Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions

Journal of Affective Disorders Volume 115, Issue 3, Pages 367-375 (June 2009)

Almost one-quarter of individuals with mood disorders (24.1%) used alcohol or drugs to relieve symptoms. The highest prevalence of self-medication was seen in bipolar I disorder (41.0%). Men were more than twice as likely as women to engage in self-medication (Adjusted Odds Ratio=2.18; 95% Confidence Interval 1.90–2.49).

After controlling for the effects of substance use disorders, self-medication was associated with higher odds of comorbid anxiety and personality disorders when compared to individuals who did not self-medicate.

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Request Reprint E-Mail: jbolton@hsc.mb.ca

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Sibling Agreement on Retrospective Reports of Parental Alcoholism and Other Childhood Events

Substance Use & Misuse Published Online 30 April 2009

Descriptive statistics showed that agreement was strong for measures of parental alcoholism and psychiatric problems, weaker for family environment, and varied little by subject characteristics. Study limitations and implications are noted, and future research suggested.

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Request Repreint E-Mail: mamodeo@bu.edu

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Self-Control in Decision-Making Involves Modulation of the vmPFC Valuation System

Science 1 May 2009:Vol. 324. no. 5927, pp. 646 - 648

Every day, individuals make dozens of choices between an alternative with higher overall value and a more tempting but ultimately inferior option. Optimal decision-making requires self-control.

We propose two hypotheses about the neurobiology of self-control: (i) Goal-directed decisions have their basis in a common value signal encoded in ventromedial prefrontal cortex (vmPFC), and (ii) exercising self-control involves the modulation of this value signal by dorsolateral prefrontal cortex (DLPFC).

We used functional magnetic resonance imaging to monitor brain activity while dieters engaged in real decisions about food consumption.

Activity in vmPFC was correlated with goal values regardless of the amount of self-control. It incorporated both taste and health in self-controllers but only taste in non–self-controllers. Activity in DLPFC increased when subjects exercised self-control and correlated with activity in vmPFC.

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Request Reprint E-Mail: thare@hss.caltech.edu

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An historical perspective on recovery

Griffith Edwards, Assistant Commissioning Editor, Addiction

Download or stream the presentation by connecting to the Pathways Internet Radio or click on "Play Now" or click on the Powerpoint Presentation to download copies of the presentation slides:

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Amygdala protein kinase C epsilon controls alcohol consumption

Genes, Brain and Behavior Published Online: 19 Feb 2009

Alcoholism is a progressive disorder that involves the amygdala. Mice lacking protein kinase C epsilon (PKCɛ) show reduced ethanol consumption, sensitivity and reward. We therefore investigated whether PKCɛ signaling in the amygdala is involved in ethanol consumption.

Local knockdown of PKCɛ in the amygdala reduced ethanol consumption and preference in a limited-access paradigm. Further, mice that are heterozygous for the PKCɛ allele consume less ethanol compared with wild-type mice in this paradigm. These mice have a >50% reduction in the abundance of PKCɛ in the amygdala compared with wild-type mice.

We conclude that amygdala PKCɛ is important for ethanol consumption in mice.

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Request Reprint E-Mail: H.M.B.Lesscher@umcutrecht.nl

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Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons With Severe Alcohol Problems

JAMA. 2009;301(13):1349-1357.

In this population of chronically homeless individuals with high service use and costs, a Housing First program was associated with a relative decrease in costs after 6 months. These benefits increased to the extent that participants were retained in housing longer.

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Request Reprint E-Mail: larimer@u.washington.edu
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Alcohol Consumption and Risk of Pancreatic Cancer in the Netherlands Cohort Study

American Journal of Epidemiology 2009 169(10):1233-1242

Overall, these findings suggest an increased pancreatic cancer risk for persons with a high ethanol intake (30 g/day). However, this increased risk was observed only during the first 7 years of follow-up.

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Request Reprint E-Mail: mirjam.heinen@epid.unimaas.nl
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Long-term wine consumption is related to cardiovascular mortality and life expectancy independently of moderate alcohol intake: the Zutphen Study

J Epidemiol Community Health. Published Online First: 30 April 2009.

Long-term light alcohol intake loweredcardiovascular and all-cause mortality risk and increased life expectancy. Light wine consumption was associated with 5 years longer life expectancy; however, more studies are needed to verify this result.

