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

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


Thursday, December 31, 2009

Media Release - Positive signs that teenagers increasingly shun the most problematic drugs

More teenagers in England who need it are receiving help for problems involving drug and alcohol use, but fewer have problems severe enough to require treatment for addiction, new national statistics reported today by the National Treatment Agency for Substance Misuse (NTA), show.

The number of teenagers entering treatment for heroin and crack has fallen by a third in four years according to the NTA report ‘Substance misuse among young people – The data for 2008/09’; this echoes the trend already seen in young adults (aged 18-24) in drug treatment.

The overall number of under-18s accessing specialist substance misuse services in England during 2008/9 was 24,053. This is a modest increase of about 150 over 2007/8, and indicates that demand for such services is levelling out. The vast majority of these young people are receiving help for problems associated with the misuse of cannabis and/or alcohol, which are treated with structured counselling. Drug treatment services in England are now widely available and anyone who needs help can get it quickly.

Evidence continues to suggest that overall drug and alcohol use among the general population of young people is declining, and the increasing availability of specialist substance misuse services ensures that many more of the minority who do need help are getting it. . . . . .

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This is the time of the holiday season when New Year's partiers are inundated with warnings about the risks of drinking and driving.

Little is ever heard, though, about the risks of drinking and walking, which can be just as dangerous, said trauma surgeon Dr. Thomas Esposito at Loyola University Health System in Maywood.

"Alcohol impairs your physical ability to walk and to drive," Esposito said. "It impairs your judgment, reflexes and coordination. It's nothing more than a socially acceptable, over-the-counter stimulant/depressant."

A trauma surgeon for more than 20 years, Esposito has witnessed the tragic aftermath of drunken walking professionally and personally. Several years ago, Esposito's cousin opted to walk instead of driving home from a party where he had been drinking.

"A driver, who I don't believe was intoxicated, did not see him and hit him and he was killed," said Esposito, who is also professor of surgery and chief of the division of trauma, surgical critical care and burns in the department of surgery, Loyola University Chicago Stritch School of Medicine. "They found him on the side of the road on New Year's Day." . . . . .

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Alcohol consumption and non-Hodgkin lymphoma survival

Epidemiological studies have shown that moderate alcohol drinkers have a lower death rate for all causes. Alcohol drinking has also been associated with reduced risk of non-Hodgkin lymphoma (NHL).

Here, we examined the role of alcohol consumption on NHL survival by type of alcohol consumed and NHL subtype.

Compared to never drinkers, wine drinkers experienced better overall survival (75% vs. 69% five-year survival rates, p-value for log-rank test = 0.030) and better disease free survival (70% vs. 67% five-year disease-free survival rates, p-value for log-rank test = 0.049). Analysis by NHL subtype shows that the favorable effect of wine consumption was mainly seen for patients diagnosed with diffuse large B-cell lymphoma (DLBCL) (wine drinkers for more than 25 years vs. never drinkers: HR = 0.36, 95% CI 0.14–0.94 for overall survival; HR = 0.38, 95% CI 0.16–0.94 for disease-free survival), and the adverse effect of liquor consumption was also observed among DLBCL patients (liquor drinkers vs. never drinkers: HR=2.49, 95% CI 1.26–4.93 for disease-free survival).

Our results suggest a moderate relationship between pre-diagnostic alcohol consumption and NHL survival, particularly for DLBCL. The results need to be replicated in larger studies.

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SAMHSA’s Award-Winning Newsletter November/December 2009, Volume 17, Number 6

In this issue:

Screening, Brief Interventions: New Populations, Effectiveness Data

Pamela S. Hyde Sworn in as New Administrator

Parity Law: Lessons Learned from California

Voice Awards Honor Consumer Leaders

TIP 52: Treatment Guide to Clinical Supervision

Guidelines: Responding to Mental Health Crises

Substance-Exposed Infants: How States Help

Gender Differences in Adolescents

New Wallet Cards for 1-800-662-HELP

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Latest IAS Alcohol Alert available

The final 'Alcohol Alert' magazine of 2009 has been released by the Institute of Alcohol Studies (IAS), reporting and commenting on some of the main goings on over the last quarter. All articles can be accessed individually from the above link.

