Is expectancy reality? Associations between tension reduction beliefs and mood following alcohol consumption.

The present study investigated whether tension reduction expectancies were uniquely associated with self-reported mood following in-lab alcohol administration, given that little research has addressed this association. We also tested whether level of experience with alcohol, which may influence the learning of expectancies, moderated expectancy-mood associations.

Regularly drinking college students (N = 145) recruited through advertisements completed self-report measures of positive alcohol expectancies, alcohol involvement, demographics, and pre- and post-drinking mood, and then consumed alcohol ad libitum up to four drinks in the laboratory.

Regression analyses controlling for pre-consumption mood, blood alcohol concentration, and all other positive expectancies showed tension reduction expectancies to be a marginally significant positive predictor of negative mood post-drinking. This association was significant only for those who achieved lower blood alcohol concentrations in lab and those who reported less involvement with alcohol (i.e., lower typical quantity, heavy episodic drinking frequency, and years of regular drinking).

Findings suggest that associations between expectations for mood and actual post-drinking mood outcomes may operate differently for less versus more involved drinkers.

Clinical implications pertain to early intervention, when expectancies may be less ingrained and perhaps more readily modified.

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Request Reprint E-Mail: merrill7@buffalo.edu
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Reliability and validity of a demand curve measure of alcohol reinforcement.

Recent clinical research suggests that several self-report behavioral economic measures of relative reinforcing efficacy (RRE) may show utility as indices of substance abuse problem severity.

The goal of the present study was to evaluate the reliability and validity of the Alcohol Purchase Task (APT), a RRE measure that uses hypothetical choices regarding alcohol purchases at varying prices (demand curves) to generate several indices of alcohol-related reinforcement.

Participants were 38 college students who reported recent alcohol consumption. Both the raw alcohol purchase/consumption values and several of the computed reinforcement parameters (intensity & Omax) showed good to excellent 2-week test–retest reliability. Reinforcement parameters derived from both a linear-elasticity (Hursh, Raslear, Bauman, & Black, 1989) and an exponential (Hursh & Silberberg, 2008) demand curve equation were generally less reliable, despite the fact that both equations provided a good fit to participants’ reported consumption data.

The APT measures of demand intensity (number of drinks consumed when price = 0), Omax (maximum expenditure), and elasticity (a) were correlated with weekly drinking, alcohol-related problems, and other self-report RRE measures (relative discretionary monetary expenditures toward alcohol and/or relative substance-related activity participation and enjoyment).

Demand intensity was uniquely associated with problem drinking in a regression model that controlled for weekly consumption.

These results provide support for the reliability and validity of the RRE indices generated with the APT.

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Request Reprint E-Mail: jgmurphy@memphis.edu
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Alcohol-induced changes in the brain as assessed by MRI and CT

This review provides an overview of structural magnetic resonance imaging and computed tomography findings of direct and indirect alcohol-related toxic effects on the brain. In addition to ethanol-related changes to the brain, this article will also describe imaging findings in the acute setting of methanol and ethylene glycol poisoning.

Alcohol will lead to brain atrophy, osmotic myelinolysis, Marchiafava–Bignami disease and, especially when related to malnutrition, may also cause Wernicke encephalopathy. Brain atrophy can be reversible if alcohol abuse is stopped. If not treated, Wernicke encephalopathy can lead to coma and death and an early diagnosis is important for immediate initiation of thiamine substitution.

As clinical symptoms are often unspecific, the radiologist plays an important role in the detection of alcohol abuse and its related clinical conditions.

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Request Reprint E-Mail: timo.krings@uhn.on.ca
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The impacts of substance abuse and dependence on neuropsychological functions in a sample of patients from Saudi Arabia

A lot of studies were directed to explore the relation between drug abuse and neuropsychological functions. Some studies reported that even after a long duration of disappearance of withdrawal or intoxication symptoms, many patients have obvious deterioration of cognitive functions. The aim of this study was to explore the relationship between the substance use disorders and the executive functions.

The study showed that the group of drug-dependent subjects performed significantly worse than the comparison group on all measures Also, there were significant differences among the subgroups as the alcoholic group was much worse followed by the amphetamine then the opioids groups. Patients with longer duration of dependence and multiple hospital readmissions were much worse in comparison to patients with shorter duration of dependence and less readmission.

The study confirmed that the functions of specific brain regions underlying cognitive control are significantly impaired in patients of drug addiction. This impairment was significantly related to type of substance, duration of use and number of hospitalization and may contribute to most of behavioral disturbances found in addicts and need much attention during tailoring of treatment programs.

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Call for Proposals

Submit a Proposal Now!

The 4th National Conference on Women, Addiction and Recovery: Thriving in Changing Times offers an opportunity for sharing the practices, programs, policies or research you have found significant and effective in addressing the needs of women and families. We are seeking proposals from a diverse group of practitioners, researchers and advocates across the addiction treatment and recovery services field, as well as related fields, interested in sharing your work. We seek proposals that will introduce ideas, allow exploration of concepts, impart knowledge to attendees, and integrate methods that encourage dialogue.

