Empirically defined subtypes of alcohol dependence in an Irish family sample

Alcohol dependence (AD) is clinically and etiologically heterogeneous.

The goal of this study was to explore AD subtypes among a sample of 1221 participants in the Irish Affected Sib Pair Study of Alcohol Dependence, all of whom met DSM-IV criteria for AD.

Variables used to identify the subtypes included major depressive disorder, antisocial personality disorder, illicit drug dependence (cannabis, sedatives, stimulants, cocaine, opioids, and hallucinogens), nicotine dependence, the personality traits of neuroticism and novelty seeking, and early alcohol use.

Using latent class analysis, a 3-class solution was identified as the most parsimonious description of the data. Individuals in a Mild class were least likely to have comorbid psychopathology, whereas a severe class had highest probabilities of all comorbid psychopathology. The third class was characterized by high probabilities of major depression and higher neuroticism scores, but lower likelihood of other comorbid disorders than seen in the severe class.

Overall, sibling pair resemblance for class was stronger within than between classes, and was greatest for siblings within the severe class, suggesting a stronger familial etiology for this class.

These findings are consistent with the affective regulation and behavioral disinhibition subtypes of alcoholism, and are in line with prior work suggesting familial influences on subtype etiology.

Read Full Abstract

Request Reprint E-Mail: cprescot@usc.edu
_____________________________________

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.

Read Full Abstract

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

_____________________________________________

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. Participants were offspring from the San Diego Prospective Study (SDPS) who were at least 15 years old at the time of their most recent interview (n=147). Discrete-time survival analysis (DTSA) was used to relate multiple characteristics to the hazard function of alcohol onset across a relevant age range.

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.

Read Full Abstract

Request Reprint E-Mail: mschuckit@ucsd.edu
__________________________________

Alcohol and drug involvement after adolescent treatment and functioning during emerging adulthood

This study identified patterns of alcohol and other drug (AOD) involvement during the decade following adolescent AOD treatment and developmental outcomes in emerging adulthood.

AOD and psychosocial variables were assessed at eight time points from adolescence into adulthood (n=153; 41.2% women) in an inpatient treatment sample of alcohol and other drug dependent teens.

Latent class growth analysis identified six trajectories based on alcohol and substance use frequency which were consistent with developmental transitions and validated by measures of dependency symptoms.

While few differences were evident at intake, the educational, occupational and interpersonal attainments were differentially associated with the alcohol/drug trajectories as youth transitioned into adulthood.

High rates of high school graduation (71.1%), professional occupations (45.2%), marriage/cohabitation (48.5%), and financial responsibility for children (F[5,27]=2.75, p=.02) were evident for those with the least alcohol and drug involvement.

More severe drug use trajectories were associated with higher rates of dependence, incarceration and more treatment at the final period of assessment.

Outcomes of the trajectory of frequent alcohol involvement were distinct from combined alcohol and drug use.

These findings highlight the long-term diversity of substance use outcomes following adolescent treatment and suggest that identification of these patterns of use following treatment can help clarify the developmental impact of youth alcohol and drug use on outcomes in young adulthood.

Read Full Abstract

Request Reprint E-Mail: sanbrown@ucsd.edu
______________________________________

Beliefs about the empirical support of drug abuse treatment interventions: A survey of outpatient treatment providers

This study assessed substance abuse treatment providers’ beliefs about empirically supported treatments (ESTs) to determine if providing information about empirical support for interventions would change beliefs.

Treatment providers (N=136) completed an interview regarding five interventions with varied empirical support: contingency management (CM), motivational interviewing (MI), relapse prevention (RP), 12-step approaches (TSA), and verbal confrontation (VC). Participants then read primers describing empirical support for each intervention prior to completing a repeat interview.

Overall, providers reported positive beliefs about ESTs. Baseline beliefs about empirical support for each intervention were inflated relative to that of expert raters except for CM. After reading the primers, beliefs about efficacy changed in the direction of the experts for all interventions except MI, but continued to be inflated except for CM.