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Request Reprint E-Mail: martinette.streppel@wur.nl

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The 2009 Jack Mendelson Honorary Lecture: Recent Findings From a 25-Year Longitudinal Study of Genetic and Environmental Contributors to Alcoholism

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) presents the 2009 Jack Mendelson Honorary Lecture. The first honorary lecturer is Marc A. Schuckit, M.D., Distinguished Professor of Psychiatry, University of California San Diego, and Director of the Alcohol Research Center, VA San Diego Healthcare System. His lecture is titled “Recent Findings From a 25-Year Longitudinal Study of Genetic and Environmental Contributors to Alcoholism.”

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Protracted Withdrawal from Alcohol and Drugs of Abuse Impairs Long-Term Potentiation of Intrinsic Excitability in the Juxtacapsular Bed Nucleus of the Stria Terminalis

The Journal of Neuroscience, April 29, 2009, 29(17):5389-5401

The juxtacapsular bed nucleus of the stria terminalis (jcBNST) is activated in response to basolateral amygdala (BLA) inputs through the stria terminalis and projects back to the anterior BLA and to the central nucleus of the amygdala.

Here we show a form of long-term potentiation of the intrinsic excitability (LTP-IE) of jcBNST neurons in response to high-frequency stimulation of the stria terminalis. This LTP-IE, which was characterized by a decrease in the firing threshold and increased temporal fidelity of firing, was impaired during protracted withdrawal from self-administration of alcohol, cocaine, and heroin. Such impairment was graded and was more pronounced in rats that self-administered amounts of the drugs sufficient to maintain dependence.

Dysregulation of the corticotropin-releasing factor (CRF) system has been implicated in manifestation of protracted withdrawal from dependent drug use. Administration of the selective corticotropin-releasing factor receptor 1 (CRF1) antagonist R121919 [2,5-dimethyl-3-(6-dimethyl-4-methylpyridin-3-yl)-7-dipropylamino-pyrazolo[1,5-a]pyrimidine)], but not of the CRF2 antagonist astressin2-B, normalized jcBNST LTP-IE in animals with a history of alcohol dependence; repeated, but not acute, administration of CRF itself produced a decreased jcBNST LTP-IE.

Thus, changes in the intrinsic properties of jcBNST neurons mediated by chronic activation of the CRF system may contribute to the persistent emotional dysregulation associated with protracted withdrawal.

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Request Reprint E-Mail: wfranc@scripps.edu

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Lost in the Sauce: The Effects of Alcohol on Mind Wandering

Psychological Science Published Online: 28 Apr 2009

The results suggest that alcohol increases mind wandering while simultaneously reducing the likelihood of noticing one's mind wandering. Findings are discussed with regard to theories of alcohol and theories of consciousness.

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Request Reprint E-Mail: sayette@pitt.edu.

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Environmental context effects on alcohol cognitions and immediate alcohol consumption
Addiction Research & Theory, Volume 17, Issue 3 June 2009 , pages 306 - 314

These results strengthen support for the influence of environmental context on retrieval of alcohol cognitions in memory and on drinking behavior. Our findings complement theoretical assertions of the critical role of alcohol cognitions in directly influencing alcohol consumption.

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Request Reprint E-Mail: clau@ria.buffalo.edu
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The Hippocampus and Cingulate Cortex Differentially Mediate the Effects of Nicotine on Learning Versus on Ethanol-Induced Learning Deficits Through Different Effects at Nicotinic Receptors

Neuropsychopharmacology advance online publication 25 March 2009

These results suggest that nicotine acts in the hippocampus to enhance contextual learning, but acts in the cingulate to ameliorate ethanol-induced learning deficits through inactivation of high-affinity 2 subunit-containing nAChRs.

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Request Reprint E-Mail: tgould@temple.edu

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Hierarchical additive modeling of nonlinear association with spatial correlations - An application to relate alcohol outlet density and neighborhood assault rates

Statistics in Medicine Published Online: 28 Apr 2009

We propose a hierarchical additive model, where the nonlinear correlations and the complex interaction effects are modeled using the multiple additive regression trees and the residual spatial association in the assault rates that cannot be explained in the model are smoothed using a conditional autoregressive (CAR) method.

We develop a two-stage algorithm that connects the nonparametric trees with CAR to look for important covariates associated with the assault rates, while taking into account the spatial association of assault rates in adjacent census tracts.

The proposed method is applied to the Los Angeles assault data (1990-1999). To assess the efficiency of the method, the results are compared with those obtained from a hierarchical linear model.

