A Developmental Perspective on Underage Alcohol Use
Alcohol Research & Health Volume 32, Number 1, 2009

FEATURES
3
A Developmental Perspective on Underage Alcohol Use [PDF] Ann S. Masten; Vivian B. Faden; Robert A. Zucker; and Linda P. Spear

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Developmental Processes and Mechanisms: Ages 0–10 [PDF] Robert A. Zucker; John E. Donovan; Ann S. Masten; Margaret E. Mattson; and Howard B. Moss

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Transitions Into Underage and Problem Drinking: Summary of Developmental Processes and Mechanisms: Ages 10–15 [PDF] Michael Windle; Linda P. Spear; Andrew J. Fuligni; Adrian Angold; Jane D. Brown; Daniel Pine; Greg T. Smith; Jay Giedd; and Ronald E. Dahl

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Underage Alcohol Use: Summary of Developmental Processes and Mechanisms: Ages 16–20 [PDF] Sandra A. Brown; Matthew McGue; Jennifer Maggs; John Schulenberg; Ralph Hingson; Scott Swartzwelder; Christopher Martin; Tammy Chung; Susan F. Tapert; Kenneth Sher; Ken C. Winters; Cherry Lowman; and Stacia Murphy

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Overview of Preventive Interventions Addressing Underage Drinking: State of the Evidence and Steps Toward Public Health Impact [PDF]Richard Spoth; Mark Greenberg; and Robert Turrisi

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Improving Treatment Through Research: Directing Attention to the Role of Development in Adolescent Treatment Success [PDF] Eric F. Wagner

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Current State of Treatment for Alcohol and Other Drug Use Disorders in Adolescents [PDF] Deborah Deas and Andrew Clark
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Increased Transforming Growth Factor-beta1 in Alcohol Dependence

J Korean Med Sci. 2009 Oct;24(5):941-944.

Ethanol and its metabolite acetaldehyde increase transforming growth factor beta1 (TGF-β1) expression in animal studies. TGF-β1 is related with the hepatic stellate cell (the key element of hepatic fibrogenesis) and the radial glia (the key element of neuronal migration).

Blood samples were collected from 41 patients with alcohol dependence, TGF-β1 levels measured by ELISA were compared with 41 normal subjects.

Plasma TGF-β1 levels in the patients with alcohol dependence (1,653.11±532.45 pg/mL) were significantly higher than those of healthy subjects (669.87±366.53 pg/mL) (P=0.000). Patients with or without liver pathology showed no difference in TGF-β1 (P=0.36).

Increased TGF-β1 may mediate deleterious effect of alcohol such as hepatic fibrosis and suppressed neuronal developments in alcohol dependence patients.

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AGENDA - EUROPEAN ALCOHOL AND HEALTH FORUM
SCIENCE GROUP
5th Meeting
Monday 19 October 2009, 11h00 – 17h00
Rue Froissart 101, B-1049 Brussels
Room 02-169

1) Welcome and introduction by the Chair

2) Quorum (Rules of Procedure art. 1.1)

3) Declaration of interests considered prejudicial to independence in relation to the items on the agenda (Rules of Procedure, Article 3.4)

4) Adoption of the agenda (Rules of Procedure, Article 11.6)

5) Election of a Chair among the members for a one-year term of office. Item 5 is chaired by the Commission. (Rules of Procedure, Article 2)

6) Formal adoption of the draft summary report of the Science Group's 4th meeting of 29 June 2009. Item 6 and onwards are chaired by the elected Chair.

7) Update on recent developments (Commission services).

8) Discussion on possible future topics for the Science Group.

9) Discussion on quality criteria applicable in the context of an EAHF database on activities and projects on alcohol and youth health. (Further information in accompanying document.)

10) Agreeing on date/s for next meeting/s.

11) Any other business.

Accompanying documents

• Rules of Procedure of the Science Group.
http://ec.europa.eu/health/ph_determinants/life_style/alcohol/Forum/docs/science_rules_en.pdf • Summary report of the 4th meeting of the Science Group, 29 June 2009 (draft).