Willingness to utilize interventions increased for RP, MI, and CM and decreased for TSA and VC, but remained higher than warranted by empirical support.

Read Full Abstract

Request Reprint E-Mail: lbenishek@tresearch.org

____________________________________________

Regulation of GABAA Receptor Subunit Expression by Pharmacological Agents

The γ-aminobutyric acid (GABA) type A receptor system, the main fast-acting inhibitory neurotransmitter system in the brain, is the pharmacological target for many drugs used clinically to treat, for example, anxiety disorders and epilepsy, and to induce and maintain sedation, sleep, and anesthesia.

These drugs facilitate the function of pentameric GABA_A receptors that exhibit widespread expression in all brain regions and large structural and pharmacological heterogeneity as a result of composition from a repertoire of 19 subunit variants.

One of the main problems in clinical use of GABA_A receptor agonists is the development of tolerance. Most drugs, in long-term use and during withdrawal, have been associated with important modulations of the receptor subunit expression in brain-region-specific manner, participating in the mechanisms of tolerance and dependence.

In most cases, the molecular mechanisms of regulation of subunit expression are poorly known, partly as a result of neurobiological adaptation to altered neuronal function. More knowledge has been obtained on the mechanisms of GABA_A receptor trafficking and cell surface expression and the processes that may contribute to tolerance, although their possible pharmacological regulation is not known.

Drug development for neuropsychiatric disorders, including epilepsy, alcoholism, schizophrenia, and anxiety, has been ongoing for several years.

One key step to extend drug development related to GABA_A receptors is likely to require deeper understanding of the adaptational mechanisms of neurons, receptors themselves with interacting proteins, and finally receptor subunits during drug action and in neuropsychiatric disease processes.

Read Full Abstract

Request Reprint E-Mail: mikko.uusi-oukari@utu.fi
______________________________________

Seminar - Drinking spaces and places: Examining who drinks alcohol, where and why?

The impact of drinking alcohol in excess is seen both in terms of individual health and disorder in public spaces. This seminar focuses on why policy levers need to recognise the importance of where and how people drink.

• Wednesday 10 February 2010 10.00am to 4.00pm

• RGS-IBG, London

9.30 Registration

10.00 Introduction

Rita Gardner, Director RGS-IBG & Morning Chair (Professor Graham Moon, Geography, Southampton)

10.05 Session 1: Policy Context

Binge drinking in England, a regional view: Dr Nicola Shelton, Department of Epidemiology and Public Health University College London
Learning to drink: 11 to 15 year olds and alcohol: Elizabeth Fuller, National Centre for Social Research (NATCEN)
Developments in Scotland: Dr Emilia Crighton, Scottish Convenor, Faculty for Public Health (FPH)
Just Added Working to put Home Office alcohol policy into practice: Eric Stark, Regional Alcohol Lead, Government Office of London

11.30 Coffee Break

11.45 Session 2: Private Drinking Places: Home and Away

The Historical culture of drinking: Historical/cultural reasons for drinking – how the ‘current crisis’ has built over thirty years, focusing on ‘public spaces’ Dr James Kneale, Geography, University College London
Where people drink - assessing the shift in emphasis from city-centre to the home, and the role of relationships at home (Joseph Rowntree Funded work): Professor Gill Valentine, Geography, Leeds; Dr Mark Jayne, Geography, Manchester; and Dr Sarah Holloway, Geography, Loughborough

12.45 Lunch Break

13.45 Session 3: Public Drinking Spaces

Just Added Night time economies: Alistair Turnham, MAKE Associates
Designing drinking spaces: From Park to Club: youth, alcohol and place Professor Marion Roberts, School of Architecture and the Built Environment, University of Westminster
Local spaces: licensing and managing public disorder John Thornhill, Chairman of the Magistrates Association