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Requerst Reprint E-Mail: qyu@lsuhsc.edu

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How do people recover from alcohol dependence? A systematic review of the research on mechanisms of behavior change in Alcoholics Anonymous
Addiction Research & Theory, Volume 17, Issue 3 June 2009 , pages 236 - 259

Results suggest AA helps individuals recover through common process mechanisms associated with enhancing self-efficacy, coping skills, and motivation, and by facilitating adaptive social network changes. Little research or support was found for AA's specific practices or spiritual mechanisms. Conclusions are limited by between-study differences in sampling, measurement, and assessment time-points, and by insufficient theoretical elaboration of recovery-related change. Similar to the common finding that theoretically-distinct professional interventions do not result in differential patient outcomes, AA's effectiveness may not be due to its specific content or process. Rather, its chief strength may lie in its ability to provide free, long-term, easy access and exposure to recovery-related common therapeutic elements, the dose of which, can be adaptively self-regulated according to perceived need.

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Request Reprint E-Mail: jkelly11@partners.org

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Alcohol Use and Its Role in Female Homicides in the Western Cape, South Africa

J. Stud. Alcohol Drugs 70: 321-327, 2009

Sixty-two percent of women who were murdered had a high BAC at the time of their death, with an overall median BAC of .11% (110 mg/100 ml). A quantile regression analysis showed that a raised median BAC at the time of death was positively associated with the victim's age; being unemployed or not known to be employed; and being killed in a rural setting, in a public space, and on a weekend.

Significant interactions between type of homicide and employment showed a modification in median BACs for unemployed victims killed by intimate partners compared with employed victims, with a median difference of .19% (190 mg/100 ml) (95% confidence interval: .14%-.23% [140-230 mg/100 ml]).

This study highlights the public health impact of excessive alcohol consumption and the need for a comprehensive approach to reduce the harmful effects of drinking

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Request Reprint E-Mail: shanaaz.mathews@mrc.ac.za

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Association of Average Daily Alcohol Consumption, Binge Drinking and Alcohol-Related Social Problems: Results from the German Epidemiological Surveys of Substance Abuse

Alcohol and Alcoholism Volume 44, Number 3 Pp. 314-320

The frequency of binge drinking occasions seems to be a better predictor of alcohol-related social problems than volume. Alcohol-related social harms especially among drinkers with moderate volume per day may be reduced by targeting prevention strategies towards episodic heavy drinkers.

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Request Reprint E-Mail: kraus@ift.de

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Ethanol inhibition of aspartyl-asparaginyl-β-hydroxylase in fetal alcohol spectrum disorder: Potential link to the impairments in central nervous system neuronal migration

Alcohol Volume 43, Issue 3, May 2009, Pages 225-240

Chronic gestational exposure to ethanol caused dose-dependent impairments in neuronal migration and corresponding reductions in AAH protein expression in developing cerebella.

In addition, prenatal ethanol exposure inhibited insulin and IGF-I–stimulated directional motility in isolated cerebellar granule neurons. Ethanol-treated neuronal cultures (50 mM × 96 h) also had reduced levels of AAH protein. Mechanistically, we showed that AAH protein could be phosphorylated on Ser residues by GSK-3β, and that chemical inhibition of GSK-3β and/or global Caspases increases AAH protein in both control- and ethanol-exposed cells.

Ethanol-impaired neuronal migration in FASD is associated with reduced AAH expression. Because ethanol increases the activities of both GSK-3β and Caspases, the inhibitory effect of ethanol on neuronal migration could be mediated by increased GSK-3β phosphorylation and Caspase degradation of AAH protein.

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Request Reprint E-Mail: Suzanne_DeLaMonte_MD@Brown.edu

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The Adolescent Substance Abuse Prevention Study: A randomized field trial of a universal substance abuse prevention program
Drug and Alcohol Dependence Volume 102, Issues 1-3, 1 June 2009, Pages 1-10

The purpose of the study was to determine whether a universal school-based substance abuse prevention program, Take Charge of Your Life (TCYL), prevents or reduces the use of tobacco, alcohol, or marijuana

The negative impact of the program on baseline nonusers of alcohol and tobacco indicate that TCYL should not be delivered as a universal prevention intervention. The finding of a beneficial effect for baseline marijuana users further supports this conclusion. The programmatic and methodological challenges faced by the Adolescent Substance Abuse Prevention Study (ASAPS) and lessons learned offer insights for prevention researchers who will be designing similar randomized field trials in the future.