Wednesday, December 30, 2009

The Good-for-You Gimlet?

Some spirit makers boast natural ingredients and nutritional additives in an effort to attract a health-conscious clientele. But can alcohol really be healthy? . . . . .

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Cannabis as a substitute for alcohol and other drugs

Substitution can be operationalized as the conscious choice to use one drug (legal or illicit) instead of, or in conjunction with, another due to issues such as: perceived safety; level of addiction potential; effectiveness in relieving symptoms; access and level of acceptance. This practice of substitution has been observed among individuals using cannabis for medical purposes. This study examined drug and alcohol use, and the occurrence of substitution among medical cannabis patients.

Fifty three percent of the sample currently drinks alcohol, 2.6 was the average number of drinking days per week, 2.9 was the average number of drinks on a drinking occasion. One quarter currently uses tobacco, 9.5 is the average number of cigarettes smoked daily. Eleven percent have used a non-prescribed, non OTC drug in the past 30 days with cocaine, MDMA and Vicodin reported most frequently. Twenty five percent reported growing up in an abusive or addictive household. Sixteen percent reported previous alcohol and/or drug treatment, and 2% are currently in a 12-step or other recovery program. Forty percent have used cannabis as a substitute for alcohol, 26% as a substitute for illicit drugs and 66% as a substitute for prescription drugs. The most common reasons given for substituting were: less adverse side effects (65%), better symptom management (57%), and less withdrawal potential (34%) with cannabis.

The substitution of one psychoactive substance for another with the goal of reducing negative outcomes can be included within the framework of harm reduction. Medical cannabis patients have been engaging in substitution by using cannabis as an alternative to alcohol, prescription and illicit drugs

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Functional characterization of human variants of the mu-opioid receptor gene

Opioids and their receptors have an important role in analgesia and alcohol and substance use disorders (ASUD). We have identified several naturally occurring amino acid changing variants of the human mu-opioid receptor (MOR), and assessed the functional consequences of these previously undescribed variants in stably expressing cell lines. Several of these variants had altered trafficking and signaling properties.

We found that an L85I variant showed significant internalization in response to morphine, in contrast to the WT MOR, which did not internalize in response to morphine. Also, when L85I and WT receptor were coexpressed, WT MOR internalized with the L85I MOR, suggesting that, in the heterozygous condition, the L85I phenotype would be dominant.

This finding is potentially important, because receptor internalization has been associated with development of tolerance to opiate analgesics. In contrast, an R181C variant abolished both signaling and internalization in response to saturating doses of the hydrolysis-resistant enkephalin [D-Ala2,
N-MePhe4,Gly5-ol]enkephalin (DAMGO). Coexpression of the R181C and WT receptor led to independent trafficking of the 2 receptors. S42T and C192F variants showed a rightward shift in potency of both morphine and DAMGO, whereas the S147C variant displayed a subtle leftward shift in morphine potency.

These data suggest that these and other such variants may have clinical relevance to opioid responsiveness to both endogenous ligands and exogenous drugs, and could influence a broad range of phenotypes, including ASUD, pain responses, and the development of tolerance to morphine.

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Average drinker thinks a unit of wine is twice what it actually is

People drinking spirits at home in England are giving themselves more than double (12 percent extra) what they would get in a pub if they ordered a single shot according to new figures revealed today by the Know Your Limits campaign.

A series of experiments across England found that the average ‘home barman’ pours themselves 57ml when they drink a spirit such as vodka, gin or whisky – 32ml more than a standard single 25ml measure.