• Report of the EAHF Task Force on youth-related aspects of alcohol, 11 March 2009, including the draft paper to establish a Clearing House on activities and projects on alcohol and youth health.
http://ec.europa.eu/health/ph_determinants/life_style/alcohol/Forum/docs/alcohol_forum_taskfreport_en.pdf eport_en.pdf
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Does marketing communication impact on the volume and patterns of consumption of alcoholic beverages, especially by young people? - a review of ongitudinal studies
Scientific Opinion of the Science Group of the European Alcohol and Health Forum

The European Alcohol and Health Forum requested scientific advice from the Science Group on the impact of marketing communication on the volume and patterns of consumption of alcoholic beverages, especially by young people. The opinion of the Science Group noted that marketing communications are just one aspect of determinants of alcohol consumption and alcohol-related harm, and that it can be difficult to isolate the impact of one aspect from another. The opinion also noted that a total marketing strategy includes not only marketing communication and promotional activities, but also product development, pricing, physical availability, and market segmentation and targeting, factors not considered in the available published studies.

The Science Group considered the advantages and disadvantages of a number of different methodologies that could be used to inform answers to the question “does marketing ommunication impact on the volume and patterns of consumption of alcoholic beverages, especially by young people”, including:

1. Qualitative studies that investigate the relationship between exposure to portrayals of alcohol use in the mass media and drinking expectancies of children and adolescents;

2. Econometric Studies that investigate the relationship between the amount of alcohol advertising and the amount of drinking taking place in a particular jurisdiction using econometric methods;

3. Cross-sectional studies which take a snapshot of advertising exposure (awareness and/or appreciation) and levels of drinking, and look for correlations between the two;

4. Experimental studies, in which exposure to alcohol in commercials or in movies is linked to immediate and observed use of alcohol;

5. Case studies, where changes in regional, national or international law that affect the volume or content of marketing communication have been studied and reported for their impact on changes in the use of alcoholic beverages; and

6. Longitudinal studies which measure exposure at time A, and how this relates to drinking at future time B .

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Tools to handle alcohol, drugs and development

Coming: New estimates of global health risks
2009-09-03

An editorial in the September issue of the Bulletin of the World Health Organization announces a new report with updated estimates of global health risks".

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Haplotype frequencies at the DRD2 locus in populations of the East European Plain

BMC Genetics 2009, 10:62

It was demonstrated previously that the three-locus RFLP haplotype, TaqI B-TaqI D-TaqI A (B-D-A), at the DRD2 locus constitutes a powerful genetic marker and probably reflects the most ancient dispersal of anatomically modern humans.

We investigated TaqI B, BclI, MboI, TaqI D, and TaqI A RFLPs in 17 contemporary populations of the East European Plain and Siberia. Most of these populations belong to the Indo-European or Uralic language families. We identified three common haplotypes, which occurred in more than 90% of chromosomes investigated. The frequencies of the haplotypes differed according to linguistic and geographical affiliation.

Populations in the northwestern (Byelorussians from Mjadel'), northern (Russians from Mezen' and Oshevensk), and eastern (Russians from Puchezh) parts of the East European Plain had relatively high frequencies of haplotype B2-D2-A2, which may reflect admixture with Uralic-speaking populations that inhabited all of these regions in the Early Middle Ages.

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The Epidemiology of At-Risk and Binge Drinking Among Middle-Aged and Elderly Community Adults: National Survey on Drug Use and Health

Am J Psychiatry 2009; 166:1162-1169

The purpose of this article was to estimate the prevalence, distribution, and correlates of at-risk alcohol use (especially binge drinking) among middle-aged and elderly persons in the United States and to compare at-risk alcohol use between women and men.