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Request Reprint E-Mail: zsloboda@aol.com
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Universal school-based substance abuse prevention programs: Modeling targeted mediators and outcomes for adolescent cigarette, alcohol and marijuana use

Drug and Alcohol Dependence Volume 102, Issues 1-3, 1 June 2009, Pages 19-29

Relationships among targeted constructs and outcomes differed for each of the drugs with communication skills having a potentially iatrogenic effect on alcohol use. Program targets were mediated through the intentions to use these substances. Finally, we found evidence of a moderating effect of decision-making skills on perceptions of harm and attitudes toward use, depending upon the outcome.

Prevention curricula may need to target specific drugs. In addition to normative beliefs, perceptions of harm, and refusal and decision-making skills, programs should directly target constructs proximal to behavioral outcomes such as attitudes and intentions. Finally, more research on the effects of communication skills on adolescent substance use should be examined.

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Request Reprint E-Mail: tonkin@uakron.edu

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Alcohol and trauma: a summary of the Satellite Symposium at the 30th Annual Meeting of the Shock Society

Alcohol Volume 43, Issue 3, Pages 247-252 (May 2009)

This article highlights the research presented at the Alcohol and Trauma Satellite Symposium at the 30th Annual Meeting of the Shock Society. The satellite meeting was held on June 8 and 9 in Baltimore, MD. Its purpose was to discuss recent findings in the areas of alcohol and injury, including the effect of alcohol use on patients in the trauma unit of hospitals. The meeting consisted of three sessions, with plenary talks by invited speakers, short talks from selected abstracts, and a poster session. Participants presented data on the effects of alcohol on organ function, healing, and immune processes after a variety of injuries including burn, hemorrhagic shock, sepsis, and ischemia reperfusion.

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Request Reprint E-Mail: ekovacs@lumc.edu

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Impulsive and non-impulsive suicide attempts in patients treated for alcohol dependence

Journal of Affective Disorders Volume 115, Issue 1, Pages 131-139 (May 2009)

Lifetime suicide attempts were reported by 43% of patients in alcohol treatment; of which 62% were impulsive. Compared to patients without a suicide attempt, those with a non-impulsive attempt were more likely to have a history of sexual abuse (OR=7.17), a family history of suicide (OR=4.09), and higher scores on a personality measure of impulsiveness (OR=2.27). The only significant factor that distinguished patients with impulsive suicide attempts from patients without a suicide attempt and from patients with a non-impulsive suicide attempt was a higher level of behavioral impulsivity (OR=1.84–2.42).

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Request Reprint E-Mail: mwojnar@umich.edu

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The 2007 ESPAD Report - Substance Use Among Students in 35 European Countries

The main purpose of the European School Survey Project on Alcohol and Other Drugs (ESPAD) is to collect comparable data on substance use among 15–16 year-old European students in order to monitor trends within as well as between countries. So far four data collection waves have been conducted within the ESPAD project.

The first study was held in 26 countries in 1995, while the 2007 data collection was performed in 35 countries.

This summary presents key results from the 2007 survey as well as findings regarding the long-term trends. An initial section gives a short overview of the methodology

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A Randomized Trial of Individual and Couple Behavioral Alcohol Treatment for Women

Journal of Consulting and Clinical Psychology Volume 77, Issue 2, April 2009, Pages 243-256

In this randomized efficacy trial of 102 heterosexual women with AUDs, the authors compared alcohol behavioral couple therapy (ABCT) and alcohol behavioral individual therapy (ABIT) on percentage of days abstinent (PDA) and percentage of days of heavy drinking (PDH) over 6 months of treatment and 12 months of posttreatment follow-up.

During treatment, women increased their PDA and decreased their PDH, with significantly greater improvements in ABCT than in ABIT (d = 0.59 for PDA; d = 0.79 for PDH). Differences favoring ABCT were maintained during follow-up.

Women with poorer baseline relationship functioning improved more on PDA during treatment with ABCT than with ABIT.

For PDH, results during treatment and follow-up favored ABCT for women with better baseline relationship functioning.

ABCT resulted in better outcomes than ABIT for women with Axis I disorders at the end of follow-up (PDA), and for women with Axis II disorders at the end of treatment (PDA) and at the end of follow-up (PDH).

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Request Reprint E-Mail: bmccrady@unm.edu

The demand for intensity versus frequency of alcohol consumption: Evidence from rural Australia

This paper develops a theoretical model for the demand of alcohol where intensity and frequency of consumption are separate choices made by individuals in order to maximize their utility.

While distinguishing between intensity and frequency of consumption may be unimportant for many goods, this is clearly not the case with alcohol where the likelihood of harm depends not only on the total consumed but also on the pattern of use.

