioral intervention; and 1 group received combined behavioral intervention only.

Incremental cost per percentage point increase in percentage of days abstinent, incremental cost per patient of avoiding heavy drinking, and incremental cost per patient of achieving a good clinical outcome.

On the basis of the mean values of cost and effectiveness, 3 interventions are cost-effective options relative to the other interventions for all 3 outcomes: medical management (MM) with placebo ($409 per patient), MM plus naltrexone therapy ($671 per patient), and MM plus combined naltrexone and acamprosate therapy ($1003 per patient).

To our knowledge, this is only the second prospective cost-effectiveness study with a randomized controlled clinical trial design that has been performed for the treatment of alcohol dependence. Focusing only on effectiveness, MM-naltrexone-acamprosate therapy is not significantly better than MM-naltrexone therapy. However, considering cost and cost-effectiveness, MM-naltrexone-acamprosate therapy may be a better choice, depending on whether the cost of the incremental increase in effectiveness is justified by the decision maker

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Childhood or adolescent parental divorce/separation, parental history of alcohol problems, and offspring lifetime alcohol dependence
Drug and Alcohol Dependence Volume 98, Issue 3, 1 December 2008, Pages 264-269

This study examined whether the experiences of childhood or adolescent parental divorce/separation and parental alcohol problems affected the likelihood of offspring DSM-IV lifetime alcohol dependence, controlling for parental history of drug, depression, and antisocial behavior problems.

Childhood or adolescent parental divorce/separation and parental history of alcohol problems were significantly related to offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Experiencing parental divorce/separation during childhood, even in the absence of parental history of alcohol problems, remained a significant predictor of lifetime alcohol dependence. Experiencing both childhood or adolescent parental divorce/separation and parental alcohol problems had a significantly stronger impact on the risk for DSM-IV alcohol dependence than the risk incurred by either parental risk factor alone.

Further research is needed to better identify the factors that increase the risk for lifetime alcohol dependence among those who experience childhood or adolescent parental divorce/separation.

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Request Reprint E-Mail: hasind@nypdrat.cpmc.columbia.edu

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Individual and community correlates of young people's high-risk drinking in Victoria, Australia
Drug and Alcohol Dependence Volume 98, Issue 3, 1 December 2008, Pages 241-248

To examine key individual- and community-level correlates of regular very high-risk drinking (more than 20 drinks at least 12 times a year for males and more than 11 drinks at least 12 times a year for females) among young (16–24) drinkers in Victoria.

One-fifth of the sample reported regular (at least monthly) very high-risk drinking. Significant individual-level correlates of very high-risk drinking included age, gender, cultural background, recreational spending money, life stage, living situation, family conflict and age at first drink. Significant community-level correlates included remoteness (living in a rural area) and packaged liquor outlet density.

The study highlights a range of important factors relating to regular drinking of dangerous amounts of alcohol by youth. Interventions aimed at preventing early initiation or managing recreational spending should be explored. Further, regulatory management of packaged liquor outlets and or remote rural communities in Victoria with high levels of dangerous drinking should be a priority.

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Development of a Readiness Ruler for use with alcohol brief interventions
Drug and Alcohol Dependence Volume 98, Issue 3, 1 December 2008, Pages 235-240

A quick method of assessing readiness to change was needed for a major study of implementing screening and alcohol brief intervention in England. For this purpose, a Readiness Ruler that had been validated among a sample of male college students in the USA was adapted and applied to a sample of excessive drinkers in a general medical practice located in a deprived area of Gateshead, England..

In terms of concurrent validity, the relationships between the Readiness Ruler, on the one hand, and either stage of change allocation or a dimensional score derived from the RCQ, on the other hand, were highly significant but weaker than expected. When patients who endorsed the “maintenance” point on the Readiness Ruler were excluded from the analysis, the above relationships were considerably strengthened for reasons that are discussed. On this basis and with another small change, a final Readiness Ruler was developed.

If the validity of the Readiness Ruler is confirmed in subsequent research, a quick and simple way of measuring readiness to change will be available for research or clinical work with alcohol brief interventions.

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Request Reprint E-Mail: nick.heather@unn.ac.uk

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A Clean and Sober Place to Live: Philosophy, Structure, and Purported Therapeutic Factors in Sober Living Houses

The call for evidence based practices (EBP’s) in addiction treatment is nearly universal. It is a noteworthy movement in the field because treatment innovations have not always been implemented in community programs. However, other types of community based services that may be essential to sustained recovery have received less attention.

This paper suggests sober living houses (SLH’s) are a good example of services that have been neglected in the addiction literature that might help individuals who need an alcohol and drug-free living environment to succeed in their recovery.

The paper begins with an overview of the history and philosophy of this modality and then describes our 5-year longitudinal study titled, “An Analysis of Sober Living Houses.” Particular attention is paid to the structure and philosophy of SLH’s and purported therapeutic factors.

The paper ends with presentation of baseline data describing the residents who enter SLH’s and 6-month outcomes on 130 residents.

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Britain decides against a new lower limit for drink-driving
October 6, 2008
Ben Webster, Transport Correspondent

Britain is to become the only European country that allows motorists to have at least one alcoholic drink and still be legally fit to drive.

The Times has learnt that the Government has changed its mind about reducing the limit from 80 to 50 milligrams of alcohol per 100 millilitres of blood, despite evidence that a lower limit would save 65 lives a year.

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Councils to set alcohol age limit
Jason Allardyce

Councils to be given power to prevent under-21s buying alcohol in shops

THE Scottish government is to press ahead with plans to reform the licensing system despite last week’s defeat in Holyrood, by giving local authorities the power to ban under-21s buying alcohol in shops.
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New legal threat to SNP's alcohol crackdown

Published Date: 06 October 2008

By HAMISH MACDONELL

A SECOND plank of the Scottish Government's flagship approach to tackling the country's booze culture appeared under threat last night.

Serious legal doubts were raised over the plans to set minimum prices for drinks, with experts warning that the controversial proposals could face court challenges in three different areas – European competition law, UK competition law and judicial review under the Scotland Act.
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