Overall, 66% of male respondents and 55% of female respondents reported alcohol use during the past year. At-risk alcohol use and binge drinking were more frequent among respondents 50 to 64 years of age relative to respondents aged 65 years or older. In the 65 years old age group, 13% of men and 8% of women reported at-risk alcohol use, and more than 14% of men and 3% of women reported binge drinking. Among male subjects, binge drinking compared with no alcohol use was associated with higher income and being separated, divorced, or widowed, while being employed and nonmedical use of prescription drugs were associated with binge drinking compared with no alcohol use among women. For all respondents, binge drinking relative to no alcohol use was associated with the use of tobacco and illicit drugs. Among women who reported using alcohol, being African American and less educated were associated with binge drinking, but race/ethnicity and educational level were not associated with binge drinking in men who reported using alcohol.

At-risk and binge drinking are frequently reported by middle-aged and elderly adults nationwide and are therefore of public health concern. Clinicians working with middle-aged and older adults should screen for binge drinking and coexisting use of other substances.

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Request Reprint E-Mail: blaze001 @ mc.duke.edu

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Alcohol consumption and all-cause mortality among elderly in Finland

Drug and Alcohol Dependence Article in Press 25 September 2009

To estimate the gender-specific prevalences of alcohol consumption levels and to investigate the association between heavy drinking and all-cause mortality among elderly males.

Heavy drinking is common among Finnish elderly males but not among females. The present study shows an increased all-cause mortality risk for males drinking, on average, more than two standard drinks per day.

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Request Reprint E-Mail: mauri.aalto@thl.fi

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A multidimensional assessment of the validity and utility of alcohol use disorder severity as determined by item response theory models

Drug and Alcohol Dependence Article in Press, 29 September 2009

The relative severity of the 11 DSM-IV alcohol use disorder (AUD) criteria are represented by their severity threshold scores, an item response theory (IRT) model parameter inversely proportional to their prevalence. These scores can be used to create a continuous severity measure comprising the total number of criteria endorsed, each weighted by its relative severity

The unadjusted mean values for all validating measures increased steadily with the severity threshold score, except that legal problems, the criterion with the highest score, was associated with lower values than expected. After adjusting for the total number of criteria endorsed, this direct relationship was no longer evident. The overall severity score was no more highly correlated with the validating measures than a simple count of criteria endorsed, nor did the two measures yield different risk curves. This reflects both within-criterion variation in severity and the fact that the number of criteria endorsed and their severity are so highly correlated that severity is essentially redundant.

Attempts to formulate a scalar measure of AUD will do as well by relying on simple counts of criteria or symptom items as by using scales weighted by IRT measures of severity.

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Request Reprint E-Mail: ddawson@mail.nih.gov

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Gaps in addressing problem drinking: Overcoming primary care and alcohol treatment deficiencies

Current Psychiatry Reports Volume 11, Number 5 / October, 2009 pp. 345-352

Despite the high prevalence of problem drinking among Americans, primary care physicians often fail to address this major health threat. In addition, once alcohol use disorders are identified, patients often fail to receive coordinated medical and substance abuse treatment.

This article reviews four types of barriers as well as potential facilitators to improving the prevention and management of problem drinking. First, primary care physicians are poorly trained about the clinical relevance of addressing alcohol problems in their daily patient care. Second, primary care physicians are concerned about the stigma and health insurance problems encountered by patients diagnosed with alcohol use disorders. Third, primary care practices have limited organizational and financial support to identify and address alcohol problems. Fourth, primary care and alcohol treatment settings communicate and collaborate poorly in delivering patient care.

Opportunities to overcome these challenges are discussed and must be initiated to reduce the myriad of adverse outcomes resulting from problem drinking.

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Request Reprint E-Mail: bturner@mail.med.upenn.edu

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The genetics of alcoholism

Current Psychiatry Reports Volume 11, Number 5 / October, 2009 pp, 364-369

Heritability estimates for alcoholism range from 50% to 60%, pointing out the importance of genetic and environmental factors in its etiology.

This review highlights recent advances in translational work investigating genetic influences on alcoholism. We focus on genetic research involving corticotropin-releasing factor, glutamatergic, and opioidergic systems.