We are seeking different types of sessions in nine emphasis areas.

Download a Call for Proposal to see proposal requirements and guidelines.

Proposals must be submitted online.
Submit a Proposal Now!

PROPOSALS ARE DUE BY
TUESDAY, JANUARY 26, 2010.

Home 4th National Conference

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Moderate Champagne consumption promotes an acute improvement in acute endothelial-independent vascular function in healthy human volunteers

Epidemiological studies have suggested an inverse correlation between red wine consumption and the incidence of CVD. However, Champagne wine has not been fully investigated for its cardioprotective potential.

In order to assess whether acute and moderate Champagne wine consumption is capable of modulating vascular function, we performed a randomised, placebo-controlled, cross-over intervention trial.

We show that consumption of Champagne wine, but not a control matched for alcohol, carbohydrate and fruit-derived acid content, induced an acute change in endothelium-independent vasodilatation at 4 and 8 h post-consumption. Although both Champagne wine and the control also induced an increase in endothelium-dependent vascular reactivity at 4 h, there was no significant difference between the vascular effects induced by Champagne or the control at any time point. These effects were accompanied by an acute decrease in the concentration of matrix metalloproteinase (MMP-9), a significant decrease in plasma levels of oxidising species and an increase in urinary excretion of a number of phenolic metabolites.

In particular, the mean total excretion of hippuric acid, protocatechuic acid and isoferulic acid were all significantly greater following the Champagne wine intervention compared with the control intervention.

Our data suggest that a daily moderate consumption of Champagne wine may improve vascular performance via the delivery of phenolic constituents capable of improving NO bioavailability and reducing matrix metalloproteinase activity.

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Request Reprint E-Mail: j.p.e.spencer@reading.ac.uk
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Predicting post-treatment-initiation alcohol use among patients with severe mental illness and alcohol use disorders.

Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes.

In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use.

Predictors of alcohol use outcomes were examined in 278 individuals diagnosed with a current schizophrenia-spectrum or bipolar disorder and an alcohol use disorder (AUD).

At 6-months follow-up, 144 of 228 available participants (63%) had good clinical outcomes. The results of structural equation modeling indicated that type of pretreatment residential setting was directly related to treatment, with participants who lived in supervised settings (41%) reporting significantly more days of treatment.

In addition, participants with more psychiatric symptoms, as assessed with the Brief Symptom Inventory and Structured Clinical Interview for the Positive and Negative Syndrome Scale, reported significantly fewer treatment days.

Number of days that participants attended treatment was indirectly associated with alcohol use outcomes and was mediated by use of alcohol-specific coping skills, such that more frequent use of such skills was associated with less post-treatment-initiation alcohol use.

This study emphasizes the favorable prognosis for alcohol outcomes among treated individuals with SMI and AUD and the importance of psychosocial interventions, particularly those that result in better alcohol-specific coping skills.

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Request Reprint E-Mail: bradizza@ria.buffalo.edu
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Partner violence before and after couples-based alcoholism treatment for female alcoholic patients.

This study examined partner violence before and in the 1st and 2nd year after behavioral couples therapy (BCT) for 103 married or cohabiting women seeking alcohol dependence treatment and their male partners; it used a demographically matched nonalcoholic comparison sample.

In the year before BCT, 68% of female alcoholic patients had been violent toward their male partner, nearly 5 times the comparison sample rate of 15%. In the year after BCT, violence prevalence decreased significantly to 31% of the treatment sample. Women were classified as remitted after treatment if they demonstrated abstinence or minimal substance use and no serious consequences related to substance use.

In Year 1 following BCT, 45% were classified as remitted, and 49% were classified as remitted in Year 2. Among remitted patients in the year after BCT, violence prevalence of 22% did not differ from the comparison sample and was significantly lower than the rate among relapsed patients (38%). Results for male-perpetrated violence and for the 2nd year after BCT were similar to the 1st year.

Results supported predictions that partner violence would decrease after BCT and that clinically significant violence reductions to the level of a nonalcoholic comparison sample would occur for patients whose alcoholism was remitted after BCT.

These findings replicate previous research among men with alcoholism.

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Request Reprint E-Mail: Jeremiah.Schumm@va.gov
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The alliance in motivational enhancement therapy and counseling as usual for substance use problems

Data from a community-based multicenter study of motivational enhancement therapy (MET) and counseling as usual (CAU) for outpatient substance users were used to examine questions about the role of the alliance in MET and CAU.

No reliable differences in patient ratings (n = 319) on the Helping Alliance Questionnaire–II (HAq-II) were evident for MET compared to CAU, but significant differences between therapists were found within each condition in mean patient-rated HAq-II scores. Overall, average levels of alliance were high.

The between-therapists component of the alliance, but not the within-therapist component, was significantly associated with self-reported days of primary substance use during the follow-up period from Week 4 to Week 16 (Cohen’s d = 0 .39; n = 257). Therapists with either low or very high alliances had relatively poorer average outcomes (quadratic effect, d = 0.44).

