National Survey of Substance Abuse Treatment Services (N-SSATS): 2008 Data on Substance Abuse Treatment Facilities (S-49)

This report presents tabular information and highlights from the 2007 National Survey of Substance Abuse Treatment Services (N-SSATS), conducted between March and October 2008, with a reference data of Marcy 30, 2008.

It is the 31st in a series of national surveys begun in the 1970s. The surveys were designed to collect data on the location, characteristics, and utilization of alcohol and drug treatment facilities and services throughout the 50 States, the District of Columbia, and other U.S. jurisdictions.

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4th national alcohol conference: presentations availablefrom Alcohol Policy UK

In November last year, the Home Office, Department of Health and Department of Children, Schools and Families in partnership with colleagues in the North West hosted the 4th National Alcohol Conference, “Safe Sensible Social: Supporting Delivery” in Liverpool. . . . . .

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Mechanisms of behavior change in alcoholics anonymous: does Alcoholics Anonymous lead to better alcohol use outcomes by reducing depression symptoms?

Indices of negative affect, such as depression, have been implicated in stress-induced pathways to alcohol relapse. Empirically supported continuing care resources, such as Alcoholics Anonymous (AA), emphasize reducing negative affect to reduce relapse risk, but little research has been conducted to examine putative affective mechanisms of AA's effects.

Findings revealed elevated levels of depression compared to the general population, which decreased during treatment and then remained stable over follow-up. Greater AA attendance was associated with better subsequent alcohol use outcomes and decreased depression. Greater depression was associated with heavier and more frequent drinking. Lagged mediation analyses revealed that the effects of AA on alcohol use was mediated partially by reductions in depression symptoms. However, this salutary effect on depression itself appeared to be explained by AA's proximal effect on reducing concurrent drinking.

AA attendance was associated both concurrently and predictively with improved alcohol outcomes. Although AA attendance was associated additionally with subsequent improvements in depression, it did not predict such improvements over and above concurrent alcohol use. AA appears to lead both to improvements in alcohol use and psychological and emotional wellbeing which, in turn, may reinforce further abstinence and recovery-related change.

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Failure of self regulation of UK alcohol advertising

Research has established that alcohol advertising,^{1 2 3} like that for tobacco⁴ and fast food,^{5 6 7} influences behaviour. It encourages young people to drink alcohol sooner and in greater quantities. From a public health perspective, advertising of alcohol should clearly be limited. The United Kingdom has opted for a system of self regulatory controls that focuses primarily on the content of advertisements, with some limitations on the channels that can be used. This is overseen by the Advertising Standards Authority, through the Committee of Advertising Practice, which represents the interests of advertisers, agencies, and media owners.

As part of its alcohol inquiry, the House of Commons health select committee wanted to explore the success of self regulation. It obtained a large number of internal marketing documents from alcohol producers and their communications agencies in order to examine the thinking and strategic planning that underpin alcohol advertising and hence show not just what advertisers are saying, but why they are saying it. Here we present the key insights to emerge. . . . .

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Preventing alcohol related harm to health

Alcohol misuse poses a huge public health problem, particularly in Europe. More than a fifth of European adults admit to binge drinking (five or more drinks on one occasion, or 50 g alcohol) at least once a week; of all World Health Organization regions Europe has the greatest proportion of alcohol related ill health and premature death; and the overall social cost of alcohol to the European Union is around 125bn (£110bn; $180bn) a year.¹ In Scotland alone, adults drink the equivalent of 46 bottles of vodka, or 537 pints of beer, or 130 bottles of wine each a year.² In England, more than a quarter of adults drink at hazardous levels, and the NHS spends £2.7bn a year on treating alcohol related conditions,³ while the overall cost to society of alcohol use each year amounts to around £20bn. ⁴ It is no wonder, however, that so many people drink so . . .

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Drinking at the last chance saloon

Distinguished voices are lining up behind England’s chief medical officer Liam Donaldson in support of a minimum price for alcohol The BMA and the Royal College of Physicians have made a good case and this week they are joined by the combined weight of the Faculty of Public Health and the Royal Society for Public Health. These two bodies list a minimum price for alcohol among 12 policy changes that will save many lives and relieve pressure on the NHS. As the faculty’s president Alan Maryon-Davies says, in lean times such action is all the more essential.

The BMJ supports calls for a minimum price on alcohol, as well as for a ban on alcohol advertising and sponsorship. In her editorial, deputy editor Trish Groves highlights evidence on the damage caused by the fall in price and increase in availability of alcohol over the past 20 years . She concludes that the serious health and societal costs of alcohol misuse are best prevented through legislation on pricing and marketing. . . . .

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Partners in treatment: relational psychoanalysis and harm reduction therapy

A relational psychoanalytic harm reduction orientation to the treatment of substance misusers is presented and illustrated with a clinical example.

Both harm reduction therapy and relational psychoanalysis rely on a two-person model in which the therapist and client are collaborators in the treatment. In both, substance use is seen in the context of the user's internal psychodynamics and external environment, and there is an emphasis on treating the person as a whole individual whose substance use is one aspect of life, rather than focusing on the substance use itself as was often done in the past.

Historically, psychoanalysis and substance abuse treatment were so different from each other that their paths rarely crossed. The introduction of harm reduction therapy to substance abuse and the relational orientation in psychoanalysis have brought the fields closer together such that the valuable contributions that each can make to the other can now be appreciated.

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Integrative harm reduction psychotherapy: a case of substance use, multiple trauma, and suicidality

Harm reduction is a new paradigm that seeks to reduce the harmful consequences of substance use and other risky behaviors without requiring abstinence.

This article discusses integrative harm reduction psychotherapy, one application of harm reduction principles to psychotherapy. Seven therapeutic tasks are described with attention to clinical process, skills, and strategies.

A case is presented that illustrates the application of this approach with life-threatening substance use that was related to multiple trauma and suicidal depression.

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Regulatory Accessibility and Social Influences on State Self-Control

The current work examined how social factors influence self-control. Current conceptions of state self-control treat it largely as a function of regulatory capacity.

The authors propose that state self-control might also be influenced by social factors because of regulatory accessibility.

Studies 1 through 4 provide evidence that individuals’ state self-control is influenced by the trait and state self-control of salient others such that thinking of others with good trait or state self-control leads to increases in state self-control and thinking of others with bad trait or state self-control leads to decreases in state self-control. Study 5 provides evidence that the salience of significant others influences both regulatory accessibility and state self-control.

Combined, these studies suggest that the effects of social influences on state self-control occur through multiple mechanisms.

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