15.00 Coffee Break

15.15 Session 4: Panel Discussion

including: Dr Mark Jayne, Geography, Manchester; Don Shenker, Chief Executive, Alcohol Concern and Alistair Turnham, MAKE Associates

16.00 Conclusions and closing statement

Afternoon Chair

Environment & Society Forum Read More

_______________________________________

Substance Use Treatment Need among Uninsured Workers

More than 18.4 million full-time employees aged 18 to 64 (15.5 percent of the full-time adult workers in that age range) had no health insurance coverage and represented the majority (54.5 percent) of adults under age 65 without health insurance coverage.

An estimated 3.0 million uninsured full-time workers (16.3 percent) needed substance use treatment in the past year; specifically, 13.3 percent needed alcohol use treatment, 5.6 percent needed illicit drug use treatment, and 2.7 percent needed both alcohol and illicit drug use treatment.

Of the uninsured workers who needed substance use treatment in the past year, 12.6 percent (378,000 persons) received treatment at a specialty facility.

Read Full Report (PDF)
________________________________________

Alcohol Consumption in Young Adults and Incident Hypertension: 20-Year Follow-up From the Coronary Artery Risk Development in Young Adults Study

The relation between alcohol consumption and incident hypertension is unclear, and most observational studies have not accounted for socioeconomic factors.

This study examined the association between alcohol consumption in a diverse group of young adults and incident hypertension over 20 years.

The 20-year incidence of hypertension for never, former, light, moderate, and at-risk drinkers was 25.1%, 31.8%, 20.9%, 22.2%, and 18.8%, respectively (P 0.001). Race, gender, age, family history of hypertension, body mass index, income, education, and difficulty paying for basics and medical care were associated with hypertension.

Adjustment using Cox proportional hazard models revealed no association between baseline alcohol consumption and incident hypertension, except among European-American women in whom any current alcohol consumption was associated with lower risk of incident hypertension.

The lack of association between alcohol and hypertension in the majority of this socioeconomically diverse cohort is not definitive.

Future studies should include social factors, such as income and education, and consider additional characteristics that may modify or confound associations between alcohol and blood pressure.

Read Full Abstract

Request Reprint E-Mail: jhalanych@uab.edu
______________________________________

How Scandinavian Publications Portray Self-Help Groups in Relation to Health and Welfare Systems

The aim of this article is to review the relationships of self-help groups to health and welfare services and professionals/service representatives in a Scandinavian research context.

Eight Swedish, Norwegian, and Danish publications written by researchers within an academic research context are discussed; understanding self-help groups in a national context is stressed. The analysis was based on a conflict/consensus model proposed by the author.

Results indicate that Scandinavian researchers often view the relationship between health and welfare services and professionals/service representatives and self-help groups as more consensus-oriented than groups described in early American self-help group literature where there is a higher degree of distrust.

The high level of trust toward governmental organizations in Scandinavian countries is suggested as one explanation for this difference.

Read Full Abstract

Request Reprint E-Mail: magnus.karlsson(at)esh.se

______________________________________

Telephone Hotlines for Men in Japan

The purposes of this study were to identify telephone hotline programs specifically for men in Japan and to describe their structure, characteristics, and practices.

Using the internet and snowball sampling, we identified 17 telephone hotlines. The hotlines were established within approximately the past 10 years. Callers learn about the hotlines from a variety of sources, including government and private websites, newspapers, doctors, and callers' family members.

Programs are largely staffed by volunteer and paid male staff with either non-professional or professional backgrounds. The hotlines are typically open about 6 hours per month. They provide free support resources, including psychological counseling, information, and referral to relevant legal and other organizations.

These findings are discussed in the context of traditional Japanese cultural values about gender and helping. By considering how belief and value systems are accommodated and assimilated by culturally diverse individuals and groups, telephone hotlines and self-help/mutual-aid groups can be more effective.

