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, October 24, 2009

Impact of Alcoholism on Sleep Architecture and EEG Power Spectra in Men and Women
SLEEP 2009;32(10):1341-1352.

To determine the impact of alcoholism on sleep architecture and sleep EEG power spectra in men and women with uncomplicated alcoholism.

Long-term alcoholism affects sleep even after long periods of abstinence in both men and women. Measures of frontal slow wave activity were particularly sensitive markers of this long-lasting effect. Sleep EEG measures would thus seem to provide a functional correlate of the changes in brain structure seen in frontal cortex of long-term alcoholics.

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Selective and Brain Penetrant Neuropeptide Y Y2 Receptor Antagonists Discovered by Whole-Cell High Throughput Screening.
Molecular Pharmacology Fast Forward First published on October 16, 2009

The role of neuropeptide Y Y2 receptor (Y2R) in human diseases such as obesity, mood disorders and alcoholism could be better resolved by use of small molecule chemical probes that are substantially different from the currently available Y2R antagonist, BIIE0246.

Presented here are five potent, selective and publicly available Y2R antagonists identified by a high throughput screening (HTS) approach. These compounds belong to four chemical scaffolds that are structurally distinct from the peptidomimetic BIIE0246.

Profiling against a panel of 40 receptors, ion channels, and transporters found in the central nervous system showed that the five Y2R antagonists demonstrate greater selectivity than BIIE0246.

Furthermore, the ability of these antagonists to penetrate the blood-brain barrier makes them better suited for pharmacologic studies of Y2R function in both the brain and periphery.

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A Multisite Randomized Effectiveness Trial of Motivational Enhancement Therapy for Spanish-Speaking Substance Users
Journal of Consulting and Clinical Psychology Volume 77, Issue 5, October 2009, Pages 993-999

Hispanic individuals are underrepresented in clinical and research populations and are often excluded from clinical trials in the United States. Hence, there are few data on the effectiveness of most empirically validated therapies for Hispanic substance users.

The authors conducted a multisite randomized trial comparing the effectiveness of 3 individual sessions of motivational enhancement therapy with that of 3 individual sessions of counseling as usual on treatment retention and frequency of substance use; all assessment and treatment sessions were conducted in Spanish among 405 individuals seeking treatment for any type of current substance use.

Results suggest that the individual treatments delivered in Spanish were both attractive to and effective with this heterogeneous group of Hispanic adults, but the differential effectiveness of motivational enhancement therapy may be limited to those whose primary substance use problem is alcohol and may be fairly modest in magnitude.

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Friday, October 23, 2009

Do Responsible Beverage Service Programs Reduce Breath Alcohol Concentration Among Patrons: A Five-Month Follow-up of a Randomized Controlled Trial
Substance Use & Misuse, Volume 44, Issue 11 September 2009 , pages 1592 - 1601

To examine whether the decrease in the mean breath alcohol concentration (BrAC) and the rowdy social atmosphere reported after one month remained stable in the five-month assessment.

The positive results after one month were not stable after five months. The study's limitations are noted.

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Alcohol and other drug treatment services in Australia 2007-08: findings from the National Minimum Data Set
AIHW bulletin no. 74

Alcohol and other drug treatment services in Australia 2007-08: findings from the National Minimum Data Set summarises data on publicly funded alcohol and other drug treatment services and their clients, including information about the types of drugs for which treatment is sought and the types of treatment provided. The data contained in this bulletin are derived from the comprehensive AODTA-NMDS 2007-08 annual report.

Publication table of contents

  • Contents

  • The AODTS-NMDS collection
  • Which agencies and clients?

  • Treatment agencies

  • Client profile
  • Drugs of concern

  • Treatment programs
  • Accessing data from the AODTS-NMDS
  • Acknowledgments

  • References

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European judge casts fresh doubt over SNP plans for minimum alcohol prices
From The Times
October 23, 2009

The Scottish government’s plans to introduce a minimum price for alcohol have suffered a setback with a move by the European Court to block similar initiatives in other EU countries.

The Advocate General of the European Court has issued an opinion that rejects the idea of setting a minimum price in order to protect public health health.
. . . . . .

