The Alcohol Flushing Response: An Unrecognized Risk Factor for Esophageal Cancer from Alcohol Consumption
PLoS Med 6(3)

ALDH2 Lys487 allele contributes to both the alcohol flushing response
and an elevated risk of squamous cell esophageal cancer from alcohol
consumption.

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Alcohol Treatment: Need, Utilization, and Barriers

Highlights:

SAMHSA's National Survey on Drug Use & Health defines need for alcohol treatment as meeting criteria for alcohol dependence or abuse using criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The criteria includes symptoms such as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference in major obligations at work, school, or home during the past year. Also included are people who received treatment in a specialty substance abuse treatment facility in the past year for their alcohol use.
Based on SAMHSA's 2007 National Survey on Drug Use & Health, 7.8% (19.3 million) persons aged 12 or older needed treatment for their alcohol problem in the past year.

The majority of those who needed alcohol treatment either did not perceive the need for treatment or did not receive it. Of those who needed alcohol treatment in the past year, 8.1% received treatment at a specialty treatment facility, 4.5% did not receive treatment but felt they needed it, and 87.4% neither received nor perceived a need for alcohol treatment.

Among those who did not receive alcohol treatment but felt they needed it, only 27.9% actually made an effort to get treatment in the past year.
Combined data from SAMHSA's 2004 to 2007 National Surveys on Drug Use & Health were used to determine reasons for not receiving alcohol treatment. The most common reasons given for not receiving alcohol treatment among those who felt the need for it were: 42% were not ready to stop using alcohol and 34.5% had cost or insurance barriers.

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British teenagers amongst worst in Europe for excessive drinking - 2007 ESPAD report

The 2007 European School Survey Project on Alcohol and other Drugs (ESPAD) report was published last week. The study focuses on alcohol and drug use amongst 15 to 16 year-olds in 35 European countries and found that UK consumption for young people was highest behind only Denmark and the Isle of Man.

The report adds weight to calls for minimum pricing. Professor Martin Plant who leads the UK part of the ESPAD study said:
There is a clear scientific consensus that alcohol education and mass media campaigns have a very poor track record in influencing drinking habits. Far more effective - and cost effective - policies include using taxation to make alcohol less affordable.

. . . . .

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Low-Alcohol Beers: Contribution to Blood-Ethanol Concentration and Its Elevation above the UK Legal Limit after ‘Topping-up’
Alcohol and Alcoholism Advance Access published online on March 25, 2009


The aim of this study was to establish the contribution of low-alcohol beers to blood-ethanol concentration (BEC) and to test if ‘topping-up’ with these beverages can increase BEC above the 80 mg/dl UK legal limit.

Healthy male and female volunteers received a dose of ethanol designed to give a BEC of just below 80 mg/dl, and then received one pint (600 ml) of a 1% v/v alcohol beer in the fasting state or after lunch, or of a zero-alcohol or a 0.5% v/v alcohol beer after fasting. BEC was determined enzymatically and data were subjected to ANOVA.

Topping-up with a pint of a 1% v/v alcohol beer increased BEC >80 mg/dl in fasting subjects, contributing an extra 12–17 mg/dl, which lasted longer in males (80 min) than in females (20 min). A 0.5% v/v alcohol beer increased BEC above 80 mg/dl only in males, which lasted for 60 min. After food intake, the 1% v/v alcohol beer increased BEC above 80 mg/dl transiently only in males.

Low-alcohol beers make a significant contribution to blood-ethanol concentration and can increase it above the UK legal limit. Their use as a ‘top-up’ should be discouraged. Low-alcohol beers have a place as a substitute for normal-strength beverages as a strategy for decreasing alcohol consumption in general and in countries where low legal alcohol limits are in force or being contemplated.

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Request Reprint E-Mail: ABadawy@uwic.ac.uk

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PAT (2009)—Revisions to the Paddington Alcohol Test for Early Identification of Alcohol Misuse and Brief Advice to Reduce Emergency Department Re-attendance
Alcohol and Alcoholism Advance Access published online on March 27, 2009

The Paddington Alcohol Test (PAT) has evolved over 15 years as a clinical tool to facilitate emergency physicians and nurses giving brief advice and the offer of an appointment for brief intervention by an alcohol nurse specialist. Previous work has shown that unscheduled emergency department re-attendance is reduced by ‘making the connection’ between alcohol misuse and resultant problems necessitating emergency care. The revised ‘PAT (2009)’ now includes education on clinical signs of alcohol misuse and advice on when to request a blood alcohol concentration.