Read Full Abstract

Request Reprint E-Mail: mikam@pdx.edu
_____________________________________

An Initial View of Self-Help Groups for Japanese Alcoholics: Danshukai in its Historical, Social, and Cultural Contexts

Danshukai is Japan's largest self-help/mutual-aid group for alcoholics, with approximately 10,000 members nationwide.

This article aims to examine Danshukai in the Tokyo area. While leaders of Danshukai in the 1950s were inspired by Alcoholics Anonymous (AA), it was AA's general structure and not its therapeutic content that was translated into the Japanese context.

For therapeutic content Danshukai turned to existing cultural understandings within Japanese society, and made the "meeting" pivotal to recovery.

In Danshukai, alcoholics manage their dependence by changing their social routines by "belonging" to Danshukai and attending meetings, paying membership fees, and sharing stories about the damaging effects of alcohol among members. Recovery is not an individual journey, but is inclusive of the family in the therapeutic process.

Danshukai also provides service to help alcoholics in need who are outside their membership. At the individual level, service is more local, being linked to supporting the family through recovery.

Read Full Abstract

Request Request E-Mail: t-oka@sophia.ac.jp

____________________________________________

Surveillance of Certain Health Behaviors and Conditions Among States and Selected Local Areas — Behavioral Risk Factor Surveillance System, United Sta

Heart disease, stroke, cancer, and diabetes are among of the leading causes of death in the United States. Controlling health-risk behaviors and using preventive health-care services can reduce or prevent morbidity and premature mortality from such diseases.

The Behavioral Risk Surveillance System (BRFSS) is an ongoing telephone survey of U.S. adults on health-risk behaviors and the use of preventative health-care services related to the leading causes of death and disability in the United States.

This report summarizes the results from the 2007 BRFSS.

Alcohol Consumption

Binge Drinking

Binge drinking was defined as adult males having five or more drinks, and adult females having four or more drinks on at least one occasion during the last 30 days. In 2007, among adults aged ≥18 years, the estimated prevalence of binge drinking ranged from 8.2% in Kentucky to 23.4% in Wisconsin (median: 15.7%) (Table 31). Among selected MMSAs, the estimated prevalence of binge drinking ranged from 4.3% in Provo-Orem, Utah, to 21.4% in Milwaukee-Waukesha-West Allis, Wisconsin (median: 15.7%) (Table 32). Among selected counties, the estimated prevalence ranged from 4.3% in Utah County, Utah, to 25.6% in Arlington County, Virginia (median: 15.6%) (Table 33).

Heavy Drinking

Heavy drinking was defined as adult males having more than two drinks, and adult females having more than one drink per day during the last 30 days. In 2007, among adults aged ≥18 years, the estimated prevalence of heavy drinking ranged from 2.5% in Utah to 7.7% in Hawaii (median: 5.2%) (Table 34). Among selected MMSAs, the estimated prevalence of heavy drinking ranged from 2.1% in Idaho Falls, Idaho and Wauchula, Florida, to 11.0% in Key West-Marathon, Florida (median: 5.3%) (Table 35). Among selected counties, the estimated prevalence ranged from 1.2% in Davis County, Utah, to 11.6% in St. Johns County, Florida (median: 5.5%) (Table 36).

Read Full Report (PDF)

_______________________________________

Initial Preference for Drinking Goal in the Treatment of Alcohol Problems: II. Treatment Outcomes

To compare treatment outcomes between clients preferring abstinence and those preferring non-abstinence at the screening stage of a randomized controlled trial of treatment for alcohol problems (the United Kingdom Alcohol Treatment Trial) and to interpret any differential outcome in light of baseline differences between goal preference groups outlined in an accompanying paper.