For therapists in both MET and CAU, increased use of MET fundamental techniques and MET advanced techniques during treatment sessions was associated with higher levels of alliance.

Implications of the findings for conceptualization of the alliance and for training of therapists are discussed.

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Request Reprint E-Mail: crits@mail.med.upenn.edu
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From in-session behaviors to drinking outcomes: A causal chain for motivational interviewing.

Client speech in favor of change within motivational interviewing sessions has been linked to treatment outcomes, but a causal chain has not yet been demonstrated.

Using a sequential behavioral coding system for client speech, the authors found that, at both the session and utterance levels, specific therapist behaviors predict client change talk. Further, a direct link from change talk to drinking outcomes was observed, and support was found for a mediational role for change talk between therapist behavior and client drinking outcomes.

These data provide preliminary support for the proposed causal chain indicating that client speech within treatment sessions can be influenced by therapists, who can employ this influence to improve outcomes.

Selective eliciting and reinforcement of change talk is proposed as a specific active ingredient of motivational interviewing.

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Request Reprint E-Mail: tmoyers@unm.edu
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Carousing Teens, Around the World

The Organization for Economic Cooperation and Development today released it updated report on health and health care in the developed world. One bright spot for those concerned about the health of American children: American youngsters appear to drink and smoke less than their peers in other countries.

About one in five American 15-year-olds reports having been drunk at least twice, compared with nearly one in three across the O.E.C.D. . . . . . .

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Alcohol consumption among adults

The global health burden related to excessive alcohol consumption, both in terms of morbidity and mortality, is considerable in most parts of the world (Rehm et al., 2009; WHO, 2004b). It is associated with numerous harmful health and social consequences, including drunkenness and alcohol dependence. High alcohol intake increases the risk for heart, stroke and vascular diseases, as well as liver cirrhosis and certain cancers. Foetal exposure to alcohol increases the risk of birth defects and intellectual impairments. Alcohol also contributes to death and disability through accidents and injuries, assault, violence, homicide and suicide, and is estimated to cause more than 2 million deaths annually. It is, however, one of the major avoidable risk factors for disease.

Alcohol consumption, as measured by annual sales, stands on average across OECD countries at 9.7 litres per adult, using the most recent data available. -Leaving aside Luxembourg - given the high volume of purchases by non-residents in that country - Ireland, Hungary and France reported the highest consumption of alcohol, with 13.0 litres or more per adult per year in 2006-07. At the other end of the scale, Turkey, Mexico and some of the Nordic countries (Norway and Sweden) have relatively low levels of alcohol -consumption, ranging from one to seven litres per adult (Figure 2.6.1).

Although average alcohol consumption has gradually fallen in many OECD countries over the past two decades, it has risen in some others (Figure 2.6.2). There has been a degree of convergence in drinking habits across the OECD, with wine consumption increasing in many traditional beer-drinking countries and vice versa. The traditional wine-producing countries of Italy, France and Spain, as well as the -Slovak Republic and Greece, have seen their alcohol consumption per capita drop substantially since 1980 (Figure 2.6.2 and Figure 2.6.3). On the other hand, alcohol consumption per capita in Iceland, Ireland and -Mexico rose by as much as 40% or more since 1980 although, in the case of Iceland and Mexico, it started from a very low level and therefore remains -relatively low. . . . . .

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Smoking and alcohol consumption at age 15

Regular smoking or excessive drinking in adolescence has immediate and long-term health consequences. Children who establish smoking habits in early adolescence increase their risk of cardiovascular diseases, respiratory illnesses and cancer. They are also more likely to experiment with alcohol and other drugs. Alcohol misuse is itself associated with a range of social, physical and mental health problems, including depressive and anxiety disorders, obesity and accidental injury (Currie et al., 2008).

Results from the Health Behaviour in School-aged Children (HBSC) surveys, a series of collaborative cross-national studies conducted in most OECD countries, allow for monitoring of smoking and drinking behaviours among adolescents. Generally, today girls smoke more than boys, but more boys get drunk. Between 13 and 15 years of age, the prevalence of smoking and drunkenness doubles in many OECD countries.

Children in Austria, Finland, Hungary, the Czech Republic and Italy smoke more often, with weekly rates of 20% or more for both boys and girls (Figure 2.1.1). In contrast, 10% or less of 15-year-olds in the United States, Canada and Sweden smoke weekly. Most countries report higher rates of smoking for girls, although only Spain and Austria have differences in excess of 5%. Greece, Finland, Hungary, -Iceland, Poland and the Slovak Republic are the only countries where smoking is more prevalent among boys.