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Out-of-Home Alcohol Advertising
A 21st-Century Guide to Effective Regulation

Marin Institute has released the country’s first guide to restricting out-of-home (OOH) alcohol advertising. The guide will help policymakers draft effective state and local laws to minimize youth exposure to ubiquitous alcohol advertising in the 21st Century.

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The relationship between age at drinking onset and subsequent binge drinking among women

The European Journal of Public Health Advance Access published online on March 25, 2009

To examine the association between age at drinking onset and subsequent binge drinking, and to examine whether there are differences in this association between four countries.

Overall, 12–26% reported binge drinking once or more per month in the four countries. Median age for starting drinking was 16 years in all four countries. Women who started drinking at 14 years or younger were significantly more likely to binge drink than women who started drinking at 19 years or older with adjusted odds ratios of 2.9 (95% confidence intervals 2.3–3.7), 2.8 (2.1–3.6) and 2.6 (1.9–3.4) for binge drinking in Denmark, Iceland and Sweden, respectively. Among Norwegian women the association was stronger with an adjusted odds ratio at 4.4 (3.5–5.6). The association in all four countries was more pronounced in women younger than 30 years than in older women.

In the four Nordic countries, there is a strong relation between age at drinking onset and later binge drinking. The strong relationship found in countries with such different alcohol cultures is most likely generalizable to other Western countries.

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Sociodemographic Differences in Binge Drinking g Adults --- 14 States, 2004
MMWR Weekly April 3, 2009 / 58(12);301-304

Binge drinking, defined in this study as consuming five or more alcoholic drinks on one occasion,* was responsible for 43,731 (54.9%) of the estimated 79,646 alcohol-attributable deaths each year in the United States during 2001--2005.†

Healthy People 2010 calls for reducing the prevalence of binge drinking among adults from the 16.6% baseline in 1998 to 6.0% (1). An overarching goal of Healthy People is to eliminate health disparities among different segments of the population.§

To assess binge drinking by sex, age group, race/ethnicity, education level, and income level, CDC analyzed data from an optional module of the 2004 Behavioral Risk Factor Surveillance System (BRFSS) survey, the most recent data available on binge drinking prevalence, frequency, and intensity (i.e., the number of drinks consumed per binge episode).

This report summarizes the results of that analysis, which indicated that the prevalence of binge drinking was more common among men (24.3%), persons aged 18--24 years (27.4%) and 2534 years (24.4%), whites (17.5%), and persons with household incomes >$50,000 (17.4%). However, after adjusting for sex and age, the highest average number of binge drinking episodes during the preceding 30 days was reported by binge drinkers whose household income was <$25,000. (4.9), and the highest average number of drinks per binge episode was reported by non-Hispanic blacks (8.4) and Hispanics (8.1).

These findings underscore the need to implement effective population-based prevention strategies (e.g., increasing alcohol excise taxes) and develop effective interventions targeted at groups at higher risk





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A model of access to and continuance in Alcoholics Anonymous



These data from a nationally representative sample of US adults with alcohol use disorders revealed a robust significant association of high symptom severity with access, continuation and discontinuation from Alcoholics Anonymous.

The association of high symptom severity and negative life events supports the behavioral economic model of AA access and continuation as proposed in this paper.

Variables associated with access to AA were also associated with continuation in AA, except for the variables for gender and education level. Women were less likely to attend AA, but more likely to continue attending AA. College educated respondents were less likely to attend AA, but more likely to continue attending AA.

A sub-group of US adults with severe externalizing disorders, identified in this study, is associated with access to and continuation in AA.

In the US there is a a significant geographic regional variation in access to and continuation in AA.

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Spirituality During Alcoholism Treatment and Continuous Abstinence for One Year

The International Journal of Psychiatry in Medicine Volume 38, Number 4 / 2008 , pp. 391 - 406

The primary aim of this prospective study was to examine the role of several aspects of spirituality in maintaining abstinence from alcohol for one year in persons treated for alcohol dependence. The roles of alcohol abstinence self-efficacy and Alcoholics Anonymous affiliation were also examined.

Twenty-eight participants were categorized as continuously abstinent for one year. The strongest associations between 12 month abstinence and the variables of interest were discharge scores of abstinence self-efficacy and existential well-being, and increases during treatment in scores of private spiritual practices. Increased age demonstrated a significant association with positive outcome.

The associations of private spiritual practices, existential well-being, and abstinence self-efficacy with one year of continuous abstinence following treatment discharge suggest the importance of addressing issues related to these variables during alcoholism treatment. More research is needed to understand the role of these variables in promoting and maintaining abstinence and to determine whether or not a related intervention would improve abstinence rates.

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Request Reprint E-Mail: piderman.katherine@mayo.edu

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