If that average English drinker knocked back eight spirits drinks over a week at home, they would be drinking nearly half a litre (456ml) of vodka, gin or whisky, compared to 200ml if they’d ordered the same number of single measures in a pub or bar.

These extra sips equate to 17 units instead of 7.5 units over a week – which can make all the difference for people who might wrongly think they are drinking within the NHS recommended limits of 2-3 units a day for women and 3-4 units a day for men. . . . .

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Heavy in utero ethanol exposure is associated with the use of other drugs of abuse in a high-risk population

Many ethanol dependent women also use other drugs of abuse that may affect pregnancy outcome and long-term child neurodevelopment.

This study investigated the association between drugs of abuse and concurrent use of ethanol in pregnancy.

A study cohort of neonates with FAEE levels above 2
nmol per gram meconium, indicative of heavy in utero ethanol exposure, was identified (n=114). Meconium and hair analyses for the presence of other drugs of abuse were obtained for some of these neonates and the rates of drug exposure were compared with the rates in a cohort of neonates who were tested negative (FAEE below 2nmol per gram meconium) for ethanol exposure (n=622). Odds ratios (ORs) for various drugs were calculated with ethanol exposure.

A 15.5% positive rate for intrauterine ethanol exposure was detected. A high rate of in utero drug exposure was detected in neonates with and without in utero ethanol exposure, 60.5% versus 62.7% respectively.

Neonates with heavy in utero ethanol exposure were almost twice as likely to be exposed to narcotic opiates (OR
=1.90; 95% confidence interval [CI]: 1.13–3.20) and 3.3 times as likely to be exposed to amphetamine (OR=3.30; 95% CI 1.06–10.27) when compared to neonates with no ethanol exposure.

Exposure to cannabinoids predicted less likely exposure to ethanol (OR
=0.61; 95% CI: 0.38–0.98) and no significant difference was noted in the exposure to cocaine (OR=1.24, 95% CI: 0.81–1.91).

Neonates suspected of heavy in utero ethanol exposure should be tested for other drugs of abuse and vice versa. Early detection of drug exposures can facilitate early intervention to both the neonate and the mother, thus decreasing the risk of long-term neurodevelopmental outcomes for the child, including secondary disabilities associated with fetal alcohol spectrum disorder.

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A neurodevelopmental framework for the development of interventions for children with fetal alcohol spectrum disorders

Despite considerable data published on cognitive and behavioral disabilities in children with fetal alcohol spectrum disorders (FASD), relatively little information is available on behavioral or pharmacological interventions for alcohol-affected children.

The main goals of this article, therefore, are to summarize published intervention studies of FASD and to present a neurodevelopmental framework, based on recent findings from a number of disciplines, for designing new therapies for alcohol-affected children.

This framework assumes a neuroconstructionist view, which posits that reciprocal interactions between neural activity and the brain's hardware lead to the progressive formation of intra- and interregional neural connections. In this view, behavioral interventions can be conceptualized as a series of guided experiences that are designed to produce neural activation.

Based on evidence from cognitive neuroscience, it is hypothesized that specific interventions targeting executive attention and self-regulation may produce greater generalizable results than those aimed at domain-specific skills in children with FASD.

In view of reciprocal interactions between environmental effects and neural structures, the proposed framework suggests that the maximum effects of interventions can eventually be achieved by optimally combining behavioral methods and cognition-enhancing drugs.

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Implementation of a shared data repository and common data dictionary for fetal alcohol spectrum disorders research

Many previous attempts by fetal alcohol spectrum disorders researchers to compare data across multiple prospective and retrospective human studies have failed because of both structural differences in the collected data and difficulty in coming to agreement on the precise meaning of the terminology used to describe the collected data.

Although some groups of researchers have an established track record of successfully integrating data, attempts to integrate data more broadly among different groups of researchers have generally faltered. Lack of tools to help researchers share and integrate data has also hampered data analysis. This situation has delayed improving diagnosis, intervention, and treatment before and after birth.