Drunkenness at least twice in their lifetime is reported by 40% or more of 15-year-olds in Denmark, the United Kingdom and Finland (Figure 2.1.2). Across all surveyed countries, 29% of girls and 33% of boys have been drunk on two or more occasions, with much lower rates in the United States, and Mediterranean countries such as Greece, Italy and Portugal. Boys are more likely to report repeated drunkenness. Switzerland, Belgium, Hungary and the Slovak Republic have the biggest differences, with rates of alcohol abuse being 5‐10% higher than those of girls. In Poland, differences are even greater, with repeated drunkenness among boys being over 10% higher than girls. Norway, Spain, Canada and the United Kingdom are the only countries where more girls report repeated drunkenness, and in each case rates are less than 5% higher. . . . . .

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Alcoholism and Intimate Partner Violence: Effects on Children’s Psychosocial Adjustment

It is widely recognized that alcoholism and relationship violence often have serious consequences for adults; however, children living with alcoholic parents are susceptible to the deleterious familial environments these caregivers frequently create.

Given the prevalence of IPV among patients entering substance abuse treatment, coupled with the negative familial consequences associated with these types of behavior, this review explores what have been, to this point, two divergent lines of research: (a) the effects of parental alcoholism on children, and (b) the effects of children’s exposure to intimate partner violence.

In this article, the interrelationship between alcoholism and IPV is examined, with an emphasis on the developmental impact of these behaviors (individually and together) on children living in the home and offers recommendations for future research directions.

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Helping someone with problem drinking: Mental health first aid guidelines - a Delphi expert consensus study

Alcohol is a leading risk factor for avoidable disease burden. Research suggests that a drinker's social network can play an integral role in addressing hazardous (i.e., high-risk) or problem drinking. Often however, social networks do not have adequate mental health literacy (i.e., knowledge about mental health problems, like problem drinking, or how to treat them). This is a concern as the response that a drinker receives from their social network can have a substantial impact on their willingness to seek help.

This paper describes the development of mental health first aid guidelines that inform community members on how to help someone who may have, or may be developing, a drinking problem (i.e., alcohol abuse or dependence).

The guidelines provide a consensus-based resource for community members seeking to help someone with a drinking problem. Improving community awareness and understanding of how to identify and support someone with a drinking problem may lead to earlier recognition of problem drinking and greater facilitation of professional help seeking.

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Can Prenatal Screening for Fetal Alcohol Spectrum Disorder Be Justified? A Commentary

Fetal alcohol spectrum disorder (FASD) is the leading cause of non-genetic mental retardation in the USA, possibly exceeding even Down syndrome, which is currently approaching 1 in 500 live births. Alcohol consumption during pregnancy results in brain, craniofacial and heart defects, neurotoxicity, and immune dysfunction.

The preferred action taken to prevent alcohol consumption during pregnancy is abstinence. However, the detection, diagnosis, and treatment of FASD remain a major public health need in this country and throughout the world.

The biochemical molecules involved in the developmental anomalities encompass a vast array of signal transduction and synaptic pathways which involve neurotransmitters and neurotrophic peptides.

Recent advances in medicine-based therapies for FASD have been reported, and include the use of small molecule agonists, antagonists, and competitive inhibitors.

Since biomarkers for FASD have previously been identified in clinical research reports, multicenter screening feasibility studies now seem warranted and could be initiated following adequate funding, protocols, procedures, and institutional review board approvals.

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Request Reprint E-Mail: mizejew@wadsworth.org
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Press Release - Alcohol Consumption May Increase Breast Cancer Recurrence Risk

Moderate consumption of alcoholic beverages (at least three to four drinks per week, no matter the type of alcohol) is associated with a 30 percent increased risk of breast cancer recurrence, according to a new Kaiser Permanente study. . . . . .

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Screening and Brief Intervention for Substance Misuse Among Older Adults: The Florida BRITE Project

We developed and examined the effectiveness of the Florida Brief Intervention and Treatment for Elders (BRITE) project, a 3-year, state-funded pilot program of screening and brief intervention for older adult substance misusers.

Prescription medication misuse was the most prevalent substance use problem, followed by alcohol, over-the-counter medications, and illicit substances. Depression was prevalent among those with alcohol and prescription medication problems. Those who received the brief intervention had improvement in alcohol, medication misuse, and depression measures.

The BRITE program effectively shaped state policy by responding to legislative mandates to address the needs of an increasing, but underserved, elder population. The pilot paved the way for obtaining a federally funded grant to expand BRITE to 27 sites in 17 counties in Florida.

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Request Reprint E-Mail: mschonfeld@fmhi.usf.edu

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Alcohol Pricing, Public Health and the HST: Proposed Incentives for BC Drinkers to Make Healthy Choices

This policy brief presents the case for altering BC’s approach to alcohol pricing, conveys basic evidence-informed principles upon which these modifications should be based, and sets out feasible recommendations that could, among other things, contribute significantly to the province’s goal of becoming one of the healthiest jurisdictions in the world


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Preferential Ethanol Consumption in Drosophila Models Features of Addiction

Alcohol addiction is a common affliction with a strong genetic component . Although mammalian studies have provided significant insight into the molecular mechanisms underlying ethanol consumption , other organisms such as Drosophila melanogaster are better suited for unbiased, forward genetic approaches to identify novel genes. Behavioral responses to ethanol, such as hyperactivity, sedation, and tolerance, are conserved between flies and mammals , as are the underlying molecular pathways However, few studies have investigated ethanol self-administration in flies .