Variation in the CRF1 receptor gene has been shown to moderate stress-induced alcohol drinking (gene-environment interaction) in animals, and this finding was recently extended to humans. Also, the hyperglutamatergic state, first observed during withdrawal from chronic alcohol exposure in animal models, is associated with aversive and dysphoric states in alcoholics.

Pharmacogenetic studies of naltrexone efficacy are in the clinical stages, and recent studies confirmed a differential response dependent on the μ-opioid receptor genotype.

Such advances will be essential for the effective treatment of alcoholism in the future.

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Request Reprint E-Mail: g.schumann@iop.kcl.ac.uk

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Reducing Youth Access – The Impact of Policy Change

Michelle Voth, MPA, Executive Director,

Kansas FamilyPartnership

The enactment of social hosting laws is increasing both at the state level and at local levels throughout the nation. While specific wording of each law and the penalties associated with them may differ slightly, all social hosting laws establish liability against those who allow underage drinking events or parties on property they own, lease or otherwise control. This article describes the progression of how one state enacted and strengthened its social hosting law and provided tools to educate parents and others at the local level.

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Adolescent Brain Development and Alcohol Abuse

Ken C. Winters, Ph.D.

Professor, Department of Psychiatry, University of Minnesota

Senior Scientist, Treatment Research Institute

New scientific discoveries have put a much different perspective on our understanding of adolescent behavior. Research now suggests that the human brain is still maturing during the adolescent years. The developing brain may help explain why adolescents sometimes make decisions that are risky and can lead to safety or health concerns, including unique vulnerabilities to alcohol abuse.

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Alcohol Promotion on Facebook

Sarah Mart, Jacob Mergendoller, Michele Simon

Marin Institute, San Rafael, California, United States

Since its debut five years ago, Facebook has grown exponentially to include colleges and universities, high school and business networks, along with the general public around the globe. In that same time, Facebook also changed its advertising policies and regulations from not offering online advertising to soliciting paid advertisements for products and services including alcohol products. Although the company’s policy requires paid advertisements for alcohol to include age restrictions, the policy is not enforced by Facebook, nor does the restriction requirement apply to other sources of alcohol content throughout Facebook.

For this article, we explored the prevalence of alcohol-related content found in popular aspects of Facebook profiles. We also identified aspects of Facebook that contain a great deal of alcohol content and are accessible by anyone, regardless of age. We offer recommendations for both Facebook and the alcohol industry to remove paid ads and other types of content promoting alcohol products and dangerous drinking behaviors in order to protect youth and young adults from the harmful effects of alcohol advertising.

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Welsh Health Survey 2008

4.4 Alcohol (pg.50)

4.4.2 Results

• 12% of adults reported that they were non-drinkers.

• 45% of all adults (i.e. including non-drinkers) reported drinking above the recommended guidelines on at least one day in the past week, including 28% who reported binge drinking.

Men were more likely than women to report drinking above the recommended guidelines in the past week (52% of men compared with 38% of women), and to report binge drinking (35% of men, 22% of women). Ths pattern applied to all age groups.

Drinking above guidelines was less common in older people, as seen in
figure 4e.

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Minimum pricing will cost moderate drinkers £11 a year

Angus Macleod, Scottish Political Editor

A minimum price system for the sale of alcohol in Scotland would see heavy drinkers pay an extra £137 a year but moderate drinkers would only have to find a further £11 a year, a major study published yesterday has found.

It also estimated that there would be a financial savings for the Scottish budget from harm reduction through savings in health, employment and crime of £60 million in year one, and £950 million over 10 years.

The study into the impact of a minimum price on alcohol planned for north of the Border, commissioned by the Scottish government, also found total alcohol consumption would fall by 5.4 per cent, mainly among those whose drinking is hazardous to their health. . . . . .

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Grapes, Wines, Resveratrol and Heart Health

Journal of Cardiovascular Pharmacology: POST ACCEPTANCE, 18 September 2009

Epidemiological and experimental studies have revealed that a mild-to-moderate drinking of wine, particularly red wine, attenuates the cardiovascular, cerebrovascular, and peripheral vascular risk. However, the experimental basis for such health benefits is not fully understood.