The results from the theoretical model are applied to data from rural Australia in order to investigate the factors that affect the patterns of alcohol use for this population group.

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Persistent Increase of Alcohol-Seeking Evoked by Neuropeptide S: an Effect Mediated by the Hypothalamic Hypocretin System

Neuropsychopharmacology advance online publication 25 March 2009

These results provide the first demonstration that activation of NPS receptors in the LH intensifies relapse to ethanol-seeking elicited by environmental conditioning factors. This effect is selective, and is mediated by activation of LH hypocretin neurones.

Based on the present findings, we also predict that antagonism at NPS receptors could represent a novel pharmacological approach to alcohol relapse treatment.

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Request Reprint E-Mail: roberto.ciccocioppo@unicam.it

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Alcohol-Related Disorders in Beijing, China: Prevalence, Socio-Demographic Correlates, and Unmet Need for Treatment
Alcoholism: Clinical and Experimental Research Published Online: 23 Mar 2009

The 12-month prevalence of alcohol use and episodic heavy drinking were 32.5 and 13.8%, respectively. The 12-month and lifetime prevalence of alcohol dependence were 1.7 and 4.3%, respectively. Age above 24 years, male sex, being married and employed, low education level (junior high school, primary school or illiterate), rural residence, and having comorbid psychiatric disorders were all significantly associated with a higher likelihood of alcohol-related disorders. Only 2.4% of the subjects with alcohol dependence were receiving treatment, and a mere 1.4% had sought treatment from mental health professionals.

Nationwide surveys are urgently needed to further explore the prevalence of alcohol-related disorders in China.

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Request Reprint E-Mail: xyutly@cuhk.edu.hk
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Decreased Sensitivity to Ethanol Reward in Adolescent Mice as Measured by Conditioned Place Preference
Alcoholism: Clinical and Experimental Research Published Online: 21 Apr 2009

Adolescents are less sensitive than adults to the rewarding effects of ethanol but can experience reward with high doses. These results extend the current literature on ethanol's effects in adolescent animals.

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Request Reprint E-Mail: dickinss@stolaf.edu
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Effects of Pregnanolone and Dehydroepiandrosterone on Ethanol Intake in Rats Administered Ethanol or Saline during Adolescence
Alcoholism: Clinical and Experimental Research Published Online: 21 Apr 2009

These results indicate that chronic intermittent ethanol (CIE) administration of 2 g/kg during adolescence did not alter preference or overall consumption of ethanol in outbred rats trained to drink ethanol as an adult under the conditions tested, and that DHEA may be more effective than pregnanolone at significantly decreasing ethanol consumption.

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Request Reprint E-Mail: pwinsa@lsuhsc.edu
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Projected Alcohol Dose Influences on the Activation of Alcohol Expectancies in College Drinkers
Alcoholism: Clinical and Experimental Research Published Online: 21 Apr 2009

Across heavy, medium, and light drinkers, expectancy dimensions were most distinguishable at higher doses; activation patterns were more similar across drinking groups at lighter doses. Modest evidence for the influence of gender on activation patterns was observed. Findings were consistent across alcohol involvement indices.

These data suggest that both dimensionality and context should be considered in the refinement of interventions designed to alter expectancies in order to decrease hazardous drinking.

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Request Reprint E-Mail: JPRead@Buffalo.edu
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Circadian Timing of Ethanol Exposure Exerts Enduring Effects on Subsequent Ad Libitum Consumption in C57 Mice
Alcoholism: Clinical and Experimental Research Published Online: 21 Apr 2009

These results demonstrate that the daily timing of ethanol exposure exerts enduring effects of self-administration of ethanol in mice. Understanding how circadian rhythms regulate ethanol consumption may be valuable for modifying subsequent intake.

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Rerquest Reprint E-Mail: : jltrujillo@ucsd.edu
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High-Alcohol Preferring Mice Are More Impulsive Than Low-Alcohol Preferring Mice as Measured in the Delay Discounting Task

Alcoholism: Clinical and Experimental Research Published Online: 21 Apr 2009

Alcohol-naïve outbred mice selected for high-alcohol drinking were more impulsive with saccharin reinforcers than low-alcohol drinkers. These data are consistent with results seen using inbred strain descendents of high-alcohol drinking and low-alcohol drinking rat lines, and suggest that impulsivity is a heritable difference that precedes alcoholism.

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Request Reprint E-Mail: ngrahame@iupui.edu __________________________________________________