Incidence of and potential risk factors for gallstone disease in a general population sample
British Journal of Surgery Volume 96, Issue 11 (November 2009) p.1315-1322

Several epidemiological studies have been published, but there are few reports on relations between gallstone incidence, symptomatology and risk factors.

A positive association for gallstone development was found only for length of follow-up and plasma low-density lipoprotein-cholesterol levels at baseline. Weekly alcohol consumption was inversely related to gallstone development.The incidence of gallstones in this population was 1·39 per 100 person-years.

Gallstone development was related to length of follow-up and LDL-cholesterol levels, and inversely related to alcohol consumption.

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A multi-centre survey of inpatient pharmacological management strategies for alcohol withdrawal
QJM 2009 102(11):773-780

It is well recognized that alcohol is a growing problem in the UK with significant morbidity and mortality and associated resource implications for the National Health Service (NHS). The inpatient management of alcohol withdrawal is felt to be variable between hospitals.

The aim of this study was to assess the variation in pharmacological management and acute inpatient alcohol services across NHS hospitals in the UK.

The results suggest poor utilization of guidelines, variable drug regimens and differences in acute alcohol-related support services.

In response to these findings, we suggest that a simplified national approach is required for what is now recognized to be an epidemic problem.

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Even low alcohol consumption has a negative impact on overall health

Low alcohol consumption is bad for your health in general. Researchers writing in BioMed Central's open access journal Cost Effectiveness and Resource Allocation studied the relationship between alcohol consumption and health to test the current theory which suggests improved health is responsible for the link found between low alcohol consumption and increased wages.

Johan Jarl, from Lund University, Sweden, worked with a team of researchers to determine the effect of low alcohol consumption on health by measuring alcohol-related medical care costs and episodes collected during the Swedish Cost of Alcohol Project in 2002. They found that, with the exception of people more than 80 years old, men who consumed up to five units a day and women who consumed up to 2.5 units a day cost the health service more than those who do not drink. Their finding calls into question the previous assumption that low alcohol consumption is good for your health. . . . . . .

Medical net cost of low alcohol consumption – a cause to reconsider improved health as the link between alcohol and wage?
Cost Effectiveness and Resource Allocation 2009, 7:17 (23 October 2009)

Studies have found a positive effect of low/moderate alcohol consumption on wages. This has often been explained by referring to epidemiological research showing that alcohol has protective effects on certain diseases, i.e., the health link is normally justified using selected epidemiological information. Few papers have tested this link between alcohol and health explicitly, including all diseases where alcohol has been shown to have either a protective or a detrimental effect.

Low alcohol consumption carries a net cost for medical care and there is a net benefit only for the oldest age group (80+). Low alcohol consumption also causes more episodes in medical care then what is saved, although inpatient care for women and older men show savings.

Using health as an explanation in the alcohol-wage literature appears invalid when applying the full epidemiological information instead of selected information.

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Thursday, October 22, 2009

Effect of beer consumption on levels of complex I and complex IV liver and heart mitochondrial enzymes and coenzymes Q9 and Q10 in adriamycin-treated rats
European Journal of Nutrition Online First 20 October 2009

There is increasing evidence indicating that the dietary intake of food with high antioxidant capacity may protect mitochondria from damage and exert positive effects on different pathogenic processes.

The present study was designed to evaluate the possible protective effect of alcohol-free beer intake on chain components dysfunction of liver and heart mitochondria, and to compare with the effect of alcohol beer intake.

These results indicate that alcohol-free beer prevents adriamycin-induced damage to mitochondrial chain components and, therefore, helps to prevent mitochondrial dysfunction.

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State of Australia’s Young People: a report on the social, economic, health and family lives of young people

The Minister for Youth, Kate Ellis, has released the State of Australia’s Young People: a report on the social, economic, health and family lives of young people.

This report presents a comprehensive picture of how young Australians are faring. The report’s findings were based on national data sources, existing literature, stakeholder interviews and focus groups with young people.
Overall the report presents a positive picture, showing how important young people are to our country and why it makes good economic and social sense for governments to invest in lifting outcomes for all young people.

It also highlights some areas of concern and underlines the important role that families, education and employment play in young people’s development.

