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.


Saturday, February 14, 2009

The TEDS Report: Treatment Outcomes among Clients Discharged from Residential Substance Abuse Treatment:

  • SAMHSA's annual Treatment Episode Data Set (TEDS) provides data on completion rates by race, gender, primary substance of abuse, and type of residential treatment for those with discharge information provided by the States for their specialty substance abuse treatment facilities.

  • In 2005, clients discharged from short-term residential treatment (30 days or less) were more likely to complete treatment than those discharged from long-term residential treatment (57% vs. 38%).

  • Among short-term residential treatment discharges, a higher proportion of American Indian/Alaska Natives (63%) and Asian/Pacific Islanders (60%) completed treatment than Whites (57%), Blacks (55%), or Hispanics (52%).

  • Clients who reported alcohol as their primary drug of abuse were more likely to complete treatment among residential short-term discharges (66%) and long-term discharges (46%) than those with other primary drugs of abuse.

  • Discharged clients who reported stimulants as their primary drug of abuse were the least likely to complete short-term residential treatment (46%) and were almost as likely (19%) as those reporting opiates (21%) as their primary drug to drop out of short-term residential treatment.

  • Treatment completion among clients discharged from long-term residential treatment was lowest among those reporting cocaine abuse (33%) or opiate abuse (35%) as their primary drug of abuse.

Read Full Report (PDF)


Wednesday, February 11, 2009

Health Disadvantage in US Adults Aged 50 to 74 Years: A Comparison of the Health of Rich and Poor Americans With That of Europeans
American Journal of Public Health March 2009, Vol 99, No. 3, 540-548

We compared the health of older US, English, and other European adults, stratified by wealth.

American adults reported worse health than did English or European adults. Eighteen percent of Americans reported heart disease, compared with 12% of English and 11% of Europeans. At all wealth levels, Americans were less healthy than were Europeans, but differences were more marked among the poor. Health disparities by wealth were significantly smaller in Europe than in the United States and England. Odds ratios of heart disease in a comparison of the top and bottom wealth tertiles were 1.94 (95% confidence interval [CI] = 1.69, 2.24) in the United States, 2.13 (95% CI = 1.73, 2.62) in England, and 1.38 (95% CI = 1.23, 1.56) in Europe. Smoking, obesity, physical activity levels, and alcohol consumption explained a fraction of health variations.

American adults are less healthy than Europeans at all wealth levels. The poorest Americans experience the greatest disadvantage relative to Europeans.

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Curbing Problem Drinking with Personalized-Feedback Interventions: A Meta-Analysis
American Journal of Preventive MedicineVolume 36, Issue 3, March 2009, Pages 247-255
The effectiveness of personalized-feedback interventions to reduce problem drinking has been evaluated in several RCTs and systematic reviews.
A meta-analysis was performed to examine the overall effectiveness of brief, single-session personalized-feedback interventions without therapeutic guidance.

The selection and analyses of studies were conducted in 2008. Fourteen RCTs of single-session personalized-feedback interventions without therapeutic guidance were identified, and their combined effectiveness on the reduction of problematic alcohol consumption was evaluated in a meta-analysis. Alcohol consumption was the primary outcome measure.

The use of single-session personalized-feedback interventions without therapeutic guidance appears to be a viable and probably cost-effective option for reducing problem drinking in student and general populations. The Internet offers ample opportunities to deliver personalized-feedback interventions on a broad scale, and problem drinkers are known to be amenable to Internet-based interventions. More research is needed on the long-term effectiveness of personalized-feedback interventions for problem drinking, on its potential as a first step in a stepped-care approach, and on its effectiveness with other groups (such as youth obliged to use judicial service programs because of violations of minimum-age drinking laws) and in other settings (such as primary care).
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State Alcohol-Use Estimates Among Youth and Adults, 1993–2005
American Journal of Preventive MedicineVolume 36, Issue 3, March 2009, Pages 218-224
Underage drinking, particularly binge drinking, is an important public health problem that results in substantial premature mortality and morbidity. Little is known about the potential influence of the alcohol-use behaviors of adults on youth alcohol use at a population level.
The purpose of this study was to examine the correlation of alcohol-use behaviors among youth with those of adults at a population level.
Overall and subgroup-specific state youth estimates of current drinking and binge drinking were generally moderately to strongly correlated with adult alcohol use (range of r -values for pooled estimates across all years: 0.35–0.68 for current drinking
Most state youth alcohol-use estimates were correlated with state adult estimates. These findings have implications for underage-drinking control strategies and suggest that efforts to address this problem need to be targeted on a broader societal level.
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Binge Drinking Among U.S. Active-Duty Military Personnel
American Journal of Preventive MedicineVolume 36, Issue 3, March 2009, Pages 208-217

Binge drinking (drinking on a single occasion ≥5 drinks for men or ≥4 drinks for women) is a common risk behavior among U.S. adults that is associated with many adverse health and social consequences. However, little is known about binge drinking among active-duty military personnel (ADMP). The objectives of this study were to quantify episodes of binge drinking, to characterize ADMP who binge-drink, and to examine the relationship between binge drinking and related harms.

In 2005, a total of 43.2% of ADMP reported past-month binge drinking, resulting in 29.7 episodes per person per year. In all, 67.1% of binge episodes were reported by personnel aged 17–25 years (46.7% of ADMP), and 25.1% of these episodes were reported by underage youth (aged 17–20 years). Heavy drinkers (19.8% of ADMP) were responsible for 71.5% of the binge-drinking episodes and had the highest number of annual per-capita episodes of binge drinking (112.6 episodes). Compared to nonbinge drinkers, binge drinkers were more likely to report alcohol-related harms, including job performance problems (AOR=6.5; 95% CI=4.65, 9.15); alcohol-impaired driving (AOR=4.9; 95% CI=3.68, 6.49); and criminal justice problems (AOR=6.2; 95% CI=4.00, 9.72).

Binge drinking is common among ADMP and is strongly associated with adverse health and social consequences. Effective interventions (e.g., the enforcement and retainment of the minimum legal drinking age) to prevent binge drinking should be implemented across the military and in conjunction with military communities to discourage binge drinking.

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Sunday, February 8, 2009

New Resource Available on Detoxification

The Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Center for Substance Abuse Treatment (CSAT) is pleased to announce the availability of the Detoxification and Substance Abuse Treatment Training Manual.

This new curriculum, based on Treatment Improvement Protocol (TIP) 45, is for use by clinical supervisors for training staff members about detoxification services for individuals with substance use disorders.

The manual includes information on the physiology of withdrawal, pharmacological management of withdrawal, patient placement, and incorporating detoxification services into comprehensive systems of care. It includes step-by-step instructions for providing inservice training.

Read Full Manual (PDF)
Low alcohol alternatives: A promising strategy for reducing alcohol related harm
International J Drug Policy Volume 20, Issue 2, Pages 183-187 (March 2009)
Less than 1% of the beer market in British Columbia comprises beers with an alcohol content below 4%, despite the success of low alcohol beers in other countries, e.g. Australia.
A small experimental study is described in which male students were given either unmarked low alcohol beer (3.8%) or regular strength beer (5.3%) to investigate their enjoyment and subjective intoxication..
We conclude beer drinkers cannot readily distinguish low and regular strength beers and can enjoy socializing equally with either. We recommend taxation strategies to create incentives for the manufacture, marketing and consumption of low alcohol alternatives.
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