Here we characterize ethanol consumption and preference in Drosophila. Flies prefer to consume ethanol-containing food over regular food, and this preference increases over time. Flies are attracted to the smell of ethanol, which partially mediates ethanol preference, but are averse to its taste. Preference for consuming ethanol is not entirely explained by attraction to either its sensory or caloric properties.

We demonstrate that flies can exhibit features of alcohol addiction. First, flies self-administer ethanol to pharmacologically relevant concentrations. Second, flies will overcome an aversive stimulus in order to consume ethanol. Third, flies rapidly return to high levels of ethanol consumption after a period of imposed abstinence.

Thus, ethanol preference in Drosophila provides a new model for studying aspects of addiction.

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Request Reprint E-Mail: anita.devineni@ucsf.edu
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New study shows: Infectious diseases have alcohol link

Researchers have studied the link between alcohol use and the transmission and development of infectious diseases. The study establishes the causal impact between alcohol use and the risk of contracting TB and pneumonia, as well as influence from alcohol use on the progression of TB and HIV. The report also explores the social and biological pathways involved, the role of development, impact of alcohol-attributable infectious diseases on the Global Burden of Disease figures, and policy implications. . . . .

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Relationships between Drinking Onset, Alcohol Use Intensity, and Nighttime Risk Behaviors in a College Bar District

To identify antecedents of risk behavior events in college bar patrons

Multilevel structural equation modeling revealed positive associations between age of drinking onset and both alcohol use intensity in the past year and recent bar-going frequency. In turn, alcohol use intensity in the past year was positively associated with bar-going frequency and intoxication at bar exit. An association between drinking onset and bar-going frequency was mediated by alcohol use intensity in the past year.

Discernable paths from age of drinking onset to monthly bar-going frequency and intoxication level after leaving a bar can be identified. The results highlight the critical role of drinking onset in development of college student alcohol abuse.

Research is needed to determine whether college bars are environmental pathogens mediating between genetic risk factors and patron risk behavior.

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Request Reprint E-Mail: dthombs@phhp.ufl.edu _______________________________________

Strategies to reduce the harmful use of alcohol: draft global strategy

1. In resolution WHA61.4 (Strategies to reduce the harmful use of alcohol) the Health Assemblyrequested the Director-General to submit to the Sixty-third World Health Assembly, through theExecutive Board, a draft global strategy to reduce harmful use of alcohol. The Health Assembly urged Member States to collaborate with the Secretariat in developing a draft global strategy, and further requested the Director-General to collaborate and consult with Member States, as well as to consult with intergovernmental organizations, health professionals, nongovernmental organizations and economic operators on ways they could contribute to reducing harmful use of alcohol.

2. The Secretariat has drafted a strategy (Annex 1) through an inclusive and broad collaborative process with Member States. In doing so, the Secretariat took into consideration the outcomes of consultations with other stakeholders on ways in which they can contribute to reducing the harmful use of alcohol. The draft strategy is based on existing best practices and available evidence of effectiveness and cost–effectiveness of strategies and interventions to reduce the harmful use of alcohol; this evidence is summarized in Annex 2.

3. The consultative process started with a public, web-based hearing from 3 October to 15 November 2008, giving Member States and other stakeholders an opportunity to submit proposals on ways to reduce harmful use of alcohol. Two separate round-table discussions, one with nongovernmental organizations and health professionals and the other with economic operators, were organized in Geneva in November 2008 in order to collect views on ways these stakeholders could contribute to reducing harmful use of alcohol. Subsequently, a consultation with selected intergovernmental organizations was held (Geneva, 8 September 2009).

4. The Secretariat began work on a draft strategy by preparing a discussion paper for further consultations with Member States. That paper was formulated on the basis of the deliberations of WHO’s governing bodies and several regional committee sessions as well as the similar outcomes of those bodies pertaining to other related areas such as noncommunicable diseases, mental health, violence and injury prevention, cancer, family and community health, social determinants of health, HIV/AIDS, and trade and health. The discussion paper was also influenced by the outcomes of the Secretariat’s technical activities on alcohol and health, including the relevant meetings of technical experts. The discussion paper was sent to the Member States and posted on the WHO web site.

5. Six regional technical consultations were held between February and May 2009, attended by participants nominated by governments of 149 Member States. Three consultations were held in the WHO Regional Offices for Africa, Europe and the Eastern Mediterranean. The governments of Brazil, Thailand and New Zealand, respectively, hosted the consultations for Member States in the Region of the Americas and the South-East Asia and Western Pacific Regions. In all these regional consultations, Member States were invited to provide their views on the possible areas for global action and coordination outlined in the discussion paper, and on how the strategy could best take into account national needs and priorities. In addition, Member States were encouraged to provide information on current national and subregional processes that could contribute to the strategy development process, as well as examples of best practices, with special emphasis on at-risk populations, young people and those affected by the harmful drinking of others.