Clients initially stating a preference for abstinence showed a better outcome than those stating a preference for non-abstinence. This superior outcome was clearer at 3 months’ follow-up but still evident at 12 months’ follow-up. The better outcome consisted almost entirely in a greater frequency of abstinent days, with only a modest benefit in drinking intensity for goal abstainers that disappeared when baseline covariates of goal preference were controlled for. Type of successful outcome (abstinence/non-problem drinking) was related to initial goal preference, with clients preferring abstinence more likely to obtain an abstinent outcome and those preferring non-abstinence a non-problem drinking outcom

The client’s personal drinking goals should be discussed in assessment at treatment entry and as a basis for negotiation. Clinicians should be prepared to identify and support goal change as an unexceptional part of the treatment process that need not jeopardize good outcome.

Read Full Abstract

Request Reprint E-Mail: nick.heather@northumbria.ac.uk

__________________________________________

Initial Preference for Drinking Goal in the Treatment of Alcohol Problems: I. Baseline Differences Between Abstinence and Non-Abstinence Groups

To compare baseline characteristics of clients initially preferring abstinence with those preferring non-abstinence at the screening stage of a randomized controlled trial of treatment for alcohol problems (UKATT) and to identify predictors of goal preference from client characteristics present before the preference was stated.

Across all UKATT sites, 54.3% of clients expressed a preference for abstinence and 45.7% for non-abstinence. In univariate comparisons, clients preferring abstinence were significantly (P <> (iii) report drinking more heavily but less frequently, (iv) have been detoxified in the 2 weeks prior to assessment, (v) report more alcohol problems, (vi) be in the action stage of change, (vii) report greater negative expectancies of drinking, (viii) report greater mental and physical ill-health, (ix) report less social support for drinking and (x) be more confident of their ability to resist heavy drinking in tempting situations. In the logistic regression model, the strongest predictors of goal preference were gender, drinking pattern, recent detoxification and social support for drinking.

The implications of these findings for service delivery are best considered in conjunction with findings from a companion paper reporting treatment outcomes associated with each goal preference.

Read Full Abstract

Request Reprint E-Mail: nick.heather@northumbria.ac.uk

_______________________________________

Interactive Voice Response Technology Can Deliver Alcohol Screening and Brief Intervention in Primary Care

Alcohol screening and brief intervention (BI) is an effective primary care preventive service, but implementation rates are low. Automating BI using interactive voice response (IVR) may be an efficient way to expand patient access to needed information and advice.

Call duration ranged from 3–7 minutes. Subjective reactions were generally positive or neutral. About 40% of subjects indicated IVR-BI had motivated them to change. About half of the patients had discussed drinking with their provider at the visit. These tended to be heavier drinkers with greater concerns about drinking. Patients who reported a provider-delivered BI and called the IVR-BI endorsed greater comfort and honesty with the IVR-BI. On average, a 25% reduction in alcohol use was reported two weeks after the clinic visit.

Using IVR technology to deliver BI in a primary care setting is feasible and data suggest potential for efficacy in a larger trial.

Read Full Abstract

Request Reprint E-Mail: Gail.Rose@vtmednet.org
______________________________________________

Candidate genes for alcohol preference identified by expression profiling in alcohol-preferring and -nonpreferring reciprocal congenic rats

Selectively bred alcohol-preferring (P) and alcohol-nonpreferring (NP) rats differ greatly in alcohol preference, in part due to a highly significant quantitative trait locus (QTL) on chromosome 4. Alcohol consumption scores of reciprocal chromosome 4 congenic strains NP.P and P.NP correlated with the introgressed interval.

The goal of this study was to identify candidate genes that may influence alcohol consumption by comparing gene expression in 5 brain regions of alcohol-naive inbred alcohol preferring and P.NP congenic rats: amygdala, nucleus accumbens, hippocampus, caudate putamen, and frontal cortex.