12.1 Alcohol pg.104
  • How many young people drink alcohol and how much do they drink?

  • Risk and alcohol use

  • How old are young people when they first consume alcohol?

  • Which young people consume the most alcohol? What do young people drink?
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Risk of Alcohol-Impaired Driving Recidivism Among First Offenders and Multiple Offenders
AJPH First Look, published online ahead of print Oct 21, 2009

We sought to determine the statewide impact of having prior alcohol-impaired driving violations of any type on the rate of first occurrence or recidivism among drivers with 0, 1, 2, or 3 or more prior violations in Maryland.

The recidivism rate among first offenders more closely resembles that of second offenders than of nonoffenders. Men and women are at equal risk of recidivating once they have had a first violation documented. Any alcohol-impaired driving violation, not just convictions, is a marker for future recidivism.

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Research into specific cells and circuitry affected by addiction may help guard against relapse

CHICAGO — New research using animal models is enabling a deeper understanding of the neurobiology of compulsive drug addiction in humans— knowledge that may lead to more effective treatment options to weaken the powerful cravings that cause people to relapse. The findings were released today at Neuroscience 2009, the Society for Neuroscience’s annual meeting and the world’s largest source of emerging news about brain science and health.

Drug addiction is known to change the structure and function of the brain, affecting a person’s self control and decision-making ability. According to the Substance Abuse and Mental Health Services Administration’s latest survey, 23.6 million persons aged 12 or older needed treatment for an illicit drug or alcohol abuse problem in 2006.
These new studies have identified brain mechanisms that help explain how addictions form, as well as the cognitive problems associated with them. Additional research findings discussed could also offer hope against addiction relapses. . . . . . .

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Sex-Specific Dissociations in Autonomic and HPA Responses to Stress and Cues in Alcohol-Dependent Patients with Cocaine Abuse
Alcohol and Alcoholism 2009 44(6):575-585

Chronic alcohol and drug dependence leads to neuroadaptations in hypothalamic–pituitary–adrenal (HPA) and sympathetic adrenal medullary (SAM) stress systems, which impact response sensitivity to stress and alcohol cue and facilitates risk of relapse. To date, gender variations in these systems have not been fully assessed in abstinent alcohol-dependent individuals who also met criteria for cocaine abuse.

While SA males showed a generalized suppression of HPA, SAM system and cardiovascular markers following both stress and cue, SA women demonstrated a selective sympatho-adrenal suppression to stress only and an enhanced HPA response to both stress and cue. These gender variations are discussed in terms of their potential impact on relapse vulnerability and treatment outcome.

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Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions
Molecular Psychiatry (2009) 14, 1051–1066;

The objective of this study was to present nationally representative findings on sociodemographic and psychopathologic predictors of first incidence of Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) substance, mood and anxiety disorders using the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.

One-year incidence rates of DSM-IV substance, mood and anxiety disorders were highest for alcohol abuse (1.02), alcohol dependence (1.70), major depressive disorder (MDD; 1.51) and generalized anxiety disorder (GAD; 1.12). Incidence rates were significantly greater among men for substance use disorders and greater among women for mood and anxiety disorders except bipolar disorders and social phobia.

Age was inversely related to all disorders. Black individuals were at decreased risk of incident alcohol abuse and Hispanic individuals were at decreased risk of GAD. Anxiety disorders at baseline more often predicted incidence of other anxiety disorders than mood disorders. Reciprocal temporal relationships were found between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder.

Borderline and schizotypal personality disorders predicted most incident disorders. Incidence rates of substance, mood and anxiety disorders were comparable to or greater than rates of lung cancer, stroke and cardiovascular disease.

The greater incidence of all disorders in the youngest cohort underscores the need for increased vigilance in identifying and treating these disorders among young adults.

Strong common factors and unique factors appear to underlie associations between alcohol abuse and dependence, MDD and GAD, and GAD and panic disorder.

The major results of this study are discussed with regard to prevention and treatment implications.

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A selective ALDH-2 inhibitor reduces anxiety in rats
Pharmacology Biochemistry and Behavior Volume 94, Issue 2, December 2009, Pages 255-261

CVT-10216 is a highly selective, reversible inhibitor of ALDH-2 that reduces excessive alcohol drinking. Anxiety plays a role in alcoholism.