We worked with various researchers and research programs in the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CI-FASD) to develop a set of common data dictionaries to describe the data to be collected, including definitions of terms and specification of allowable values. The resulting data dictionaries were the basis for creating a central data repository (CI-FASD Central Repository) and software tools to input and query data. Data entry restrictions ensure that only data that conform to the data dictionaries reach the CI-FASD Central Repository.

The result is an effective system for centralized and unified management of the data collected and analyzed by the initiative, including a secure, long-term data repository. CI-FASD researchers are able to integrate and analyze data of different types, using multiple methods, and collected from multiple populations, and data are retained for future reuse in a secure, robust repository.

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Zebrafish fetal alcohol syndrome model: effects of ethanol are rescued by retinoic acid supplement

This study was designed to develop a zebrafish experimental model to examine defects in retinoic acid (RA) signaling caused by embryonic ethanol exposure. RA deficiency may be a causative factor leading to a spectrum of birth defects classified as fetal alcohol spectrum disorder (FASD).

Experimental support for this hypothesis using Xenopus showed that effects of treatment with ethanol could be partially rescued by adding retinoids during ethanol treatment.

Previous studies show that treating zebrafish embryos during gastrulation and somitogenesis stages with a pathophysiological concentration of ethanol (100mM) produces effects that are characteristic features of FASD.

We found that treating zebrafish embryos with RA at a low concentration (10−9M) and 100mM ethanol during gastrulation and somitogenesis stages significantly rescued a spectrum of defects produced by treating embryos with 100mM ethanol alone.

The rescued phenotype that we observed was quantitatively more similar to embryos treated with 10−9M RA alone (RA toxicity) than to untreated or 100mM ethanol-treated embryos. RA rescued defects caused by 100mM ethanol treatment during gastrulation and somitogenesis stages that include early gastrulation cell movements (anterior–posterior axis), craniofacial cartilage formation, and ear development.

Morphological evidence also suggests that other characteristic features of FASD (e.g., neural axis patterning) are rescued by RA supplement.

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A 14-year retrospective maternal report of alcohol consumption in pregnancy predicts pregnancy and teen outcomes

Detecting patterns of maternal drinking that place fetuses at risk for fetal alcohol spectrum disorders (FASDs) is critical to diagnosis, treatment, and prevention but is challenging because information on antenatal drinking collected during pregnancy is often insufficient or lacking.

Although retrospective assessments have been considered less favored by many researchers due to presumed poor reliability, this perception may be inaccurate because of reduced maternal denial and/or distortion.

The present study hypothesized that fetal alcohol exposure, as assessed retrospectively during child adolescence, would be related significantly to prior measures of maternal drinking and would predict alcohol-related behavioral problems in teens better than antenatal measures of maternal alcohol consumption.

Drinking was assessed during pregnancy, and retrospectively about the same pregnancy, at a 14-year follow-up in 288 African-American women using well-validated semistructured interviews. Regression analysis examined the predictive validity of both drinking assessments on pregnancy outcomes and on teacher-reported teen behavior outcomes.

Retrospective maternal self-reported drinking assessed 14 years postpartum was significantly higher than antenatal reports of consumption. Retrospective report identified 10.8 times more women as risk drinkers (≥ one drink per day) than the antenatal report. Antenatal and retrospective reports were moderately correlated and both were correlated with the Michigan Alcoholism Screening Test.

Self-reported alcohol consumption during pregnancy based on retrospective report identified significantly more teens exposed prenatally to at-risk alcohol levels than antenatal, in-pregnancy reports.

Retrospective report predicted more teen behavior problems (e.g., attention problems and externalizing behaviors) than the antenatal report. Antenatal report predicted younger gestational age at birth and retrospective report predicted smaller birth size; neither predicted teen IQ. These results suggest that if only antenatal, in-pregnancy maternal report is used, then a substantial proportion of children exposed prenatally to risk levels of alcohol might be misclassified.