6. To write a working document for developing a draft global strategy to reduce harmful use of alcohol, the Secretariat built on the outcomes of the regional consultations with Member States and taking into consideration the outcomes of the previous consultative process with all stakeholders on ways in which they could contribute to reducing the harmful use of alcohol. The resulting document provided background information, suggested aims, objectives and guiding principles for a global strategy, target areas and a set of policy measures and interventions that it was proposed Member States could implement at the national level. The working document was sent to Member States in August 2009 with an invitation for written feed-back on its content, and posted on the WHO web site. The Secretariat received written feedback from 40 Member States.

7. To continue the collaboration with Member States on the draft strategy the Secretariat held an informal consultation with Member States on 8 October 2009 in Geneva in order to discuss the feedback on the working document and to offer an opportunity for Member States to provide further guidance on finalizing a draft global strategy. Further taking into account the outcome of that informal consultation, the Secretariat finalized a draft global strategy.

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Drinking and future thinking: acute effects of alcohol on prospective memory and future simulation

It has recently been shown that acute alcohol globally impairs ‘prospective memory’ (PM)—remembering to do something in the future (Leitz et al. in Psychopharmacology 205:379–387, 2009). In healthy, sober individuals, simulating future events at encoding enhances PM performance.

We therefore aimed to determine if future event simulation could attenuate the impairing effects of acute alcohol on PM.

We replicated the finding of Leitz et al. that acute alcohol consumption impairs prospective memory for event-based tasks. Future event simulation significantly improved PM performance on these tasks and eliminated the PM deficit caused by acute alcohol consumption.

This is the first evidence that future event simulation can overcome alcohol-induced deficits in prospective memory and may have important clinical implications for the rehabilitation of chronic alcohol users.

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Request Reprint E-Mail: v.curran@ucl.ac.uk
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Caffeine doesn't reverse the negative cognitive impact of alcohol, study shows

People who drink may want to know that coffee won't sober them up, according to new laboratory research. Instead, a cup of coffee may make it harder for people to realize they're drunk.

What's more, popular caffeinated "alcohol-energy" drinks don't neutralize alcohol intoxication, suggest the findings from a mouse study reported in the journal Behavioral Neuroscience, which is published by the American Psychological Association. . . . . .

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Alcohol Use and Sexual Risk Behaviors and Outcomes in China: A Literature Review

This review systematically examines the empirical evidence regarding the association between alcohol use and sexual risk behaviors and outcomes among the Chinese population in mainland, China.

Articles published in English (n = 11) and in Chinese (n = 7) from 1980 to 2008 documented consistent associations between alcohol use and several sexual risk behaviors, sexual coercion, sexual violence, and HIV/STIs across both the general population and high-risk groups, except for men having sex with men.

This review suggests that alcohol use is associated with diverse sexual risk behaviors and outcomes across a variety of social groups in China, consistent with the evidence from the Western countries and Sub-Saharan Africa. Alcohol use is an important but under-researched correlate of sexual risk behaviors and outcomes in China.

This review indicates the importance of research assessing alcohol use among both genders and with standardized measures, and suggests the importance of integrating alcohol use control in sexual risk reduction and prevention efforts in China.

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Request Reprint E-Mail: youliqing@hotmail.com
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Post-Soviet Placebos: Epistemology and Authority in Russian Treatments for Alcoholism

The dominant modalities of treatment for alcoholism in Russia are suggestion-based methods developed by narcology—the subspecialty of Russian psychiatry which deals with addiction.

A particularly popular method is the use of disulfiram—an alcohol antagonist—for which narcologists commonly substitute neutral substances. Drawing on 14 months of fieldwork at narcological clinics in St. Petersburg, this article examines the epistemological and institutional conditions which facilitate this practice of “placebo therapy.”

I argue that narcologists’ embrace of such treatments has been shaped by a clinical style of reasoning specific to a Soviet and post-Soviet psychiatry, itself the product of contested Soviet politics over the knowledge of the mind and brain.

This style of reasoning has facilitated narcologists’ understanding of disulfiram as a behavioral, rather than a pharmacological, treatment and has disposed them to amplify patients’ responses through attention to the performative aspects of the clinical encounter and through management of the treatment’s broader reputation as an effective therapy.

Moreover, such therapies have generally depended upon, and helped to reinforce, clinical encounters premised on a steeply hierarchical physician–patient relationship.

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Request Reprint E-Mail: eugene.raikhel@mail.mcgill.ca
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An evaluation of the impact of a large reduction in alcohol prices on alcohol-related and all-cause mortality: time series analysis of a population-ba

We examined the effect of a large reduction in the price of alcohol that occurred in Finland in 2004 on alcohol-related and all-cause mortality, and mortality due to cardiovascular diseases (CVDs) from which alcohol-attributable cases were excluded.