The present study asks whether CVT-10216 has anxiolytic properties, as reflected in social interaction behavior in four unrelated rodent models: endogenous anxiety-like behavior in naïve Fawn-Hooded rats, repeated alcohol-withdrawal-induced anxiety, restraint stress-induced anxiety and drug-induced anxiety.

CVT-10216 counteracted anxiety in all models except that produced by the 5-HT2C agonist, mCPP. CVT-10216 exhibited both acute and prophylactic inhibitions of repeated alcohol-withdrawal-induced anxiety. Importantly, anxiogenic behavior induced by the benzodiazepine receptor inverse agonist, DMCM, was counteracted dose-dependently by CVT-10216.

Thus, a non-addictive selective inhibitor of ALDH-2 has both anxiolytic and antidipsotropic properties, which may be dependent, in part on the involvement of the GABA–benzodiazepine system.

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Introduction: Gendering Socio Cultural Alcohol and Drug Research
Alcohol and Alcoholism 2009 44(6):602-606

The gender gap in alcohol consumption and alcohol-related harm still is considerable and largely unexplained. This paper introduces four studies performed in Sweden that explore factors influencing gender differences in levels of consumption, adverse consequences and treatment.

Future studies need to focus more on these complex associations to secure that treatment settings provide both genders with fair and adequate treatment of high quality and that prevention activities will start to test measures that take gender into consideration.

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Alcohol Use and Patterns of Delinquent Behaviour in Male and Female Adolescents
Alcohol and Alcoholism 2009 44(6):607-614;

The overall aim was to study patterns of delinquent behaviour in relation to adolescent alcohol use. The more specific aims were to examine whether alcohol use varied between groups of adolescents with different patterns of delinquent behaviour, and to explore whether the association between delinquent behaviour patterns and alcohol use was similar for males and females.

The present results further emphasize the importance of distinguishing between different offender groups when examining the relationship between delinquent behaviour and associated problems, such as excessive alcohol use.

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Cultural Analysis as a Perspective for Gender-Informed Alcohol Treatment Research in a Swedish Context
Alcohol and Alcoholism 2009 44(6):615-619;

An exploratory study to investigate the role of culture in women's drinking at a clinic for women with alcohol problems in a Swedish treatment context.

Using cultural analysis as a perspective for gaining gendered information may allow for identifying new patterns within specific cultural and subgroup contexts. It may contribute new information to the following treatment research areas: gender-appropriate measurement issues; service integration; gender-appropriate services for women; and, drinking rituals and patterns.

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Does Gender Matter? A Vignette Study of General Practitioners’ Management Skills in Handling Patients with Alcohol-Related Problems
Alcohol and Alcoholism 2009 44(6):620-625;

The aims of this study were to analyse the perceptions of female and male primary care physicians (PCPs) of alcohol problems in male and female patients, their recommendations to reduce or abstain from alcohol, their referrals to treatment and their views of safe levels of drinking for male and female patients. These factors were related to the physicians’ own alcohol consumption.

Male patients were less likely to be advised to stop drinking altogether than female patients and were less likely to be referred, according to this vignette study. Taking into account that male patients have a higher prevalence of alcohol problems, this may be of considerable importance for men's health outcomes. Implications of these findings are the need to increase awareness of male excessive drinking and that gendered perceptions might bias alcohol management recommendations.

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Lack of Leadership Confidence Relates to Problem Drinking in Women: Gender Identity, Heavy Episodic Drinking and Alcohol Use Disorders in Swedish Women
Alcohol and Alcoholism 2009 44(6):626-633

The aim of this study was to analyse in women the association between four dimensions of gender identity, heavy episodic drinking (HED) and alcohol use disorders (AUD), taking into account age, personality, psychiatric co-morbidity and level of education.

Of the four gender identity dimensions, only low scores on leadership remained significantly associated with AUD and HED after adjustment for age and personality. Clinical work could focus on the development of leadership abilities in women scoring low on these items to improve the ability.