The validity of retrospective assessment of prior drinking during pregnancy as a more effective indicator of prenatal exposure was established by predicting more behavioral problems in teens than antenatal report.

Retrospective report can provide valid information about drinking during a prior pregnancy and may facilitate diagnosis and subsequent interventions by educators, social service personnel, and health-care providers, thereby reducing the life-long impact of FASDs.

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Collaborative initiative on fetal alcohol spectrum disorders: methodology of clinical projects

The Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) was created in 2003 to further understanding of fetal alcohol spectrum disorders.

Clinical and basic science projects collect data across multiple sites using standardized methodology.

This article describes the methodology being used by the clinical projects that pertain to assessment of children and adolescents.

Domains being addressed are dysmorphology, neurobehavior, 3-D facial imaging, and brain imaging.

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The pros and cons of drinking: Weighing alcohol's effects on the body

A few months ago I received a book called "The Two Martini Diet" (Authorhouse, 2008), in which Jerry Sorlucco documents his success at losing more than 100 pounds without forgoing his daily cocktails. He doesn't break new diet-book ground: Sorlucco follows well-established practices such as controlling portion sizes, eating plenty of fruits and vegetables, and managing his calorie intake and expenditure to accommodate those drinks.

I've kept the book on my desk because I'm intrigued by the interplay between healthful eating and alcohol consumption. Is it really possible, I've wondered, to incorporate alcoholic beverages into a healthful diet and lifestyle, or are those of us who hope it is possible just fooling ourselves? . . . . .

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Monday, December 28, 2009

Stimulus Checkup A closer look at 100 projects funded by the American Recovery and Reinvestment Act.

As this and the last report, 100 Stimulus Projects: A Second Opinion suggest, billions of dollars of stimulus funding have been wasted, mismanaged, or directed towards silly and shortsighted projects. Many projects may not produce the types of jobs that most Americans had hoped for or expected. . . . . .

17. Buffalo Residents Paid to Keep Daily Journal of Malt Liquor and Marijuana Use ($389,357)

Researchers at the State University of New York at Buffalo will receive nearly $390,000 to study young adults who drink malt liquor and smoke marijuana,

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Hospital admissions data 08/09

The finalised 08/09 NI 39 hospital admissions data was published by the North West Public Health Observatory's (NWPHO) Local Alchol Profiles for England (LAPE) earlier this month. Their December E-bulletin highlighted some key findings in comparison with the previous year’s figures: . . . . .

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Polymorphisms in Alcohol Metabolizing Genes and the Risk of Head and Neck Cancer in a Brazilian Population

The incidence of head and neck cancer (HNC) in Brazil has increased substantially in recent years. This increase is likely to be strongly associated with alcohol and tobacco consumption, but genetic susceptibility also should be investigated in this population.

The aim of this study was to evaluate the association of polymorphisms in genes of alcohol metabolism enzymes and the risk of HNC.

Chronic alcohol intake increased approximately four times the risk of HNC. The mutant genotype ADH1B Arg48His was more frequent in controls (12.7%) than HNC patients (5.8%) conferring protection for the disease , 0.21–0.85). Similar results were observed for individuals with ADH1B*2 or ADH1B*2/ADH1C*1 mutated haplotypes. Multiple regression analyses showed that individuals with the mutant genotype ADH1B Arg48His who consume alcohol >30 g/L/day have more than four times the risk for HNC .

The fast alcohol metabolizing genotypes may prevent HNC when the amount of alcohol intake is <30.655>

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Dopamine D2 Receptor Genotype Is Associated with Increased Mortality at a 10-Year Follow-up of Alcohol-Dependent Individuals

Because the TAQ1 A1 allele may be associated with alcohol-related medical illnesses, and medical illnesses in alcohol-dependent individuals are associated with increased mortality, we test the hypothesis that the TAQ1 A1 allele of the DRD2 gene is associated with increased mortality in alcohol-dependent individuals.