The cardioprotective effect of wine has been attributed to both components of wine; the alcoholic portion and more importantly, the alcohol-free portion containing antioxidants. Wines are manufactured from grapes, which also contain a large variety of antioxidants including resveratrol, catechin, epicatechin and proanthocyanidins. Resveratrol is mainly found in the grape skin, while proanthocyanidins are found only in the seeds. Recent studies have demonstrated that resveratrol and proanthocyanidin are the major compounds present in grapes and wines responsible for cardioprotection.

The purpose of this review is to provide evidence that grapes and wines as well as resveratrol are equally important in reducing the risk of morbidity and mortality due to cardiovascular complications. Both wines and grapes can attenuate cardiac diseases such as atherosclerosis and ischemic heart disease. Recently, wine was also found to increase life span by inducing longevity genes. It appears that resveratrol and proanthocyanidins, especially resveratrol, present in grapes and wines play a crucial role in cardioprotective abilities of grapes and wines.

(C) 2009 Lippincott Williams & Wilkins, Inc

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Request Reprint E-Mail: studiojh@usa.net

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DEAD ON ARRIVAL: ZERO TOLERANCE LAWS DON'T WORK

Economic Inquiry Early View 23 Sep 2009

By 1998, all states had passed laws lowering the legal blood alcohol content for drivers under 21 to effectively zero.

Theory shows these laws have ambiguous effects on overall fatalities and economic efficiency, and the data show they have little effect on driver behavior.

A panel analysis of the 1988–2000 Fatality Analysis Reporting System indicates that zero tolerance laws have no material influence on the level of fatalities, while quantile regression reveals virtually no change in the distribution of blood alcohol content among drivers involved in fatal accidents.

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Request Reprint E-Mail: dgrant@ shsu.edu.

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Approach to treatment of mental illness and substance dependence in remote Indigenous communities: results of a mixed methods study

Australian Journal of Rural Health;17(4):174-182

To develop and evaluate a culturally adapted brief intervention for Indigenous people with chronic mental illness.

Psycho-education resources and a brief intervention, motivational care planning (MCP), were developed and tested in collaboration with aboriginal mental health workers in three remote communities in northern Australia.

Random effects regression analyses showed significant advantage for the treatment condition in terms of well-being with changes in health of the nation outcome scales and Kessler 10 , which were sustained over time. There was also significant advantage for treatment for alcohol dependence, with response also evident in cannabis dependence and with changes in substance dependence sustained over time.

These results suggest that MCP is an effective treatment for Indigenous people with mental illness and provide insight into the experience of mental illness in remote communities.

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Request Reprint E-Mail: tricia.nagel@menzies.edu.au

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The Influence of Self-Construal on Impulsive Consumption

In this article, we investigate the motivational component of willpower. We look at the possible influence of self-construal—both at the cultural level and individual level—on impulsive consumption.

Some correlational evidence indicates an interrelation between individualism–collectivism (independence–interdependence), trait buying impulsivity, and impulse buying behavior (Kacen and Lee 2002). That research suggests that members of individualistic societies may exhibit more impulsive consumption than do members of collectivistic societies. However, this effect is not because interdependents feel less impulse, but because they are more motivated to suppress their impulses than are members of individualistic societies.

Although the results are correlational, and thus vulnerable to alternative explanations, they also have a number of implications. For one, cultures should differ on the extent to which they engage in particular impulsive consumption behaviors. A second is that, to the extent that the self is malleable (Mandel 2003; Markus and Kunda 1986) and subject to situational changes (Trafimow, Triandis, and Goto 1991), such situational changes in self-construal should have corresponding influences on impulsivity. A third implication is that situations that affect the motivation to suppress impulsive consumption tendencies should interact with self-construal in influencing impulsive consumption tendencies.