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Wednesday, October 21, 2009

Scientific Management Review Board: Substance Use, Abuse and Addiction Working Group

Wednesday, October 14, 2009\
The Scientific Management Review Board
Total Running Time: 02:21:24


News Release - Alcohol Tolerance Switch Found in Fruit Flies

Researchers at North Carolina State University have found a genetic “switch” in fruit flies that plays an important role in making flies more tolerant to alcohol.

This metabolic switch also has implications for the deadly liver disease cirrhosis in humans. A counterpart human gene contributes to a shift from metabolizing alcohol to the formation of fat in heavy drinkers. This shift can lead to fatty liver syndrome – a precursor to cirrhosis.

In the study, published in the October print issue of the journal Genetics, the research team measured the time it takes for flies to stagger due to alcohol intake while simultaneously identifying changes in the expression of all their genes. They used statistical methods to identify genes that work together to help the flies adapt to alcohol exposure. In looking at corresponding human genes, a counterpart gene called ME1 was associated with alcohol consumption in humans, as people with certain variations of the gene showed a tendency to drink stronger alcoholic beverages. . . . . . .


Alcohol Sensitivity in Drosophila: Translational Potential of Systems Genetics
Genetics. Published Articles Ahead of Print: August 3, 2009

Identification of risk alleles for human behavioral disorders through genome-wide association studies (GWAS) has been hampered by a daunting multiple testing problem. This problem can be circumvented for some phenotypes by combining genome-wide studies in model organisms with subsequent candidate gene association analyses in human populations.

Here, we characterized genetic networks that underlie the response to ethanol exposure in Drosophila melanogaster by measuring ethanol knock-down time in 40 wild-derived inbred Drosophila lines. We associated phenotypic variation in ethanol responses with genome-wide variation in gene expression and identified modules of correlated transcripts associated with a first and second exposure to ethanol vapors as well as the induction of tolerance.

We validated the computational networks and assessed their robustness by transposon-mediated disruption of focal genes within modules in a laboratory inbred strain, followed by measurements of transcript abundance of connected genes within the module. Many genes within the modules have human orthologues, which provides a stepping stone for the identification of candidate genes associated with alcohol drinking behavior in human populations.

We demonstrated the potential of this translational approach by identifying seven intronic SNPs of the Malic Enzyme 1 (ME1) gene that are associated with cocktail drinking in 1,687 individuals of the Framingham Offspring cohort, implicating that variation in levels of cytoplasmic malic enzyme may contribute to variation in alcohol consumption.

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Almost 100,000 people could die over the next ten years as a direct result of their drinking, a charity has today warned. Research from the Alcohol & Health Research Unit at the University of the West of England and Alcohol Concern shows that 90,800 people could die avoidable deaths from alcohol-related causes by 2019 if we continue to drink at the average rate of the past 15 years.

The research maps the whole population’s level of drinking with the number of deaths from alcohol-related causes. The new findings also show there has been a trebling of deaths from 3,054 in 1984 to 8,999 in 2008, as consumption has increased over the past 25 years. . . . . .

Dissociable Control of Impulsivity in Rats by Dopamine D2/3 Receptors in the Core and Shell Subregions of the Nucleus Accumbens
Neuropsychopharmacology advance online publication 21 October 2009

Previous research has identified the nucleus accumbens (NAcb) as an important brain region underlying inter-individual variation in impulsive behavior. Such variation has been linked to decreased dopamine (DA) D2/3 receptor availability in the ventral striatum of rats exhibiting spontaneously high levels of impulsivity on a 5-choice serial reaction time (5-CSRT) test of sustained visual attention.

This study investigated the involvement of DA D2/3 receptors in the NAcb core (NAcbC) and the NAcb shell (NAcbS) in impulsivity. We investigated the effects of a DA D2/3 receptor antagonist (nafadotride) and a DA D2/3 partial agonist (aripiprazole) infused directly into either the NAcbC or NAcbS of rats selected for high (HI) and low (LI) impulsivity on the 5-CSRT task.

These findings indicate an opponent modulation of impulsive behavior by DA D2/3 receptors in the NAcbS and NAcbC. Such divergent roles may have relevance for the etiology and treatment of clinical disorders of behavioral control, including attention-deficit hyperactivity disorder and drug addiction.