The prevalence of the A1 allele differed between the deceased
and living patients and the controls: 47% of the deceased were A1+, compared to 37% of the living patients and 32% of the controls. The frequency of the TAQ1 A1/A2 genotype also differed between the groups. Thus, 43% had the A1/A2 genotype in comparison with 32% in the living patients and 29% in the controls. The TAQ 1 A1 allele frequency differed between the groups. The frequency of A1 allele was 25% in the deceased patients compared to 21% in the living patients and 17% in the controls.

The TAQ I A1 allele of the DRD2 gene (or DRD2 gene region) was associated with increased mortality over a 10-year period in alcohol-dependent individuals.

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Variant in PNPLA3 is associated with alcoholic liver disease

Two genome-wide association studies (GWAS) have described associations of variants in PNPLA3 with nonalcoholic fatty liver and plasma liver enzyme levels.

We investigated the contributions of these variants to liver disease in Mestizo subjects with a history of alcohol dependence.

We found that rs738409 in
PNPLA3 is strongly associated with alcoholic liver disease and clinically evident alcoholic cirrhosis.

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Saturday, December 26, 2009

Thinking about drinking: Need for cognition and readiness to change moderate the effects of brief alcohol interventions.

Research has demonstrated the efficacy of brief motivational interventions (BMI) and alcohol expectancy challenge (AEC) in reducing alcohol use and/or problems among college students. However, little is known about variables that may qualify the effectiveness of these approaches.

The present analyses tested the hypothesis that need for cognition (NFC), impulsivity/sensation seeking (IMPSS) and readiness to change (RTC) would moderate the effects of BMI and AEC.

Simple slopes analyses were used to probe these relationships and revealed that higher levels of NFC at baseline were associated with a stronger BMI effect on drinking outcomes over time. Similarly, higher levels of baseline RTC were associated with stronger AEC effects on alcohol use.

Future preventive interventions with this population may profit by considering individual differences and targeting approaches accordingly.

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A method for mapping intralocus interactions influencing excessive alcohol drinking

Excessive alcohol (ethanol) consumption is the hallmark of alcohol use disorders. The F1 hybrid cross between the C57BL/6J (B6) and FVB/NJ (FVB) inbred mouse strains consumes more ethanol than either progenitor strain.

The purpose of this study was to utilize ethanol-drinking data and genetic information to map genes that result in overdominant (or heterotic) ethanol drinking.

About 600 B6 × FVB F2 mice, half of each sex, were tested for ethanol intake and preference in a 24-h, two-bottle water versus ethanol choice procedure, with ascending ethanol concentrations. They were then tested for ethanol intake in a Drinking in the Dark (DID) procedure, first when there was no water choice and then when ethanol was offered versus water. DNA samples were obtained and genome-wide QTL analyses were performed to search for single QTLs (both additive and dominance effects) and interactions between pairs of QTLs, or epistasis.

On average, F2 mice consumed excessive amounts of ethanol in the 24-h choice procedure, consistent with high levels of consumption seen in the F1 cross. Consumption in the DID procedure was similar or higher than amounts reported previously for the B6 progenitor.

QTLs resulting in heightened consumption in heterozygous compared to homozygous animals were found on Chrs 11, 15, and 16 for 24-h choice 30% ethanol consumption, and on Chr 11 for DID. No evidence was found for epistasis between any pair of significant or suggestive QTLs.

This indicates that the hybrid overdominance is due to intralocus interactions at the level of individual QTL.

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Prohibitin is expressed in pancreatic β-cells and protects against oxidative and proapoptotic effects of ethanol

Pancreatic β-cell dysfunction is a prerequisite for the development of type 2 diabetes. Alcoholism is a diabetes risk factor and ethanol increases oxidative stress in β-cells, whereas the mitochondrial chaperone prohibitin (PHB) has antioxidant effects in several cell types.