These results obtained from the time series analyses suggest that the reduction in alcohol prices led to an increase in alcohol-related mortality, except in persons <40> of age. However, it appears that beneficial effects in older age, when CVD deaths are prevalent, counter-balance these adverse effects, at least to some extent.

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Request Reprint E-Mail: kimmo.herttua@helsinki.fi
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Screening and brief interventions: learning and examples across England

A report examining learning from screening and brief intervention projects across England has been released, available here. The findings were presented by HubCAPP manager Sarah Ward as a poster presentation at the recent Inebria conference. It examines key outcomes and learning from 25 different screening and brief intervention projects, also known in England as Identification and Brief Advice (IBA). . . . .

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Gene expression profiling in blood: new diagnostics in alcoholism and addiction?

The successful treatment of most diseases relies heavily upon early detection. Biomarkers with diagnostic and prognostic value are critical to the addiction field. Most individuals with alcohol or drug dependence or use problems evade detection until severe medical, legal, or social consequences arise. The short half-life of alcohol in the blood after cessation of drinking eliminates the feasibility for using blood alcohol as a biomarker. Carbohydrate-deficient transferrin (CDT) is currently the most specific serum marker of chronic, heavy alcohol use (Reynaud et al, 2000), but the low sensitivity of the CDT test in the general population makes it an unreliable candidate for predicting either heavy alcohol use or for diagnosing alcohol abuse and/or dependence (Alte et al, 2004). Except for the drugs and their metabolites, there are not biomarkers for addiction.

Discovery of reliable blood-based molecular markers of alcohol dependence and use would mark a milestone for addiction research and offer a great benefit for predicting the disease even without knowing the role of the markers in the disease process. Once biomarkers are discovered, the opportunity for early detection and intervention as well as personalized therapeutics should lead to new treatments for the disease.

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Use of small interfering ribonucleic acids to inhibit the adipogenic effect of alcohol on human bone marrow-derived mesenchymal cells

This study tested the potential of small interfering RNAs (siRNA) targeting human peroxisome proliferator activated receptor gamma (PPARγ) to repress the adipogenic effect of alcohol on human bone marrow-derived mesenchymal cells (hBMSCs).

PPARγ-siRNA transfection resulted in significantly lower adipocyte number, increased matrix mineralisation, repressed adipogenic gene markers, up-regulated osteogenic gene marker and bone matrix protein synthesis in the PPARγ-siRNA group compared to controls .

PPARγ-siRNA is a useful strategy to inhibit the adipogenic effect and the osteogenic repression of alcohol on hBMSCs.

This may be a novel therapeutic intervention for osteopenic disorders in alcoholism and other conditions.

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Fatalities and Fatality Rates in Alcohol- Impaired-Driving Crashes by State, 2007-2008

In 2008, as compared to 2007, the overall fatality rate declined from 1.36 to 1.25 fatalities per 100 million vehicle miles of travel (VMT), and the alcohol-impaired driving fatality rate declined from 0.43 to 0.40 fatalities per 100 million VMT.

From 2007 to 2008, the alcohol-impaired-driving fatality rate declined in 40 States, the District of Columbia and Puerto Rico and remained the same or increased in the remaining 10 States.

An alcohol-impaired-driving crash is defined as a crash involving at least one driver or motorcycle rider (operator) with a blood alcohol concentration (BAC) of .08 grams per deciliter (g/dL) or higher. In all 50 States, the District of Columbia, and Puerto Rico, it is illegal per se to drive a vehicle or operate a motor-cycle with a BAC of .08 g/dL or above.

This research note presents, by State, the fatality rates as well as the number of deaths in alcohol-impaired-driving crashes in those States.

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Alcohol consumption-associated breast cancer incidence and potential effect modifiers - The Japan public health center-based prospective study

Epidemiological studies have evaluated whether the impact of alcohol intake on breast cancer risk is modified by use of exogenous estrogens, folate intake, body weight, and smoking status, but results have been inconsistent. Further, effect modification by intake of isoflavones and alcohol-induced facial flushing, which are prevalent in Asian populations, have not been investigated. We investigated the association between alcohol intake and breast cancer risk and whether the association is modified by these factors among 50,757 pre- and postmenopausal women (aged 40-69y) in the population-based Japan Public Health Center-based Prospective Study.

Compared with never-drinkers, regular alcohol drinkers (>150 g of ethanol/week) had a higher risk of the development of breast cancer; the multivariable-adjusted RRs were 1.75 for overall, 1.78 for premenopausal, and 1.21 for postmenopausal women.

There was no statistical evidence for effect modification by menopausal status, use of exogenous estrogens, intakes of isoflavone and folate, body weight, alcohol-induced facial flushing, or smoking .