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Congressional briefing on Substance Abuse Policy: "What We Know and Where We Need to Go"

  • David Colby, Ph.D., Vice President of Research and Evaluation at RWJF, will summarize the panel discussion and key lessons learned from the Foundations investment in this area.
  • Dennis McCarty, Ph.D., Oregon Health and Science University, speaks about delivery and quality of substance abuse treatment, integration with primary care and patient-centered medical homes, disparities and cost of care.

  • Marjorie Gutman, Ph.D., SAPRP Co-Director, speaks about criminal justice, prevention policies in schools and among youth, prescription drug abuse and clinical trials for drug prevention

  • Harold Holder, Ph.D., Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), speaks about data collection, prevention, availability and pricing

  • Michael Cummings, Ph.D., M.P.H., Roswell Park Cancer Institute, speaks about tobacco regulation, pricing, marketing, smoke-free air laws and cessation treatments.


News Release - Teens behaving badly?
By Cheryl Walker
Office of Communications and External Relations
Published October 15, 2009

Drinking. Drugs. Caving into peer pressure. When parents expect their teenagers to conform to negative stereotypes, those teens are in fact more likely to do so, according to new research by Professor of Psychology Christy Buchanan.

“Parents who believe they are simply being realistic might actually contribute to a self-fulfilling prophecy,” says Buchanan, who studies adolescent development and behavior. “Negative expectations on the part of both parents and children predict more negative behaviors later on.” . . . . .

Alcohol hinders having a baby through IVF, couples warned
Ian Sample, science correspondent, Tuesday 20 October 2009

Couples who share a bottle of wine a week reduce their chances of having a baby through IVF by more than a quarter, according to a study by American fertility specialists.

Research into alcohol consumption among couples being treated at a fertility clinic found fewer successful pregnancies when the women drank several glasses of wine a week, or the man had a daily beer. . . . . . .


Tuesday, October 20, 2009

Coaches’ Attitudes and Involvement in Alcohol Prevention Among High School Athletes
Journal of Community Health Online First 17 October 2009

A total of 288 high school coaches completed a survey on their attitudes toward and involvement in alcohol prevention among male high school athletes.

Results indicated that coaches felt alcohol use was less of a problem among high school student-athletes than high school students in general. Only one-third of coaches (39%) worked at a school requiring them to talk to their athletes about alcohol use.

Coaches most likely to be involved in alcohol prevention were those who had attended an alcohol prevention class/workshop and those who worked for schools with strong alcohol prevention policies and schools that required them to talk with athletes about alcohol use.

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Selective and Brain Penetrant Neuropeptide Y Y2 Receptor Antagonists Discovered by Whole-Cell High Throughput Screening
Molecular Pharmacology Fast Forward First published on October 16, 2009

The role of neuropeptide Y Y2 receptor (Y2R) in human diseases such as obesity, mood disorders and alcoholism could be better resolved by use of small molecule chemical probes that are substantially different from the currently available Y2R antagonist, BIIE0246.

Presented here are five potent, selective and publicly available Y2R antagonists identified by a high throughput screening (HTS) approach. These compounds belong to four chemical scaffolds that are structurally distinct from the peptidomimetic BIIE0246.

In contrast to BIIE0246, Schild analysis with NPY suggests that two of the five compounds behave as competitive antagonists. Profiling against a panel of 40 receptors, ion channels, and transporters found in the central nervous system showed that the five Y2R antagonists demonstrate greater selectivity than BIIE0246.

Furthermore, the ability of these antagonists to penetrate the blood-brain barrier makes them better suited for pharmacologic studies of Y2R function in both the brain and periphery.

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Department of Health to deliver national liver strategy

The Department of Health today announced it would deliver a National Liver Strategy to combat the rise of liver disease, the 5th most common cause of death in England. Liver disease rates have doubled in the last decade and are currently costing the NHS £460 million a year.

The rise in liver disease is attributable to trends in alcohol consumption, which alongside obesity are key lifestyle factors determining risk. A Daily Mail story reports that last year 105 people a day were admitted to hospital with a primary or secondary diagnosis of alcoholic liver disease. The Department of Health will will recruit a National Clinical Director to develop and implement the national liver strategy. . . . . .