Within the QTL region, 104 cis-regulated probe sets were differentially expressed in more than one region, and an additional 53 were differentially expressed in a single region. Fewer trans-regulated probe sets were detected, and most differed in only one region. Analysis of the average expression values across the 5 brain regions yielded 141 differentially expressed cis-regulated probe sets and 206 trans-regulated probe sets. Comparing the present results from inbred alcohol-preferring vs. congenic P.NP rats to earlier results from the reciprocal congenic NP.P vs. inbred alcohol-nonpreferring rats demonstrated that 74 cis-regulated probe sets were differentially expressed in the same direction and with a consistent magnitude of difference in at least one brain region.

Cis-regulated candidate genes for alcohol consumption that lie within the chromosome 4 QTL were identified and confirmed by consistent results in two independent experiments with reciprocal congenic rats. These genes are strong candidates for affecting alcohol preference in the inbred alcohol-preferring and inbred alcohol nonpreferring rats.

Read Full Text (PDF)

New NHS Campaign Reveals Unseen Alcohol Damage

A new campaign backed by major health charities will warn drinkers of the unseen health damage caused by regularly drinking more than the NHS advises. The £6 million Government funded campaign shows the damage that is being done to drinkers’ organs while they are drinking in a pub or at home.

This is being launched by Public Health Minister, Gillian Merron today and is part of the cross-Government strategy to tackle the harms that alcohol causes.

The Department of Health has developed the campaign in association with Cancer Research UK, the British Heart Foundation and the Stroke Association to create the series of stark TV, press and outdoor adverts showing the harm that regularly drinking more than two drinks a day can cause.

A new YouGov poll launched to coincide with the campaign shows that more than half (55%) of English drinkers misguidedly believe that alcohol only damages your health if you regularly get drunk or binge drink. . . .

Read Full Release

__________________________________________

Alda-1 is an agonist and chemical chaperone for the common human aldehyde dehydrogenase 2 variant

In approximately one billion people, a point mutation inactivates a key detoxifying enzyme, aldehyde dehydrogenase (ALDH2).

This mitochondrial enzyme metabolizes toxic biogenic and environmental aldehydes, including the endogenously produced 4-hydroxynonenal (4HNE) and the environmental pollutant acrolein, and also bioactivates nitroglycerin.

ALDH2 is best known, however, for its role in ethanol metabolism. The accumulation of acetaldehyde following the consumption of even a single alcoholic beverage leads to the Asian alcohol-induced flushing syndrome in ALDH2*2 homozygotes. The ALDH2*2 allele is semidominant, and heterozygotic individuals show a similar but less severe phenotype.

We recently identified a small molecule, Alda-1, that activates wild-type ALDH2 and restores near-wild-type activity to ALDH2*2.

The structures of Alda-1 bound to ALDH2 and ALDH2*2 reveal how Alda-1 activates the wild-type enzyme and how it restores the activity of ALDH2*2 by acting as a structural chaperone.

Read Full Abstract

Request Reprint E-Mail: thurley@iupui.edu.
___________________________________________

Supervised Disulfiram in Relapse Prevention in Alcohol-Dependent Patients Suffering From Comorbid Borderline Personality Disorder—A Case Series

Disulfiram is widely used to prevent alcoholic relapse. However, due to the intended adverse reaction with ethanol, some believe that its use is dangerous for patients with personality disorders or psychiatric comorbidities because of their increased risk of impulsivity or suicidal behaviour.

We examined the safety and efficacy in relapse prevention of a series of alcoholics with borderline personality disorder (BPD).

Two out of eight patients remained completely abstinent during the supervised disulfiram therapy over a mean period of 9.25 months. Adherence to treatment was 18.44 ± 21.78 months. The first relapse occurred after 1.38 ± 1.41 months. The cumulated time of abstinence was 16.88 ± 20.48 months. The overall tolerability was considered to be high; dizziness and fatigue appeared in all patients at the beginning of the therapy but did not persist. No serious adverse events or ethanol–disulfiram interactions were observed. No suicidal behaviour was reported.

Although case observations should be interpreted with caution, supervised disulfiram seems to deserve further investigation in patients with comorbid BPD, for whom it appears to help prevent alcoholic relapse.