Excessive alcohol intake was associated with an increase in the risk of breast cancer in this population. There was no statistical evidence for effect modification. Read Full Abstract Request Reprint E-Mail: moiwasak@ncc.go.jp ___________________________________________

Naltrexone and combined behavioral intervention effects on trajectories of drinking in the COMBINE study

COMBINE is the largest study of pharmacotherapy for alcoholism in the United States to date, designed to answer questions about the benefits of combining behavioral and pharmacological interventions.

Trajectory-based analyses of daily drinking data allowed identification of distinct drinking trajectories in smaller studies and demonstrated significant naltrexone effects even when primary analyses on summary drinking measures were unsuccessful.

The objective of this study was to replicate and refine trajectory estimation and to assess effects of naltrexone, acamprosate and therapy on the probabilities of following particular trajectories in COMBINE. It was hypothesized that different treatments may affect different trajectories of drinking.

We replicated the trajectories (“abstainer”, “sporadic drinker”, “consistent drinker”) established previously in smaller studies. However, greater numbers of trajectories better described the heterogeneity of drinking over time. Naltrexone reduced the chance to follow a “nearly daily” trajectory and Combined Behavioral Intervention (CBI) reduced the chance to be in an “increasing to nearly daily” trajectory of any drinking. The combination of naltrexone and CBI increased the probability of membership in a trajectory in which the frequency of any drinking declined over time. Trajectory membership was associated with different patterns of treatment compliance.

The trajectory-analyses identified specific patterns of drinking that were differentially influenced by each treatment and provided support for hypotheses about the mechanisms by which these treatments work.

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Request Reprint E-Mail: ralitza.gueorguieva@yale.edu

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Late-life and life history predictors of older adults’ high-risk alcohol consumption and drinking problems

This prospective, longitudinal study focused on late-life and life history predictors of high-risk alcohol consumption and drinking problems during a 20-year interval as adults matured from age 55–65 to 75–85.

Older adults who, at baseline, had more friends who approved of drinking, relied on substances for tension reduction, and had more financial resources were more likely to engage in high-risk alcohol consumption and to incur drinking problems at 10- and 20-year follow-ups. With respect to life history factors, drinking problems by age 50 were associated with a higher likelihood of late-life high-risk alcohol consumption and drinking problems; having tried to cut down on drinking and participation in Alcoholics Anonymous were associated with a lower likelihood of high-risk consumption and problems.

Specific late-life and life history factors can identify older adults likely to engage in excessive alcohol consumption 10 and 20 years later. Targeted screening that considers current alcohol consumption and life context, and history of drinking problems and help-seeking, could help identify older adults at higher risk for excessive or problematic drinking.

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Predicting drinking onset with discrete-time survival analysis in offspring from the San Diego prospective study

Previous research has shown that an early onset of drinking is associated with a range of problematic drinking outcomes in adulthood.

However, earlier drinking is also linked to additional characteristics that themselves predict alcohol problems including male gender, a family history (FH) of alcoholism, age, race, parental alcoholism, depression symptoms, prior drug use, and conduct problems.

This study tested the relationship between the age of first drink (AFD) and a range of risk factors that predict the onset of alcohol use.

The results demonstrated the predicted relationships to AFD for conduct problems, male gender, prior marijuana use, and a FH of alcoholism, even when these characteristics were estimated together. Furthermore, an interaction occurred such that offspring with both conduct problems and marijuana use were at substantially higher risk for alcohol use onset during this time period than would be predicted from the effect of these two risk factors alone.

However, age at interview, ethnicity, parent education, and depressive symptoms did not predict the pattern of onset of drinking.

Implications for future research and prevention efforts are discussed.

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Request Reprint E-Mail: mschuckit@ucsd.edu

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DRAFT REPORT on the proposal for a regulation of the European Parliament and of the Council on the provision of food information to consumers

The report of the Rapporteur, Ms Renate Sommer (EPP-Ed, DE), on the proposal for a regulation on the provision of food information to consumers is now available in English.

In her report, Ms Sommer proposes to exempt from the obligation to provide information on ingredients and nutritional values, alcoholic mixed beverages, liqueur wines, sparkling wines, aromatised wines and similar products obtained from fruits other than grapes and fruit beer.

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Measuring Alcohol-Related Consequences in School Surveys: Alcohol-Attributable Consequences or Consequences With Students’ Alcohol Attribution

In alcohol epidemiology surveys, there is a tradition of measuring alcohol-related consequences using respondents’ attribution of alcohol as the cause.

The authors aimed to compare the prevalence and frequency of self-attributed consequences to consequences without self-attribution using alcohol-attributable fractions (AAF).

Although relative risk estimates were higher when alcohol-attributed consequences were compared with nonattributed consequences, the use of AAFs resulted in more alcohol-related consequences (10,422 self-attributed consequences vs. 24,520 nonattributed consequences determined by means of AAFs).

The likelihood of underreporting was higher among drinkers with intermediate frequencies than among either rare drinkers or frequent drinkers. Therefore, the extent of alcohol-related adverse consequences among adolescents may be underestimated when using self-attributed consequences, because of differential attribution processes, especially among infrequent drinkers.

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