Policy options for alcohol price regulation: the importance of modelling population heterogeneity
Addiction Early View 19 October 2009

Internationally, the repertoire of alcohol pricing policies has expanded to include targeted taxation, inflation-linked taxation, taxation based on alcohol-by-volume (ABV), minimum pricing policies (general or targeted), bans of below-cost selling and restricting price-based promotions. Policy makers clearly need to consider how options compare in reducing harms at the population level, but are also required to demonstrate proportionality of their actions, which necessitates a detailed understanding of policy effects on different population subgroups. This paper presents selected findings from a policy appraisal for the UK government and discusses the importance of accounting for population heterogeneity in such analyses.

Age, sex and level of drinking fundamentally affect beverage preferences, drinking location, prices paid, price sensitivity and tendency to substitute for other beverage types. Pricing policies vary in their impact on different product types, price points and venues, thus having distinctly different effects on subgroups. Because population subgroups also have substantially different risk profiles for harms, policies are differentially effective in reducing health, crime, work-place absence and unemployment harms.

Policy appraisals must account for population heterogeneity and complexity if resulting interventions are to be well considered, proportionate, effective and cost-effective.

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News Release - Charge For Harm Alliance Launches Campaign to Pass AB 1019
California Coalition Promotes Alcohol Mitigation Fee

Los Angeles, CA (October 19, 2009) --- The Charge for Harm Alliance – a diverse coalition of treatment and prevention providers, public health advocates, consumers advocates, public safety groups, youth and labor – launched a campaign today to pass an alcohol mitigation fee in California in 2010.

Over 100 people rallied with the new Alliance in South Central Los Angeles to advocate for the passage of AB 1019, the Alcohol-Related Services Program. Simultaneously, Supervisor Bevan Dufty of San Francisco held a hearing on a resolution asking San Francisco to support AB 1019. A new web site loaded with information on the bill and alcohol harm was launched at

AB 1019, authored by Assembly Member Jim Beall (D-San Jose), would stablish the Alcohol-RelatedServices Program within the California Department of Alcohol, Tobacco and Drugs. A $1.44 billion annual alcohol mitigation fee will fund the program and mark the first time the industry has begun to pay its fair share of California’s annual alcohol-related trauma care, hospitalization, reatment, prevention, and criminal justice costs. As AB 1019 is a fee program, it only requires a majority vote in Sacramento. . . . . . .

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Opioids in the Nucleus Accumbens Stimulate Ethanol Intake
Physiol Behav. Author manuscript; available in PMC 2009 October 19. Published in final edited form as: Physiol Behav. 2009 October 19; 98(4): 453–459.

The nucleus accumbens (NAc) participates in the control of both motivation and addiction. To test the possibility that opioids in the NAc can cause rats to select ethanol in preference to food, Sprague-Dawley rats with ethanol, food, and water available, were injected with two doses each of morphine, the μ-receptor agonist [D-Ala2,N-Me-Phe4,Gly5-ol]-Enkephalin (DAMGO), the δ-receptor agonist DAla-Gly-Phe-Met-NH2 (DALA), the k-receptor agonist (±)-trans-U-50488 methanesulfonate (U-50,488H), or the opioid antagonist naloxone methiodide (m-naloxone). As an anatomical control for drug reflux, injections were also made 2 mm above the NAc.

The main result was that morphine in the NAc significantly increased ethanol and food intake, whereas m-naloxone reduced ethanol intake without affecting food or water intake. Of the selective receptor agonists, DALA in the NAc increased ethanol intake in preference to food.

This is in contrast to DAMGO, which stimulated food but not ethanol intake, and the k-agonist U-50,488H, which had no effect on intake. When injected in the anatomical control site 2 mm dorsal to the NAc, the opioids had no effects on ethanol intake.

These results demonstrate that ethanol intake produced by morphine in the NAc is driven in large part by the δ-receptor. In light of other studies showing ethanol intake to increase enkephalin expression in the NAc, the present finding of enkephalin-induced ethanol intake suggests the existence of a positive feedback loop that fosters alcohol abuse.