Three studies are presented that tested these possibilities and investigated their underlying processes. Studies 1a and 1b present results from two secondary data sets that link cultural orientation with a behavior often associated with impulsive consumption (alcohol consumption). Following that, two experiments are presented that manipulated self-construal via priming procedures to determine its impact on impulsive consumption tendencies.

We also investigate the implications of our findings for previous research on the relation between peer presence and impulsive consumption, and the processes that mediate and moderate these effects.

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Minimum alcohol pricing will save billions - report

A REPORT commissioned by the Scottish Government has found a minimum set price for alcohol would save billions from the cost of dealing with the nation's alcohol problem.

Health Secretary Nicola Sturgeon launched a Government-commissioned study into the measure today and heard first-hand accounts of the impact of alcohol abuse during a visit to Edinburgh Royal Infirmary.

The study by Sheffield University academics suggests that hundreds of lives can be saved every year with minimum pricing, which may also reduce crime and alcohol-related illnesses. . . . . .

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News Release - Minimum pricing of alcohol

Minimum pricing for alcohol and a ban on off-sales promotions would save hundreds of lives every year, according to research commissioned by the Scottish Government and carried out by experts at Sheffield University.

Findings show that, using an example minimum price of 40p per unit combined with a ban on promotions, alcohol-related deaths would fall by about 70 in the first year of the policy and about 370 per year after 10 years of operation - a drop in such deaths of nearly 20 per cent.
It also shows that a minimum pricing policy would lead to significant falls in alcohol-related illnesses and crimes, leading to yearly savings for taxpayers.

It would also have economic benefits - including nearly 30,000 fewer absence days from work every year, using the 40p example with a promotions ban.

The report confirms that the greatest impact of the policy will be on heavy drinkers, who tend to choose cheap, higher-strength products such as white cider and own label spirits.

These drinkers would see the highest additional spend on alcohol and the biggest fall in consumption as a result. Moderate drinkers, by contrast, will barely be affected at all. . . . . .

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Model-Based Appraisal of Alcohol Minimum Pricing and Off-Licensed Trade Discount Bans in Scotland: A Scottish adaptation of the Sheffield Alcohol Policy Model version 2

From June to September 2008, the Scottish Government consulted on a range of proposals aimed at reducing levels of alcohol-related harm. The proposals included taking action to restrict promotions of alcoholic beverages and introducing a minimum retail price for a UK unit of alcohol.

Simultaneously to the Scottish consultation, the University of Sheffield was appraising pricing and promotion policy options as part of a programme of work funded by the UK Department of Health (DH) Policy Research Programme. The results of this research were published by DH in December 2008 and relate specifically to the English population.

On 2 March 2009, the Scottish Government announced specific actions in reaction to the consultation responses received, including modifications to the existing licensing regulations to prohibit discounting of alcohol and to introduce a minimum retail price per unit of alcohol. The initial threshold for the minimum price is yet to be decided, and requires in part further information on the likely impacts of such an intervention applied in a Scottish context. The xisting modelling infrastructure developed for DH – known as the Sheffield Alcohol Policy model – provides a strong platform for such an investigation and so the University of Sheffield was asked to adapt the English version of the model to a Scottish population.

The following set of policies has been prioritised for analysis:

1. What are the likely effects of introducing a minimum unit price on alcohol consumption, sales, health, crime and workplace harms in Scotland?

2. What are the likely effects of introducing a ban on price-based promotions in the offlicensed trade in Scotland?

3. What are the likely effects of introducing a minimum unit price simultaneously with a ban on price-based promotions in the off-licensed trade in Scotland?

The Sheffield Alcohol Policy Model version 2 has been adapted to a Scottish context incorporating Scotland-specific data on levels of alcohol consumption, the prices paid by population sub-groups for different categories of alcohol and the preferences for off-licensed trade versus on-licensed trade purchasing. The model also includes Scottish data on the prevalence of alcohol-related diseases, alcohol-attributable fractions for acute conditions, the prevalence of alcohol-related crime, and levels of absenteeism and unemployment.

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