Read Full Abstract

Request Reprint E-Mail: jochen.mutschler@puk.zh.ch :

______________________________________________

Use of Carbohydrate-Deficient Transferrin (CDT) and a Combination of GGT and CDT (GGT–CDT) to Assess Heavy Alcohol Consumption in Traffic Medicine

Carbohydrate-deficient transferrin (CDT) has become widely used in traffic medicine to detect chronic alcohol abuse among subjects applying for driving-license renewal or regranting. By defining cut-off values in a large population of abstainers and moderate drinkers, we report on CDT, GGT–CDT (a combination of gamma-glutamylaminotransferase (GGT) and CDT) and the association between blood alcohol concentration (BAC) and CDT among Italian drivers.

A common CDT cut-off (1.8%) and gender-specific GGT–CDT cut-off (4.15% for males, 3.56% for females) were calculated as 99.9th percentiles of the control population. Also, 3% and 27% of subjects were classified as CDT positive respectively among drivers applying for license regranting and drivers involved in car accidents. A significant association between BAC and both CDT values and CDT positivity was found, with a frequency up to 49% of CDT samples, suggesting chronic alcohol abuse, among drivers with BAC >2.5g/l. Concordance between CDT and GGT–CDT was only moderate (kappa = 0.44), with CDT performing better than GGT–CDT.

A relevant proportion of drivers with high BAC are chronic abusers. GGT–CDT, previously validated with CDT immunoassays, should not be applied to traffic medicine in its current form and its performances re-evaluated with CDT measured by HPLC.

Read Full Abstract

Request Reprint E-Mail: vidali@med.unipmn.it
____________________________________________

H2 haplotype at chromosome 17q21.31 protects against childhood sexual abuse-associated risk for alcohol consumption and dependence

Animal research supports a central role for corticotropin-releasing factor (CRF) in actions of ethanol on brain function.

An examination of alcohol consumption in adolescents reported a significant genotype × environment (G × E) interaction involving rs1876831, a corticotropin-releasing hormone receptor 1 (CRHR1) polymorphism, and negative events. and at least four other genes are located at 17q21.31 in an extremely large block of high linkage disequilibrium resulting from a local chromosomal inversion; the minor allele of rs1876831 is contained within the H2 haplotype.

Here, we examine whether G × E interactions involving this haplotype and childhood sexual abuse (CSA) are associated with risk for alcohol consumption and dependence in Australian participants (CRHR1n = 1128 respondents from 476 families) of the Nicotine Addiction Genetics project.

Telephone interviews provided data on DSM-IV alcohol dependence diagnosis and CSA and enabled calculation of lifetime alcohol consumption factor score (ACFS) from four indices of alcohol consumption. Individuals reporting a history of CSA had significantly higher ACFS and increased risk for alcohol dependence.

A significant G × E interaction was found for ACFS involving the H2 haplotype and CSA (P <>

Our results also suggest that severe early trauma may prove to be an important clinical covariate in the treatment of alcohol dependence.

Read Full Abstract

Request Reprint E-Mail: nelsone@wustl.edu
__________________________________________

Readiness to Change in Brief Motivational Interventions: A Requisite Condition for Drinking Reductions?

Brief motivational interventions (BMIs) have been found to be efficacious for reducing alcohol use and consequences among college student drinkers. Despite the putative emphasis on motivation, surprisingly little is known about the role of motivation in BMI-facilitated changes.

Using data from three published randomized trials implementing BMIs, we examined motivation or readiness to change (RTC) as a potential mechanism of behavior change.

Two of the three studies indicated that BMI were associated with increases in motivation to change alcohol use that are apparent immediately after BMI sessions and persist up to 6-months post-intervention.

However, RTC does not appear to be a mechanism of behavior change, as it did not mediate reductions in alcohol use or problems in any of the studies.