Naltrexone therapy for alcohol abuse may then act, in part, in the NAc by blocking this opioid-triggered cycle of alcohol intake.

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Monday, October 19, 2009

Civilian Aviation Fatalities Involving Pilot Ethanol and a Previous Record of Substance Abuse
Aviation, Space, and Environmental Medicine, Volume 80, Number 10, October 2009 , pp. 841-844(4)

Pilots are subject to the same temptations as the general population, but due to the demands of flying, the use of ethanol or other impairing substances are more likely to have severe consequences. The Federal Aviation Administration (FAA) requires pilots to report all adverse legal actions involving their use of ethanol and/or other drugs.

The purpose of this study was to evaluate fatal civil aviation accidents between the years 2000 and 2007 in which ethanol was present in the pilot and the pilot had a record of previous drug and/or alcohol offenses.

These results confirm earlier reports that pilots with previous alcohol and/or drug offenses are more likely than others to engage in repeated substance abuse in association with flying with resultant fatal accidents.

These findings support the NTSB's recommendation that the FAA implement more thorough verification of alcohol and drug offenses as a means of identifying pilots at increased risk of causing accidents.

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Europe's health ministries start discussions for Council conclussions on alcohol related harm

Europe's health Ministries have started discussing the Council Conclussions on the prevention and reduction of alcohol related harm on the 1 October.

The Council Conclussions are expected to follow Sweden's priority areas:
1) Alcohol advertising and commercial communications
2) Alcohol and ageing
3) Cross-border trade of alcoholic beverages
4) Harm caused by alcohol to the unborn child

Sweden, which holds the ratating EU presidency has prepared a draft document setting out the priorities.

According to EurActiv Sweden wants national governments to implement the EU alcohol strategy with renewed vigour and to incorporate new evidence on the role of pricing policy as an effective tool in curbing Europe's drinking habits. The Swedish presidency also wants Member States to support evidence-based preventative measures to reduce alcohol consumption during pregnancy and is calling for more research into the links between alcohol and the spread of infectious diseases, including HIV.

Sweden wants health ministers to put pressure on the EU executive to take further steps to protect young people from alcohol advertising. It wants a proactive approach to enforcing regulatory and self-regulatory codes on responsible marketing.

EurActiv points out that this is a hot topic in several countries where drinks companies sponsor high-profile sporting events, several of which attract a young audience.

Sweden intents to have an agreed set of conclusions by the time health ministers meet again on 1 December


Alcohol, Other Drugs, and Health: Current Evidence
Table of Contents: September-October 2009


Heroin to Treat Opioid Dependence: A Randomized Trial
Meta-analysis Confirms Methadone Maintenance Reduces Illicit Opioid Use and Improves Treatment Retention in Patients with Opioid Dependence
Methadone Maintenance Therapy Decreases Arrests
Impaired Memory in Subjects Receiving Opioid Agonist Treatment Who Also Abuse Benzodiazepines
Impact of Buprenorphine Inquiries and Treatment on an Urban Community Health Center
Improving Entry into Post-detoxification Treatment
Injectable Risperidone for the Treatment of Methamphetamine Dependence

AUDIT-C Scores Greater than 7 Predict Fracture Risk

Does Heavy Alcohol Use Increase Risk of Prostate Cancer?

Alcohol Consumption Limits Associated with Alcohol Problems in Older Adults

Greater Alcohol Intake Increases the Risk for Hypertension, but Perhaps Not for Consumers of Red Wine

Moderate Alcohol Intake Is Associated with Better Endothelial Function

More than Half of All Deaths in Russia among People Aged 15-54 Years Are Attributable to Alcohol

Action toward Change Predicts Reduced Alcohol Consumption among Unhealthy Drinkers, but Recognition of the Problem Does Not


Update on Alcohol, Other Drugs, and Health

Journal Club

CME Opportunities

Results from the 2008 National Survey on Drug Use and Health:National Findings

This report presents the first information from the 2008 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older. The survey interviews approximately 67,500 persons each year. Unless otherwise noted, all comparisons in this report described using terms such as "increased," "decreased," or "more than" are statistically significant at the .05 level.