In the present study we investigated whether PHB is expressed in β-cells and protects these cells against deleterious effects of ethanol, using INS-1E and RINm5F β-cell lines.

In ethanol-treated cells, MTT reduction and ATP production decreased, whereas reactive oxygen species, uncoupling protein 2 and cleaved caspase-3 levels increased. In addition, flow cytometry analysis showed an increase of apoptotic cells. Ethanol treatment increased PHB expression and induced PHB translocation from the nucleus to the mitochondria. PHB overexpression decreased the apoptotic effects of ethanol, whereas PHB knockdown enhanced these effects. The protective effects of endogenous PHB were recapitulated by incubation of the cells with recombinant human PHB.

Thus, PHB is expressed in β-cells, increases with oxidative stress and protects the cells against deleterious effects of ethanol.

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Friday, December 25, 2009

Efficacy of Physician-delivered Brief Counseling Intervention for Binge Drinkers

Binge drinking is a common pattern of alcohol use in the US. However, no studies have evaluated the effectiveness of brief interventions targeting only binge drinkers.

This study provided evidence that screening and brief counseling delivered by a primary care physician as part of regular health care significantly reduced binge drinking episodes in binge drinkers.

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Thursday, December 24, 2009

Brain metabolite changes in alcoholism: Localized proton magnetic resonance spectroscopy study of the occipital lobe

Chronic alcoholism is associated with altered brain metabolism, morphology and cognitive abilities. Besides deficits in higher order cognitive functions, alcoholics also show a deficit in the processing of basic sensory information viz. visual stimulation.

To assess the metabolic changes associated with this deficit, 1H MRS was carried out in the occipital lobe of alcohol dependents.

A significant increase in Cho/Cr ratio (p <>

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Brief Intervention conference presentations available

A large collection of presentations covering the most up to date international research, learning and developments in the in field of brief interventions for alcohol are now available
. . . . .

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Patterns of alcohol consumption in diverse rural adults populations in the Asian region

Alcohol abuse, together with tobacco use, is a major determinant of health and social well-being, and is one of the most important of 26 risk factors comparatively assessed in low and middle income countries, surpassed only by high blood pressure and tobacco.

The alcohol consumption patterns and the associations between consumption of alcohol and socio-demographic and cultural factors have been investigated in nine rural Health and Demographic Surveillance System (HDSS) located in five Asian countries.

Alcohol was rarely consumed in five of the HDSS (four in Bangladesh, and one in Indonesia). In the two HDSS in Vietnam (Chililab, Filabavi) and one in Thailand (Kanchanaburi), alcohol consumption was common in men. The mean number of drinks per day during the last seven days, and prevalence of at-risk drinker were found to be highest in Filabavi. The prevalence of female alcohol consumption was much smaller in comparison with men. In Chililab, people who did not go to school or did not complete primary education were more likely to drink in comparison to people who graduated from high school or university.

Although uncommon in some countries because of religious and cultural practices, alcohol consumption patterns in some sites were cause for concern. In addition, qualitative studies may be necessary to understand the factors influencing alcohol consumption levels between the two sites in Vietnam and the site in Thailand in order to design appropriate interventions.

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Wednesday, December 23, 2009

A new definition of early age at onset in alcohol dependence

The accurate cut-off of an early onset of alcohol dependence is unknown. The objectives of this analysis are (1) to confirm that ages at onset variability in alcohol dependence is best described as a two subgroups entity, (2) to define the most appropriate cut-off, and (3) to test the relevancy of such distinction.

The best-fit model distinguished two subgroups of age at onset of alcohol dependence, with a cut-off point at 22 years. Subjects with an earlier onset of alcohol dependence (≤22 years old) reported higher lifetime rates of specific phobia, antisocial behaviors and nearly all addictive disorders.

The early onset of alcohol dependence is best defined as beginning before the age of 22 years.

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