Issues regarding the conceptualization and measurement of RTC are discussed, as well as promising directions for future research.

Read Full Text (PDF)
________________________________________

Neurokinin-1 receptors (NK1R:s), alcohol consumption, and alcohol reward in mice

Reduced voluntary alcohol consumption was recently found in neurokinin-1 receptor (NK1R)-deficient (KO) mice. It remains unknown whether this reflects developmental effects or direct regulation of alcohol consumption by NK1R:s, and whether the reduced consumption reflects motivational effects.

The objective of this study is to obtain an expanded preclinical validation of NK1R antagonism as a candidate therapeutic mechanism in alcohol use disorders.

Acute blockade of NK1R:s mimics the effects of NKR1 gene deletion on alcohol consumption, supporting a direct rather than developmental role of the receptor in regulation of alcohol intake. Inactivation of NK1R:s critically modulates alcohol reward and escalation, two key characteristics of addiction.

These data provide critical support for NK1R antagonism as a candidate mechanism for treatment of alcoholism.

Read Full Abstract

Request Reprint E-Mail: markus.heilig@mail.nih.gov

____________________________________

Effect of prenatal stress on alcohol preference and sensitivity to chronic alcohol exposure in male rats

In rats, prenatal restraint stress (PRS) induces persistent behavioral and neurobiological alterations leading to a greater consumption of psychostimulants during adulthood. However, little is known about alcohol vulnerability in this animal model.

We examined in adolescent and adult male Sprague Dawley rats the long-lasting impact of PRS exposure on alcohol consumption.

Our data suggest that negative events occurring in utero do not modulate alcohol preference in male rats but potentiate chronic alcohol-induced molecular neuroadaptation in the brain reward circuitry.

Further studies are needed to determine whether the exacerbated ΔFosB upregulation in PRS rats could be extended to other reinforcing stimuli. lasting impact of PRS exposure on alcohol consumption.

Read Full Abstract

Request Reprint E-Mail: vincent.vanwaes@rosalindfranklin.edu
______________________________________

Press Release - Teens Who Drink With Parents May Still Develop Alcohol Problems

Parents who try to teach responsible drinking by letting their teenagers have alcohol at home may be well intentioned, but they may also be wrong, according to a new study in the January issue of the Journal of Studies on Alcohol and Drugs.

In a study of 428 Dutch families, researchers found that the more teenagers were allowed to drink at home, the more they drank outside of home as well. What’s more, teens who drank under their parents’ watch or on their own had an elevated risk of developing alcohol-related
problems. . . . . . .

Read Full Press Release
____________________________________

Do Parents and Best Friends Influence the Normative Increase in Adolescents' Alcohol Use at Home and Outside the Home?

The present study explored the possible impact of parental supervision of adolescents' alcohol use and drinking with parents on concurrent and prospective associations between adolescents' drinking at home and drinking outside the home. The impact of drinking with their best friend, parental drinking behaviors, and sibling influence on adolescent alcohol use were also examined, as well as whether drinking at home and outside the home predicted problem drinking.

We used three waves of longitudinal full-family data (fathers, mothers, and two adolescent siblings; N = 428).

Bi-directional effects between drinking at home and drinking outside the home were found for both adolescents, with drinking in one setting predicting drinking in another setting over time. Both drinking at home and drinking outside the home predicted subsequent problem drinking. These associations did not differ as a function of adolescents drinking with parents or their best friend or of parental supervision of adolescents' alcohol use. Only adolescents' gender seemed to moderate these effects but solely in midadolescence. For 15-year-old boys (but not for girls), at-home drinking predicted outside-the-home drinking 1 year later.

Taken together, adolescents' alcohol use increases over time, regardless of setting or with whom they drink. According to these results, prevention workers should focus on making parents more aware of their role in delaying the age at drinking onset.

Read Full Abstract

Request Reprint E-Mail: h.vandervorst@pwo.ru.nl
___________________________________________